Chronic Psychiatric Conditions Research Articles

Comparative Study of COVID-19 Vaccination Frequency Between Chronic Psychiatric Patients and the General Population

Background: COVID-19 vaccination rates among individuals with mental illness have raised concerns due to these individuals' increased vulnerability to infection and complications. Objectives: This study aimed to compare the frequency of COVID-19 vaccination between individuals with chronic psychiatric conditions and the general population. Methods: A descriptive-analytical study was conducted, including patients with psychiatric disorders and a comparison group without psychiatric problems. Data were collected between May 2023 and August 2023 using a simple random sampling method. Participants were diagnosed with psychiatric disorders according to DSM-5 criteria and completed a questionnaire. Results: In a study of 137 participants, including 67 healthy individuals, 38 with schizophrenia, and 32 with affective disorders, psychiatric patients had lower full vaccination rates (P < 0.001). Patients with schizophrenia received fewer doses than healthy individuals and those with affective disorders (coefficient = -0.54, P = 0.007). Even after adjusting for demographics, the relationship between schizophrenia and vaccination rates remained significant. Conclusions: Chronic psychiatric patients have lower COVID-19 vaccination rates compared to the general population. Targeted vaccination programs and improved access to psychiatric healthcare facilities are crucial for addressing the pandemic's disproportionate impact on this vulnerable group.

Health and income inequality: a comparative analysis of USA and Italy.

Socio-economic background is often an important determinant for health with low income households having higher exposure to risk factors and diminished access to healthcare and prevention, in a way that is specific to each country. Here, we perform a comparative analysis of the relations between health and income inequality in two developed countries, USA and Italy, using longitudinal and cross-sectional data from surveys. We show that the income class determines the incidence of chronic pathologies, associated risk-factors and psychiatric conditions, but find striking differences in health inequality between the two countries. We then focus our attention on a fraction of very disadvantaged households in the USA whose income in persistently at the bottom of the distribution over a span of 20 years and which is shown to display particularly dire health conditions. Low income people in the USA also display comorbidity patterns that are not found in higher income people, while in Italy income appears to be less relevant for comorbidity. Taken together our findings illustrate how differences in lifestyle and the healthcare systems affect health inequality.

Clusters from chronic conditions in the Danish adult population.

Multimorbidity, the presence of 2 or more chronic conditions in a person at the same time, is an increasing public health concern, which affects individuals through reduced health related quality of life, and society through increased need for healthcare services. Yet the structure of chronic conditions in individuals with multimorbidity, viewed as a population, is largely unmapped. We use algorithmic diagnoses and the K-means algorithm to cluster the entire 2015 Danish multimorbidity population into 5 clusters. The study introduces the concept of rim data as an additional tool for determining the number of clusters. We label the 5 clusters the Allergies, Chronic Heart Conditions, Diabetes, Hypercholesterolemia, and Musculoskeletal and Psychiatric Conditions clusters, and demonstrate that for 99.32% of the population, the cluster allocation can be determined from the diagnoses of 4-5 conditions. Clusters are characterized through most prevalent conditions, absent conditions, over- or under-represented conditions, and co-occurrence of conditions. Clusters are further characterized through socioeconomic variables and healthcare service utilizations. Additionally, geographical variations throughout Denmark are studied at the regional and municipality level. We find that subdivision into municipality levels suggests that the Allergies cluster frequency is positively associated with socioeconomic status, while the subdivision suggests that frequencies for clusters Diabetes and Hypercholesterolemia are negatively correlated with socioeconomic status. We detect no indication of association to socioeconomic status for the Chronic Heart Conditions cluster and the Musculoskeletal and Psychiatric Conditions cluster. Additional spatial variation is revealed, some of which may be related to urban/rural populations. Our work constitutes a step in the process of characterizing multimorbidity populations, leading to increased comprehension of the nature of multimorbidity, and towards potential applications to individual-based care, prevention, the development of clinical guidelines, and population management.

Regional Vulnerability Indices in Youth With Persistent and Distressing Psychoticlike Experiences

Distressing and persistent psychoticlike experiences (PLEs) in youth are associated with greater odds of developing psychiatric conditions in adulthood. Despite this risk, it is unclear whether early PLEs show similar brain patterns compared with adults with psychiatric and neurologic conditions. To examine the degree to which persistent and distressing PLEs exhibit neural metrics that show similarity to adults with chronic psychiatric and neurologic conditions. This cohort study used Adolescent Brain Cognitive Development (ABCD) Study examining the persistence and distress associated with PLEs across the first 3 waves of data with baseline structural magnetic resonance imaging data. Analyzed data were collected between September 1, 2016, and September 27, 2021. Children were recruited from 21 research sites across the US. Psychoticlike experiences were assessed using the Prodromal Questionnaire-Brief Child Version, and participants were categorized into groups based on the persistence and distress associated with PLEs. Cortical and subcortical regional vulnerability indices (RVIs) were created by quantifying the similarity of participants' baseline neuroimaging measures to the expected patterns found in adult neuropsychiatric samples. The PLE groups were compared on the following RVI cortical and subcortical metrics: schizophrenia spectrum disorders, bipolar disorder, major depressive disorder, Parkinson disease, Alzheimer disease, and metabolic diseases. Analyses examined PLE groups created from 8242 children in the ABCD sample (52.5% male; mean [SD] age, 9.93 [0.63] years; and 56.3% White), including persistent distressing PLEs (n = 329), transient distressing PLEs (n = 396), persistent nondistressing PLEs (n = 234), transient nondistressing PLEs (n = 390), and low distressing PLEs (n = 6893) groups. Participants with persistent or transient distressing PLEs broadly showed increased subcortical RVI scores across most RVI metrics, with persistent distressing PLEs additionally showing increased scores for cortical RVI metrics. The greatest effect sizes were found for persistent distressing PLEs with cortical RVI-schizophrenia spectrum disorders (β estimate, 1.055; 95% CI, 0.326-1.786) and RVI-Alzheimer disease (β estimate, 2.473; 95% CI, 0.930-4.018). In this cohort study of ABCD participants, the findings suggest that especially the persistent distressing PLEs in children were associated with neural metrics resembling those observed in adults with severe psychiatric and neurologic conditions. These findings support the potential use of brain-based risk scores for early identification and precision medicine approaches in the assessment of PLEs.

Thermocoagulation in Multiple Targets to Treat Obsessive-Compulsive Disorder Associated with Drug Addiction: Case Report

AbstractSubstance-related disorders are chronic psychiatric conditions defined by substance abuse, and they compromise patients both clinically and functionally. Currently, pharmacotherapy, behavioral therapy, or an association of both are the treatments of choice for obsessive-compulsive disorder associated with drug addiction. However, the refractoriness to treatment, as a result of the high failure rates of these approaches, has led to the need to develop surgical techniques to treat severe cases of substance-related disorders. In the present article, we report the case of a patient who underwent neurosurgery through the stereotactic technique after refractoriness to the conventional treatment for drug addiction. The patient showed sustained improvement in his addiction to drugs. Despite the numerous reports on the effectiveness and applicability of neurosurgery in psychiatric disorders, some concerns regarding stereotactic surgery as a treatment for drug addiction still remain, especially in relation to its efficacy, safety, and ethical implications.

Predictors of Suicidal Ideation During Residential Substance Use Treatment.

Background: Individuals with substance use disorders (SUDs) and co-occurring chronic health and/or psychiatric conditions face unique challenges in treatment and may be at a greater risk for suicidal ideation relative to persons with SUD alone.Methods: In a sample of individuals entering residential SUD treatment in 2019 and 2020 (N = 10,242), we tested adjusted and unadjusted associations between suicidal ideation and (1) psychiatric symptoms and (2) chronic health conditions at treatment intake and during treatment using logistic and generalized logistic models.Results: Over a third of the sample endorsed suicidal ideation at intake, though the prevalence of suicidal ideation decreased during treatment. In both adjusted and unadjusted models, individuals who reported past-month self-harm, those who reported a lifetime suicide attempt, and individuals who screened positive for co-occurring anxiety, depression, and/or posttraumatic stress disorder were at elevated risk of endorsing suicidal ideation at intake and during treatment (P values < .001). In unadjusted models, chronic pain (odds ratio [OR] = 1.51, P < .001) and hepatitis C virus (OR = 1.65, P < .001) were associated with an elevated risk for suicidal ideation at intake, and chronic pain was associated with elevated risk for suicidal ideation during treatment (OR = 1.59, P < .001).Conclusions: Increasing accessibility to integrated treatments (ie, those that address psychiatric and chronic health conditions) for patients experiencing suicidal ideation may be beneficial in residential SUD treatment settings. Developing predictive models to identify those most at risk of suicidal ideation in real time remains a relevant direction for future work.

Apraxia testing to distinguish early Alzheimer’s disease from psychiatric causes of cognitive impairment

Objective: Mood- and stress-related disorders commonly cause attentional and memory impairments in middle-aged individuals. In memory testing, these impairments can be mistakenly interpreted as symptoms of dementia; thus, more reliable diagnostic approaches are needed. The present work defines the discriminant accuracy of the Dementia Apraxia Test (DATE) between psychiatric conditions and early-onset Alzheimer’s disease (AD) on its own and in combination with memory tests. Method: The consecutive sample included 50–70-year-old patients referred to dementia investigations for recent cognitive and/or affective symptoms. The DATE was administered and scored as a blinded measurement, and a receiver operating curve analysis was used to define the optimal diagnostic cut-off score. Results: A total of 24 patients were diagnosed with probable AD (mean age 61 ± 4) and 23 with a psychiatric condition (mean age 57 ± 4). The AD patients showed remarkable limb apraxia, but the psychiatric patients mainly performed at a healthy level on the DATE. The test showed a total discriminant accuracy of 87% for a total sum cut-off of 47 (sensitivity 79% and specificity 96%). The limb subscale alone reached an accuracy of 91% for a cut-off of 20 (sensitivity 83% and specificity 100%). All memory tests were diagnostically less accurate, while the combination of the limb praxis subscale and a verbal episodic memory test suggested a correct diagnosis in all but one patient. Conclusions: Apraxia testing may improve the accuracy of differentiation between AD and psychiatric aetiologies. Its potential in severe and chronic psychiatric conditions should be examined in the future.

Initial evidence of the effectiveness of a short, online Recovery College Model: a co-learning model to support mental health in the context of the Covid-19 pandemic

Introduction. The Covid-19 pandemic (C-19) has a negative impact on the mental health of the general population and in particular, women, people with chronic physical illness or psychiatric conditions, students and health care providers. Targeting these needs, the Recovery College (RC) model offers a new and innovative approach based on co-learning and learner diversity. The model provides a co-learning space where at-risk populations and the general public learn together and collectively equip themselves to better address psychological well-being and mental health issues. Objective. The objective is to present the initial results of the RC co-learning model in a short online format to meet the pressing needs of mental health intervention in the C-19 context. Method. A pre-post research design with repeated measures was used. Results. Results suggest improved knowledge and use of tools to support mental health interventions, self-management strategies, anti-stigma attitudes, and protection against increased anxiety. Conclusion. This RC model allows people from all backgrounds to participate in an innovative co-learning model in which experiential knowledge is central to learning to stimulate reflection and change in attitudes and behaviors.

A Review of Chronic Pain with Depression and/or Anxiety Comorbidities in the Indian Population

Chronic pain and psychiatric conditions often coexist with shared risk factors and a reverse causal link. Depression and anxiety comorbidities are associated with increased pain intensity, less favorable response to treatments, and higher medical costs. The management of psychiatric comorbidities in chronic pain conditions is less explored in India. This paper aims to review the current literature landscape of comorbid depressive and/or anxiety disorders with chronic pain conditions in the Indian populations and identify need gaps for future research. A literature search on MEDLINE database and other sources conducted from January 2010 through March 2020 retrieved 84 shortlisted eligible articles and their findings were synthesized into a narrative review. There was a high prevalence of comorbid depression and anxiety with chronic pain observed across multiple pain etiologies and population groups in the Indian setting. Women had a higher burden of psychiatric comorbidities in chronic pain conditions compared with men. Poor socioeconomic conditions and pain severity were important risk factors that predisposed individuals to psychological distress. There was limited data on evidence-based management of chronic pain and comorbid depression or anxiety for Indian populations. Barriers toward effective pain management in India occur at the level of patients, physicians, or healthcare systems; some of these challenges relate to patient’s health-seeking behavior, stigma associated with psychiatric treatment, physician awareness, and education, and access to pain medications. Future initiatives are needed toward building an evidence base for effective management of pain and comorbid psychiatric conditions in India.

Comorbidities in older adults with opioid use disorders.

There is a growing number of opioid use disorders (OUDs) and overdose deaths in older adults. In addition, older adults with OUD routinely receive lower-quality preventive and chronic care that result in poorer overall health. The purpose of this study was to identify older patients with OUD at the study site and determine the prevalence of medical and psychiatric comorbidities. This retrospective study used a computer algorithm employed by a network of Federally Qualified Health Center primary care clinics in lower New York state. With the approval from institutional review board, the IT department of the organization captured data about older adults with an OUD diagnosis. The IT department identified 664 patients and provided anonymized demographic and medical history data of these patients for analysis. Patients with OUD had 2-3 times more medical and psychiatric co-occurring conditions than national sample of older adults with no OUD of similar age and income. The most frequent co-occurring medical conditions in the patients were heart or circulatory disorders, movement disorders, respiratory disorders, pain disorders, nutritional disorders, and metabolic disorders. The most common co-occurring psychiatric conditions were anxiety disorders, major depressive disorder, post-traumatic stress disorder (PTSD), and bipolar disorder. Older adults with OUD often have complex health care needs that often include one or more chronic medical and psychiatric conditions. Providers should be aware of the multiple needs of older adults with OUD so that appropriate and comprehensive care can be offered to the patients.

Association between asthma and work absence in working adults in the United States

Objectives: The present study aimed to investigate the association between asthma and work absence in a large sample of US working adults, while controlling for several sociodemographic and health characteristics. Methods: This study used data from the 2019 Health and Functional Capacity Survey of the RAND American Life Panel (ALP). Work absence corresponded to the number of days of absence from work for health-related reasons in the past 12 months. Current asthma was self-reported and was included in the analyses as a dichotomous variable. Control variables included sex, age, ethnicity, marital status, education, occupation, annual family income, health insurance, and number of chronic physical or psychiatric conditions. Finally, the association between asthma and work absence was analyzed using logistic regression models. Results: This study included 1,323 adults aged 22–65 years (53.1% males; mean [SD] age 43.1 [11.7] years). Individuals with asthma were more likely to report at least one (81.5% versus 56.8%, p-value<0.001) or three days of absence (56.9% versus 31.3%, p-value=0.003) from work in the past 12 months than those without asthma. These findings were corroborated in the regression analyses, as asthma was positively and significantly associated with work absence after adjusting for all control variables (at least one day of absence: OR=3.24, 95% CI=1.44–7.29; at least three days of absence: OR=2.61, 95% CI=1.26–5.40). Conclusions: This US study of working adults showed that asthma was a risk factor for work absence. Further research is warranted to better understand the factors predisposing to work absence in the asthma population.

A Holistic Approach to Physical and Mental Health: Associations Between Chronic Disease and Psychiatric Conditions

ABSTRACT Prior studies suggest that patients with chronic conditions are more likely to develop psychiatric disorders compared to healthy individuals without any medical conditions. The objective of this study was to investigate the link between chronic conditions and psychiatric disorders. The authors hypothesize that patients with chronic conditions have a higher comorbidity of certain psychiatric disorders compared to healthy individuals. Patients from Rowan University School of Osteopathic Medicine (Rowan SOM) Family Medicine offices completed an anonymous survey about medical and psychiatric diagnoses (Appendix 1). Multivariate analysis was used to examine the relationships between patients’ rank of control of their chronic medical and psychiatric conditions compared to the age of onset and total number of conditions. One-hundred thirteen study participants reported having at least one chronic condition and seventy-four reported having at least one psychiatric disorder listed on the survey. Among the participants comorbid with both medical and psychiatric conditions, patients’ ranking of control of their chronic conditions positively correlated with their ranking of control of their psychiatric disorders (p = 0.009). Patients’ ranking of control of their chronic conditions negatively correlated with the total number of psychiatric disorders (p = 0.002). The study did not generate significant evidence to support the original hypothesis. The results highlight a strong relationship between patients’ perceived control of their physical health and mental health. The comorbidity of both chronic conditions and psychiatric disorders may present challenges for patients. Utilizing a holistic approach to patient care can help clinicians improve patient outcomes.

Opioid use disorder-related emergency department visits among deaf or hard of hearing adults in the United States

BackgroundDespite the devastating consequences of the opioid epidemic, little is known about its impact on the deaf and hard of hearing (DHH) community. ObjectiveTo determine risk of OUD-related ED visits, ED visits involving a prescription or non-prescription opioid overdose, and mortality during OUD-related ED visits among DHH adults, compared to non-DHH adults. MethodsWe analyzed the combined 2016–2017 National Emergency Department Sample (NEDS). We identified DHH adults using ICD-10-CM codes, extracting 63,865 case records of ED visits among DHH adults ages 18–64. The control group of non-DHH adult ED visits was age-, sex-, and admission year-matched in a 1:3 case-control ratio. We conducted multi-level logistic regression models for the binary dependent variables. Covariates included sociodemographic, hospital, and clinical characteristics. ResultsIn our unadjusted models, compared to non-DHH adults, DHH adults had significantly higher risk for OUD-related ED visits (OR = 1.69, 95%CI: 1.59–1.80, p < 0.001), ED visits involving prescription (OR = 1.80, 95%CI: 1.47–2.20, p < 0.001) and non-prescription opioid overdose (OR = 1.31, 95%CI: 1.05–1.63, p < 0.05), and mortality during OUD-related ED visits (OR = 2.22, 95%CI: 1.21–4.08, p < 0.05). However, after adjustment for confounding variables, including comorbid chronic pain and psychiatric conditions, except OUD-related ED visits, the risk for ED visits involving prescription and non-prescription opioid overdose, and OUD-related mortality became non-significant. ConclusionsCompared to adults without hearing loss, DHH non-elderly adults are at a higher risk of OUD-related ED visits. Future research is needed to understand the interplay between chronic pain, psychiatric conditions, and OUD among DHH adults.

Association between Anxious and Depressive Symptomatology and Sexual Activity in Spain: A Cross-Sectional Study during the COVID-19 Quarantine.

Introduction: Evidence on sexual behaviour and COVID-19 shows a change in sexual habits; however, there is no research on the association between mental health and sexual activity. Aim: To examine the relationship between mental health and sexual activity during the quarantine in Spanish adults. Methods: A sample of 305 adults filled out an online questionnaire. Sexual activity was assessed with one question. Anxiety and depression symptoms were assessed using the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI), respectively. To check associations between levels of both anxiety and depressive symptoms (exposure) and weekly prevalence of sexual activity (outcome), we conducted multiple logistic regression adjusted for control variables (marital status, employment, average household annual income, place of living, pre-COVID-19 sexual activity, current smoking, current alcohol consumption, chronic physical conditions, chronic psychiatric conditions, physical symptoms, and days of confinement). Results: Higher depression level was associated with lower weekly sexual activity in a dose-response fashion in the three implemented models. Participants with higher levels of depression were associated with significantly lower sexual activity in the fully adjusted model (OR: 0.09, 95% CI 0.01–0.61). Mild anxiety-level participants consistently presented significantly lower ORs for lower sexual activity than their minimal-anxiety category counterparts. Particularly, the fully adjusted model showed the lower values (OR: 0.40, 95% CI 0.19–0.84). Conclusion: The results of this study support existing evidence stressing the association between mental health and sexual activity in quarantined adults.

Selective Serotonin Reuptake Inhibitors: How Long Is Long Enough?

Selective serotonin reuptake inhibitors (SSRIs) are among the most commonly prescribed medications. They are among the first-line medications for several chronic or relapsing-remitting psychiatric conditions, including major depressive disorder and anxiety disorders. The advantages of SSRI use include ease of titration and their tolerability and safety profile. Guidelines for the short-term use of SSRIs are widely available, but there is no well-organized guidance on how and whether to maintain a patient on SSRIs for the long-term. In this article, we discuss the benefits and possible adverse consequences of long-term SSRI use, as well as clinical practice considerations when using SSRIs chronically. The major benefit of long-term SSRI use is relapse prevention. The current literature suggests that the general health risks of long-term SSRI use are low; however, further research, particularly in special populations including youth and the elderly, is needed. Long-term SSRI use increases the risk of tachyphylaxis and discontinuation syndrome. Recognizing that many patients may remain on SSRIs for many years, there are several factors that prescribers should consider if they choose to use an SSRI when initiating treatment and during long-term monitoring. The decision to continue or to discontinue an SSRI should be an active one, involving both the patient and prescriber, and should be revisited periodically. Patients who remain on SSRIs for the long-term should also have periodic monitoring to reassess the risk-benefit ratio of remaining on the SSRI, as well as to assess the safety, tolerability, and efficacy of the medication.

Gender differences in the associations of multiple psychiatric and chronic conditions with major depressive disorder among patients with opioid use disorder

Purpose The study examined the associations of multiple psychiatric and chronic conditions with the self-reported history of major depressive disorder (MDD) among patients with opioid use disorder (OUD) and tested whether the associations differed by gender. Methods We conducted a secondary data analysis of baseline data from a clinical trial including 1,646 participants with OUD, of which 465 had MDD. A variable cluster analysis was used to classify chronic medical and psychiatric conditions. Multivariable logistic regression analyses were used to estimate their associations with MDD in subjects with OUD. Results Nine variables were divided into three clusters: cluster 1 included heart condition, hypertension, and liver problems; cluster 2 included gastrointestinal (GI) problems and head injury, and cluster 3 included anxiety disorder, bipolar disorder, and schizophrenia. The overall prevalence of MDD in participants with OUD was 28.3% (22.8% for males and 39.5% for females). Gender, anxiety disorder, schizophrenia, liver problems, heart condition, GI problems, and head injury were significantly associated with MDD. Gender-stratified analyses showed that bipolar disorder, liver problems and individuals with one chronic condition were associated with MDD only in males, whereas heart condition, hypertension, and GI problems were associated with MDD only in females. In addition, anxiety disorder, head injury, individuals with one or more than two psychiatric conditions, and individuals with more than two chronic conditions were associated with MDD regardless of gender. Conclusions Treatment plans in patients with OUD should not only address MDD but also co-morbid psychiatric and chronic medical conditions that occur with MDD.

Trauma as an Entry Point to the Health Care System

This study examines unmanaged chronic medical and psychiatric conditions in hospitalized trauma patients.

Challenges in the Practice of Sexual Medicine in the Time of COVID-19 in the United Kingdom

BackgroundOn 23rd March 2020, the UK government released self-isolation/social distancing guidance to reduce the risk of transmission of SARS-CoV-2. The influence such guidance has on sexual activity is not known. AimTo investigate levels and correlates of sexual activity during COVID-19 self-isolation/social distancing in a sample of the UK public. MethodsThis paper presents preplanned interim analyses of data from a cross-sectional epidemiological study, administered through an online survey. OutcomesSexual activity was measured using the following question: “On average after self-isolating how many times have you engaged in sexual activity weekly?” Demographic and clinical data were collected, including sex, age, marital status, employment, annual household income, region, current smoking status, current alcohol consumption, number of chronic physical conditions, number of chronic psychiatric conditions, any physical symptom experienced during self-isolation, and number of days of self-isolation/social distancing. The association between several factors (independent variables) and sexual activity (dependent variable) was studied using a multivariable logistic regression model. Results868 individuals were included in this study. There were 63.1% of women, and 21.8% of adults who were aged between 25 and 34 years. During self-isolation/social distancing, 39.9% of the population reported engaging in sexual activity at least once per week. Variables significantly associated with sexual activity (dependent variable) were being male, a younger age, being married or in a domestic partnership, consuming alcohol, and a higher number of days of self-isolation/social distancing. Clinical ImplicationsIn this sample of 868 UK adults self-isolating owing to the COVID-19 pandemic, the prevalence of sexual activity was lower than 40%. Those reporting particularly low levels of sexual activity included females, older adults, those not married, and those who abstain from alcohol consumption. Strength and LimitationsThis is the first study to investigate sexual activity during the UK COVID-19 self-isolation/social distancing. Participants were asked to self-report their sexual activity potentially introducing self-reporting bias into the findings. Second, analyses were cross-sectional and thus it is not possible to determine trajectories of sexual activity during the current pandemic. ConclusionInterventions to promote health and well-being during the COVID-19 pandemic should consider positive sexual health messages in mitigating the detrimental health consequences in relation to self-isolation/social distancing and should target those with the lowest levels of sexual activity.Jacob L, Smith L, Butler L, et al. Challenges in the Practice of Sexual Medicine in the Time of COVID-19 in the United Kingdom. J Sex Med 2020;17:1229–1236.

Effect of music listening on P300 event-related potential in patients with schizophrenia: A pilot study

Reduced amplitude and increased latency of P300 auditory event-related potential (ERP) in patients with schizophrenia (SZ) indicate impairment in attention. Overall arousal level can determine the amount of processing capacity required for attention allocation. Music evokes strong emotions and regulates arousability. Music has been used to modulate P300, especially in normals. This exploratory study examined the effect of music listening on the amplitude and latency of P300 in SZ patients.EEG/ERP was recorded (32-channels) while SZ patients (n = 20; 18–45 years) performed an auditory oddball P300 task after the eyes-closed rest condition (Condition-A) and ten-minute music listening condition (Condition-B) as per the complete counterbalancing design (AB-BA). Patients listened to the researcher chosen, instrumental presentation of raag-Bhoopali in the North-Indian-Classical-Music, for ten-minutes. All patients rated the music excerpt as a relaxing and positively valenced.A significant increase in accuracy score and reaction time during the oddball task after music listening was noted. There was an increase in amplitude at TP7. A trend of increased amplitude was noted across all electrodes in the music condition compared to the rest condition. Mean amplitude in an apriori defined time window of interest (250 to 750 ms) showed significant changes in the frontal and central electrode sites. Power spectral analysis indicated a slight increase in frontal and central alpha and theta activity during music listening. However, this was not statistically significant.Findings add further impetus to examine the effect of music in chronic psychiatric conditions. Need for systematic studies on a larger cohort is underscored.

Prevalence and Odds of Signs of Depression and Anxiety in Patients with Lichen Planus: Systematic Review and Meta-analyses.

The association between certain chronic inflammatory skin diseases and psychiatric disorders or conditions has been well documented. However, the exact magnitude of the association between lichen planus and depression/anxiety symptoms and disorders is unknown. A systematic review and pooled meta-analyses were performed to examine the prevalence and odds of depression and anxiety in patients with lichen planus. The meta-analyses showed a high prevalence of signs of depression (27% [19-36%]) and anxiety (28% [21-36%]). The geographical location of the study may partly explain these variations, but methodological differences could also be involved. Case-control studies showed a strong association between lichen planus and signs of depression (odds ratio 3.79, 95% confidence interval [2.35; 6.12]) or anxiety (odds ratio 2.54, 95% confidence interval [1.73; 3.72]). These results raise the necessity of screening for the presence of depressive and anxiety symptoms or disorders in patients with lichen planus, and of referring such patients for psychiatric evaluation and appropriate treatment, if necessary.