Comorbid Mental Disorders Research Articles

Norman Sartorius: The Mental Health Crusader Who Simply Won’t Stop

Abstract Professor N. Sartorius, MD, PhD, FRCPsych, previously the Director of the Mental Health Program of the World Health Organization and President of the World Psychiatric Association and of the European Psychiatric Association, now serves as President of the Association for the Improvement of Mental Health Programs, a nongovernmental organization located in Geneva, Switzerland. Professor Sartorius holds several professorial positions in Europe, the USA, and elsewhere. He has published more than 500 papers in peer-reviewed journals and authored, co-authored, edited, or co-edited more than 120 books. However, more than all these, Professor Sartorius will be remembered by posterity as a relentless crusader for mental health and against stigma toward mental illness. Professor Sartorius has focused his sustained attention on the reduction of the stigma of mental illness, on the comorbidity of mental and physical disorders, and on support to carers of people with mental disorders. He has been particularly interested in the education of young professionals and conducted leadership and professional skills courses in some 60 countries involving more than 3000 psychiatrists early in their careers. In this interview, he briefly but importantly talks about the phases of his life, work, passion, vision, and mission, and leaves important messages for future generations.

Dissecting the shared genetic landscape of anxiety, depression, and schizophrenia

BackgroundNumerous studies highlight the genetic underpinnings of mental disorders comorbidity, particularly in anxiety, depression, and schizophrenia. However, their shared genetic loci are not well understood. Our study employs Mendelian randomization (MR) and colocalization analyses, alongside multi-omics data, to uncover potential genetic targets for these conditions, thereby informing therapeutic and drug development strategies.MethodsWe utilized the Consortium for Linkage Disequilibrium Score Regression (LDSC) and Mendelian Randomization (MR) analysis to investigate genetic correlations among anxiety, depression, and schizophrenia. Utilizing GTEx V8 eQTL and deCODE Genetics pQTL data, we performed a three-step summary-data-based Mendelian randomization (SMR) and protein–protein interaction analysis. This helped assess causal and comorbid loci for these disorders and determine if identified loci share coincidental variations with psychiatric diseases. Additionally, phenome-wide association studies, drug prediction, and molecular docking validated potential drug targets.ResultsWe found genetic correlations between anxiety, depression, and schizophrenia, and under a meta-analysis of MR from multiple databases, the causal relationships among these disorders are supported. Based on this, three-step SMR and colocalization analyses identified ITIH3 and CCS as being related to the risk of developing depression, while CTSS and DNPH1 are related to the onset of schizophrenia. BTN3A1, PSMB4, and TIMP4 were identified as comorbidity loci for both disorders. Molecules that could not be determined through colocalization analysis were also presented. Drug prediction and molecular docking showed that some drugs and proteins have good binding affinity and available structural data.ConclusionsOur study indicates genetic correlations and shared risk loci between anxiety, depression, and schizophrenia. These findings offer insights into the underlying mechanisms of their comorbidities and aid in drug development.

The Impact of Mental Health on Patient Outcomes in Peripheral Arterial Disease and Critical Limb Threatening Ischemia and Potential Avenues to Treatment

The physical consequences of peripheral arterial disease (PAD) are well established, however, the impact of comorbid mental health disorders such as depression and anxiety are not well understood. The impact of psychological stress is not only associated with worse perioperative morbidity and mortality but also with a physiologic cascade that accelerates plaque formation. Increasing screening to identify and subsequently treat comorbid mental health disorders is an integral next step in improving outcomes in PAD management. Failure to adequately address social and psychological impact on PAD patients will further widen the gap in disparities faced by high risk and disenfranchised populations. Integration of mental health professionals, addiction specialists, and community navigators into multidisciplinary care teams can bolster support for PAD patients and improve outcomes.

Comorbidity of mental disorders in synthetic cannabinoids abuse: clinical dynamics, behavior, adaptation

IntroductionThe study of the phenomenon of deformation of mental disorders, clinical dynamics, behaviors, and adaptations in case of abuse of synthetic cannabinoids is of relevance.ObjectivesTo study the phenomenon of deformation of mental disorders, clinical dynamics, behaviors, and adaptations in case of abuse of synthetic cannabinoidsMethodsCatamnestic, clinical-psychopathological methods (PANS, SANS, CGI, MMPI, CGI, STAI, LSI, TPA, ICD-10), statistical (Python 3.11.0).Results291 men (age from 18 to 35 years) were examined: 240 - F12.2xx, of which 98 - F60.xx-F62.xx, 142 - F20.xx and 51 - F20.xx without substance abuse. The study took place from 2018 to 2023 based on psychiatric institutions of the Russia, Tomsk region, St. Petersburg, Noyabrsk and Nizhnevartovsk.ConclusionsThe phenomenon of abuse of synthetic cannabinoids is a factor in the deformation of mental disorders. Persistent exogenous visual and delusional disorders contribute to the symptoms of exacerbations of schizophrenia; schizophrenic symptoms are included in psychotic episodes in personality disorders. In remission of schizophrenia, there is a quasi-adaptation from socio-professional environments, mostly addictive and criminalized, a pronounced smoothing of emotional impoverishment, a stigmatizing symptom is mainly a volitional defect, as well as frequent rehospitalizations not indirectly related to drugs. In remissions of drug use in patients with personality disorder, persistent schizophrenia of behavior. In patients with schizophrenia and patients with personality disorders, there is a distortion of behavior with a predominance in patterns of inclinations to delict, nonconformity, isolation in an addictive environment, suspiciousness. Drug abuse may initiate auto-aggression predominantly in individuals with personality disorders and to a lesser extent in patients with schizophrenia. True suicides in drug users include only episodes with depressive symptoms.Disclosure of InterestNone Declared

Obesity and Aging: Optimizing Health at the Intersection of Ageism and Weight Bias

Obesity is a chronic and complex disease that can negatively impact health, functioning and quality of life. In the past decade, obesity's largest prevalence growth occurred in older adults, particularly among racial and ethnic minorities. By the year 2030, an estimated 50% of the population over 65 is likely to be living with obesity. Until recently, little attention has been given to obesity as a chronic disease, and those living with obesity have encountered challenges accessing high quality medical care. Despite growing evidence for bariatric and obesity medicine, these treatments remain inaccessible for most patients, especially for older adults. Obesity research focused on older adults has been very limited and ideal weight standards for older adults are more controversial, especially in later life where frailty and sarcopenia may develop. As concerns about the public health effects of obesity have risen in the U.S., so too have negative and stigmatized views of individuals with obesity. Weight stigma has serious negative emotional and physical health consequences including low self-esteem, negative body image, engagement in disordered eating patterns, reduced physical activity and may promote weight gain. Older adults with obesity may encounter the double stigma of both ageism and weight bias, which are two of the most socially acceptable forms of bias and discrimination in the U.S. This interactive session will focus on three areas related to obesity and older adults. Through case examples, small and large group discussions, the presenters will: i) explore potential weight bias amongst participants and discuss strategies to mitigate this bias in working with older adults; ii) discuss complex connections between obesity and frailty syndrome in older adults, and the risks associated with weight loss in later life; iii) introduce evidence-based assessment and treatment recommendations for older adults interested in obesity treatment. This session will focus on the role of psychiatrists and other mental health clinicians in the care of older patients with co-morbid obesity and mental health disorders. Also, presenters will discuss the importance of increasing awareness, advocacy, and practical strategies to combat the impact of weight bias and ageism in healthcare settings. Ultimately, the goal is to raise awareness of this complex problem and provide clinically helpful information to improve care for older patients with obesity. This symposium is sponsored by the AAGP's IDEA committee.

Evaluation of Psychiatric High and Intensive Care (EPHIC-study): monitoring innovative care from a value-based approach

IntroductionSystematic monitoring and evaluation of innovative healthcare programs are essential to develop sustainable solutions to health needs in the population (Porter & Teisberg, 2006). Development of Psychiatric High and Intensive Care Units (HIC’s) in Belgium, following the Dutch Model (van Mierlo et al., 2013), is an innovative model for patients with acute and severe psychiatric illness, resulting in potential danger. HIC aims to provide intensive, need-adapted care with interventions that reduce (perceived) coercion, focusing on participative processes and continuity of care.Objectives(1) What are the clinical characteristics of admitted patients? (2) How does clinical symptomatology evolve during admission? (3) How do patients, relatives and caregivers experience the process of care and recovery? (4) What is the role of HIC’s in the reformed mental health care?MethodsThis is an explorative, hypothesis-generating study, using a mixed-method approach, consisting of qualitative and quantitative methods against a value-based framework. Data collection lasted 18 months in the first 9 HIC’s in Belgium. Results are based on validated questionnaires completed by adult patients and their HIC caregivers at admission and discharge (N=472).ResultsWe provide the first, preliminary results. Suicidality, psychotic and substance-related symptoms are the most important primary symptoms. Almost 70% have 2 or more symptoms, with psychiatric comorbidity of 50%. Substance-related- and psychotic disorders are the two most common diagnoses, followed by personality disorder cluster B and depressive disorder. 83% have been in residential care in the past, of whom 87% twice or more. The median age is 36 years, but the median age of onset of mental disorders is 21 years, which equals to 15 years in mental disorder progress and comorbidity development. Over 50% meet the criteria for Severe Mental Illness and 56% are involuntary admitted. There is a high degree of unmet needs: no outpatient care is provided for one out of five prior to admission and there is a low follow-up by mobile teams prior to and after admission (around 12% each). We found significant improvements after an average stay of 22 days for aggression, suicidality and crisis (respectively decrease of 68%, 25% and 9%); readiness to change and motivation for treatment (respectively increase of 5% and 14%) The Client Satisfaction Questionnaire scores range from 1 to 4, with an average score 3.15 out of 4.ConclusionsBased on these preliminary results we can conclude that aggression, suicidality, crisis, readiness to change and motivation for treatment all improve significantly after a short stay of 3 weeks. Despite a vulnerable, severely distressed population, patients are generally satisfied with received care. There is a high degree of unmet needs: insufficient provided outpatient care and low follow up by mobile teams.Disclosure of InterestNone Declared

Prevalence and impact of comorbid mental disorders in hospitalized patients with obstructive sleep apnea: a protocol for a nationwide retrospective study

Introduction Obstructive sleep apnea (OSA) is a common sleep disorder in the adult population, often associated with an increased prevalence of comorbid conditions such as obesity and diabetes, but also several mental disorders that have been independently associated with worse hospitalization outcomes in a variety of situations. However, and despite such associations, there is a relative dearth of studies exploring comorbid psychopathology beyond depression and anxiety, and no studies seem to address the impact of comorbid mental disorders on the hospitalization outcomes of patients with OSA.ObjectivesThis study aims to characterize and compare mental comorbidities among hospitalization episodes of adult patients with and without OSA held in mainland Portugal, regardless of the primary cause of admission, and to analyze the impact of such comorbidities on hospitalization outcomes.MethodsAn observational retrospective study will be conducted using an administrative database comprising de-identified routinely collected discharge data from all Portuguese mainland public hospitals. Inpatient episodes spanning from 2008 to 2015 will be categorized into two groups according to the presence of an OSA code (ICD-9-CM codes 780.51, 780.53, 780.57, 327.20 and 327.23). For both groups, mental disorders will be identified according to categories 650 to 670 of the Clinical Classifications Software (CCS) for ICD-9-CM. Descriptive, univariate, and multivariate analyses will be performed. Study reporting will comply with the RECORD statement guidelines.Results Out of 6,072,538 sampled episodes, 57,301 have an OSA code. Prevalence of any comorbid mental disorder is 30.4% in the OSA group, and 19.3% in the non-OSA group. For both groups, sociodemographic, administrative, and clinical variables will be characterized and compared, as well as the prevalence of each mental disorder category, yearly hospitalization trends, and most common primary diagnoses. Hospitalization outcomes, including length of stay, in-hospital mortality, and readmissions, will be compared taking into consideration the presence of CCS categories of mental disorders.ConclusionsWe expect to improve the understanding of the prevalence of mental comorbidities among hospitalized patients with OSA, including understudied mental disorders, and to elucidate their impact on relevant hospitalization outcomes, thus highlighting the need to recognize and treat this common association to achieve optimal outcomes.Disclosure of InterestNone Declared

Adult self-reported childhood maltreatment types are associated with treatment satisfaction and alcohol relapse in patients with comorbid substance use and mental health disorders.

Individuals with comorbid substance use and mental health disorders (concurrent disorders; CD) report poor treatment outcomes, high prevalence of childhood maltreatment, and mostly negative experiences with treatment. No studies to date have examined childhood maltreatment and treatment outcomes in CD. This study investigated self-reported childhood maltreatment as it relates to treatment satisfaction and substance use relapse among CD patients. The 258 CD inpatients completed a self-report questionnaire package, comprising the Childhood Trauma Questionnaire and the Inpatient Consumer Survey (ICS). Childhood maltreatment was assessed according to five subtypes and self-perceived treatment satisfaction was rated across six ICS domains. Psychiatric diagnoses, substance use status and relapse data were retrieved via patient medical charts. Emotional neglect was associated with lower ratings across all ICS domains and physical neglect was associated with a lower rating for 'outcome of care'. Childhood sexual abuse was associated with a greater likelihood of alcohol relapse. No other relationships were statistically significant. The presence of childhood neglect (but not abuse) was more associated with overall treatment dissatisfaction, and sexual abuse alone increased the likelihood of alcohol relapse. These findings suggest some early adverse experiences in CD patients may increase negative experiences in treatment while others contribute to the risk of substance use. Broader longitudinal research is needed to examine the trajectory leading to negative outcomes. This is the first study to report differential patterns of association by type of childhood maltreatment on negative outcomes in treatment among CD patients.

Medical use of cannabis and psychedelics in treating symptoms of mental disorders among military and veteran populations: A systematic review

Military personnel and veterans experience distinct trauma exposures, resulting in totally different mental disorder prevalence, comorbidities, and treatment responses compared to the general population. The medical use of psychoactive substances as novel strategies for specific mental health conditions within military contexts is being investigated, while their therapeutic efficacy and safety remain uncertain. This systematic review aims to summarize the available evidence for the medical use of these substances, mainly cannabis and psychedelics, in treating symptoms of mental disorders in military populations. A systematic search was conducted in Medline, PubMed, and Web of Science databases from inception until May 16th, 2023, following PRISMA guidelines. References of relevant papers and high-quality reviews were also hand-searched. The included studies were randomized controlled trials, self-controlled trials, and case reports that explored the use of cannabis or psychedelics for the treatment of mental disorders in military and veteran populations. Two independent reviewers screened all studies and performed data extraction. Eight studies were included, with five focused on cannabis and three on psychedelics. Most of the studies reported positive results, but detailed information on side effects and long-term follow-up was limited. In conclusion, the potential benefits yet the lack of high-quality RCTs underscore the need for more rigorous research in this field.

Prevalence of mental disorders among Australian females: Comparison according to motherhood status using Australian birth cohort data

PurposeStudies examining mental disorders among women have primarily focused on either depression, anxiety, or substance use disorders and not included the broader spectrum of mental disorders. Mixed evidence exists on the prevalence rates of mental disorders among mothers. This study compares the prevalence of different mental disorders and mental comorbidities between mothers and non-mothers and assesses correlates of mental disorders among mothers.MethodsA population-based birth cohort design was adopted, consisting of 40,416 females born in Queensland, Australia, in 1983/84. Linked administrative data from hospital admissions were used to identify mental disorders. Cumulative incidence curves of different mental disorders were created separately for mothers and non-mothers.ResultsMental disorder prevalence among females by age 29–31 years was 7.8% (11.0% for mothers and 5.2% for non-mothers). Mothers were overrepresented in almost all categories of mental disorders, with overrepresentation becoming more pronounced with age. Mothers with a mental disorder were more likely to be unmarried, Indigenous, young at birth of first child, have greater disadvantage, and have a single child, compared to mothers without a mental disorder. Nearly half of the mothers (46.9%) had received a mental disorder diagnosis before having their first child.ConclusionsMothers, particularly unmarried, Indigenous, having greater disadvantage, and younger at birth of first child, represent a unique group with high vulnerability to mental disorders, that begins in childhood and is amplified with age. Presence of significant mental disorder comorbidities among females highlights the critical importance of a comprehensive, integrated approach to prevent and address multiple comorbidities.

Examining patterns of patient adherence to Cognitive Behavioural Therapy in chronic physical illnesses and comorbid mental health disorders: a scoping review protocol

Objective To examine the patient adherence patterns to Cognitive Behaviour Therapy (CBT) intervention in persons living with long term physical illness and co-occurring mental health conditions. Introduction Current literature on patient treatment adherence is mostly focused on the medical/pharmacological treatment or is disorder/ therapy specific and does not address co-occurring or comorbid mental health disorders with physical health disorders in general. The objective of this scoping review is to provide insights into adherence behaviours and patterns outside of pharmacological intervention focusing on psychotherapeutic intervention specifically Cognitive Behaviour Therapy (CBT) in persons living with long-term medical conditions with co-existing mental health disorders/ conditions. The results of the review will highlight different aspects of adherence to CBT including facilitating and impeding factors influencing adherence, and variations across comorbid mental and physical health conditions. These results will aid in developing targeted CBT interventions and strategies to improve adherence rates. Furthermore, identifying gaps in the existing literature will guide future research to optimise health outcomes in this population. Inclusion Criteria Using the Population, Concept, and Context (PCC) criteria, studies will be included if they reported on patient adherence patterns of CBT in persons living with chronic medical conditions and co-occurring mental health conditions. Methods The scoping review will follow the Joanna Briggs Institute (JBI) guidelines for scoping review and reported according to the PRISMA-ScR checklist. A systematic search of PubMed, CINAHL Plus (including full academic search, APA PsychInfo, and Medline), Scopus, Cochrane library, EMBASE, Google Scholar, and University College Cork (UCC) library’s one search platform will be conducted. The JBI standard data extraction tool will be tailored to the review objectives. The findings will be presented using a descriptive and narrative approach.

The impact of psychiatric comorbidities associated with depression: a literature review.

The comorbidity with anxiety disorders has profound adverse implications on the evolution, prognosis and therapeutic responsiveness of depression, it will prolong the time required to achieve remission of the depressive episode, and patients under treatment will tend to drop out of their therapeutic regimens faster than those with depression but without anxious comorbidity. The purpose of this study is to evaluate the importance of the clinical, etiopathogenetic, prognostic and especially therapeutic connotations given by the presence of psychiatric comorbidities in depression. Articles evaluating the presence of psychiatric comorbidities in depression were analyzed using PubMed, Medline, Scopus, Google Academics and WoS databases. To select the articles, we used keywords: psychiatric comorbidity, depression with anxiety disorders, depression with dysthymia, depression with psychoactive substances, depression with personality disorders. From a psychiatric perspective, the comorbidity of mental disorders can be divided into psychiatric comorbidity, when two or more distinct psychiatric conditions are present in the same individual, and medical comorbidity, when a medical-surgical illness is associated with a mental disorder. The presence of major depression is in itself a predictive factor for a later onset of generalized anxiety disorder. The comorbidity of depression in those with substance abuse or addiction has profound implications on their clinical prognosis. The association of personality disorder has a significant impact on the suicidal behavior of patients with major depression.

Clinical characteristics and outcomes of children, adolescents and young adults with overweight or obesity and mental health disorders

BackgroundMental disorders are important comorbidities in youth with obesity. Aim was to describe the clinical characteristics and outcome of youth with overweight or obesity having comorbid mental disorders.MethodsData from children, adolescents, and young adults (age 6–30 years) with overweight or obesity and mental disorders (depression, anxiety disorder, eating disorder, attention deficit disorder (ADHD)) from 226 centers in Germany and Austria participating in the Adiposity Patient Registry (APV) were analyzed and compared with those without reported mental disorders using regression modeling.ResultsMental health comorbidity was reported in a total of 3969 out of 114,248 individuals with overweight or obesity: 42.5% had ADHD, 31.3% anxiety disorders, 24.3% depression, and 12.9% eating disorders. Being male (OR 1.39 (95%CI 1.27;1.52)), of older age (1.42 (1.25;1.62)), or with extreme obesity (1.45 (1.30;1.63)) were most strongly associated with mental health comorbidity. Regression analysis showed that mean BMI-SDS was significantly higher in the group of individuals with depression and eating disorders (BMI-SDS 2.13 (lower; upper mean:2.09;2.16) and 2.22 (2.17;2.26)) compared to those without reported mental health comorbidity (BMI-SDS 2.008 (2.005;2.011); p < 0.001). In youth with ADHD, BMI-SDS was lower compared to those without reported mental disorders (BMI-SDS 1.91 (1.89;1.93) vs 2.008 (2.005;2.011); p < 0.001). Proportion of severe obesity was higher in individuals with depression (23.7%), anxiety disorders (17.8%), and eating disorders (33.3%), but lower in ADHD (10.3%), compared to those without reported mental disorders (13.5%, p < 0.002). Proportions of dyslipidaemia and abnormal carbohydrate metabolism were not different in youth with and without reported mental health comorbidity. BMI-SDS change after one year of lifestyle intervention program ranged between −0.22 and −0.16 and was similar in youth without and with different mental disorders.ConclusionHealth care professionals caring for youth with overweight or obesity should be aware of comorbid mental disorders and regular mental health screening should be considered.

Clinical and Sociodemographic Differences in Adult Women and Men with Obsessive-Compulsive Disorder

Aim/background: Gender is related to differences in the prevalences, manifestations and comorbidities of mental disorders. Findings on the effect of sex on adults with obsessive-compulsive disorder (OCD) are limited and inconsistent. We aimed to compare male and females with OCD in a large sample of adults. Methods: We included 559 patients with OCD (299 females, 50.68%). We employed the Yale-Brown Obsession and Compulsion Scale (Y-BOCS), Hamilton Depression Rating Scale-17 (HDRS-17) and Beck Anxiety Inventory (BAI). We gathered data about the onset of illness, the years of education, marital status, long-term unemployment, history of hospitalization and suicide attempts, lifetime attention deficit and hyperactivity disorder (ADHD), tic disorder, alcohol use disorder (AUD), substance use disorder (SUD), smoking and symptom dimensions. Results: The Y-BOCS, HDRS-17 and BAI scores were significantly higher in women. Men were characterized by earlier onset of OCD, younger age, longer years of education, higher prevalence of past or current tic disorders and higher frequency of AUD/SUD and smoking. Ratio of being married was higher among women whereas most of males were never-married. History of suicide attempt was more common among women. Conclusions: Our research offers additional support for variations in clinical characteristics of OCD based on gender. It is essential to investigate the biological foundation of gender differences on OCD.

Mental disorders, social and demographic characteristics of patients with chronic and episodic migraine

To compare socio-demographic, clinical and psychological characteristics and comorbid mental disorders in patients with chronic migraine (CM) and episodic migraine (EM). Eighty patients with migraine (40 with CM (16 men and 24 women, mean age 33.5±6.1 years) and 40 with EM (9 men and 31 women, mean age 31.4±5.7 years) were examined. All patients were interviewed and tested with psychometric methods. Socio-demographic and clinical-psychological characteristics were determined in all patients. The psychiatrist assessed the mental status of patients and diagnosed comorbid mental disorders according to the ICD-10 criteria. Symptoms of depression, high levels of trait and state anxiety, and a tendency to emotional inadequacy of response were more common in CM patients than in EM patients (p<0.05). Mental disorders, predominantly of the anxiety-depressive spectrum, were more common in CM patients than EM patients (OR (95% CI)=2.54 (2.03 to 2.98, p<0.001). Seventy-five percent of CM patients had more than one psychiatric diagnosis, almost a quarter of CM patients had schizotypal disorder, which is significantly higher than in EM patients (OR (95% CI)=1.99; 1.03 to 2.42, p<0.001). There were more unmarried, single (without constant partner), unemployed, high-education patients in the CM group than in the EM group. The negative impact of headache on the daily activity of patients was significantly higher in the CM group than in the EM group (p<0.05). Mental disorders and psychological features (anxiety, depression symptoms, a tendency to emotional inadequacy of response) are more common in CM patients than in EM patients. The presence of these factors may contribute to the chronification of migraine.

Mental Disorders in Chronic Pain Patients Seeking Treatment at a Tertiary Pain Hospital

Abstract: Background: The high co-occurrence of chronic pain and mental disorders is well-established. Yet, an up-to-date account of the prevalence of mental disorders according to revised diagnostic criteria is lacking. Aims: The present study investigated the point and lifetime prevalence of a broad range of mental disorders according to DSM-5 in patients with chronic pain and examined associations of current mental health comorbidity with pain catastrophizing and health-related quality of life (HRQoL). Method: In this cross-sectional, observational study, patients with self-reported chronic pain receiving inpatient treatment at a specialized tertiary hospital were recruited for participation. Structured clinical interviews were conducted to assess current and lifetime diagnoses of mental disorders. Pain catastrophizing and HRQoL were assessed via questionnaires. Results: 145 patients (63.5% female; Mage = 54.9 years) participated in the study. 57.2% of the sample met the criteria for any current and 77.9% for any lifetime mental disorder. The most prevalent diagnostic groups of current mental disorders were substance-related and addictive disorders (26.2%), somatic symptom and related disorders (17.9%), depressive disorders (17.2%), and anxiety disorders (15.9%). Current mental health comorbidity was significantly associated with increased levels of pain catastrophizing and poorer HRQoL outcomes. Limitations: Chronic pain was only assessed by self-report, and no data regarding the exact medical diagnoses of the participants were collected. Conclusion: Comorbid mental disorders are highly prevalent in patients with chronic pain. Given the adverse effects of this comorbidity, the findings emphasize the need for addressing comorbid mental disorders in the management of chronic pain.

Post traumatic stress disorder and co-morbid psychological disorders after Palestinians' home demolition: a comparative study.

Home demolition is one of the issues that the Palestinian community faces as a result of Israeli procedures that can impact Palestinian mental health. This study aimed to measure the prevalence of Post-Traumatic Stress Disorder (PTSD), depression, anxiety, and stress among Palestinian citizens whose homes were demolished. A comparative cross-sectional design was adopted using a purposive sample of home demolished versus not home demolished Palestinian people. The Impact of Event Scale-Revised (IES-R) and the Depression and Anxiety Stress Scales (DASS) were used to assess the participants' levels of PTSD, depression, anxiety, and stress. The Statistical Package for the Social Sciences, Version 25, was applied to the statistical analysis. This study showed that PTSD levels among people whose homes were demolished are significantly high, with a mean of 3.2, which could be indicative of a clinical concern. However, the PTSD level in the comparison group had no significance, with a mean of 1.48. Stress, depression, and anxiety levels were represented as 32.71, in their means, 32.61, and 32.08, respectively, among home-demolished people, compared to stress 18.46, depression 15.87, and anxiety 13.06 among the non home demolished group. This study is one of the few that sheds light on one of the disadvantaged groups who suffer from home demolition and the severe mental problems that affect them, including PTSD, stress, depression, and anxiety). Furthermore, many related risk factors were studied in this research. As a future recommendation, further research is needed in this field, especially among disadvantaged groups. Stakeholders need to take action to improve the health system in Palestine.

The relationship between immunological and psychopathological characteristics in patients with focal epilepsy depending on the profile of interhemispheric asymmetry

To identify the possible influence of cellular immunity parameters and neurobiological variables (frequency of seizures of various semiotics and their severity) on comorbid psychopathological symptoms depending on the profile of interhemispheric asymmetry in patients with focal forms of epilepsy. The study included 92 patients with epilepsy (38 men, 54 women, mean age 38.7+8.45 years). Focal temporal lobe epilepsy was diagnosed in 36 patients, focal frontal lobe epilepsy in 16 patients, and temporal-frontal lobe epilepsy in 40 patients. For each type of seizure, severity was assessed according to the National Seizure Severity Scale (NHS3). The mental status of patients was assessed using the SCL-90 self-report questionnaire. The Annette scale was used to assess the profile of interhemispheric asymmetry. The number of different clusters of lymphocytes was studied, including the number of T-lymphocytes (CD3+), T-helpers (CD3+CD4+), T-cytotoxic (CD3+CD8+), T-NK (natural killers CD3+CD16+CD56+), B-lymphocytes (CD3-CD19+), as well as immunoregulatory index (CD4/CD8 ratio). In order to identify any possible relationships between neurobiological and immune variables, on the one hand, and the SCL-90 constructs, on the other hand, a separate correlation analysis of Spearman ranks within the left-handed group and the right-handed group was carried out. We revealed the differences between groups of patients with epilepsy with right and left profiles of hemispheric asymmetry regarding the relationship between the frequency of seizures, their severity and accompanying psychopathological variables, on the one hand, and between immunity indices and psychopathological constructs, on the other hand. It has been established that neurobiological and immune variables in left-handers can determine the psychopathological structure of the comorbid mental disorder. Prediction of concomitant psychopathological syndromes in patients with epilepsy on the basis of clinical data and data on immunity is quite possible, but only in left-handed patients.

EXPLORING THE NEXUS: METHAMPHETAMINE-INDUCED PSYCHOSIS, CO-MORBID MENTAL DISORDERS, AND ASSOCIATED RISKS AMONG DEPENDENT INDIVIDUALS IN TERTIARY CARE HOSPITAL OF PESHAWAR

Objective: This study examined the risk of lifetime and present methamphetamine-induced psychosis in dependentindividuals. The relationship between methamphetamine-induced psychosis and mental co-morbidity was examined.Study design : A Cross-sectional studyDuration and place of study : tertiary care hospital of Peshawar from January 2022 to January 2023Methods: This Cross-sectional study done simultaneously at a Peshawar Tartary care hospital from January 2022to January 2023. The Mini International Neuropsychiatric Interview (M.I.N.I.) was used to interview DSM-IV-diagnosed methamphetamine users for psychosis and other Axis I psychiatric disorders. Social demographics and druguse history were acquired via interviews or medical records.Results: There was a history of psychotic symptoms in 65 (45.4% of the total) participants, and 23 (15.6% ofthe total) patients at the present time. After adjusting for other covariates, there was a substantial association betweenheavy methamphetamine use, childhood methamphetamine-induced psychosis, and co-morbid major depressive disorder(n-24, 16.2%), bipolar disorder (n-6, 5.8%), and antisocial personality disorder (n-14, 10.8%). The only variableslinked to present psychosis were major depressive illness (n-6, 5.8% of the population) and antisocial personalitydisorder (n-4, 4.2% of the population).Conclusion: this study sheds light on the interplay between methamphetamine use, psychosis, and co-morbid mentaldisorders. Early detection and integrated treatment approaches are vital for mitigating the adverse effects of substanceabuse and improving mental health outcomes in affected individuals.Keywords: Methamphetamine, Psychosis, Co-morbidity, Dependent individuals, Mental disorders

SEXUAL ABUSE IN CHILDHOOD: RELATIONSHIP WITH POST-TRAUMATIC STRESS DISORDER

This study is a systems research that aims to investigate whether children who have been sexually abused develop post-traumatic stress disorder. Research has shown that traumatic events in a person's life such as an accident, a natural disaster, and sexual abuse are directly related to the development of PTSD, as demonstrated by the research used in this thesis. The paper was guided by PRISMA 2020, which helped guide the research. The surveys used for the paper were 8 (n=8) and involved children who had been sexually abused between the ages of 1-17 and developed PTSD and in some cases in co-morbidity with other mental disorders. The surveys were briefly analyzed and then converted into tables for easier understanding. An important finding from the surveys is that children who have been sexually abused over the age of 6 have higher rates of PTSD and also higher rates than children who have been diagnosed with PTSD but have not been sexually abused. Surely, several factors such as gender, age, and frequency play a role in the development and comorbidity of mental disorders. Of course, as child sexual abuse is a sensitive and topical problem, further research is necessary as well as the development of a treatment focused on child sexual abuse.&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/soc/0075/a.php" alt="Hit counter" /&gt;&lt;/p&gt;