Comorbid Psychiatric Disorders Research Articles

Navigating the Complex Intersection of Substance Use and Psychiatric Disorders: A Comprehensive Review.

The co-occurrence of substance use disorders (SUDs) and psychiatric conditions, often referred to as comorbidity or concurrent disorders, presents intricate challenges in both diagnosis and treatment. This comprehensive narrative review aims to synthesize and critically evaluate the existing evidence surrounding the management of individuals with comorbid SUDs and psychiatric disorders. Comorbidity in these domains carries profound implications for clinical practice, research, and policymaking, emphasizing the need for a holistic understanding of the intricate dynamics that arise when these conditions coexist. This review explores recent research findings, evidence-based guidelines, and emerging trends within the field, offering valuable insights for clinicians, researchers, and policymakers seeking to navigate the complex terrain of comorbidity in substance use and psychiatric disorders.

Culturally Responsive CBT for Psychological and Physical Symptoms in Pakistani Youth: Role of Religious and Cultural Attunement

Cognitive Behavioral Therapy (CBT) is used widely throughout the world in diverse populations for successful treatment of a wide range of psychiatric and comorbid conditions. Over the years clinicians have been making efforts to culturally adapt CBT to various groups. This paper discusses the assessment and treatment of a young female from Pakistan with depression and anxiety with comorbid headache. After ruling out all organic causes, the treatment continued over 20 sessions with the initial phase consisting of introduction to CBT, risk assessment, and identification of treatment goals. Following this, the patient was helped in identifying automatic thoughts, feelings, and behaviors. Finally, tools such as thought substitutions, reappraisals, and positive diversions were used effectively to decrease automatic negative thoughts. A focus on the patient’s religio-cultural identity was maintained throughout. Understanding of contextual factors like religio-cultural values and family dynamics helped to bring about favorable therapy outcomes. A case conceptualization that cohesively addressed factors relating to ethnicity, class, and gender yielded a positive result in our case. Involvement of the family and psychoeducation regarding neurobiological causes also proved to be helpful. Such an approach can facilitate a culturally responsive application of CBT in Pakistani youth experiencing comorbid medical and psychiatric disorders.

Diagnostic psychiatric and somatic comorbidity in patients with depression in the Western Balkan countries.

This paper aims to examine the frequency and significance of diagnostic comorbidity of psychiatric disorders and somatic diseases in a sample of patients with depression as well as present current psychopharmacological treatment of the patients in the sample. The subjects in this study sample were 489 patients from the four Western Balkan countries with current primary diagnosis of major depression according to ICD 10. Comorbid psychiatric disorders and non-psychiatric illnesses were noted according to ICD 10 criteria during the diagnostic interview and analysed later. Additionally, the pharmacological treatment (existing and newly introduced) for each patient was noted and analysed later. At least one comorbid psychiatric disorder was present in 72.5% of patients. The most frequent were anxiety disorders (53.6%), specifically generalized anxiety disorder (20.2%); non-organic sleep disorders (50.7%), specifically insomnia (48.4%); and sexual dysfunctions (21.4%), specifically lack of sexual desire (20.2%). Comorbidity with any non-psychiatric illness was present in 80.3% of patients. The most frequent were circulatory system diseases (55.9%), specifically hypertension (45.9%); endocrine, nutritional and metabolic disorders (51.3%), specifically hyperlipidaemia (24.0%); and other non-psychiatric disorders (60.7%), specifically low back pain (22.7%). All patients received pharmacological treatment with different medications. Most patients received monotherapy or combination therapy of antidepressants, anxiolytics, antipsychotics and antiepileptics. The most frequently used antidepressants were escitalopram, sertraline, and duloxetine. The most frequently used anxiolytics were alprazolam and diazepam, the most used antiepileptic was pregabalin, and the most used antipsychotics were olanzapine, quetiapine, and aripiprazole. The results of the study confirm the results of previous research studies about the high prevalence of psychiatric and non-psychiatric comorbidities in patients with depression that were conducted in the past. It would be important if future studies could prove the importance of those comorbidities on clinical severity, choice of treatment, and its outcome in patients with depression.

Identifying potential scalp acupuncture targets for chronic pain and comorbid disorders using functional and anatomical connectivity of critical deep brain structures

Scalp acupuncture is an innovative approach that integrates acupuncture needling stimulation with the modern understanding of brain function. In recent decades, scalp acupuncture has been applied to treat chronic pain and has achieved promising results. This study aimed to identify potential brain surface targets for scalp acupuncture based on the functional and anatomical connectivity of the hippocampus, amygdala, and nucleus accumbens, three deep brain structures that are believed to play an important role in the pathophysiology of chronic pain, as well as multiple comorbid psychiatric and neurological disorders. Resting-state functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) datasets from 119 healthy participants were included in our analysis. We found that the medial prefrontal cortex (mPFC), corresponding to the acupoints EX-HN3 (Yintang) / BL2 (Cuanzhu), is functionally and anatomically connected to all three subcortical regions, while the precuneus, corresponding to the acupoints GV19 (Houding) / GV20 (Baihui) and the MS12 scalp acupuncture line, is connected to the hippocampus and amygdala. Our results suggest that the mPFC and precuneus, two key hubs of the default mode network (DMN), and other cortical areas distributed at the prefrontal, parietal, and temporal cortices may hold potential as novel targets for scalp acupuncture in the treatment of chronic pain and its comorbidities. These identified locations may also be used for the treatment of psychiatric and neurological disorders, such as anxiety, depression, insomnia, and cognitive decline, in which the three corresponding deep brain structures play a crucial role.

Factors Inducing Alcohol Seeking Behaviors in Patients Dependent on Alcohol-A Case-control Analysis

Abstract Context: Alcohol use has increased to the extent that it has become a menace to society. There are certain external or social factors which linger an individual around alcohol despite efforts to cut its consumption. Furthermore, the ingrained factors as an individual’s personality and associated comorbid psychiatric disorders render alcohol-seeking behaviors. These factors further lead to problems in help-seeking, adjustment in society, and continuation of treatment. Although studies in the past have highlighted these risk factors, this study was conducted to understand the role of social factors, personality, and simultaneously occurring illness in patients of alcohol dependence with healthy controls. Aim: The aim of this study was to study the factors inducing alcohol-seeking behaviors in patients dependent on alcohol. Settings and Design: This case–control study was conducted among 100 male patients. It included 50 patients diagnosed with alcohol use disorder and other 50 patients as healthy controls. Subjects and Methods: Participants were assessed clinically and the Clinical Institute Withdrawal Assessment of Alcohol Scale-Revised scale, Alcohol, Smoking, and Substance Involvement Screening Test, Mini-international neuropsychiatric interview, and International Personality Disorder Evaluation scales were administered. Statistical Analysis: A Chi-square test was applied for the categorical variable. Univariate linear regression was done for the independent variable. Results: Marital status, occupation, and residential area significantly affect alcohol use behavior. Affective disorders (22%) were the most common comorbidity and dissocial personality disorders (24%) were most prevalent. Conclusions: While addressing the issues related to dependence a focused approach including social, biological, and psychological factors must be considered.

High perceived stress in patients on opioid agonist therapies during rapid transitional response to the COVID-19 pandemic in Ukraine.

The COVID-19 pandemic resulted in marked disruptions in healthcare delivery in Ukraine related to emergency guidance in response to treating opioid use disorder (OUD). Patients with OUD, a group with high levels of comorbid medical and psychiatric disorders, and prescribed opioid agonist therapies (OAT) were rapidly shifted to take-home dosing if they were deemed clinically stable. The impact of these shifts on patient stress and related substance use during the pandemic, however, is unknown. In early May 2020, 269 randomly selected OAT patients in Ukraine were surveyed to assess their stress level and substance use using the validated Perceived Stress Scale and examined correlates of severe perceived stress. Overall, 195 (72.5%) met criteria for moderate to severe levels of stress, which was independently correlated with having started OAT within the past 12 months (aOR: 1.33; 95%CI: 1.15-1.55), living in a large metropolitan area (aOR: 1.31; 95%CI: 1.18-1.46), having been asked by others to share their medication (aOR: 1.13; 95%CI: 1.02-1.25), and having an increase of over 10 min in transportation time to get to treatment (aOR: 1.16; 95%CI: 1.04-1.29). Twenty seven (10%) patients felt at high risk of relapse, while 24 (8.9%) patients reported purchasing drugs. During a time of great uncertainty soon after emergency guidance to the COVID-19 pandemic, there was extraordinary high levels of perceived stress reported. In response to emergency guidance, OAT patients should be screened for perceived stress and certain subgroups should be targeted for additional psychosocial support.

Co-morbid psychiatric disorders in children with arachnoid cyst

Arachnoid Cysts (AC) are benign lesions containing cerebrospinal fluid, and although most of them are asymptomatic, they can cause neurological symptoms like headaches, seizures, and neuropsychiatric problems. The aim of this study was to asses and document co-morbid psychiatric disorders in children with AC aged between 6 and 17. Wechsler Abbreviated Scale of Intelligence–Second Edition (WASI-II), a clinical measure used to assess the intelligence quotient (IQ) scores of the patients, Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (K-SADS-PL; semi-structured interview) was used to assess psychiatric disorders among the patients. A total of 12 patients with AC was evaluated with an even distribution of males and females. Half of the patients had a normal IQ score with a mean IQ score of 104.5. Among patients with normal IQ scores, one patient had epilepsy and attention deficit hyperactivity disorder and two patients had epilepsy without any psychiatric disorder. The remaining six patients had moderate intellectual disability with a mean IQ of 48.2. Among them, three out of six had epilepsy and four had accompanying psychiatric disorders. It is therefore apparent that patients with AC have a high rate of co-morbid psychiatric disorders. Our study demonstrates that intellectual disability and psychiatric disorders should be evaluated in children with AC in the clinical settings.

Baseline Characteristics From a New Longitudinal Cohort of Patients With Noncancer Pain and Chronic Opioid Use in the United States

Retrospective cohort studies have consistently observed that long-term prescription opioid use is a risk factor for new major depressive episodes. However, prospective studies are needed to confirm these findings and establish evidence for causation. The Prescription Opioids and Depression Pathways cohort study is designed for this purpose. The present report describes the baseline sample and associations between participant characteristics and odds of daily versus nondaily opioid use. Second, we report associations between participant characteristics and odds of depression, dysthymia, anhedonia, and vital exhaustion. Patients with noncancer pain were eligible if they started a new period of prescription opioid use lasting 30 to 90 days. Participants were 54.8 (standard deviation ± 11.3) years of age, 57.3% female and 73% White race. Less than college education was more common among daily versus nondaily opioid users (32.4% vs 27.3%; P = .0008), as was back pain (64.2% vs 51.3%; P < .0001), any nonopioid substance use disorder (12.8% vs 4.8%; P < .0001), and current smoking (30.7% vs 18.4% P < .0001). High pain interference (50.9% vs 28.4%; P < .0001) was significantly associated with depression, as was having more pain sites (6.9 ± 3.6 vs 5.7 ± 3.6; P < .0001), and benzodiazepine comedication (38.2% vs 23.4%; P < .0001). High pain interference was significantly more common among those with anhedonia (46.8% vs 27.4%; P < .0001), and more pain sites (7.0 ± 3.7 vs 5.6 ± 3.6; P < .0001) were associated with anhedonia. Having more pain sites (7.9 ± 3.6 vs 5.5 ± 3.50; P < .0001) was associated with vital exhaustion, as was back pain (71.9% vs 56.8%; P = .0001) and benzodiazepine comedication (42.8% vs 22.8%; P < .0001). Patients using prescription opioids for noncancer pain have complex pain, psychiatric, and substance use disorder comorbidities. Longitudinal data will reveal whether long-term opioid therapy leads to depression or other mood disturbances such as anhedonia and vital exhaustion. PerspectiveThis study reports baseline characteristics of a new prospective, noncancer pain cohort study. Risk factors for adverse opioid outcomes were most common in those with depression and vital exhaustion and less common in dysthymia and anhedonia. Baseline data highlight the complexity of patients receiving long-term opioid therapy for noncancer pain.

Hikikomori (Severe Social Withdrawal) in Italian Adolescents: Clinical Features and Follow-Up.

Severe social withdrawal, including staying alone in one's bedroom, non-attendance at school or work, and minimal or absent social contacts, sometimes only through electronic devices, can be found in several psychiatric disorders, or in a 'primary' form, firstly defined in Japan as 'Hikikomori'. The distinction between primary and secondary forms is questionable, as it prevalently depends on the quality of psychiatric assessment. To date, few studies specifically explored Hikikomori in an adolescent population outside Japan. The aim of the present study is to describe clinical features of a consecutive group of 80 referred youth (13 to 18 years, 57 males) with social isolation, of which 40 were followed up on for 4-6 months, to characterize clinical features and outcome. All the participants presented psychiatric comorbid disorders, prevalently anxiety disorders, mood disorders, and autism spectrum disorder. Suicidality (ideation and behavior) was reported in 32.5% of the participants, and 20% of the participants attempted suicide. More than half of the participants exceeded the cut-off of the Internet Addiction Test, and 42.4% met the criteria for the Internet Gaming Disorder. At the follow-up appointment, an improvement of social withdrawal was reported in 75% of the sample; 67.5% of the participants significantly improved according to the CGI-improvement scale; and 55% of the participants had an improvement of functioning according to the C-GAS. Our findings suggest that Hikikomori is a transnosographic entity, with high rates of suicidality and Internet addiction, and that can it improve when it is timely diagnosed and treated.

Psychimmunological Aspects and Quality of Life in Patients with Irritable Bowel Syndrome

Background: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder and may coexist with psychiatric disorders. We aimed to establish new directions for diagnosis of psychiatric disorders in IBS patients by assessment of the quality of life (QOL) and the immunological role in IBS.&#x0D; Methods: This study was carried out on 80 subjects aged from 18 to 65 years old, both sexes, assigned into two groups: group I included 60 patients were diagnosed with IBS according to ROM-IV diagnostic criteria and were further divided according to age into two groups, first group is (18-40) years and second group is (41-65) years. Group II: Included 20 subjects as a healthy Control group.&#x0D; Results: The younger age group of patients with IBS have a significantly better overall QOL and its domains than the older age group. Hamilton Rating Scale of Depression scores were significantly higher in female patients and older age groups. Patients with psychiatric comorbidity had a lower QOL and its domains than patients without psychiatric comorbidity with a significant difference between both groups. There was a significant difference in serum Interlukin-6 between patients with IBS and healthy control group. Also in serum Interlukin-6 patients with IBS comorbid psychiatric disorders and patients without psychiatric comorbidity with.&#x0D; Conclusions: Psychiatric symptoms are presented earlier in Egyptian IBS. A higher percentage of psychiatric disorders are presented with severe forms of IBS affecting the prognosis of IBS and subsequently the QOL and health costs.

Evidence Base Update on Behavioral Treatments for Overweight and Obesity in Children and Adolescents

ABSTRACT Objective This review provides an update to a previous Evidence Base Update addressing behavioral treatments for overweight and obesity in children and adolescents. Method Articles were identified through a systematic search of the biomedical literature in PubMed/MEDLINE (1946-), Elsevier EMBASE (1947-), SCOPUS (1823-), Clarivate Web of Science Core Collection (WOS, 1900-), PsycINFO (1800-), The Cochrane Library and Clinicaltrials.gov published between June 2014 and August 2022. Results Family-based treatment (FBT) remains a well-established treatment for overweight and obesity in children and is now well-established in adolescents and toddlers. Parent-only behavioral treatment remains well-established in children and is now well-established among adolescents and children. Possibly effective treatments continue to include FBT-parent only for adolescents, and behavioral weight loss (BWL) with a family component for adolescents, children, and toddlers. Several variations of FBT and BWL can now be considered possibly effective including FBT+motivational interviewing, FBT+social facilitation maintenance, group-based FBT, low-dose FBT, BWL+stress management, and camp-based BWL. Cognitive behavioral treatment (CBT) for adolescents also met criteria for possibly effective treatments. Current research has also established that behavioral treatments can be effectively delivered in alternative settings (e.g. primary care) and through alternative mediums (e.g. telehealth). Conclusions Research continues to support the use of multicomponent lifestyle interventions in accordance with recent recommendations from the American Academy of Pediatrics, the American Psychological Association, and the United State Preventative Services Task Force. However, more work is needed to ensure appropriate access for children with comorbid medical and psychiatric disorders and children from socially, politically, and economically marginalized groups.

Development of a body dysmorphic disorder screener for DSM-5 (BDDS-5)

Early identification of individuals with Body dysmorphic disorder (BDD) is essential to direct them to appropriate care and to reduce the chance of developing or maintaining comorbid psychiatric disorders (like an eating disorder (ED)). The present study aimed to develop a simple screener, the Body Dysmorphic Disorder Screener for DSM-5 (BDDS-5), to overcome existing screeners' limitations and test its psychometric properties.The BDDS-5 consists of 12 statements with dichotomous answer options. Specific attention is paid to the readability of the screener for those with lower reading skills. Additional eating disorder screening questions (S section) were added to investigate whether these questions are necessary for detecting potential BDD cases. Finally, the factor structure, internal consistency, and validity of the BDDS-5 were examined within populations with a high risk of screening positive for BDD or ED. Principal axis factor analysis showed that two factors accounted for 63.5% of the variance. The factor analysis was based on polychoric correlation. Based on the BDDS-5, 33 persons (14% of N = 235) were screened as likely BDD cases. Nineteen persons were excluded as potential BDD cases based on the eating disorder related question (question D). Based on the S-section, this turned out to be largely correct for the majority, however, in 8% (n = 4) of the cases BDD was probably missed. The convergent validity appeared to be high (r > 0.80) with three other BDD measures.The BDDS-5 is a valid and widely applicable screener for BDD that may help in the early detection of BDD. The BDDS-5 uses simple wording and is thus suitable for people 8 years and older.

Sexual Dysfunction in a Sample of Women Having Infertility and Its Impact on Quality of Life

Conflict of interest None of the above authors have any conflict of interest to disclose. Background Female sexual disorders are prevalent disorder which is underdiagnosed due to cultural barriers in seeking help in management, having huge impact on mental health quality of life. The studies investigating the impact of infertility on female sexual dysfunction are scarce, but they have consistently demonstrated that sexual complaints are very common among infertile women. Sometimes appropriate treatment of female sexual dysfunction can preclude the use of expensive and unnecessary treatment for infertility. This study will compare sexual dysfunction and quality of life among infertile women and fertile women. Aim of the Work To assess the female sexual function among infertile women and comorbid psychiatric disorders among infertile women. Subjects and method: This is cross sectional study, which was conducted on random sample of 168 infertile females and 167 fertile females, attending outpatient infertile clinic, and the gynaecology outpatient clinic, Ain Shams University hospital, the study started September 2017 until February 2019, all females who fulfil inclusion criteria were subjected to SCID-I, The Arabic version of (FSFI), The Arabic version of PCASEE. Results there was a statistically significant relationship between female sexual dysfunction among infertile group and fertile group, in the infertile group, 123 females (73.2%) of the infertile females did not have mental disorder and 45 females (26.7%) had mental disorder, 19 females (11.3%) of them had anxiety disorder (generalized anxiety disorder, social phobia, and panic disorder) and 26 females (15.5%) of them had major depression disorder. Conclusion There is high prevalence of female sexual dysfunction among the infertile female group, and there was strong association between infertility, sexual dysfunction and developing comorbid psychiatric disorder. Further assessments should be considered in the infertility clinic, proper documentation as well. Management should include psychotherapy, lubricants, targeted sexual-therapy and pharmacological treatment. Abbreviation SCID-I: Structured Clinical Interview for the DSM-IV Axis I Disorder; FSFI: Female sexual dysfunction index; PCASEE: Physical, cognitive, Affect, Social, economic, ego, quality of life

Circadian typologies and insomnia in individuals with internet gaming disorder comorbid with attention deficit/hyperactivity disorder

The alteration in circadian typology and insomnia were prevalent among both Individuals with IGD and those with attention deficit hyperactivity disorder (ADHD), the most comorbid psychiatric disorder of IGD. This study aimed to evaluate the relationships between circadian typologies, insomnia, and internet gaming disorder (IGD) and how ADHD affects this relationship. We recruited three groups of 69 young adults: an IGD group, a control group comprising age- and sex-matched nongamers, and a group of gamers without IGD through diagnostic interviews. The participants with IGD exhibited lower composite scale of morningness (CSM) scores and thus a higher eveningness preference In addition, the score of Pittsburgh insomnia rating scale—20-item version (PIRS_20) was significantly higher among those with IGD. The participants with IGD and ADHD exhibited lower CSM scores but higher PRIS_20 scores than the participants with IGD but without ADHD. The present findings indicate that participants with IGD exhibited a tendency of eveningness preference and experienced more severe insomnia. ADHD exacerbated the eveningness preference and insomnia of individuals with IGD. Close attention should be paid to sleep problems in individuals with IGD, particularly to those with ADHD.

Optimization of Therapy in Patients with Epilepsy and Psychiatric Comorbidities: Key Points.

Psychiatric disorder comorbidity in patients with epilepsy (PWE) is very frequent with a mean percentage prevalence of up to 50% and even higher. Such a high frequency suggests that epilepsy and psychiatric disorders might share common pathological pathways. Various aspects contribute in making the matter very complex from a therapeutic point of view. Some antiseizure medications (ASMs), namely valproic acid, carbamazepine, and lamotrigine, have mood-stabilising effects and are routinely used for the treatment of bipolar disorder in patients who do not have epilepsy. Pregabalin and, to a lesser extent, gabapentin, exerts anxiolytic effects. However, several ASMs, in particular levetiracetam, topiramate, and perampanel, may contribute to psychiatric disorders, including depression, aggressive behaviour, and even psychosis. If these ASMs are prescribed, the patient should be monitored closely. A careful selection should be made also with psychotropic drugs. Although most of these can be safely used at therapeutic doses, bupropion, some tricyclic antidepressants, maprotiline, and clozapine may alter seizure threshold and facilitate epileptic seizures. Interactions between ASMs and psychotropic medication may make it difficult to predict individual response. Pharmacokinetic interactions can be assessed with drug monitoring and are consequently much better documented than pharmacodynamic interactions. Another aspect that needs a careful evaluation is patient adherence to treatment. Prevalence of non-adherence in PWE and psychiatric comorbidities is reported to reach values even higher than 70%. A careful evaluation of all these aspects contributes in optimizing therapy with a positive impact on seizure control, psychiatric wellbeing, and quality of life.

Psychiatric Co-Morbidity in Patients Presenting with Primary Headache

Background: Headache is a common neurological disorder and most disabling conditions in the worldwide. Psychiatric disorders can occur with at least two to three-fold greater frequencies among the patients presenting with headache than among general population. The presence of psychiatric co-morbidity further complicates headache management and portends a poorer prognosis. Therefore, the present study of psychiatric co-morbidity in patients presenting with primary headache and to know the nature and extent of psychiatric co-morbidity associated with headache among the patients was undertaken. Methods: Present sample consists of 62 patients who presented with the complaints of headache to the department of Psychiatry and Neuropsychiatry from August 2016 to June 2018 was included in the study. MINI 7.0.0 was applied to elicit the presence of any Psychiatric disorder. Results: In this study 65% of the patients presenting with headache had co-morbid psychiatric disorders. Out of 65% of the psychiatric illnesses; 43.55% had MDD, 14.52% had GAD, 3.23% had Panic disorder and 3.23%had Social phobia among the patients presenting with headache. Conclusions: Patients presenting with headache have high levels of co-morbid psychiatric disorders. In view of the present findings, the management of patients presenting with headache should include the detail assessment of coexisting psychopathology and treatment of both coexisting conditions.

Population-Based Repeated Cross-Sectional Study of Hospitalizations for Comorbid Physical and Psychiatric Disorders in Young Adults in Ontario, Canada

PurposeTo measure trends in the rates and costs of hospitalizations over a 15-year period among young adults with physical and/or psychiatric disorders. MethodsThis population-based, repeated cross-sectional study identified all 18- to 26- year-olds hospitalized in Ontario, Canada from April 1, 2003 and March 31, 2018 (fiscal years 2003–2017). Using discharge diagnoses, we assigned hospitalizations to one of four categories: 1) psychiatric disorder only; 2) primary psychiatric disorder with comorbid physical illness; 3) primary physical with comorbid psychiatric disorder; and 4) physical illness only. We compared health service utilization and changes in rates of hospitalizations over time using restricted cubic spline regression. Secondary outcome measures included change in hospital costs for each hospitalization category over the study period. ResultsOf 1,076,951 hospitalizations in young adults (73.7% female), 195,726 (18.2%) had a psychiatric disorder (either primary or comorbid). There were 129,676 hospitalizations (12.0%) with psychiatric disorders only, 36,287 (3.4%) with primary psychiatric and comorbid physical disorders, 29,763 (2.8%) with primary physical and comorbid psychiatric disorders, and 881,225 (81.8%) with physical disorders only. Rates of hospitalization for psychiatric disorders only increased 81% from 4.32 to 7.84/1,000 population, and those with physical health disorders with comorbid psychiatric disorders increased 172% from 0.47 to 1.28/1,000 population. Substance-related disorders were the most common comorbid psychiatric disorders among youth hospitalized for physical illness and increased 260% from 0.9 to 3.3/1,000 population. DiscussionHospitalizations among young adults with primary and comorbid psychiatric disorders have increased significantly over the past 15 years. Health system resources should be adequately directed to meet the shifting and complex needs of hospitalized young adults.

Executive functions and psychiatric disorders in adults with iron deficiency anemia

Purpose: The focus has been on the hematological complications of iron deficiency, while the nonhematological complications have been less studied. Its effects on cognitive functions were mostly investigated in children and adolescents. The purpose of this study is to compare the executive functioning of persons with iron deficiency anemia to healthy controls in order to determine whether they have any comorbid psychiatric disorders.&#x0D; Materials and Methods: 42 patients with iron deficiency anemia and 44 healthy controls participated in this study. To investigate whether any psychiatric disorders existed, the individuals were given a Structured Clinical Interview for DSM-5 Clinician's Version. Executive functioning was assessed using the Stroop Test and the Number Sequence Learning Test.&#x0D; Results: When compared to the control group, the IDA group took longer on average to complete parts 1–5 of the Stroop Test. There was no difference between the groups with regards to the results of number sequence learning test. Psychiatric illnesses were more common (43%) in the IDA group than they were in the control group (13.6%). The difference was significant when the groups were compared in terms of psychiatric disorders.&#x0D; Conclusion: According to the study's findings, those with iron deficiency anemia have worse executive functioning scores than healthy controls and are more likely to have psychiatric disorders. An extensive assessment of the health consequences of iron deficiency anemia is extremely important.

Associations between psychiatric comorbid disorders and executive dysfunctions in hypocretin-1 deficient pediatric narcolepsy type1

Objective/BackgroundPsychiatric symptoms and cognitive deficits add significantly to impairment in academic achievement and quality of life in patients with narcolepsy. The primary aim of this study was to evaluate the prevalence of psychiatric disorders and executive dysfunctions, secondly to explore the association between psychiatric comorbidity, executive dysfunctions, subjective and objective sleep measures, and severity of cerebrospinal fluid (CSF) hypocretin-1 deficiency in pediatric narcolepsy type 1 (PNT1). Patients/MethodsCross-sectional study of 59 consecutively included PNT1 patients (age: 6-20 years; 34:25 girls: boys; 54/59 H1N1 (Pandemrix®)-vaccinated). Core narcolepsy symptoms including subjective sleepiness, polysomnography and multiple sleep latency test results, CSF hypocretin-1 levels, psychiatric disorders (by semistructured diagnostic interview Kaufmann Schedule for Affective Disorders and Schizophrenia Present and Lifetime version (KSADS)), and executive dysfunction (by Behavior Rating of Executive Function (BRIEF)) were assessed. Results52.5% of the patients had one or more psychiatric comorbid disorder, and 64.7% had executive dysfunction in a clinically relevant range, with no sex difference in prevalence, while older age was associated with poorer executive function (p=0.013). Having any psychiatric comorbid disorder was associated with poorer executive functions (p=0.001). CSF hypocretin-1 deficiency severity was significantly associated with presence of psychiatric comorbidity (p=0.022) and poorer executive functions (p=0.030), and poorer executive functions was associated with subjective sleepiness (p=0.009). ConclusionsThe high occurrence of, and association between, psychiatric comorbidity and executive dysfunction underlines the importance of close attention to both these comorbidities in clinical care of NT1.

Personal experiences of suicidality in women with gambling disorder – A qualitative interview study

AbstractBackgroundGambling disorder is associated with increased suicidality, especially in women who also are more likely to have psychiatric comorbid disorders and more often have experiences of traumatic life events. Although suicidality is increased and several risk factors have been identified, knowledge of the suicidal process is lacking, especially for women.AimTo explore the lived experiences of suicidality in women with gambling disorder and to investigate potential factors involved in the development of suicidality.MethodSemi-structured interviews were held with seven women with experiences of gambling disorder and suicidality in Malmö, Sweden between November 2021 and June 2022, when saturation was reached. Interviews were audio-recorded, transcribed, and coded in NVivo. Qualitative content analysis was used to build categories and themes.ResultsSeveral women had experienced suicidality before developing gambling disorder and gambling-related suicidality. However, for some, suicidality had appeared seemingly only due to the gambling disorder. Suicidality ranged from ideation to severe suicide attempts. Three themes of factors modulating suicidality related to gambling were found; a) guilt shame and self-stigmatization, b) loss of control/chaotic life circumstances, and c) social consequences/fear of guilt and shame from others.ConclusionMore research on the experience of suicidality in women with gambling disorder is needed. Attempts to address self-stigmatization, guilt, and shame in women with gambling disorder and society at large as well as aiding women to regain a sense of control over their economy and gambling may be ways to reduce suicidality.