Disease In Psychiatric Patients Research Articles

2868 – Comorbid psychiatric disorder and physical disorder in the elderly

Introduction With aging, the risk of many diseases increases. The prevalence of somatic diseases in psychiatric patients is high. This comorbidity is more common that the subject is old. Objectives The aim of our study was to determine the different somatic pathologies associated with various psychiatric disorders in the elderly. Patients and methods This is a retrospective study conducted in the outpatient hospital razi, involving 90 patients aged consultant during 2011. The data were collected from patient records. Results Ninety patients were found during the study period. The average age of patients was 77.5 years. The sex ratio (M / F) was 1.04. The majority of consultants had an iron status of married (51.1%) and widowed (41.1%). 63% of patients were retired and 49% of cases were low socioeconomic level. Personal psychiatric histories were found in 12% of patients consultants. 51 patients (56.6%) had somatic pathology associated with psychiatric disorders. Conclusions Elderly patients' organic disease is unknown in most cases and is a causal or aggravating the mental disorder.

Substantial skin disorders in psychiatric illness coincide with diabetes and addiction

Dermatological diseases in psychiatric patients are common; however, epidemiological data on this subject are scarce and to our knowledge integral studies of dermatological disease in psychiatric inpatients are not available yet. The aim of this study was to describe the incidence of dermatological problems in psychiatric inpatients. This study evaluates the consultations for new dermatological problems by inpatients of a general psychiatric hospital of over 700 beds during a 6-month period. A total of 255 patients consulted their physician because of a new dermatological problem. Diagnoses (n=360) included skin infections (32%), accidents (7%), decubitus ulcers (7%), complications of medical treatment (3%), auto mutilation (1%) and neoplasms of the skin (1%). Patients with skin infections were likely to have diabetes [odds ratio (OR)=3.6; 95% confidence interval (CI): 1.56-8.40]. Patients with decubitus ulcers were likely to have an addiction problem (OR=6.4; 95% CI: 1.46-28.00). Dermatitis was associated with affective disorder (OR=2.5; 95% CI: 1.12-5.43) but not with psychosis (OR=0.5; 95% CI: 0.23-0.90). Only a poor correlation existed between the length of hospital stay and skin problems. Dermatological problems are common in hospitalized psychiatric patients. Patients with diabetes mellitus are at high risk for skin infections. There are significant relationships between the psychiatric and the dermatological diagnoses. The length of the admission to a psychiatric hospital does not seem to play a major role in skin diseases.

Excess Mortality from Chronic Physical Disease in Psychiatric Patients—The Forgotten Problem

The article discusses various reports published within the issue, including one by David Lawrence and Joanne Pais on the mortality rate of mentally ill, another by Chris J. Busche and Richard Hodgson on cancer complexities, and on the incidence of chronic disorders among Canadians.

Oral lesions in patients with psychiatric disorders

Oral diseases in psychiatric patients are usually a result of bad oral hygiene and psychopharmaceutical side-effects. The aim of this study was to detect oral lesions in patients hospitalized in psychiatric institutions with the confirmed diagnosis of psychiatric illness and mood disorder with psychotic characteristics, as well as to discover the factors that can influence these oral lesions. Cross-section study consisted of 186 hospitalized patients with psychiatric disorders in the experimental group, out of whom 87 were males and 99 females. Patients were aged from 18 to 59 years, mean age 46.0 +/- 8.0 years. The control group consisted of 186 healthy persons matched for age and gender. Data on oral lesions were obtained within history and clinical examination of the oral cavity. Other medical data were collected from medical documentation. Statistical analysis was performed by Student's t-test, chi-square test and logistic regression. Dry mouth was registered in 78.5% of patients. The difference in tongue and lip lesions, burning and stinging symptoms, bruxism, facial pain, low saliva rates, halitosis, taste changes and swallowing difficulties between the patients and healthy persons was highly statistically significant (p < 0.001). Age and gender, as well as the factors of main disease, influence burning and stinging, bruxism, low saliva rates, swallowing difficulties, taste changes and facial pain of the psychiatric patients. Results imply that psychiatric patients are more frequently involved with oral lesions than healthy persons. It is necessary to organize specific preventive and educational oral health programmes with these patients, as well as with doctors who treat the basic illness.

Medical and psychiatric comorbidity in psychiatric beds in general hospitals: A cross‐sectional study in Tokyo

Although somatic diseases in psychiatric patients are increasing with the increase of the aged population, psychiatric wards in general hospitals in Japan have progressively been decreasing. The purpose of this cross-sectional study was to clarify whether psychiatric beds in general hospitals play sufficient roles in medical comorbidities of psychiatric patients or not. This was a cross-sectional study performed all over Tokyo during the 2-month period from April to May 2007. The total number of patients who require admission due to both somatic and psychiatric diseases was investigated with their demographic and clinical characteristics. The total number of patients admitted to psychiatric beds in general hospitals for the above-mentioned reason was 326, while the number of patients who could not be admitted to them despite the same reason was 88. The rate of surgical diseases in the latter group was higher than that in the former group. In the latter group, diseases requiring orthopedic surgery (22%) and abdominal surgery (22%) were the most frequent, followed by gastrointestinal and hepatic diseases (8%), and gynecological diseases (7%). Patients who had attempted suicide were included more in the latter group than in the former group. Even in the former group, general hospitals could not respond to 34% of requests for emergency admission. Psychiatric beds in general hospitals do not necessarily function for medical comorbidities in psychiatric patients, especially in severe and emergency cases. Not only the quantity but also the quality of psychiatric wards in general hospitals should be reconsidered.

Routine thyroid screening in psychiatric inpatients

AbstractRoutine thyroid screening tests are frequently ordered in psychiatric hospitals but there is no substantial evidence to justify this practice. Furthermore, there is little evidence to substantiate the belief that thyroid disease is more commonly associated with mood disorders than other psychiatric disorders. The few reports available do not take age and sex into account. The authors attempted to clarify both of these issues. A retrospective review of 3,188 psychiatric inpatient charts was conducted to determine the usefulness of routine thyroid junction tests (TFTs). While 25% of this population exhibited some abnormality in TFTs, the majority were judged insignificant. There was a 2.5% prevalence of thyroid disease and a 0.5% incidence of newly diagnosed thyroid disease based solely on screening TFTs. There was a significant relationship between mood disorders and thyroid disease with age and sex held constant. The prevalence of thyroid disease in psychiatric patients is consistent with the general population. Since there was a significant relationship between mood disorders and thyroid disease, if screening TFTs are performed, they may be most appropriate in this group. Whether routine TFTs should or should not be done on all psychiatric inpatients is not answered with this study. Depression 1:143–148 (1993). © 1993 Wiley‐Liss, Inc.

A Medical Algorithm for Detecting Physical Disease in Psychiatric Patients

An algorithm for screening psychiatric patients for physical disease was empirically derived from a comprehensive assessment of 509 patients in California's mental health system. The first 343 patients were used to develop the algorithm, and the remaining 166 were used as a test group. Calculations were made for several versions of the algorithm, and the data were compared with the diagnoses listed in the patients' admission mental health record. The algorithmic procedure was more accurate and more cost-effective than the medical evaluation procedures used by the state mental health system. When applied to the test group, the algorithm detected up to 90 percent of patients who had an active, important physical disease at a cost of $156 per patient. The mental health system had detected 58 percent of test-group patients with a disease at a cost of $230 per patient.

Incidence of somatic disease in psychiatric patients.

This study tested the hypothesis that persons with impaired psychological adaptive capacity, operationally defined by status as psychiatric patients, would demonstrate a greater incidence of somatic disease than would a control group. Four hundred and seventy one university students seen in a psychiatric out-patient clinic were compared with 480 control subjects for the incidence of thirteen categories of disease based on their medical records. Results confirm the hypothesis at appropriate statistical levels of confidence. The data support the thesis that there is a higher incidence of somatic disease in those with impaired psychological adaptive capacity rather than simply a differential body consciousness.

Dental disease in psychiatric patients.

Dental disease in psychiatric patients.