Disorders In General Population Research Articles

Low Psychological Resilience Predict the Risk for Alcohol Use Disorder in General Population: National Mental Health Survey of Korea 2021

Low Psychological Resilience Predict the Risk for Alcohol Use Disorder in General Population: National Mental Health Survey of Korea 2021

Establishing a child and adolescent mental health center in Herat, Afghanistan: a project description

ObjectiveAfghanistan has witnessed a long-lasting 4-decade armed conflict, which together with high levels of poverty and interpersonal violence, resulted in high incidence and prevalence of mental disorders in general population, including children and adolescents. Until mid-2018, there was neither mental health care facility nor a child psychiatrist in Afghanistan. Here, we report the establishment of the first children and adolescents’ mental health center (CAMHC) in Herat province of Afghanistan. MethodsIn July 2018, CAMHC was initiated at Mental Health Training Center – Herat. CAMHC was initially planned by the International Assistance Mission (IAM) and Herat Public Health Directorate; and financially supported by the Tearfund UK, the United Methodist Committee on Relief and Tearfund Australia. The target population of CAMHC was children and adolescents in Herat and neighboring provinces, healthcare professionals, staff of government and non-governmental organizations, school teachers and community leaders. ResultsA group of eight mental health professionals were trained and made the interdisciplinary board for diagnosis and management of mental disorders in children and adolescents. During the initial three-year period, 2 448 patients, including 1 264 (51.6%) boys and 1 184 (48.4%) girls, presented with mental disorders to CAMHC. Diagnosis and management of mental disorders were performed according to standard international protocols. Eighteen awareness-raising seminars were held; 2 000 leaflets, 10 000 posters, and 30 000 brochures were prepared and distributed; and two short video clips were produced and broadcast via IAM website, social media and local TV channels. A database was developed to house for project data, assessment of outcomes and reporting to stakeholders. ConclusionEstablishment of CAMHC resulted in significant achievements in diagnosis and management of mental disorders among children and adolescents, healthcare staff capacity building, and awareness-raising about mental disorders. Data obtained in CAMHC offers government, mental health professionals and the community the opportunity of improving mental health in the region.

Prevalence of Post-Traumatic Stress Disorder in General Population During COVID-19 Pandemic: An Umbrella Review and Meta-Analysis

During the COVID-19 pandemic, global populations have experienced quarantine and lockdown restrictions, adversely affecting individuals' psychological well-being. This comprehensive review aims to estimate the prevalence of Post-traumatic Stress Disorder (PTSD) within the general population amidst the COVID-19 pandemic. Employing the PRISMA guideline, the databases PubMed/Medline, Science Direct, Web of Science, Cochrane and Google Scholar were used in the data extraction process, and publications from December 2019 to 30th November 2022 were searched. A meta-analysis using the random effects model and an evaluation of heterogeneity using the I<sup>2</sup> index was performed. The initial search yielded 264 studies, from which 11 were selected for this comprehensive review after eliminating duplicates and assessing study quality. The findings revealed an overall prevalence of PTSD among the general population during the COVID-19 pandemic at 19.34% (95% CI: 16.29-22.38%; I<sup>2</sup> = 40.44%; <0.1). Subgroup analysis based on region and scale did not reveal significant differences between groups. Future research should focus on conducting additional studies to examine the long-term impact of the COVID-19 pandemic on the mental health status of the general population worldwide.

Association between Plasma Homocysteine Level and Atherogenic Index of Plasma among Hypothyroid Patients - A Case-Control Study

Introduction: Hypothyroidism is a common metabolic disorder in general population. Hypothyroidism is a commonly encountered health problem in Bangladesh and morbidity and mortality toll due to cardiovascular disease resulting from hypothyroidism is quite high. Hypothyroidism, dyslipidaemia and hyperhomocysteinemia are recognized risk factor for atherosclerosis and cardiovascular disease. Aim of the Study: The aim of this study was to evaluate the association between plasma Homocysteine level and atherogenic Index of plasma in patients with hypothyroidism. Methods: This was a case-control study and conducted in the Department of Biochemistry in cooperation with Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh during the period from January, 2012 to December, 2013. In our study, we included 60 newly diagnosed hypothyroid individuals as case and 60 euthyroid individuals as control. Result: In this study, most of the participants were female (62%) compared to male (38%) and we found the mean age of the case and control group was 34.31 ± 11.77 years and 32.42 ± 12.51 years. Mean serum homocysteine was found significantly higher in case group (19.00 ± 7.58 µmol/L) than control group (9.59 ± 1.91µmol/L).Mean AIP was found significantly higher in case (0.75 ± 0.27) than control (0.35 ± 0.20). We found 49 (81.67%) cases were within increased risk group of atherogenesis where as in control group it was 28 (46.67%).In present study, mild hyperhomocysteinemia was found in 80% cases and moderate hyperhomocysteinemia in 13.3% cases where as in control group it was 10% & 0% respectively. Conclusion: In this study, we found that total plasma homocysteine level was significantly increased in recently diagnosed hypothyroidism and was normal in control groups. We also found that hypothyroidism is associated with high atherogenic index and hyperhomocysteinemia which causes premature atherosclerosis.

Psychotic-like experiences are associated with physical disorders in general population: A cross-sectional study from the NESARC II

BackgroundPsychotic-like experiences (PLEs) constitute subthreshold symptoms of psychotic disorders, and belong to five distinct dimensions: Positive, Negative, Depressive, Mania and Disorganization. PLEs are associated with various psychiatric disorders. However, few studies examined their association with physical disorders. ObjectiveOur aims were (1) to assess the associations between various physical disorders and PLEs in a U.S. representative sample, and (2) to examine these associations according to the five dimensions of PLEs. MethodWe used data from the wave II (2004–2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-II), a large national sample representative of the US population (N = 34,653). Participants were assessed with the Alcohol Use Disorder and Associated Disabilities Interview Schedule 4. Twenty-two PLEs were examined. Lifetime prevalence and adjusted Odds-Ratio (aOR) reflecting the association of sixteen physical disorders (including notably metabolic conditions and heart diseases) with PLEs were calculated. ResultsAll studied physical disorders were associated with the presence of PLEs. Particularly the presence of any physical condition, any heart disease and diabetes were more frequent in participants with at least one PLE compared with the group without any PLE (aOR = 1.74, 95% CI = 1.62–1.87, aOR = 1.44, 95% CI = 1.33–1.55 and aOR = 1.38, 95% CI = 1.24–1.54, respectively). Almost all physical disorders were associated with the five dimensions of PLEs. ConclusionsPLEs were associated with a large range of physical disorders, with a gradual dose effect. To assess PLEs in the general population could help with the screening of subjects with physical disorders.

The association between dietary anti-oxidant quality score and psychological disorders among Iranian adults: a population-based study

ABSTRACT Objective Evidence linking relation between dietary antioxidant quality score (DAQS) and psychological disorders is limited. Therefore, this study aimed to assess relationship between DAQSs and psychological disorders including depression, anxiety and stress among Iranian adults. Methods This cross-sectional study used data on 7165 participants of the recruitment phase of Yazd Health Study (YaHS) and Taghzieh Mardom-e-Yazd Study (TAMYZ). Dietary intakes and psychological problems were evaluated using a validated semi-quantitative food frequency questionnaire and the validated Iranian version of depression, anxiety and stress scale questionnaire. DAQS was calculated for each person by summing up the assigned scores to a ratio between daily consuming each of the nutrients including vitamin A, C, E, selenium, manganese, zinc and their daily recommended intake (Score of 0 for a ratio of <2/3 and 1 for a ratio of >2/3). Eventually, association between DAQS and psychological disorders was assessed via logistic regression analysis. Results Although no significant relationship was observed between DAQS and psychological disorders in general population, a protective role was found for DAQS against anxiety only in women after adjusting history of chronic disease; age; marital status; education level; smoking status; total energy intake and physical activity level (second tertile versus first tertile: OR: 0.63, 95% CI: 0.40–0.99). However, this finding was nonsignificant after further adjustment for body mass index. Conclusion Average levels of DAQS might be related to psychological distress especially among women. However, more studies are recommended to valid the findings.

Sleep spindles in people with schizophrenia, schizoaffective disorders or bipolar disorders: a pilot study in a general population-based cohort

BackgroundSleep spindles have been involved in sleep stabilization and sleep-related memory mechanisms and their deficit emerged as possible biomarker in schizophrenia. However, whether this sleep phenotype is also present in other disorders that share psychotic symptoms remains unclear. To address this gap, we assessed sleep spindles in participants of a prospective population-based cohort who underwent psychiatric assessment (CoLaus|PsyCoLaus) and polysomnographic recording (HypnoLaus).MethodsSleep was recorded using ambulatory polysomnography in participants (N = 1037) to the PsyCoLaus study. Sleep spindle parameters were measured in people with a lifelong diagnosis of schizophrenia (SZ), schizoaffective depressive (SAD), schizoaffective manic (SAM), bipolar disorder type I (BP-I) and type II (BP-II). The associations between lifetime diagnostic status (independent variables, SZ, SAD, SAM, BPD-I, BPD-II, controls) and spindle parameters (dependent variables) including density, duration, frequency and maximum amplitude, for all (slow and fast), slow- and fast-spindle were assessed using linear mixed models. Pairwise comparisons of the different spindle parameters between the SZ group and each of the other psychiatric groups was performed using a contrast testing framework from our multiple linear mixed models.ResultsOur results showed a deficit in the density and duration of sleep spindles in people with SZ. They also indicated that participants with a diagnosis of SAD, SAM, BP-I and BP-II exhibited different sleep spindle phenotypes. Interestingly, spindle densities and frequencies were different in people with a history of manic symptoms (SAM, BP-I, and BP-II) from those without (SZ, SAD).ConclusionsAlthough carried out on a very small number of participants due to the low prevalence of these disorders in general population, this pilot study brought new elements that argued in favor of a deficit of sleep spindles density and duration in people with schizophrenia. In addition, while we could expect a gradual change in intensity of the same sleep spindle parameters through psychotic diagnoses, our results seem to indicate a more complex situation in which the frequency of sleep spindles might be more impacted by diagnoses including a history of mania or hypomania. Further studies with a larger number of participants are required to confirm these effects.

Positive Predictive Value: A Clinician's Guide to Avoid Misinterpreting the Results of Screening Tests.

Background: Recent studies have used self-administered screening scales in community and clinical samples to identify individuals who probably or likely had the disorder of interest. A better understanding of the statistics of screening, specifically positive predictive value, would indicate that the conclusions drawn from these studies are not justified.Methods: The principles and statistics of diagnostic screening and how screening is distinguished from case-finding are reviewed, followed by a review of studies that have failed to consider the positive predictive value of the screening scales in the samples studied.Results: Multiple studies of both clinical and general population samples have used screening measures as case-finding instruments. For example, two recent studies of response to electroconvulsive therapy in depressed patients used a screening scale for borderline personality disorder (BPD) and concluded that the patients with and without BPD responded equally well to treatment. However, the positive predictive value of the screening scale in these studies was less than 50%, meaning the majority of patients considered to have BPD would not have been so diagnosed if interviewed. A similar problem has also been observed in studies using screening scales for bipolar disorder in general population and primary care settings.Conclusions: When studying a disorder with a relatively low prevalence, it is near impossible for a screening test to have sufficient positive predictive value to be used to validly compare the individuals who do and do not screen positive. Researchers using screening measures as diagnostic proxies need to discuss the issue of positive predictive value.

Genome-wide association study of posttraumatic stress disorder among childhood cancer survivors: results from the Childhood Cancer Survivor Study and the St. Jude Lifetime Cohort

Genetic influence shapes who develops posttraumatic stress disorder (PTSD) after traumatic events. However, the genetic variants identified for PTSD may in fact be associated with traumatic exposures (e.g., interpersonal violence), which appear heritable as well. Childhood cancer survivors (CCS) are at risk for PTSD, but genetic influences affecting cancer are unlikely to overlap with those affecting PTSD. This offers a unique opportunity to identify variants specific to PTSD risk. In a genome-wide association study (GWAS), 3984 5-year survivors of childhood cancer of European-ancestry from the Childhood Cancer Survivor Study (CCSS) were evaluated for discovery and 1467 survivors from the St. Jude Lifetime (SJLIFE) cohort for replication. Childhood cancer-related PTSD symptoms were assessed using the Posttraumatic Stress Diagnostic Scale in CCSS. GWAS was performed in CCSS using logistic regression and lead markers were replicated/meta-analyzed using SJLIFE. Cross-associations of identified loci were examined between CCS and the general population. PTSD criteria were met for 671 participants in CCSS and 161 in SJLIFE. Locus 10q26.3 was significantly associated with PTSD (rs34713356, functionally mapped to ECHS1, P = 1.36 × 10–8, OR 1.57), and was replicated in SJLIFE (P = 0.047, OR 1.37). Variants in locus 6q24.3-q25.1 reached marginal significance (rs9390543, SASH1, P = 3.56 × 10–6, OR 0.75) in CCSS and significance when meta-analyzing with SJLIFE (P = 2.02 × 10–8, OR 0.75). Both loci were exclusively associated with PTSD in CCS rather than PTSD/stress-related disorders in general population (P-for-heterogeneity < 5 × 10–6). Our CCS findings support the role of genetic variation in PTSD development and may provide implications for understanding PTSD heterogeneity.

Frequency of neuropathic pain in patients with shoulder pain.

Shoulder pain is one of the most common musculoskeletal disorders in general population. Although shoulder pain is completely resolved within one year after treatment in more patients, persistent pain is observed in remaining patients. Neuropathic pain may play a role in persistent shoulder pain in some patients. The aim of the study was to investigate the neuropathic pain component in patients with shoulder pain. 49 patients with shoulder pain were enrolled in this study. The Pain-Detect questionnaire was used to determine the presence of neuropathic pain. Visual analogue scale (VAS) was used to evaluate shoulder pain. Quick Disabilities of the Arm, Shoulder and Hand (Quick-Dash) was used to determine to measure physical function and symptoms. The neuropathic pain component in patients with shoulder pain was 20% and possible neuropathic pain was 19% according to Pain-Detect questionnaire. The mean VAS score, Quick-Dash score and symptom duration were significantly higher in the neuropathic pain group. The patients with shoulder pain have a neuropathic pain component. We suggest that neuropathic pain should be assessed when prescribing treatment programs in patients with shoulder pain.

A systematic review of the relationship between emotional intelligence and diabetes management

IntroductionDiabetes has been associated to affective disorders and mental health problems which complicate the management of the disease. Emotional intelligence (EI), or the ability to perceive, facilitate, understand and regulate emotions has shown to be a protective factor of emotional disorders in general population.ObjectivesTo evaluate the role of EI and EI training in the biological and psychological variables related to people with Type 1 and 2 diabetes.MethodsA systematic review was conducted in PubMed and Scopus database without time limitations, for studies examining the link between diabetes and EI. A total of 11 eligible studies were selected according to the inclusion criteria.ResultsWe divided the results into four sections: 1) EI and HbA1c, 2) EI training effects, 3) Differences in EI between persons with diabetes and without diabetes, and 4) EI and psychological adjustment and well-being. The results showed negative correlations between EI and HbA1C, positive effects of EI training on quality of life, anxiety and glycaemic control, no differences in EI between people with diabetes and healthy individuals and, finally, negative correlations between EI and different psychological variables such as diabetes-related anxiety and distress, and positive correlations with quality of life, well-being and marital satisfaction.ConclusionsEI appear to be a promising protective factor for biological and psychological variables in individuals with diabetes. This systematic review offers a starting point for a theoretical and practical understanding of the role played by EI in the management of diabetes. Limitation and future lines of investigations will be discussed.DisclosureNo significant relationships.

STUDY OF GENERALISED ANXIETY DISORDER AND FACTORS AFFECTING IT DURING POSTNATAL PERIOD.

ABSTRACT&#x0D;  &#x0D; Background: Anxiety disorders remain the commonest mental disorder in general population. Both these disorders are common in pregnant women and postpartum period and are underdiagnosed. There is a paucity of research on mental disorders and their risk factors among women during postnatal period in India. This study aims to estimate the incidence of generalised anxiety disorder (GAD) and depression and explore the common associated factors among postnatal women in India.&#x0D; Aim: The present study aims to study the incidence and risk factors of generalised anxiety disorders among mothers attending the outpatient department clinic (OPD) for vaccination of their children or gynaecology OPD for follow up.&#x0D; Methods: Total of 180 women of postpartum period, up to 6 months, was randomly selected and assessed using self-report questionnaire GAD-7 for GAD. General demographic details were obtained via a revalidated proforma. Incidence and risk factors for both these mental disorders were assessed.&#x0D; Results: The incidence of GAD was found to be 31.11%. Primigravida mothers scored higher on GAD-7 score than multigravida mothers and incidence of GAD was also higher in primigravidas mothers (p=0.042). There was no significant association between age of mother, socioeconomic status of mother, and sex of the child born, with development of GAD in the postnatal period. Substance abuse in husband was significantly related to development of GAD in women in postnatal period.&#x0D; Conclusion: A significant proportion of women had generalised anxiety disorder. Pregnancy for the first time was associated with increased risk of GAD. Substance abuse by husband is significantly associated with development of GAD and depression during postnatal period.

Psychiatric morbidity in the parents of children with Attention Deficit Hyperactivity Disorder

Background: Attention deficit hyperactivity disorder (ADHD) is one of the most common mental disorders of childhood and adolescence. It is a chronic and pervasive condition characterized by developmental deficiencies in sustained attention, impulse control, and the regulation of motor activity in response to situational demands. Parents may find it difficult in dealing with behavioral problems of ADHD children. Some studies have shown that parents of ADHD children display substantial psychiatric morbidity in the form of depression and anxiety. Aim : The aim of current study was to examine psychiatric morbidity in parents of children with ADHD. Methods: Thirty parents of children with ADHD were screened for psychological distress over the last week by applying GHQ-12. Those parents who had score of ≥2 on GHQ-12 and/or history of substance use were subjected to SCAN based clinical interview which evaluated psychiatric morbidity in the parents. Results: The results of this study suggest that 46.67% of parents of children with ADHD had presence of a psychiatric diagnosis in which the majority (26.67%) of them had depressive disorder which is several times higher when compared to general population. With respect to substance use diagnosis, 26 % of parents of children with ADHD had substance use diagnosis which is similar to prevalence of substance use disorder in general population. Conclusions: In our study, psychiatric disorder is seen in atleast half of the parents of children with ADHD which suggests that there is need for early assessment and management of psychiatric  problems in parents of children with ADHD.

Incidence and Direct Medical Cost of Adjustment Disorder and in Korea Using National Health Insurance Service Claims Data From 2011 to 2017.

ObjectiveWe aimed to investigate the annual incidence and direct medical cost of adjustment disorder in general population using the National Health Insurance Service Database (NHID) in Korea. MethodsTo examine the incidence, we selected patients who had at least one medical claim for adjustment disorder and had not been diagnosed in the previous 365 days, from 2010 to 2017. ResultsThe number of newly diagnosed cases of adjustment disorder from 2011 to 2017 were total 101,922. Annual incidence of adjustment disorder was ranged from 22.0 to 36.8 per 100,000 persons. The incidence of adjustment disorder was found more in female and highest among 70–79 years of age group and medical aid beneficiaries group. Annual prevalence of adjustment disorder was in the range from 95.4 to 116.4 per 100,000 persons. Estimated annual medical cost per person of adjustment disorder was ranged from 162 to 231.4 US dollars.ConclusionFrom 2011 to 2017, the annual incidence and direct medical cost of adjustment disorder in Korea were increased. Proper information on adjustment disorder will not only allows us to accumulate more knowledge but also lead to more appropriate therapeutic interventions.

An epidemiological survey of mental disorders 5years after the Lushan earthquake in Ya'an, China.

This study aimed to (1) explore the prevalence and relevant influencing factors of different mental disorders 5years after the Lushan earthquake in Ya'an, China. An epidemiological mental health survey was conducted to identify the prevalence of mental disorders in general population in Ya'an. A multi-stage, group-matching random sampling method was adopted. Face-to-face interviews were done with a two-stage design by trained interviewers and psychiatrists. The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) was used for the diagnosis. There were 8876 participants who were interviewed in this study. The total 12-month and lifetime prevalence of all mental disorders were 12.5% and 14.7%, respectively. There was a significant difference between males and females in the prevalence patterns of several mental disorders. Han ethnic group had higher prevalence of anxiety disorders (2.7%), and the Tibetan group had higher prevalence of alcohol-related disorders (5.0%). Logistic regression analysis showed that the areas severely affected by the earthquake had significantly higher prevalence of depressive disorders, and the extremely severe affected areas had significantly higher prevalence of trauma- and stressor-related disorders. Our findings show that the prevalence of a range of mental disorders 5years after the earthquake in Ya'an are high, and the prevalence of depressive and trauma- and stressor-related disorders may be influenced differently by the various severity of earthquake impact. This study may be crucial for the health policy-making, cultural-specific mental health services and long-term mental recovery after the earthquake.

Neural correlates of polygenic risk score for autism spectrum disorders in general population.

Autism spectrum disorder is a highly prevalent and highly heritable neurodevelopmental condition, but studies have mostly taken traditional categorical diagnosis approach (yes/no for autism spectrum disorder). In contrast, an emerging notion suggests a continuum model of autism spectrum disorder with a normal distribution of autistic tendencies in the general population, where a full diagnosis is at the severe tail of the distribution. We set out to investigate such a viewpoint by investigating the interaction of polygenic risk scores for autism spectrum disorder and Age2 on neuroimaging measures (cortical thickness and white matter connectivity) in a general population (n = 391, with age ranging from 3 to 21 years from the Pediatric Imaging, Neurocognition and Genetics study). We observed that children with higher polygenic risk for autism spectrum disorder exhibited greater cortical thickness for a large age span starting from 3 years up to ∼14 years in several cortical regions localized in bilateral precentral gyri and the left hemispheric postcentral gyrus and precuneus. In an independent case–control dataset from the Autism Brain Imaging Data Exchange (n = 560), we observed a similar pattern: children with autism spectrum disorder exhibited greater cortical thickness starting from 6 years onwards till ∼14 years in wide-spread cortical regions including (the ones identified using the general population). We also observed statistically significant regional overlap between the two maps, suggesting that some of the cortical abnormalities associated with autism spectrum disorder overlapped with brain changes associated with genetic vulnerability for autism spectrum disorder in healthy individuals. Lastly, we observed that white matter connectivity between the frontal and parietal regions showed significant association with polygenic risk for autism spectrum disorder, indicating that not only the brain structure, but the white matter connectivity might also show a predisposition for the risk of autism spectrum disorder. Our findings showed that the fronto-parietal thickness and connectivity are dimensionally related to genetic risk for autism spectrum disorder in general population and are also part of the cortical abnormalities associated with autism spectrum disorder. This highlights the necessity of considering continuum models in studying the aetiology of autism spectrum disorder using polygenic risk scores and multimodal neuroimaging.

Knowledge assessment among caregivers about various allergic disorders in a hospital-based pediatric outpatient department in North India

CONTEXT: Various types of allergic disorders are increasing worldwide. The diagnostic and treatment facilities are limited compared to their vast magnitude. Lack of awareness among caregivers and beneficiaries could be one of the critical factors for inadequate management especially in developing countries. AIM: This study aims to evaluate the knowledge among caregivers about various allergic disorders in a pediatric setup. SUBJECTS AND METHODS: Caregivers of children, presenting for their illness at pediatric outpatient department of a tertiary care hospital of North India, were recruited over 6 months' period using a 22-item prevalidated questionnaire. STATISTICAL ANALYSIS USED: Sigma Plot Software version 12. RESULTS: Among the 1000 participants, majority (94%) had some knowledge about allergy. Doctors were major source (55%) of information. More than half (53%) believed it to be contagious. House dust (70%) and food additives (24%) were considered major allergens. Seasonal variations (54%) and environmental pollution (48%) were considered the most common aggravating factors while steam inhalation (14%), yoga (11%), and air purifiers (10%) helped in symptom reduction. Skin and respiratory symptoms were a common knowledge amongst many study participants. Only 8% were aware about skin tests for allergy diagnosis. Alternative medicine was the treatment of choice among two-third of people. Oral route was preferred over inhaled medicines. CONCLUSION: The current study highlights limited knowledge and existence of misconceptions regarding allergic disorders in general population necessitating the need to improvise awareness campaigns.

Burden of Illness Due to Fibromyalgia in a Neurology Clinic.

Background  Fibromyalgia (FM) is a common disorder in general population and it causes an increased patient load in hospitals and specialty clinics. FM attendance will be high in clinics dealing with neuropathic pain and other pain syndromes. Though prevalence of FM has been studied in community and pain clinics in other countries, it has not so far been studied in India. So, a study is relevant and hence it was planned in neurology clinic of a teaching government hospital. At present, they are treated mainly by nonsteroidal anti-inflammatory drugs (NSAIDs) which are public health hazard. Methods  Using 2016 revision of 2010/2011 American College of Rheumatology criteria of FM, patients were screened in neurology OPD. Proportion and clinical profile were noted. Study was continued for 6 months till the sample size was met. Results  A total of 2,300 patients were screened. Two hundred and ninety-eight FM patients were identified among them. Proportion was 12.96%. Delayed diagnosis of more than a year occurred in 55%. Only 29.2% were treated, but none was offered cognitive behavioral therapy (CBT) before. NSAIDs for pain were given for 51.01%. Conclusion  Proportion of FM detected is considerable. Affection of homemakers and manual laborers, delayed diagnosis, coexisting comorbid illness, and treatment of pain with NSAIDs are causes of concern. Clinicians should be sensitized to clinical profile and criteria of FM. Patients should be diagnosed and treated by CBT at the earliest and NSAIDs should be avoided as far as possible.

Depression in Relation to Serum Ferritin a Cross-sectional Study at Najaf Governorate

depression is a common psychiatric disorder that leads to disability and increases morbidity and mortality, and iron deficiency is a common nutritional disorder in general population that lead to change in brain function and affecting the quality of life. Methodology; a cross-sectional study that was conducted at Iraq Al-Najaf governorate, patient with depression was (51), and control group was (95), both were assessed by Beck depressive inventory Arabic version for the scoring of depressive symptoms, for both group serum ferritin was evaluated from fasting blood sample. Result; The age of participants (mean=36.25 years), the male was (55) while the female (91), of them (88) were married, there is significant differences between groups in age group (36-45) years and female gender while not to another variable. serum ferritin was significantly deferent with P-value (0.001). Conclusion; there is a strong relationship between the level of serum ferritin and depression with inverse correlation.

Sleep Disordered Breathing in Hospitalized African-Americans

RationaleSleep-disordered breathing (SDB) is a common disorder in general population, with higher prevalence in population with comorbid cardiovascular disease, and yet it remains frequently undiagnosed. Prior published data show that hospitalized obese patients have a high incidence of unrecognized SDB. However, limited data exists on the incidence, prevalence, and impact of SDB in hospitalized obese African-American (AA) patients. This study was performed to better understand the burden of undiagnosed SDB in hospitalized AA patients and its implications on readmission. MethodsA total of 1243 consecutive obese AA patients admitted to medical or telemetry service were screened utilizing a screening questionnaire (STOP/STOPBANG) from October 2016 to October 2017. If the results of the screening questionnaire were positive, the patients were offered inpatient testing with either High Resolution Pulse Oximetry (HRPO), or a type 3 portable monitor (PM). SDB was suspected if the Oxygen Desaturation Index (ODI) or Apnea Hypopnea Index (AHI) ≥ 5. We collected 30-day readmission and emergency department (ED) visit data on all patients and requested a formal outpatient sleep study for patients identified as SDB positive. ResultsOf the 1243 AA patients screened, 852 (68.5%) patients screened positive for SDB. Of these high-risk screens, 538 (63.1%) patients underwent inpatient testing with either High Resolution Pulse Oximetry (HRPO) or PM. Of these 538 patients, 319 (59.3%) were found to have suspected obstructive sleep apnea (OSA) based on ODI/AHI >5. Mild SDB (AHI 5–14) was present in 149 (46.7%) patients; moderate (AHI 15–29) in 74 (23.2%) patients; and severe (AHI >30) in 96 (30.1%) patients. The patients with suspected SDB were educated and encouraged to get an out-patient polysomnogram (PSG) but only 32 (10.0%) returned to undergo a formal PSG. The 30-day readmission rate/ED visits for patient with SDB was 13.5% compared to 13.7% of patients without SDB. ConclusionThis is the largest SDB registry that included obese hospitalized AA patients in a tertiary care academic center and reveals a high prevalence of undiagnosed SDB in this cohort. Despite proactive screening and patient education only 3.8% (32/852) of patients returned post-discharge for formal polysomnography. The presence of SDB did not impact the 30-day readmission rate/ED visit rate in this cohort.