DSM-IV Disorders Research Articles

The association between psychotic experiences and health-related quality of life: a cross-national analysis based on World Mental Health Surveys

Psychotic experiences (PEs) are associated with a range of mental and physical disorders, and disability, but little is known about the association between PEs and aspects of health-related quality of life (HRQoL). We aimed to investigate the association between PEs and five HRQoL indicators with various adjustments. Using data from the WHO World Mental Health surveys (n = 33,370 adult respondents from 19 countries), we assessed for PEs and five HRQoL indicators (self-rated physical or mental health, perceived level of stigma (embarrassment and discrimination), and social network burden). Logistic regression models that adjusted for socio-demographic characteristics, 21 DSM-IV mental disorders, and 14 general medical conditions were used to investigate the associations between the variables of interest. We also investigated dose-response relationships between PE-related metrics (number of types and frequency of episodes) and the HRQoL indicators. Those with a history of PEs had increased odds of poor perceived mental (OR = 1.5, 95% CI = 1.2–1.9) and physical health (OR = 1.3, 95% CI = 1.0–1.7) after adjustment for the presence of any mental or general medical conditions. Higher levels of perceived stigma and social network burden were also associated with PEs in the adjusted models. Dose-response associations between PE type and frequency metrics and subjective physical and mental health were non-significant, except those with more PE types had increased odds of reporting higher discrimination (OR = 2.2, 95% CI = 1.3–3.5). Our findings provide novel insights into how those with PEs perceive their health status.

Sympathetic activation in chronic anxiety: not just at the "height" of stress. Editorial Focus on "Relative burst amplitude of muscle sympathetic nerve activity is an indicator of altered sympathetic outflow in chronic anxiety".

Sympathetic activation in chronic anxiety: not just at the "height" of stress. Editorial Focus on "Relative burst amplitude of muscle sympathetic nerve activity is an indicator of altered sympathetic outflow in chronic anxiety".

Bidirectional Relationship Between Methamphetamine Use and Positive Psychotic Symptoms in Regular Methamphetamine Users: Evidence From a Prospective Cohort Study

Background: Methamphetamine (MA) use is a major public health concern worldwide. MA has been causally associated with positive psychotic symptoms, but research is yet to determine if the reverse also occurs. This study prospectively determined whether the relationship between MA use and positive psychotic symptoms is bidirectional. impact of lifetime psychotic disorders and MA dependence on these relationships was also examined. Methods: This 12-month prospective study recruited a cohort of 201 regular (at least monthly use) primary MA users from free needle syringe programs in three Australian cities. Data on the frequency of MA use (Timeline Followback) and the severity of positive psychotic symptoms (Brief Psychiatric Rating Scale subscale) in the past 2 weeks were collected in 12 contiguous monthly face-to-face interviews. Diagnoses were derived using the Psychiatric Research Interview for DSM-IV Substance and Mental Disorders. Outcomes: Participants had a mean age of 31.71 years (SD=8.10) and 38% (n=77) were female. At baseline 55% (n=110) were dependent on MA and 51% (n=101) had a lifetime psychotic disorder, comprised of 23% (n=23) primary and 77% (n=79) substance-induced psychotic disorders. Participants completed a mean of 9.14 (SD=3.16) out of the 11 follow up interviews were completed, 52% (n=104) completed all 11 interviews. Cross-lagged dynamic panel models were used to simultaneously test whether psychotic symptoms predicted higher levels of MA use in the next wave; and higher MA use predicted psychotic symptoms in the same next wave. This indicated there was a significant bidirectional relationship between psychotic symptoms and MA use (CFI = 0.94, RMSEA = 0.05 (95% CI = 0.04, 0.06). magnitude of the relationship in each direction was similar, indicating neither direction predominated. This bidirectional relationship was found, regardless of whether participants had MA dependence or a lifetime psychotic disorder. Interpretation: A bidirectional relationship between MA use and psychotic symptoms, of similar magnitude in each direction was found over one year. This highlights the dynamic and reciprocal nature of the relationship between MA and psychotic symptoms among MA users, and suggests integrated treatments that simultaneously target both of these variables may be of most benefit. Funding Statement: This project was funded by an Australian National Health and Medical Research Council (NHMRC) Project Grant (APP326220). Leanne Hides and Maree Teesson are supported by NHMRC Senior Research and Principal Research Fellowships. Gary Chan and Rebecca McKetin are supported by University of Queensland and Curtin University Research Fellowships. Declaration of Interests: authors state: The authors have no conflicts of interest. Ethics Approval Statement: This project was approved by the relevant ethics review board and all participant provided written informed consent after receiving a description of the study.

Long-term incidence and recurrence of common mental disorders after abortion. A Dutch prospective cohort study

In a previous study (Van Ditzhuijzen et al., 2017) we investigated the incidence and recurrence of mental disorders 2.5 to 3 years post-abortion. The aim of the current study was to extend these findings with longer term follow up data, up until 5–6 years post-abortion. We compared data of women who had had an abortion of the Dutch Abortion and Mental Health Study (DAMHS) to women who did not have an abortion from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2) (Ntotal = 2227). We used 1-to-1 matching on background confounding variables and measured post-abortion incidence and recurrence of common DSM-IV mental disorders (mood, anxiety, and substance use disorders) using the Composite International Diagnostic Interview (CIDI) version 3.0. After matching on confounding variables, abortion did not increase the likelihood that women had incident or recurrent mental disorders in the 5–6 years post-abortion (any incident mental disorder: OR = 3.66, p = .16; any recurrent mental disorder: OR = 0.22, p = .47). We found no evidence that experiencing an abortion increases the risk on new or recurrent mental disorders on the longer term.

F172. INDIVIDUAL PREDICTION OF RISK IN ADOLESCENT OFFSPRING OF PARENTS WITH SCHIZOPHRENIA OR BIPOLAR DISORDER: A MACHINE LEARNING NEUROIMAGING STUDY WITH A CROSS-STAGE VALIDATION

BackgroundSchizophrenia (SZ) and bipolar disorder (BD) are severe psychiatric disorders that are not easily distinguishable based on clinical measures. Offspring of patients with SZ or BD have a tenfold increased risk of developing the disorder as well as an increased risk for other severe mental disorders. Reliable identification of these subjects might allow for early recognition and intervention, which have been shown to be beneficial for treatment outcome and may even prevent transition to illness. Based on abundant evidence that SZ and BD are associated with structural brain abnormalities, we investigated whether MRI brain-scans can be used to detect individual risk of developing SZ or BD in adolescents.MethodsStructural MRI brain-scans were acquired in adolescent offspring (8–19 year) of parents with schizophrenia (oSZ;N=50), bipolar disorder (oBD;N=82), and without a mood or psychotic DSM-IV disorder (oHC;N=53), as part of the Dutch Bipolar and Schizophrenia Offspring Study (DBSOS). Support vector machine (SVM) models were trained on the gray matter tissue density maps to predict to which offspring class (oHC/oBD/oSZ) an individual belonged. Prediction accuracy was assessed using cross-validation. To validate our prediction models, we applied them to the tissue maps from subjects from a sample of unrelated HC/BD/SZ adults. Secondly, validated prediction models built from the adult subjects’ MRI scans were applied to the tissue maps of the adolescents to predict illness class (HC/BD/SZ).ResultsThe offspring-based model separated oHC/oSZ individuals with 77% accuracy (p<0.001), oHC/oBD with 68% accuracy (p<0.001), and oBD/oSZ with 64% accuracy (p<0.01). The adult-based models could separate the patients’ offspring from the healthy offspring with 66–70% accuracy, but oBD from oSZ with lower accuracy (59%). In addition, the offspring models could separate adult patients from control subjects with comparable accuracy (66–68%) and separate the two patient groups with moderate accuracy (69%).DiscussionThe familial high-risk adolescents could be separated from controls with moderate to high accuracy (up to 77%), based on their MRI-scans. Moreover, the brain tissue patterns based on risk (adolescents) or illness (adults) were able to predict (risk) class in the other stage group. These results show (1) that high-risk individuals already show brain abnormalities, and (2) display similarities with abnormalities in ill adults, and (3) which can be used to detect (risk of) the disorder at the individual level. This suggests that MRI-scans, after further improvement and independent validation, may be of added value in the risk profiling of BD and SZ.

S29. CONCORDANCE BETWEEN SELF-REPORT AT INTERVIEW-BASED RATINGS OF PSYCHOTIC EXPERIENCES IN PRE-ADOLESCENCE AND ASSOCIATED PSYCHOPATHOLOGY

BackgroundSelf-report measures are often used to assess psychotic experiences (PE) in large-scale epidemiological samples, and have contributed substantially to our knowledge on PE. However, different self-report PE (PE-S) measures have yielded particularly wide-spread prevalence-estimates of PE ranging from 21–66 % in 7–13 year old children, whereas interview based measures of PE (PE-I) vary less (10 -23 %). Especially PE-S have been criticized for being over-inclusive and not capturing the essence of low-grade psychosis. The current study is the first large-scale study to examine the psychometric properties of a PE-S measure in children, and the first to compare the clinical correlates of PE-S and PE-I in the same sample.MethodsAs part of the general population Copenhagen Child Cohort 2000 studies, 1571 children aged 11–12 years were independently assessed for both PE-I and PE-S. PE-I were assessed by trained professionals with 22 items on hallucinations and delusions from the Kiddie Schedule for Affective Disorders and Schizophrenia present and life-time version (Kiddie-SADS-PL). PE-S were assessed by 10 questions covering hallucinations, delusions and subjective thought disturbances ever in life, forming a new section of the diagnostic interview, the Development and Well Being Questionnaire (DAWBA).We assessed the psychometric properties of PE-S, using PE-I as the “gold-standard”. We analyzed the association between PE-S and emotional and neurodevelopmental DSM-IV disorders of the child as well as a history of psychotic disorders in 1st degree family members. Both have previously been examined in previous studies of the current cohort, and were significantly associated with PE-I.ResultsThe prevalence of PE-S was higher compared to PE-I, 28.1% and 10.2% respectively. The predictive values of any type of PE-S for any PE-I were: sensitivity = 73.8%, specificity = 77.1%, positive predictive value = 26.8% and negative predictive value = 96.3%.The association between PE and mental health disorders and a family history of psychotic disorders yielded slightly lower odds ratios (OR) for PE-S compared to PE-I. However, the associations remained statistically significant and had overlapping confidence intervals: For any emotional or neurodevelopmental DSM-IV disorder: PE-I OR 3.3 (CI95% 2.3–4.8) and PE-S OR 2.7 (CI95% 2.1–3.6), for a 1st degree family history of psychotic disorder; PE-I OR 4.9 (CI95% 1.9–12.5) and PE-S OR 2.6 (CI95% 1.1–6.3).DiscussionPE-S were almost 3 times more likely to be reported, compared to observer-rated PE-I. However, the associations with unfavorable clinical correlates were only slightly attenuated for PE-S when compared to PE-I. The study confirmed that PE-S are clinically relevant, and the DAWBA-section proved valuable as a screening tool for PE in the pre-adolescent general population.

Error-related brain activity in pediatric anxiety disorders remains elevated following individual therapy: a randomized clinical trial.

Anxiety disorders are associated with an overactive action monitoring system as indexed by a larger error-related negativity (ERN). This study tests whether ERN magnitude changes following treatment, predicts response to treatment, and varies by treatment type. The sample included 130 youth (9-14years): youth with an anxiety disorder (ANX; n=100) and healthy control (HC; n=30) youth with no lifetime DSM-IV disorders. ANX youth were randomized to either a manualized cognitive-behavior therapy (CBT) or a comparison child-centered therapy (CCT). The ERN was assessed before and after 16 sessions of treatment and within a comparable interval for HC. Subjective ratings about making errors on the task were obtained following each testing session. The ClinicalTrials.gov identifier is NCT00774150. The ERN was larger in ANX than HC youth but ERN magnitude did not significantly change following treatment in the ANX youth, regardless of treatment type, and baseline ERN did not predict treatment response. Post-task ratings revealed that ANX youth worried more about task performance feedback than HC. Like the ERN, mean ratings did not significantly change following treatment. However, these ratings were not correlated with ERN amplitude. Findings of greater ERN in pediatric anxiety disorders are replicated in a larger sample. More importantly, findings from this randomized control trial show that a larger ERN and feeling worried about performance feedback remain unchanged following treatment and are unrelated to treatment response. Such findings suggest that action monitoring systems remain overactive in anxious youth treated with psychotherapy, suggesting the need for future investigation of whether novel complimentary cognitive and emotional training programs can modify these systems would be warranted.

Co-occurring internalizing and externalizing psychopathology in childhood and adolescence: a network approach

The network approach suggests that psychopathology arises from complex associations between symptoms and may offer insight into the mechanisms that underpin psychiatric comorbidities. The transition from childhood to adolescence is a key period in the development of psychopathology, yet has rarely been considered from a network perspective. As such, the present study examined the network structure of internalizing and externalizing psychopathology from middle childhood through adolescence using data from the Avon Longitudinal Study of Parents and Children (ALSPAC; n = 4405). Eight DSM-IV disorders were assessed using maternal reports when children were aged 7.5, 10.5 and 14 years. Weighted, undirected networks were estimated and the relative importance of each node was assessed using three common measures of node centrality; strength, betweenness, and closeness. A consistent network structure emerged at all three time points; nodes clustered together in two regions of space broadly reflecting the internalizing and externalizing spectra. Permutation tests supported structural invariance across this developmental period. These spectra were bridged by numerous disorder-level interactions, the most consistent of which was between depression and oppositional defiant disorder (ODD). Furthermore, inspection of the centrality indices indicated that generalised anxiety disorder and ODD were the most central disorders in the networks. These findings demonstrate that symptom/disorder-level interplay and reciprocal influence are plausible mechanisms for the association between internalizing and externalizing psychopathology in childhood/adolescence.

Bridging the Canyon of Stigma

Bridging the Canyon of Stigma

Comparing men and women with binge-eating disorder and co-morbid obesity.

This study examined differences in clinical presentation of men and women with binge-eating disorder (BED) who participated in treatment research at a medical-school based program. Participants were 682 adults (n = 182 men, n = 500 women) with DSM-IV-defined BED. Doctoral-level research clinicians assessed eating-disorder psychopathology, including BED diagnosis, using the Structured Clinical Interview for DSM-IV Disorders (SCID) and Eating Disorder Examination (EDE) interview. Research clinicians measured height and weight and participants completed a battery of established self-report measures. Men had significantly higher body mass index (BMI) than women; women had significantly higher eating-disorder psychopathology (EDE scales and global score) and depression than men. Differences in eating-disorder psychopathology and depression remained higher for women than men after adjusting for race/ethnicity and BMI. Frequency of binge-eating episodes, subjective binge-eating episodes, and overeating episodes did not differ significantly by sex. Women had younger ages of onset for dieting and binge-eating behaviors than men but ages of onset for obesity and BED did not significantly differ between men and women. There are some sex differences in clinical presentation and age-of-onset timeline of adults with BED. Men and women develop obesity and BED (at diagnostic threshold) around the same age but women begin dieting and binge-eating behaviors earlier than men. At presentation for treatment for BED, men and women did not differ in binge-eating frequency and although men and women differed significantly on BMI and eating-disorder psychopathology, the magnitude of these differences was quite modest.

Obsessive-compulsive disorder and the risk of subsequent mental disorders: A community study of adolescents and young adults.

Comorbidity of obsessive-compulsive disorder (OCD) with other mental disorders has been demonstrated repeatedly. Few longitudinal studies, however, have evaluated the temporal association of prior OCD and subsequent mental disorders across the age period of highest risk for first onset of mental disorders. We examined associations between prior OCD and a broad range of subsequent mental disorders and simulated proportions of new onsets of mental disorders that could potentially be attributed to prior OCD, assuming a causal relationship. Data from 3,021 14- to 24-year-old community subjects were prospectively collected for up to 10 years. DSM-IV OCD and other DSM-IV mental disorders were assessed with the Munich-Composite International Diagnostic Interview. We used adjusted time-dependent proportional hazard models to estimate the temporal associations of prior OCD with subsequent mental disorders. Prior OCD was associated with an increased risk of bipolar disorders (BIP; [hazard ratio, HR=6.9, 95% confidence interval, CI, (2.8,17.3)], bulimia nervosa [HR=6.8 (1.3,36.6)], dysthymia [HR=4.4 (2.1,9.0)], generalized anxiety disorder (GAD; [HR=3.4 (1.1,10.9)], and social phobia [HR=2.9 (1.1,7.7)]). Of these outcome disorders, between 65 and 85% could be attributed to OCD in the exposed group, whereas between 1.5 and 7.7% could be attributed to OCD in the total sample. This study provides strong evidence that prior OCD is associated with an increased risk of subsequent onset of BIP, bulimia nervosa, dysthymia, GAD, and social phobia among adolescents and young adults. Future studies should evaluate if early treatment of OCD can prevent the onset of these subsequent mental disorders.

The associations between psychotic experiences and substance use and substance use disorders: findings from the World Health Organization World Mental Health surveys

Prior research has found bidirectional associations between psychotic experiences (PEs) and selected substance use disorders. We aimed to extend this research by examining the bidirectional association between PEs and various types of substance use (SU) and substance use disorders (SUDs), and the influence of antecedent mental disorders on these associations. We used data from the World Health Organization World Mental Health surveys. A total of 30 902 adult respondents across 18 countries were assessed for (a) six types of life-time PEs, (b) a range of types of SU and DSM-IV SUDs and (c) mental disorders using the Composite International Diagnostic Interview. Discrete-time survival analyses based on retrospective age-at-onset reports examined the bidirectional associations between PEs and SU/SUDs controlling for antecedent mental disorders. After adjusting for demographics, comorbid SU/SUDs and antecedent mental disorders, those with prior alcohol use disorders [odds ratio (OR)=1.6, 95% confidence interval (CI)=1.2-2.0], extra-medical prescription drug use (OR=1.5, 95% CI=1.1-1.9), alcohol use (OR=1.4, 95% CI=1.1-1.7) and tobacco use (OR=1.3, 95% CI=1.0-1.8) had increased odds of subsequent first onset of PEs. In contrast, those with temporally prior PEs had increased odds of subsequent onset of tobacco use (OR=1.5, 95% CI=1.2-1.9), alcohol use (OR=1.3, 95% CI=1.1-1.6) or cannabis use (OR=1.3, 95% CI=1.0-1.5) as well as of all substance use disorders (ORs ranged between 1.4 and 1.5). There was a dose response relationship between both count and frequency of PEs and increased subsequent odds of selected SU/SUDs. Associations between psychotic experiences (PEs) and substance use/substance use disorders (SU/SUDs) are often bidirectional, but not all types of SU/SUDs are associated with PEs. These findings suggest that it is important to be aware of the presence of PEs within those with SUDs or at risk of SUDs, given the plausibility that they may each impact upon the other.

Fatigue in chronically critically ill patients following intensive care - reliability and validity of the multidimensional fatigue inventory (MFI-20)

BackgroundFatigue often occurs as long-term complication in chronically critically ill (CCI) patients after prolonged intensive care treatment. The Multidimensional Fatigue Inventory (MFI-20) has been established as valid instrument to measure fatigue in a wide range of medical illnesses. Regarding the measurement of fatigue in CCI patients, the psychometric properties of the MFI-20 have not been investigated so far. Thus, the present study examines reliability and validity of the MFI-20 in CCI patients.MethodsA convenience sample of n = 195 patients with Critical Illness Polyneuropathy (CIP) or Myopathy (CIM) were recruited via personal contact within four weeks (t1) following the transfer from acute care ICU to post-acute ICU at a large rehabilitation hospital. N = 113 (median age 61.1 yrs., 72.6% men) patients were again contacted via telephone three (t2) and six (t3) months following the transfer to post-acute ICU. The MFI-20, the Euro-Quality of Life (EQ-5D-3 L) and the Structured Clinical Interview for the Diagnostic and Statistical Manual of mental disorders DSM-IV (SCID-I) were applied within this prospective cohort study.ResultsThe internal consistency Cronbach’s α was adequate for the MFI-total and all but the subscale Reduced Motivation (RM) (range: .50–.91). Item-to-total correlations (range: .22–.80) indicated item redundancy for the subscale RM. Confirmatory Factor analyses (CFAs) revealed poor model fit for the original 5-factor model of the MFI-20 (t2/t3, Confirmatory Fit Index, CFI = .783/ .834; Tucker-Lewis Index, TLI = .751/ .809; Root Mean Square Error of Approximation, RMSEA = .112/ .103). Among the alternative models (1-, 2-, 3-factor models), the data best fit to a 3-factor solution summarizing the highly correlated factors General −/ Physical Fatigue/ Reduced Activity (GF/ PF/ RA) (t2/ t3, CFI = .878/ .896, TLI = .846/ .869, RMSEA = .089/ .085, 90% Confidence Interval .073–.104/ .066–.104). The MFI-total score significantly correlated with the health-related quality of life (range: −.65-(−).66) and the diagnosis of major depression (range: .27–.37).ConclusionsIn the present sample of CCI patients, a reliable and valid factor structure of the MFI-20 could not be ascertained. Especially the subscale RM should be revised. Since the factors GF, PF and RA cannot be separated from each other and the unclear factorial structure in the present sample of CCI patients, the MFI-20 is not recommended for use in this context.Trial registrationGerman Clinical Trials Registration DRKS00003386. Registered 13 December 2011, retrospectively registered.

Lifetime prevalence and age-of-onset of mental disorders in adults from the Argentinean Study of Mental Health Epidemiology.

Although the Global Burden of Disease Study estimated that depressive disorders and anxiety disorders are the second and fifth leading causes of disability in Argentina, these estimates were based on imputations rather than epidemiological data. The policy implications of these results for the necessary expansion of mental health services in Argentina are sufficiently great that more direct estimates of the population burdens of common mental disorders are needed. Therefore, the purpose is to present the first results regarding lifetime prevalence, projected lifetime risk up to age 75, age-of-onset, cohort effects and socio-demographic correlates of DSM-IV mental disorders among adults (18+) from the general population of urban areas of Argentina. A multistage clustered area probability household survey was administered to 3927 individuals using the World Mental Health Composite International Diagnostic Interview. Lifetime prevalence of any disorder was 29.1% and projected lifetime risk at age 75 was 37.1%. Median age-of-onset of any disorder was 20years of age. Disorders with highest lifetime prevalence were major depressive disorder (8.7%), alcohol abuse (8.1%), and specific phobia (6.8%). Anxiety disorders were the most prevalent group of disorder (16.4%) followed by mood (12.3%), substance (10.4%), and disruptive behavior disorders (2.5%). Women had greater odds of anxiety and mood disorders; men had greater odds of substance disorders. Age-at-interview was inversely associated with lifetime risk of any disorder. The results provide direct evidence for high lifetime societal burdens of common mental disorders in Argentina due to a combination of high prevalence and early age-of-onset.

Psychotic experiences and religiosity: data from the WHO World Mental Health Surveys.

Religiosity is often associated with better health outcomes. The aim of the study was to examine associations between psychotic experiences (PEs) and religiosity in a large, cross-national sample. A total of 25 542 adult respondents across 18 countries from the WHO World Mental Health Surveys were assessed for PEs, religious affiliation and indices of religiosity, DSM-IV mental disorders and general medical conditions. Logistic regression models were used to estimate the association between PEs and religiosity with various adjustments. Of 25 542 included respondents, 85.6% (SE = 0.3) (n = 21 860) respondents reported having a religious affiliation. Overall, there was no association between religious affiliation status and PEs. Within the subgroup having a religious affiliation, four of five indices of religiosity were significantly associated with increased odds of PEs (odds ratios ranged from 1.3 to 1.9). The findings persisted after adjustments for mental disorders and/or general medical conditions, as well as religious denomination type. There was a significant association between increased religiosity and reporting more types of PEs. Among individuals with religious affiliations, those who reported more religiosity on four of five indices had increased odds of PEs. Focussed and more qualitative research will be required to unravel the interrelationship between religiosity and PEs.

Prevalence and gender differences in psychiatric disorders and DSM-IV mental disorders: a population-based study

Background: The early diagnosis of psychiatric disorders is critical as it improves the chance of recovery for patients. The aim of this study was to determine gender disparities in psychiatric and mental disorders in adult persons and to examine the validity of the 28-item General Health Questionnaire (GHQ-28; Persian version) in the diagnosis of patients with suspected psychiatric disorders, along with receiver operating characteristic (ROC) analysis.&#x0D; Materials and Methods: The cross-sectional study was conducted using cluster random sampling method in three steps. Subjects were screened by GHQ-28 and then evaluated by Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) for diagnosis/classification of mental disorders. Chi-square test and independent t-test were used for statistical analysis. The ROC curve was used to assess cut-off points.&#x0D; Results: Of the 763 participants (aged 15 and above), 25.8% of responders demonstrated characteristics of psychological distress; the prevalence in males and females were 20.9% and 29.8%, respectively. The common mental disorders in males were anxiety disorder (18.2%), followed by any major depressive disorder (MDD) (17.4. %), and compulsive disorder (10.0%). In females, the common mental disorders were anxiety disorder (23.6%), followed by any MDD (22.7%), compulsive disorder (13.9%), phobia disorder (10.4%) and psychotic disorder (6.1%). ROC analysis showed that 91.7% of suspected persons had a mental disorder as assessed by DSM-IV-TR.&#x0D;

Psychiatric symptoms in preclinical behavioural-variant frontotemporal dementia in MAPT mutation carriers

ObjectiveTo characterise psychiatric symptoms in preclinical and early behavioural-variant frontotemporal dementia (bvFTD), a neurodegenerative disorder whose symptoms overlap with and are often mistaken for psychiatric illness.MethodsThe present study reports findings...

Interpersonal trauma moderates the relationship between personality factors and suicidality of individuals with posttraumatic stress disorder.

Individuals with posttraumatic stress disorder (PTSD) are more prone to suicidal ideation and behavior. While those who have experienced interpersonal trauma exhibit more suicidality than those who have experienced non-interpersonal trauma, it is unclear how the traumatic effects are related to an individual’s personality characteristics. This study examined the association between interpersonal trauma and personality factors with suicidality, and elucidated the moderating role of interpersonal trauma in individuals with PTSD. The study included 6,022 participants from the Korean Epidemiologic Catchment Area Study 2011. The Korean Version of Composite International Diagnostic Interview was used for the survey, including the participants’ history of suicidality, the traumas they have experienced, and their PTSD symptoms. The 11-item version of the Big Five Inventory (BFI-11) was used to assess the participants’ personality factors. 76 individuals were diagnosed with PTSD, while 810 had been exposed to trauma but were not diagnosed with any DSM-IV mental disorder. Among the individuals with PTSD, those who had experienced interpersonal trauma were more likely to have suicidal ideation than those who had experienced non-interpersonal trauma (p = .020; odds ratio [OR] = 3.643; 95% confidence interval of OR = [1.226, 10.825]). High agreeableness and conscientiousness predicted less suicidality in those exposed to non-interpersonal trauma, while predicting more suicidality in those exposed to interpersonal trauma. Clinicians examining individuals with PTSD should pay closer attention to the trauma that they have experienced, as well as their personality factors, to provide appropriate treatment.

Pain as a risk factor for common mental disorders. Results from the Netherlands Mental Health Survey and Incidence Study-2: a longitudinal, population-based study.

Pain might be an important risk factor for common mental disorders. Insight into the longitudinal association between pain and common mental disorders in the general adult population could help improve prevention and treatment strategies. Data were used from the first 2 waves of the Netherlands Mental Health Survey and Incidence Study-2, a psychiatric epidemiological cohort study among the Dutch general population aged 18 to 64 years at baseline (N = 5303). Persons without a mental disorder 12 months before baseline were selected as the at-risk group (n = 4974 for any mood disorder; n = 4979 for any anxiety disorder; and n = 5073 for any substance use disorder). Pain severity and interference due to pain in the past month were measured at baseline using the Short Form Health Survey. DSM-IV mental disorders were assessed at both waves using the Composite International Diagnostic Interview version 3.0. Moderate to very severe pain was associated with a higher risk of mood (odds ratio [OR] = 2.10, 95% confidence interval [CI] = 1.33-3.29) or anxiety disorders (OR = 2.12, 95% CI = 1.27-3.55). Moderate to very severe interference due to pain was also associated with a higher risk of mood (OR = 2.14, 95% CI = 1.30-3.54) or anxiety disorders (OR = 1.92, 95% CI = 1.05-3.52). Pain was not significantly associated with substance use disorders. No interaction effects were found between pain severity or interference due to pain and a previous history of mental disorders. Moderate to severe pain and interference due to pain are strong risk factors for first-incident or recurrent mood and anxiety disorders, independent of other mental disorders. Pain management programs could therefore possibly also serve as a preventative program for mental disorders.

Neurodevelopmental disorder in dsm-5 from manual to clinical practice

The new Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) has a number of changes to what used to be disorders first diagnosed in childhood or infancy. This lecture outlines some of the major changes to these conditions. According to the American Psychiatric Association (APA), the publisher of the DSM-5, this chapter from the DSM-IV has been superseded by a new chapter entitled, ‘Neurodevelopmental Disorders’ The new chapter includes intellectual disability (Intellectual Developmental Disorder), communication disorders, autism spectrum disorder, attention deficit hyperactivity disorder, Specific learning disorder and motor disorders. The Neurodevelopmental Disorders section replaces the outmoded term mental retardation with intellectual disability (intellectual developmental disorder) and defines levels of severity based on adaptive functioning and not IQ scores. Attention-deficit hyperactivity disorder (ADHD) is newly placed in the Neurodevelopmental Disorders section in DSM-5, whereas it was classified with disruptive behavior disorders in DSMIV. The biggest change in the Neurodevelopmental Disorders section in DSM-5 is the creation of a new category, Autism Spectrum Disorder, along with the elimination of the DSMIV diagnostic category Pervasive Developmental Disorder and its subgroupings. ASD is characterized by deficits in two core domains instead of three as in DSMIV. other changes will be explain.