High Prevalence Of Psychiatric Comorbidity Research Articles

Baş ağrısı yalnızca baş ağrısı mıdır? Baş ağrısı ile ruhsal bozuklukların eştanısı

Objective: To determine the psychiatric disorders comorbid with headaches and the characteristics of these disorders. Method: Patients who admitted to the neurology outpatient clinic with a main complaint of headache (n=71), and the same number of age and sex matched patients (n=71) who admitted to the psychiatry outpatient clinic and had a non-psychotic diagnose in axis I were included into the study. Socio-demographic data and information about their headaches were obtained from all patients. The Visual Analog Scale and MINI-scan form were obtained and psychiatric diagnoses were made after the assessment by MINI. Results: There was not any difference between headache and psychiatric patients group in terms of socio-demographic data. Headache history was found higher in the families of headache group than the psychiatric patients group. High prevalence of psychiatric comorbidity was found in patients with headache (80.3%). All of the patients with tension-type headache (TTH) fulfilled the criteria for diagnosing a pain disorder by MINI, and also the high prevalence of psychiatric comorbidity (63.4%) was still taking place after excluding the pain disorder. The most frequent diagnose of psychiatric comorbidity was found as depressive disorders (64.8%) which is compatible with the literature. Discussion: The high prevalence of psychiatric comorbidity with headache is remarkable. More common family history of headache in headache patients than the other group suggests that there is a tendency to have headache independent from a psychiatric disorder in these patients. High comorbidity rate in the presence of psychosocial stressors suggests that there is a continuum among psychiatric comorbidity, headache and psychosocial stressors. Among the psychiatric comorbidity, depressive disorders predominate. On the other hand, the higher frequency of psychiatric comorbidity in patients with TTH is remarkable. It is observed that the uncertainty between the diagnostic criteria of pain disorder in DSM-IV and diagnostic criteria of TTH (Tension Type Headache) in ICHD (International Classification of Headache Disorders) causes some problems both in diagnosing and treatment of patients and also in researches.

Impact of psychiatric comorbidity in individuals at Ultra High Risk of psychosis — Findings from the Longitudinal Youth at Risk Study (LYRIKS)

Recent studies have reported a high prevalence of psychiatric comorbidities in Ultra High Risk (UHR) for psychosis populations. This study examined the prevalence of comorbidity and its impact on symptoms, functioning, cognition and transition to psychosis in the Longitudinal Youth at Risk Study (LYRIKS) sample. The Comprehensive Assessment of At-Risk Mental State (CAARMS) was used to identify UHR individuals and 163 participants were included in the study. Comorbid disorders were identified using the Structured Clinical Interview for DSM-IV-TR Axis I Disorders. Participants were evaluated on the CAARMS, Positive and Negative Syndrome Scale, Calgary Depression Scale for Schizophrenia, Beck Anxiety Inventory, Global Assessment of Functioning and Brief Assessment of Cognition in Schizophrenia. Clinical, functioning and cognitive characteristics by lifetime and current comorbidity groups were compared using multivariate tests. Independent predictors of comorbidity were identified through logistic regression. Chi-squared tests were used to compare comorbidity rates between those who had developed psychosis at one year and those who had not. We found that 131 UHR participants (80.4%) had a lifetime comorbidity while 82 (50.3%) had a current comorbidity with depressive disorders being the most common. UHR individuals with comorbidity had more severe symptoms, higher distress and lower functioning with no differences in general cognition. Lower functioning was associated with current comorbidity. Eleven participants (6.7%) had developed psychosis after one year and there were no differences in the comorbidity rates between those who developed psychosis and those who did not. Psychiatric comorbidities in the UHR group are associated with adverse clinical outcomes and warrant closer attention.

Repetitive Negative Thinking and Psychological Distress in Fibromyalgia

Excessive and repetitive negative thinking (RTN) about past experiences or worries about the future is present across a large range of psychological disorders and appears to be involved in the maintenance of emotional problems. Studies have supported that RNT is characterized by the same process across disorders and can be reliably distinguished from other forms of recurrent cognitions and functional forms of repeated thinking, leading Harvey and colleagues (2004) to propose it as a definite transdiagnostic process. As a transdiagnostic phenomenon, RNT is underexplored in fibromyalgia (FM), a highly prevalent syndrome characterized by chronic, medically unexplained widespread musculoskeletal pain that causes significant disability. FM is associated with a high prevalence of psychiatric co-morbidity, mostly anxiety and depression, and a large variety of psychological processes. In these patients, cognitive processes and cognitions may play an important role as mediating mechanisms between FM and psychological distress. The content of RNT in patients with FM may be related with excessive monitorization of pain and other physical signs, leading to higher pain intensity and more pain-related fear-avoidance behaviour. In this way, persistence on RNT works as a maladapative coping strategy, impairing emotional regulation and perpetuating psychological distress. Improvement in the understanding of the cognitive processes implicated in FM that could be targeted in cognitive interventions may have positive results in reducing the burden of the syndrome.

Addiction and Other Psychiatric Disorders in a Population of Portuguese Prisoners.effects in Violent Crime and Addiction Severity.

Objectives Addiction, depression, anxiety and antisocial personality disorder may share common biological mechanisms and changes in impulsivity may contribute to the characterization of different clinical phenotypes. Our aim was to identify diagnostic profiles in a sample of inmates in a Portuguese prison. Methods We examined a sample recruited at Pacos de Ferreira Penitentiary Centre (n=89). Diagnosis was performed using the International Neuropsychiatric Interview (MINI). Six Version of Addiction Severity Index – European version (EuropASI) and the Psychopathy Checklist –Revised (PCL-R) were used to assess the severity of drug addiction and the presence of psychopathy. Results Drug misuse was found in 61.8% of the studied subjects according to MINI. A high prevalence of psychiatric comorbidity was detected, with antisocial personality disorder (70.9%), depression (30.9%), and anxiety (32.7%) being the most common disorders. The total PCL-R score was 24. 1 (SD 8.8), 36 prisoners presented a diagnosis of psychopathy (PCL-R>30). The presence of depression in addicted individuals is associated with a lower severity of dependence (p 30) increases (OR = 3.87, p Conclusions Psychiatric disorders and addiction were successfully evaluated. Depression is associated with a lower addiction severity. The different types of psychiatric diagnoses produce a modulation in the frequency of violent crimes. The prevalence of psychiatric comorbidity underscores the advantages of a structured psychiatric assessment in prison inmates in order to provide the best treatment.

Efficacy and Safety of Varenicline to Treat Nicotine Dependence in a Smokers Population with High Prevalence of Psychiatric Comorbidities

Introduction Smokers with psychiatric comorbidities are prevalent in our current practice. Varenicline (Champix) is a first line pharmacotherapy indicated to treat nicotine addiction. Aim To assess efficacy and safety of varenicline in current practice of a smoking cessation center treating smokers with high prevalence of psychiatric disorders. Material and method 128 smokers with concurrent stable psychiatric, respiratory or cardiovascular disorders (study group) and 124 healthy smokers (control group) were treated with varenicline and counseling, for 12 weeks to stop smoking. Abstinence rate was assessed in both groups at 12 weeks. Varenicline safety, cessation profile and compliance to treatment were monitored in psychiatric disorders smokers compared to other co-morbidities and to controls. Results 54.6 % smokers with comorbidities (12/22 cardiovascular, 14/30 respiratory, 44/76 psychiatric) and 33.8 % healthy smokers successfully quit smoking. Withdrawal symptoms and adverse effects picture did not differ significantly between groups. The figure shows compliance to treatment and number of adverse events in healthy and psychiatric, respiratory and cardiovascular disease smokers. Compliance to treatment (%) Adverse effects (n) 2 weeks 4 weeks 8 weeks 12 weeks Healthy smokers (n=124) 80.6 80.6 77.4 72.5 11 Smokers with psychiatric disorders (n=76) 97.3 94.7 86.8 86.8 14 Smokers with respiratory disorders (n=30) 83.3 70 56.6 40 8 Smokers with cardiovascular disorders (n=22) 100 72.7 59 59 8 Conclusions Smokers with psychiatric co-morbidities achieved a higher abstinence rate, compared to respiratory and cardiovascular disease smokers and to control group. Varenicline proved comparable safety in both study and control groups.

Risk of psychiatric disorders following polycystic ovary syndrome: a nationwide population-based cohort study.

BackgroundPolycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age. A higher prevalence of psychiatric comorbidities, including depressive disorder, anxiety disorder, and bipolar disorder has been proved in patients with PCOS. However, a clear temporal causal relationship between PCOS and psychiatric disorders has not been well established.ObjectiveWe explored the relationship between PCOS and the subsequent development of psychiatric disorders including schizophrenia, bipolar disorder, depressive disorder, anxiety disorder, and sleep disorder.MethodsWe identified patients who were diagnosed with PCOS by an obstetrician-gynecologist in the Taiwan National Health Insurance Research Database. A comparison cohort was constructed of patients without PCOS who were matched according to age and sex. The occurrence of subsequent new-onset psychiatric disorders was evaluated in both cohorts based on diagnoses made by psychiatrists.ResultsThe PCOS cohort consisted of 5431 patients, and the comparison cohort consisted of 21,724 matched control patients without PCOS. The incidence of depressive disorder (hazard ratio [HR] 1.296, 95% confidence interval [CI] 1.084–.550), anxiety disorder (HR 1.392, 95% CI 1.121–1.729), and sleep disorder (HR 1.495, 95% CI 1.176–1.899) were higher among the PCOS patients than among the patients in the comparison cohort. In addition, a higher incidence of newly diagnosed depressive disorder, anxiety disorder, and sleep disorder remained significantly increased in all of the stratified follow-up durations (0–1, 1–5, ≥5 y).ConclusionsPCOS might increase the risk of subsequent newly diagnosed depressive disorder, anxiety disorder, and sleep disorder. The risk of newly diagnosed bipolar disorder, which has often been reported in the literature to be comorbid with PCOS, was not significantly elevated.

Psychiatric Comorbidity and Aspects of Cognitive Coping Negatively Predict Outcome in Cognitive Behavioral Treatment of Psychophysiological Insomnia

Cognitive behavioral treatment is the gold standard treatment for insomnia, although a substantial group does not respond. We examined possible predictors for treatment outcome in psychophysiological insomniacs, with a focus on the presence of clearly defined psychiatric comorbidity. This was a longitudinal uncontrolled case series study comprising 60 patients with chronic psychophysiological insomnia consecutively referred to a tertiary sleep medicine center, to receive cognitive behavioral treatment for insomnia (CBT-I). Remission of insomnia was defined as a posttreatment Insomnia Severity Index score below 8. As an alternative outcome, we used a clinically relevant decrease on the Insomnia Severity Index (drop of > 7 points). Personality, coping, and social support questionnaires were assessed before the start of the treatment and were compared between treatment responders and nonresponders. To examine whether these variables were predictive for negative treatment outcome, logistic regression analyses were applied. Treatment nonresponders had a significantly higher prevalence of psychiatric comorbidity. Logistic regression analyses showed that the presence of psychiatric comorbidity was strongly predictive for negative treatment outcome (odds ratios: 20.6 and 10.3 for the 2 outcome definitions). Additionally, higher scores on the cognitive coping strategy called “refocus on planning” were associated with worse CBT-I outcome. Current psychiatric comorbidity is strongly predictive for negative treatment outcome. The presence of a psychiatric disorder must therefore be one of the leading arguments in the choice of treatment modalities that are being proposed to patients with insomnia.

Management of neuropsychiatric symptoms in multiple sclerosis

AbstractMultiple sclerosis is associated with a high prevalence of psychiatric comorbidity, including affective, psychotic and cognitive disorders. In this review, Dr Sommerlad and colleagues discuss the epidemiology, aetiology and management of neuropsychiatric symptoms in multiple sclerosis, using case vignettes to demonstrate the wide range of clinical presentations. Copyright © 2014 John Wiley & Sons

Mental disorders in leprosy: An underdiagnosed and untreated population

ObjectiveTo describe the frequency of psychiatric comorbidities in leprosy patients and check if they had been previously diagnosed and were in psychiatric care. MethodThe study was conducted with a sample of 120 leprosy patients being treated at two reference hospitals for leprosy in Salvador, Bahia, Brazil. Survey participants were more than 18years of age, had a confirmed diagnosis of leprosy and was undergoing antimicrobial treatment. Patients were evaluated face-to-face with a socio-demographic questionnaire and the Mini-International Neuropsychiatric Interview (MINI-Plus) in Portuguese. The period of data collection was between October 2009 and June 2012. ResultsThe assessment using the MINI-Plus showed that 34 (28.3%) patients did not receive any psychiatric diagnosis and 86 (71.7%) met the criteria for at least one. Of these 86 patients, 25 (20.8%) had one diagnosis, 26 (21.7%) had two diagnoses and the rest, 35 (29.2%), had three or more psychiatric diagnoses. All patients with a moderate or high risk of suicide had one or more psychiatric comorbidities. ConclusionLeprosy patients have a high prevalence of psychiatric comorbidities. Furthermore, most of them had no previous psychiatric diagnosis and the majority was not undergoing treatment.

Roles of PI3K/AKT/PTEN Pathway in the Pathogenesis of Parkinson’s Disease and the Neuropsychiatric Symptoms

Parkinson's disease is a neurodegenerative disorder associated with loss of dopaminergic neurons in substantianigra caused by severe neuro-degeneration, which is the second most common neurodegenerative disorder after Alzheimer’s disease.Parkinson's disease has a high prevalence of psychiatric comorbidity including depression. The neuropsychiatric symptoms are common in Parkinson's disease and may precede onset of motor symptoms. Increasing interest is often addressed to the selective targeting of some of metabotropic glutamate receptors that inhibit the transmitter release at synapses in the basal ganglia. The metabotropic glutamate receptors may be coupled to the phosphatidylinositol-3-kinase (PI3K), AKT, and PTEN pathways, whichplay a central role in cell survival. A better understanding of the molecular connections in the PI3K pathways could uncover new targets for drug development in Parkinson's disease.

Introduction—Treatment of psychiatric disorders in adults with epilepsy: What every epileptologist should know

The International League Against Epilepsy (ILAE) has recognized the importance of comorbidities in the management of patients with epilepsy. Psychiatric disorders are relatively frequent comorbidities, with a lifetime history identified in one of every three patients and a deleterious impact on quality of life, morbidity, and mortality. However, these problems are, more often than not, ignored, unless they are sufficiently severe to cause major disability. This is due to multiple factors, including patients’ reluctance to volunteer spontaneously information about existing psychiatric symptoms, a paucity (or total lack) of a specific training of the treating neurologist to recognize these psychiatric comorbidities, and a lack of time in busy clinics to screen for them. In general, treatment of psychiatric disorders, especially when sufficiently severe to require hospitalization, should be managed in a psychiatric setting. However, collaboration between psychiatrists and epileptologists is of the essence in the choice of the proper psychotropic drug to avert unnecessary adverse events resulting from their pharmacokinetic and pharmacodynamic interaction with antiepileptic drugs. Such communication can avert the omission of treatment caused by unfounded (although common, alas!) concerns of potential proconvulsant risks associated with psychotropic drugs. Moreover, mild to moderate psychiatric syndrome, especially mild to moderate mood and anxiety disorders, could be managed in epilepsy clinics, thereby simplifying the management of patient and ensuring access to treatment, which is often difficult to find in the community. In the past, different documents have been published under the auspices of the ILAE (Cornaggia et al., 2002) or by ILAE-selected experts (Kerr et al., 2011) discussing the use of psychotropic medications in patients with epilepsy and suggesting treatment options. With this special issue, the ILAE Commission on Neuropsychobiology brought together a number of experts to present pragmatic approaches to the treatment of psychiatric comorbidities. The aim of these articles is to integrate commonly adopted guidance of treatment for psychiatric disorders outside epilepsy to the special needs of people with epilepsy. Two articles address mood and anxiety disorders, and suggest algorithms of treatment in each specific category. The use of antidepressant drugs and the long-lasting misconceptions about seizure worsening are clarified. In addition, psychotherapy approaches are also indicated. One article is dedicated to psychoses of epilepsy, and specific treatment strategies are suggested for specific clinical entities (i.e., interictal psychoses of epilepsy or periictal psychoses). One article discusses the special needs of patients with intellectual disabilities, taking into account the spectrum of behavioral manifestations. Another article is dedicated to the challenging issue of postsurgical psychiatric complications and proposes pragmatic therapeutic approaches. Finally, one article is dedicated to psychogenic nonepileptic seizures (PNES). Obviously, PNES vary in their clinical manifestations and vary in their etiologies; however, standardized therapeutic approaches may be adopted. In conclusion, the relatively high prevalence of psychiatric comorbidities in patients with epilepsy, their negative effect on quality of life, and their association with an increased mortality risk and overall morbidity demand that any clinician treating these patients be familiarized with the recognition and treatment principles of these comorbidities. The Commission on Neuropsychobiology is grateful to the ILAE for its support of the publication of this supplement. The contents of this supplement reflect the opinions of the individual authors and do not necessarily represent official policy or position of the ILAE. MM has received travel grants or consultancy fees from various pharmaceutical companies including Pfizer, UCB Pharma, and Janssen, which are involved in the manufacture of antiepileptic drugs. AMK has received research funding from Pfizer Laboratories. We confirm that we have read the Journal's position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.

Who are the children and adolescent patients of a national referral service of eating disorders in Brazil?: a cross-sectional study of a clinical sample.

To investigate the sociodemographic and clinical profile of patients receiving treatment at a specialized service for children and adolescents with eating disorders (ED) in São Paulo, Brazil, and to compare data with the relevant literature. This cross-sectional study assessed male and female patients with ED up to 18 years of age. All data were collected upon admission. A total of 100 subjects were assessed. Mean age was 15.41±0.18 years, and mean age at ED onset was 13.5±0.19 years. Mean disease duration was 21.06 ±1.67 months. Of the total sample, 82% of the patients were female, 84% were Caucasian, 64% came from A and B economic tiers. Moreover, in 60% ED started at 14 years of age or less, and 74% had psychiatric comorbidities. Anorexia nervosa was the most prevalent diagnosis (43%). Hospitalized patients had lower body mass index, longer ED duration, and more severe scores on the Children's Global Assessment Scale than outpatients (p < 0.05). Our young Brazilian patients with ED present epidemiological and symptomatic characteristics very similar to those found in the scientific literature, including a high prevalence of psychiatric comorbidities. The higher frequency of full syndrome ED, the predominance of cases with an early onset, the delay in beginning specialized treatment, and the more severe state of inpatients provide grounds for concern because these factors differ from what has been reported in reference studies and indicate greater ED severity.

1906 – Mental disorders in leprosy: High prevalence and low psychiatric care

Introduction Leprosy is an infectious disease with high physical disability and is strongly associated with chronic pain, since there may be significant impairment of the peripheral nervous system. Additionally, the stigma associated with the label of leprosy persists and imposes a high social commitment of the disease. Objective/aims Describe the frequency of psychiatric comorbidities in leprosy patients and check if they had been previously diagnosed and were in psychiatric care. Method The study was conducted with a sample of 120 leprosy patients treated at two hospitals for leprosy: Hospital Dom Rodrigo de Menezes and University Hospital of Federal University of Bahia, in Salvador, Bahia, Brazil. Survey participants were older than 18 years of age, had confirmed the diagnosis of leprosy and were in antimicrobial treatment. Patients were evaluated face to face with a socio-demographic questionnaire and the Mini-International Neuropsychiatric Interview (MINIPlus) in Portuguese. The period of data collection was limited from October 2009 to June 2012. Results The assessment using the MINI-Plus showed that 34 (28.33%) patients did not have any psychiatric diagnosis and 86 (71.66%) had at least one. Of these 86 patients, 25(20.83%), met the criteria for one diagnosis, 26 (21.66%) had two diagnoses and the rest, 35 (29.16%), had three or more psychiatric diagnoses. All patients with moderate or high risk for suicide had one or more psychiatric comorbidities. Conclusion Leprosy patients have a high prevalence of psychiatric comorbidities. Beyond that, most of them had no previous psychiatric diagnosis and the absolute majority were not in treatment.

1754 – Psychiatric symptoms in patients on methadone maintenance treatment

The high prevalence of psychiatric comorbidity in drug dependent individuals is well known. However, there is limited literature available regarding the comorbidity of psychiatric disorders in drug addicts on methadone maintenance treatment (MMT). To determine the comorbidity of mental disorders in patients on MMT. The Symptom Checklist 90-Revised (SCL-90R) [1] was completed by 85 drug addicts (65 male and 20 female) on MMT. We recorded demographic data, duration of addiction, and duration of MMT. The mean age of the sample was 42.0 ± 8.8 years old, the mean duration of substance use was 24.3 ± 8.2 years and the mean duration of MMT was 6.8 ± 4.1. The majority of participants (78.8%) were unemployed and 58.3% of them had no children. Participants scored higher on the depression, paranoid ideation, anxiety, hostility, somatization, interpersonal sensitivity and psychoticism SCL-90R sub-scales, with average scores >1 [2]. On the contrary, lower scores were recorded in the obsessive-compulsive and phobic anxiety sub-scales. The percentage of participants that reported abnormal scores for each sub-scale was as follows: 89.3% for depression, 83.3% for paranoid ideation, 74.7% for anxiety, 66.7% for hostility, 64.7% for somatization, 51.2% for psychoticism and 35.7% for phobic anxiety. No abnormal scores were recorded regarding obsessive-compulsive symptoms. Only 8.4% of participants did not score abnormally on any sub-scale. Drug-addicted patients on MMT show a high comorbidity of psychiatric disorders. In particular, the likely presence of depressive and paranoid symptoms should be taken into serious account when deciding on a therapeutic strategy.

1. 心因性めまい&amp;mdash;精神疾患合併&amp;mdash;

We classified psychogenic dizziness into 3 types, such as the narrow type, the wide type and psychiatric comorbidity. Among these, 69.1% (362/524) of our patients with dizziness were diagnosed as having psychiatric comorbidity, and independently in a German facility, similar number of 68.3% (129/189) of patients with dizziness were diagnosed as having psychiatric comorbidity. Therefore, in our hospital, psychological tests are routinely performed on our patients with dizziness. Patients with dizziness of unknown cause (DUC), otogenic vertigo (OV) and Meniere's disease (MD) exhibited a higher prevalence of psychiatric comorbidity (DUC=73.6%, OV=69.5%, MD=70.1%). Of patients with dizziness and psychiatric comorbidity, various types of psychiatric disorders were found, such as anxiety or panic disorders (F41), mood disorders (F3), adjustment disorders or post-traumatic stress disorders (F43), dissociative disorders (F44), other neurotic disorders, organic mental disorders (F0) and schizophrenia (F2). These patients suffering from dizziness were not only treated by otolaryngologists, but also received psychiatric therapy, and 72.9% of these patients were prescribed psychotropic drugs in our hospital. We believe that psychotropic drugs should be prescribed according to the advice given from psychiatrists or the doctors who are familiar with these drugs. Patients with depression often complain of somatic symptoms. In clinical practice 90% of these patients with depression are in general examined by physicians (non-expert psychiatrists) for their primary medical examination. However, it is not easy to distinguish patients with depression from those with bipolar disorder. Recently, serotonin selective re-uptake inhibitors (SSRI) have been prescribed more frequently by physicians, but caution should be exercised in the treatment of patients with depression when physicians prescribe SSRI because these patients may have bipolarity or mild manic symptoms. To reduce the risk of these incidents of misdiagnosis, physicians are strongly encouraged to consider referring these patients with psychiatric disorders to psychiatrists. We believe that collaboration between psychiatrists and physicians in the hospital and/or local doctors can improve the mental condition and the quality of life (QOL) of patients who are suffering from dizziness with psychiatric comorbidity.

Diagnosis and management of psychosis in Parkinson's disease

AbstractParkinson's disease is associated with a high prevalence of psychiatric co‐morbidity including psychosis. In this review, Dr Latoo and colleagues discuss the epidemiology, aetiology and diagnosis of psychosis in Parkinson's disease and emphasise the importance of close liaison between neurologists and psychiatrists for optimal management.

Depression in Parkinson’s disease: diagnosis and management

Parkinson's disease has a high prevalence of psychiatric comorbidity including depression. This review highlights the epidemiology, aetiology and diagnosis of depression in patients with Parkinson's disease. Recommendations are made on treatment and a closer partnership between neurology and psychiatry.

Psychiatric symptoms and quality of life in systemic sclerosis.

Introduction: Systemic sclerosis (SSc) is a rare conjunctive tissue disorder characterized by fibrosis of the skin and internal organs, and vascular obliteration phenomena. Patients with SSc often experience elevated symptoms of psychological distress, determined by the disfiguration, the pain, the fatigue sensation, and the difficult in daily life occupations. The characteristics of the disease may influence the perceived quality of life (QoL) in people with SSc.Methods: This is a narrative review aiming to define the amount of impairment of Quality of Life in patients with Systemic Sclerosis and the component of this impairment due to depressive or other psychiatric symptoms. The search of the significant articles was carried out in PubMed for the key words “Psychiatric symptoms and Systemic Sclerosis”; “Quality of life and Systemic Sclerosis”; “Depressive Disorders and Systemic Sclerosis”.Results: Psychiatric symptoms are frequents in patients with SSc, but pain, fatigue, disability, body changes don’t appear to explain the high prevalence of psychiatric comorbidity in SSc. Many studies founded a significant impairment in SSc patients’ QoL, and despite the undeniable correlation between physical symptoms and SSc patients’ QoL, mental health was found significantly impaired.Discussion: The high rate of depression seems to strictly correlate with poor quality of life, and this finding needs more research to establish the cause of such a correlation. Patients’ point of view regarding their health-related QoL could help physicians to enlarge the knowledge about physical and mental correlates of the disease, and to fit therapies as patient required. Particular attention must be given to provide the patient with correct information, in order to mitigate the anxious state on disease course, and to enhance coping skills of the patients.

Potential Risk Factors for Psychiatric Disorders in Patients With Headache

Psychiatric comorbidities are common among patients with headache. These can compromise the quality of life of patients and may affect the result of treatment. No available systematic study concerning this problem has been conducted in Thailand. The study aimed to determine the prevalence and risk factors of psychiatric disorders in patients with headache in tertiary care facility. The study was conducted at the Headache Clinic, King Chulalongkorn Memorial Hospital in Bangkok, Thailand. One hundred and thirteen patients were enrolled. Diagnosis of headache was made based on International Classification of Headache Disorders II system. Mental disorders were assessed using Primary Care Evaluation of Mental Disorders. Other possible risk factors were extracted using significant physical symptoms count and accumulated risk for mental disorder. Of the 113 samples analyzed, the prevalence of depression, anxiety, and somatoform disorder was found to be 29.2%, 9.7%, and 27.4%, respectively. No definite relationship between headache types and mental disorders was observed. High number of significant physical complaints and health concerns significantly increased the risk for depression (OR = 4.6, 95% CI = 1.6 to 13.5) while the level of possible risk for mental disorder was associated with an increased risk for somatoform disorder (OR = 1.6, 95% CI = 1.2 to 2.2). The study confirmed high prevalence of psychiatric comorbidities in patients with headache. The results of this study will raise the awareness of physicians to possible underlying mental disorders in patients with headache and facilitate appropriate treatment or psychiatric referral.

Psychiatric co-morbidities and cardiovascular risk factors in people with lifetime history of epilepsy of an urban community

Objectives Depression has been consistently reported in people with epilepsy. Several studies also suggest a higher burden of cardiovascular diseases. We therefore analysed psychosocial co-morbidity and cardiovascular risk factors in patients with a lifetime history of epilepsy in the PsyCoLaus study, a Swiss urban population-based assessment of mental health and cardiovascular risk factors in adults aged between 35 and 66 years. Patients and methods Among 3719 participants in the PsyCoLaus study, we retrospectively identified those reporting at least 2 unprovoked seizures, defined as epilepsy. These subjects were compared to all others regarding psychiatric, social, and cardiovascular risk factors data using uni- and multivariable assessments. Results A significant higher need for social help ( p < 0.001) represented the only independent difference between 43 subjects with a history of epilepsy and 3676 controls, while a higher prevalence of psychiatric co-morbidities ( p = 0.015) and a lower prevalent marital status ( p = 0.01) were only significant on univariate analyses. Depression and cardio-vascular risk factors, as well as educational level and employment, were similar among the groups. Conclusions This analysis confirms an increased prevalence of psychosocial burden in subjects with a lifetime history of epilepsy; conversely, we did not find a higher cardiovascular risk. The specific urban and geographical location of our cohort and the age span of the studied population may account for the differences from previous studies.