ICD-10 Criteria Research Articles

Prevalence of psychiatric morbidity in orthopaedic inpatient: a hospital based cross-sectional study

Background: Identification of a psychiatric problem should be a necessity part of treatment planning in orthopedic practice, and prompt referral for diagnosis and treatment should be made for better outcome. There have been very few studies in Nepal that has assessed the presence of psychiatric disorders in injured inpatients. The aim of the study was to find out the prevalence of psychiatric disorders in patients with injury admitted to the orthopedic ward of CMC teaching hospital. Methods: The study was carried out among 150 randomly selected patients of age group 18-60 years from the orthopedic ward suffering from any orthopedic injury. The study design is a hospital based cross sectional descriptive study. Diagnosis of psychiatric Disorders were made using ICD10 criteria. Data entry and analysis was done using the SPSS software version 21.0. Results: The prevalence of psychiatric disorder in patients with orthopedic injury was found to be 32% with depressive disorders being the most common diagnosis (12.1%) followed by anxiety disorder (8%) and somatoform disorder(6%). Psychiatric disorders were significantly associated with age, age group and gender. Psychiatric disorders were the most commonly found in those with patients with road traffic accident (52.1%) and those with lower limb injury (47.9%). Conclusions: Since, there is presence of psychopathology in orthopedic injured patients, early referral by the orthopedic surgeons to the psychiatric department is necessary for early evaluation and treatment.

Factor analysis and validation of the Bush Francis catatonia rating scale-Spain version

Background and objectivesThe aim of this study was to assess the reliability and validity of the Bush Francis Catatonia Screening Instrument and Bush Francis Catatonia Rating Scale Spain Version (BFCSI-SV and BFCRS-SV) using the ICD-11 and DSM-5 diagnostic criteria as well as other catatonia scales. MethodsOne hundred patients were admitted to the inpatient psychiatry unit at Hospital Universitari Germans Trias I Pujol and two psychiatrists administered the BFCRS-SV to the first 10 patients to assess inter-rater reliability. The BFCRS-SV, BFCSI-SV, Modified Rogers Scale (MRS), Abnormal Involuntary Movement Scales, Barnes Akathisia Rating Scale, and Modified Simpson-Angus Scale were then employed. ResultsThe results showed that 27% of patients had catatonia using the DSM-5 diagnostic criteria. Additionally, 51% of patients had 2 or more BFCRSI-SV items (Sensitivity: 100%; Specificity: 67.12%). The alpha coefficient values were 0.80 and 0.84 for the BFCSI-SV and BFCRS-SV, respectively, and the intraclass correlation coefficient values were 0.902 and 0.903. The area under the ROC curve was 0.971 and 0.96, and the instruments had a strong positive correlation with the DSM-5 score, ICD-11 score, and MRS. The study identified a three-factor model comprising the inhibition, excitement, and parakinetic dimensions. ConclusionsOverall, the results suggest that the BFCSI-SV and BFCRS-SV are valid and reliable tools for the diagnosis of catatonia, especially when using a cut-off score of 5 or higher for the BFCSI-SV and 7 or higher for the BFCRS-SV.

Psychometric properties of the Youth Self-rated Insomnia Scale (YSIS) in adolescent psychiatric patients.

The 8-item Youth Self-rated Insomnia Scale (YSIS) was developed to assess insomnia severity in the past month among youths. The YSIS has satisfactory psychometric properties in the general adolescent population. This study examined psychometric properties of the YSIS in a large sample of adolescent psychiatric patients. A total of 536 patients aged 10-19years were consecutively recruited from the outpatient department of Shandong Mental Health Center between December 2021 and March 2022. Patients completed a structured questionnaire consisting of the YSIS scale and questions about sleep duration, nightmares, psychiatric history, depression, psychiatric and sleep medications, and demographics. Patients were diagnosed following the ICD-10 criteria. Of the participants, the mean age was 15.30 years(SD = 1.95), 61.0% were female, 60.9% were diagnosed with mood disorders, 65.7% were on antidepressants, and 49.0% were on anxiolytics or hypnotics. The mean YSIS score was 22.6 (SD = 8.07). Coefficient omega was 0.84. Exploratory factor analysis revealed one factor and two correlated residuals. The YSIS scores were significantly correlated with depression scores (r = 0.68) and significantly increased with sleep onset latency, short sleep duration, nightmare frequency, and sleep medication use. The YSIS demonstrated satisfactory internal consistency reliability, construct validity, and criteria-related validity in adolescent psychiatric patients. The YSIS appears to be a reliable and valid scale for measuring insomnia severity in adolescent psychiatric patients.

Nature and prevalence of PTSD as per DSM-5 and ICD-11 after natural and unnatural deaths

The death of a loved one may lead to posttraumatic stress disorder (PTSD). Although it is conceivable that unnatural losses (caused by e.g., accidents, homicide, or suicide) render people more vulnerable to PTSD than natural losses (e.g., caused by illnesses) this is an understudied issue. The current study sought to enhance knowledge about the presentation and prevalence of PTSD symptoms, in people confronted with natural, non-sudden and unnatural, sudden losses. Considering that PTSD is defined differently in DSM-5 and ICD-11, we compared PTSD severity and prevalence rates between these diagnostic systems. Self-reported data were available from a heterogeneous sample of 1064 bereaved people (Mage = 52.13 years, 86 % female). Confirmatory factor analyses supported the DSM-5-based and ICD-11-based symptom clustering. DSM-5 yielded higher prevalence rates of probable PTSD than ICD-11 criteria. PTSD cluster and total scores were significantly higher for participants confronted with unnatural losses than participants confronted with natural losses. Rates of probable PTSD (based on DSM-5 and ICD-11) were also higher in the former group. Confrontation with an unnatural loss was not associated with PTSD scores beyond other sociodemographic and loss-related variables considered. Results show that bereavement-related PTSD is assessed differently in DSM-5 and ICD-11. Cause of death affected PTSD but less strongly than anticipated.

Sensitivity and specificity of the Patient Health Questionnaire (PHQ-9, PHQ-8, PHQ-2) and General Anxiety Disorder scale (GAD-7, GAD-2) for depression and anxiety diagnosis: a cross-sectional study in a Peruvian hospital population

ObjectivesThe Patient Health Questionnaire (PHQ) and Generalised Anxiety Disorder Scale (GAD) are widely used screening tools, but their sensitivity and specificity in low-income and middle-income countries are lower than in...

The application of virtual reality exposure versus relaxation training in music performance anxiety: a randomized controlled study

BackgroundPerformance anxiety is the most frequently reported anxiety disorder among professional musicians. Typical symptoms are - on a physical level - the consequences of an increase in sympathetic tone with cardiac stress, such as acceleration of heartbeat, increase in blood pressure, increased respiratory rate and tremor up to nausea or flush reactions. These symptoms can cause emotional distress, a reduced musical and artistical performance up to an impaired functioning. While anxiety disorders are preferably treated using cognitive-behavioral therapy with exposure, this approach is rather difficult for treating music performance anxiety since the presence of a public or professional jury is required and not easily available. The use of virtual reality (VR) could therefore display an alternative. So far, no therapy studies on music performance anxiety applying virtual reality exposure therapy have investigated the therapy outcome including cardiovascular changes as outcome parameters.MethodsThis mono-center, prospective, randomized and controlled clinical trial has a pre-post design with a follow-up period of 6 months. 46 professional and semi-professional musicians will be recruited and allocated randomly to an VR exposure group or a control group receiving progressive muscle relaxation training. Both groups will be treated over 4 single sessions. Music performance anxiety will be diagnosed based on a clinical interview using ICD-10 and DSM-5 criteria for specific phobia or social anxiety. A behavioral assessment test is conducted three times (pre, post, follow-up) in VR through an audition in a concert hall. Primary outcomes are the changes in music performance anxiety measured by the German Bühnenangstfragebogen and the cardiovascular reactivity reflected by heart rate variability (HRV). Secondary outcomes are changes in blood pressure, stress parameters such as cortisol in the blood and saliva, neuropeptides, and DNA-methylation.DiscussionThe trial investigates the effect of VR exposure in musicians with performance anxiety compared to a relaxation technique on anxiety symptoms and corresponding cardiovascular parameters. We expect a reduction of anxiety but also a consecutive improvement of HRV with cardiovascular protective effects.Trial registration: This study was registered on clinicaltrials.gov. (ClinicalTrials.gov Number: NCT05735860)

A mental health outreach program in child welfare centre with homoeopathy

Mental health problems during childhood and adolescence are a major health concern globally. Children in welfare centres pose varied emotional and behavioural problems (EBP) and need special treatment with a multidisciplinary approach. Homoeopathy has an evidence base for effectiveness in the management of some behavioural problems in children. Objective was to evolve the approach to mental health intervention using homeopathic medicines in the management of behavioural issues in children at a child welfare centre (CWC) through an outreach initiative. A screening program was conducted on 46 children at a child welfare centre, out of which 20 children were diagnosed with mental health issues according to ICD-10 criteria. These children were treated with individualised homoeopathic medicines and are followed up in regular intervals to assess the changes in behaviour of children after homoeopathic intervention. 3 cases of conduct disorders are illustrated to show the constitutional approach in children with behavioural problems. Causal attribution to the outcome after intervention are described as per Monarch criteria. 85% of cases were found to have moderate to marked improvement after 1 year of treatment. The remedies indicated are Sulphur (6), Carcinosinum (3), Natrum Mur (3), Silicea (2), Lachesis, Lycopodium, Merc Sol, Phosphorus, Staphysagria and Tarantula hispanica. Individualized homoeopathic medicines are found to be useful in the management of EBP of children in CWC. This preliminary mental health outreach serves as a model for future pragmatic research. Studies with appropriate study designs focussing on specific behavioural problems in juvenile delinquents are suggested.

Association between Autism Spectrum Disorder (ASD) and vision problems. A systematic review and meta-analysis.

To conduct a systematic review and meta-analysis assessing whether vision and/or eye disorders are associated with Autism Spectrum Disorder (ASD). Based on a pre-registered protocol (PROSPERO: CRD42022328485), we searched PubMed, Web of Knowledge/Science, Ovid Medline, Embase and APA PsycINFO up to 5th February 2022, with no language/type of document restrictions. We included observational studies 1) reporting at least one measure of vision in people of any age with a diagnosis of ASD based on DSM or ICD criteria, or ADOS; or 2) reporting the prevalence of ASD in people with and without vision disorders. Study quality was assessed with the Appraisal tool for Cross-Sectional Studies (AXIS). Random-effects meta-analyses were used for data synthesis. We included 49 studies in the narrative synthesis and 46 studies in the meta-analyses (15,629,159 individuals distributed across multiple different measures). We found meta-analytic evidence of increased prevalence of strabismus (OR = 4.72 [95% CI: 4.60, 4.85]) in people with versus those without ASD (non-significant heterogeneity: Q = 1.0545, p = 0.7881). We also found evidence of increased accommodation deficits (Hedge's g = 0.68 [CI: 0.28, 1.08]) (non-significant heterogeneity: Q = 6.9331, p = 0.0741), reduced peripheral vision (-0.82 [CI: -1.32, -0.33]) (non-significant heterogeneity: Q = 4.8075, p = 0.4398), reduced stereoacuity (0.73 [CI: -1.14, -0.31]) (non-significant heterogeneity: Q = 0.8974, p = 0.3435), increased color discrimination difficulties (0.69 [CI: 0.27,1.10]) (non-significant heterogeneity: Q = 9.9928, p = 0.1890), reduced contrast sensitivity (0.45 [CI: -0.60, -0.30]) (non-significant heterogeneity: Q = 9.9928, p = 0.1890) and increased retinal thickness (=0.29 [CI: 0.07, 0.51]) (non-significant heterogeneity: Q = 0.8113, p = 0.9918) in ASD. ASD is associated with some self-reported and objectively measured functional vision problems, and structural alterations of the eye, even though we observed several methodological limitations in the individual studies included in our meta-analyses. Further research should clarify the causal relationship, if any, between ASD and problems of vision during early life. CRD42022328485.

Extent and Severity of Internet Addiction in Persons with Common Mental Disorders

Abstract Background: There is a scarcity of literature about Internet addiction (IA) in common mental disorders (CMDs) such as depression, anxiety, obsessive-compulsive disorder, and substance use disorders. Early identification of IA in CMDs can help in better management of both disorders. Aims: To assess the extent and severity of IA in persons with CMDs. Methodology: This was a cross-sectional, single-group, exploratory study conducted at the Department of Psychiatry of tertiary care teaching hospital in North India. Patients aged 18 years and above and diagnosed with CMDs (Neurotic and stress-related disorders, Depressive Disorder, and substance use disorder) as per the ICD-11 criteria were included in the study after taking written informed consent. The severity of CMDs was assessed on Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D), Yale-Brown Obsessive-compulsive Scale, Severity of Alcohol Dependence Questionnaire and Severity of Opioid Dependence Questionnaire. The level of IA was assessed using Young’s IA Test. Results: A total of 150 patients diagnosed with CMDs were included. Males were slightly more than females (56% v/s 44%), most were younger than 40 years of age (55.3%), married (66.7%) and from urban (65.3%) background. Out of 150, 84 (56%) had depressive disorder, 45 (30%) had anxiety disorder, 15 (10%) had OCD and only 6 (4%) had substance use disorders. 69 (46%) participants had IA (36 mild and 33 moderate) and none had severe IA. A significant association was found between IA and CMDs (P < 0.05). Age, marital status, and type of residence were independent predictors or risk factors for IA. Conclusion: The index study concludes that there is a strong association between CMDs and IA. About half of persons with CMDs have IA.

Prevalence and modifiable risk factors for dementia in persons with intellectual disabilities

BackgroundPeople with intellectual disability (ID) without Down syndrome (DS) are presumed to be at higher risk of developing dementia due to their lower baseline cognitive reserve. We aimed to determine the prevalence of dementia in people with ID without DS and to identify risk factors of dementia.MethodsThis was a cross-sectional survey and multicenter study in Japan. Adults with ID without DS residing in the facilities were included. Caregivers of all participants were interviewed by medical specialists, and participants suspected of having cognitive decline were examined directly. ICD-10 criteria for dementia, DC-LD criteria for dementia, and DSM-5 criteria for neurocognitive disorders were used to diagnose dementia. The severity of ID, educational history, and comorbidities were compared by dividing the groups into those with and without dementia.ResultsA total of 1831 participants were included; 118/1831 (6.44%) were diagnosed with dementia. The prevalence of dementia for each age group was 8.8%, 60–64 years; 9.0%, 65–69 years; 19.6%, 70–74 years; and 19.4%, 75–79 years. Age, severity of ID, duration of education, hypertension, depression, stroke, and traumatic brain injury were significantly associated with the presence of dementia.ConclusionsAlthough the prevalence of dementia in people with ID without DS was found to be higher at a younger age than in the general population, the results of this study suggested that adequate education, prevention of head trauma and stroke, and treatments of hypertension and depression may reduce the risk of dementia. These may be potentially important modifiable risk factors for the prevention of dementia in these people.

Decoding the link between substance dependence and attention deficit hyperactivity disorder in adults: A cross-sectional study from North India.

Attention deficit hyperactivity disorder (ADHD) and Substance dependence are often thought to be linked as they are found to co-exist in many individuals. ADHD is estimated to be an essential indicator for the development of substance use disorder. Aim and Objective: To explore the relationship between different substance dependence and ADHD. This cross-sectional single-interview study was done at a tertiary care hospital in which a total of 153 Cases presenting to the Psychiatry OPD in a period of 03 months were selected serially based on inclusion and exclusion criteria. The diagnosis of substance dependence was made as per ICD-10 criteria. These subjects were then evaluated for the presence of ADHD and physical and psychological symptoms using the Adult ADHD self-rating scale and Maudsley's Addiction Profile. The majority of our study subjects were aged between 24-29 years (45%) and were predominantly males (98.7%). Most of our subjects were dependent on smack (adulterated heroin) (38.5%) followed by cannabis (27.4%) and alcohol (18.3%). When evaluated for ADHD using the ADHD self-rating scale, we found that almost one-third of the study population had ADHD (33%). Prevalence of ADHD was maximum in the subjects with cannabis dependence (47.6%) followed by tobacco/smoking (38.8%), cocaine (33%), and alcohol (21.5%). This association was statistically significant for cannabis (p = 0.035). The standard mean of both the physical as well as psychological symptoms experienced by subjects was higher in the ADHD group compared to the non-ADHD group which was statistically significant (p < 0.05). While managing patients with substance dependence we need to target both underlying ADHD and any co-morbid physical and psychological illness if present for holistic recovery of the patient.

Efficacy of cognitive behavioural therapy for bipolar disorder: A systematic review

IntroductionBipolar disorder (BD) is a serious mental illness with a chronic course and significant morbidity and mortality. BD has a lifetime prevalence rate of 1%–1.5% and is characterised by recurrent episodes of mania and depression, or a mixture of both phases. Although it has harmacological and psychotherapeutic treatment, cognitive behavioural therapy (CBT) has shown beneficial effects, but there is not enough clinical information in the current literature. MethodsThe main aim was to determine the efficacy of CBT alone or as an adjunct to pharmacological treatment for BD. A systematic review of 17 articles was carried out. The inclusion criteria were: quantitative or qualitative research aimed at examining the efficacy of CBT in BD patients with/without medication; publications in English language; and) being 18–65 years of age. The exclusion criteria were: review and meta-analysis articles; articles that included patients with other diagnoses in addition to BD and that did not separate the results based on such diagnoses; and studies with patients who did not meet the DSM or ICD criteria for BD. The PubMed, PsycINFO and Web of Science databases were searched up to 5 January 2020. The search strategy was: “Bipolar Disorder” AND “Cognitive Behavioral Therapy”. ResultsA total of 1531 patients both sexes were included. The weighted mean age was 40.703 years. The number of sessions ranged from 8 to 30, with a total duration of 45–120 min. All the studies show variable results in improving the level of depression and the severity of mania, improving functionality, reducing relapses and recurrences, and reducing anxiety levels and the severity of insomnia. ConclusionsThe use of CBT alone or adjunctive therapy in BD patients is considered to show promising results after treatment and during follow-up. Benefits include reduced levels of depression and mania, fewer relapses and recurrences, and higher levels of psychosocial functioning. More studies are needed.

Neurobiological factors of aggressive behavior in patients with multi-infarction dementia

Introduction. In the modern literature, the problem of the influence of multifocal brain damage in vascular dementia on the development of aggressive behavior in patients is only partially covered.The purpose of this work is to study the influence of neurobiological factors (number, localization of lesions) on the development of aggressive behavior in multi-infarct dementia.Materials and methods. The study involved 98 subjects diagnosed in multi-infarct dementia (F 01.1), established according to the ICD-10 criteria (1992), in which 52 were men (53.1 %) and 46 women (46.9 %), aged 60 to 90 years, the average age was 74.5 [67; 81] years. Patients are divided into a main group – with aggressive behavior (n = 49), and a control group − without aggressive behavior (n = 49). The study used clinical-anamnestic, clinical-psychopathological, psychometric and neuroimaging methods.Results. The study showed that patients with aggressive behavior compared to patients without aggressive behavior have a greater number of lesions (p &lt; 0.0001). The localization of which is statistically significantly more often determined in the left frontal lobe, subcortical nuclei on the left and in the left ventricular region (p = 0.0002, 0.0212, 0.0036), and patients without aggressive behavior often do not have frontal lobe lesions.Discussion. Patients who show aggression in general, or in isolation physical, verbal aggression, or irritability, have a statistically significantly greater number of lesions than patients without these symptoms (p &lt; 0,0001). Each additional lesion increases the likelihood of developing aggression and its severity. In patients with irritability, lesions localized in the left frontal lobe and left ventricle.Conclusion The study suggests that the number of lesions from four or more, as well as their predominant localization in the left hemisphere of the brain, leads to the development of various types of aggressive behavior.

Predictori ai evoluţiei clinice a schizofreniei

Introduction. Schizophrenia is a serious disorder that influences all aspects of the patients’ life. The most important goals in schizophrenia are remission, recovery, and improving psychosocial functioning and quality of life. Unfortunately, there are important barriers to achieving optimal long-term outcomes in this disease due to patient-related factors and treatment-related factors. Lack of insight is considered the main reason for partial/non-adherence and, therefore, for the long-term outcome. Aim. The aim of this study was to identify the predictive factors involved in long-term schizophrenia, and especially the role of the awareness of illness. Materials and method. Eighty patients (44 males and 36 females) recruited from the First and Second Psychiatric Clinic from Cluj-Napoca, diagnosed according to ICD-10 criteria with schizophrenia, participated in this study. A semi-structured interview collected the demographical data. Psychotic symptoms were evaluated using Positive and Negative Syndrome Scale (PANSS), severity of the disease using Clinical Global Impression (CGI) and insight using the Scale for the Assessment of Unawareness of Mental Disorder (SUMD), the Schedule for Assessment of Insight-Expanded version (SAI-E) and Beck Cognitive Insight Scale (BCIS). Results. Our results showed that, among potential predictors of psychotic symptoms change measured in this research, those significantly correlated with changes are the level of insight measured with SUMD scale (r=-0.41; p&lt;0.01), presence of family history (r=0.24; p&lt;0.05), and belonging to urban areas (r=0.23; p&lt;0.05). The level of insight, as one predictor, with PANSS initially controlled, explained 16% of variance of improving psychotic symptoms during hospitalization. Also, patients from urban areas seem to have a slight tendency towards higher magnitudes of the changes (low correlation, but statistically significant). Again, the square of the correlation obtained (coefficient of determination) indicates that urban membership explaines 5% of variance when symptoms improve. Also, it seems that the family history is positively associated with the magnitude of symptoms’ change, but the level of this relationship is also reduced. Conclusions. The awareness of illness is one of the predictive factors for long-term schizophrenia, and the best predictive model of disease progression is composed of variables SUMD total and PANSS total on admission.

The possibilities of osteopathic correction using for the treatment of children with attention defi cit hyperactivity disorder

Introduction. Attention defi cit hyperactivity disorder (ADHD) is diagnosed in childhood and is the most common mental disorder in children — about 5–7 % among school-age children. None of the treatment methods, as clinical observations showed, is completely effective for the treatment of ADHD. In most cases, the main method of treatment is pharmacotherapy. But despite the proven short-term effectiveness, pharmacotherapy may have limitations: partial response or no response, side effects, questionable long-term benefi ts, poor adherence to the treatment regimen, negative attitude of parents. Limitations of existing pharmacological treatment methods emphasize the need to develop effective non-pharmacological interventions that improve short- and long-term results in regard to neuropsychological defi ciency symptoms and disorders of other general activity fi elds. Currently, there are publications noting the positive clinical effect of osteopathic correction on the children′s health state in various mental sphere disorders. But only a few studies are aimed at studying the effect of osteopathic correction in ADHD. At the same time, there are no publications about the osteopathic correction use in the ADHD treatment without pharmacotherapy.The aim of the study is to investigate the possibility of osteopathic correction using for the treatment of children with attention defi cit hyperactivity disorder.Materials and methods. The study was conducted on the basis of the medical organization «Health′ Clinic» Tver from March 2021 to February 2022. Inclusion criteria: children age 7–10 years; established ADHD diagnosis; absence of diseases and conditions that are an absolute contraindication for osteopathic correction; parental consent to osteopathic examination and correction. Criteria for non-inclusion: age of children younger than 7 and older than 10 years; not confi rmation of the diagnosis according to the «ADHD Assessment Scale — ICD-10 criteria»; the presence of diseases and conditions that are an absolute contraindication for osteopathic correction. Exclusion criteria: failure to attend repeated examinations. The total number of children was 38 people. The patients were distributed by randomization envelopes into 2 groups of 19 people each. The main group: the osteopathic correction and the behavioral psychotherapy were used. The comparison group: the drug hopanthenic acid and the behavioral psychotherapy were used. Before and after the treatment, osteopathic status was assessed in both groups, and the severity of ADHD was assessed according to the ADHD assessment scale (ICD-10 criteria), and an attention test was conducted in the form of a Bourdon correction test.Results. At the beginning of the study, the patients were characterized by regional biomechanical disorders of the head region — in 100 % of participants in both groups, as well as the neck (structural component) — in 63 % of participants in both groups, and the dura mater — in 89 % of participants in the comparison group and 79 % of the main group. After the course of treatment, a signifi cant (p&lt;0,05) positive dynamics was observed in the main group according to the three above indicators, and there was no signifi cant dynamics in the comparison group. After the treatment, the statistically signifi cant (p&lt;0,05) positive dynamics was observed in both groups with respect to the severity of ADHD and the main characteristics of attention: the indicators of the ADHD assessment scale (ICD-10 criteria) decreased, the accuracy coeffi cients and concentration of attention increased, and the fatigue index decreased. At the same time, in the main group, the fatigue index decrease was statistically signifi cant (p&lt;0,05) more pronounced than in the comparison group.Conclusion. The obtained results allow us to recommend osteopathic correction in the treatment of children with ADHD, especially in the cases where, for some reasons, there are restrictions on the medications use.

Clinical and epidemiological aspects of schizotypal disorder in children and adolescents according to the Moscow psychiatric service

BACKGROUND: Given the significant increase in the number of children and adolescents diagnosed with schizotypal disorder and the simultaneous decrease in the incidence of schizophrenia in recent years, studying possible causes of the tendency and provision of psychiatric care to these patients is necessary. AIMS: To analyze the frequency of schizotypal disorder (F21) in children and adolescents and study the correspondence of diagnosis with the ICD-10 criteria and changes in accordance with disease dynamics to improve the continuity of psychiatric care. MATERIALS AND METHODS: This retrospective observational study analyzed data of patients who underwent examination and treatment at Sukhareva Scientific and Practical Center for Child and Adolescent Mental Health between 1999 and 2019, and the inpatient and outpatient records of the center and outpatient records of psychoneurological clinics at the place of patients residence were analyzed. RESULTS: The number of patients diagnosed with F21 schizotypal disorder increased along with the general increase in the number of patients (2812 people in 1999 and 5675 in 2019). They account for nearly half (48.3%) of the patients with diagnoses related to the schizophrenia spectrum (F2 schizophrenia and schizotypal and delusional disorders). Moreover, 71.2% of patients with F21 were diagnosed with F21.8 (schizotypal personality disorder). The number of patients diagnosed with schizophrenia decreased threefold, and the number of patients diagnosed with schizotypal disorder increased six-fold. Among those discharged with F21.8 diagnosis excluding rehospitalizations, 527 patients were selected for the clinical and follow-up study. After the exclusion of patients for various reasons, the patient cohort consisted of 139 patients who had been regularly followed up at psychoneurological clinics. The diagnoses with F2 code remained in 96% of 139 patients included in the cohort for the follow-up study, and only five patients had other disease codes. The diagnosis of schizotypal disorder (F21) persisted in 89 patients (64%). CONCLUSION: The decrease in schizophrenia diagnoses and the increase in the diagnosis of schizotypal disorders in children and adolescents, as revealed in the clinical and epidemiological study of ICD-10 use in 20 years, require further in-depth studies of the possible causes of this transformation. In light of the forthcoming adaptation of ICD-11, unified and clear criteria must be developed for schizotypal disorders, and a common understanding of their nosological affiliation is needed to develop more advanced approaches to diagnosis. The organization of psychiatric care provision must be improved to ensure the continuity of inpatient and outpatient care, including non-state institutions.

The Role of Buspirone in the Treatment of Patients with Paranoid Schizophrenia with Non-Suicidal Auto Aggression Who Have Had a Coronavirus Infection

The relevance of this work is due to the insufficient number of modern studies on the treatment of patients with paranoid schizophrenia with non-suicidal autoaggressive actions or in short: “NSAA”, who have had a coronavirus infection. The aim of the study was to study the role of buspirone in the complex therapy of patients with paranoid schizophrenia with NSAA who had a coronavirus infection. Materials and research methods: 99 patients with paranoid schizophrenia meeting ICD-10 criteria were examined by a continuous, non-randomized clinical method. Fisher’s test was used for statistical evaluation. Results: It was established that the consequence of the coronavirus infection was an increase in the proportion of residual organic changes in the form of manifestations of the dysphoric syndrome, specific changes in the cognitive sphere, and the autonomic nervous system. The manifestations of dysphoria included an increase in the frequency of openly manifested aggression, anxiety, impulsivity, and the implementation of NSAA by the type of affective discharge. The structure of acquired cognitive impairments consisted of changes in thinking by the type of thoroughness, and rigidity of perseveration. Changes in the autonomic nervous system are presented in the form of diencephalic crises. Also, psychotic states not characteristic of the previously examined patients were noted, such as twilight stupefaction, delusional symptoms of Cappgras, Fregoli, and tactile hallucinosis. It has been established that the use of buspirone as part of complex therapy with neuroleptics, compared with monotherapy with neuroleptics, increases the effectiveness of therapy in relation to these clinical manifestations in the studied individuals. Conclusion: The use of buspirone in combination with neuroleptic drugs increases the effectiveness of therapy in relation to the leading psychopathological manifestations in patients with paranoid schizophrenia with NSAA who have undergone coronavirus infection.

A comparison of ICD-11 and DSM-5 criteria of PTSD among Chinese trauma-exposed adolescent samples.

This study aimed at comparing the prevalence and comorbidity differences of PTSD according to ICD-11 and DSM-5 definitions across two Chinese adolescent trauma-exposed samples. A total of 1,201 students exposed to earthquake and 559 students from vocational schools exposed to potentially traumatic events were included in this study. The PTSD Checklist for DSM-5 was used to measure PTSD symptoms. The MDD and GAD subscales of the Revised Children's Anxiety and Depression Scale were used to measure major depression disorder (MDD) and generalized anxiety disorder (GAD) symptoms. No significant PTSD prevalence differences between ICD-11 and DSM-5 were found across the two samples. The differences regarding comorbidities between ICD-11 and DSM-5 definitions were not significant among these two samples. The results revealed that the ICD-11 and DSM-5 provided similar prevalence of PTSD and comorbidity rates with MDD and GAD in Chinese trauma-exposed adolescent samples. This study contributes to the current understanding of the similarities and differences using different PTSD criteria and informs the organization and application of these two globally applied PTSD criteria.

A 15-year comparative follow-up study of adolescent schizophrenia and acute and transient psychotic disorders with onset in adolescence

Aim: Comparative follow-up studies on the course of adolescent schizophrenia, on the one hand, and syndromes diagnosed initially as acute and transient psychotic disorders in adolescence, on the other, are rare in the literature. In our analysis, we compared the course of these syndromes based on selected clinical and social indicators. Materials and methods: A total of 34 patients hospitalised in adolescence (time point 1) for schizophrenia (11 patients) and for acute and transient psychotic disorders (23 patients – both diagnoses according to the ICD-10 criteria) were re-examined 15 years later (time point 2). The assessment was based on a psychiatric examination as well as questionnaires, letters and queries in selected hospitals and psychiatric wards. Results: After 15 years, the respondents in the group with a baseline diagnosis of schizophrenia revealed a significantly higher severity of schizophrenia symptoms, particularly the axial symptoms of the illness, as well as a higher severity of cognitive deficits. They had more frequent and longer psychiatric hospitalisations during the follow-up period, with the difference being more pronounced in the sub-period of the first five years after hospitalisation. These subjects experienced a deeper regression at time point 2, with lower levels of insight and poorer working lives, and were significantly more likely to receive a diagnosis of schizophrenia than patients in the other group. Conclusions: A diagnosis of adolescent schizophrenia proves to be a more significant predictor of the patients’ deteriorated functioning both in terms of clinical and social parameters than a diagnosis of acute and transient psychotic disorders made during the same developmental period.

Prescription drug dependence with and without concurrent illicit drug use: a multicenter cross-sectional survey among an addiction treatment seeking population.

Dependence on prescription drugs and illicit drugs imposes a global health and social burden. Despite accumulating evidence of prescription drugs and illicit drugs dependence, none of the systematized studies has explored the magnitude of this problem in Pakistan. The aim is to investigate the extent and associated factors of prescription drug dependence (PDD), as opposed to concomitant prescription drug dependence and illicit drug use (PIDU), within a sample of individuals seeking addiction treatment. The cross sectional study was conducted on the sample recruited from three drug treatment centers in Pakistan. Face-to-face interviews were conducted with participants who met ICD-10 criteria for prescription drug dependence. Several aspects like substance use histories, negative health outcomes, patient attitude, pharmacy and physician practices also collected to predict the determinants of (PDD). Binomial logistic regression models examined the factors associated with PDD and PIDU. Of the 537 treatment seeking individuals interviewed at baseline, close to one third (178, 33.3%) met criteria for dependence on prescription drugs. The majority of the participants were male (93.3%), average age of 31 years, having urban residence (67.4%). Among participants who met criteria for dependence on prescription drugs (71.9%), reported benzodiazepines as the most frequently used drug, followed by narcotic analgesics (56.8%), cannabis/marijuana (45.5%), and heroin (41.5%). The patients reported alprazolam, buprenorphine, nalbuphine, and pentazocin use as alternatives to illicit drugs. PDD was significantly negatively associated with injectable route (OR = 0.281, 95% CI, 0.079-0.993) and psychotic symptoms (OR = 0.315, 95% CI, 0.100, 0.986). This implies that PDD is less likely to be associated with an injectable route and psychotic symptoms in contrast to PIDU. Pain, depression and sleep disorder were primary reasons for PDD. PDD was associated with the attitude that prescription drugs are safer than illicit drugs (OR = 4.057, 95%CI, 1.254-13.122) and PDD was associated with being on professional terms (i.e., having an established relationship) with pharmaceutical drugs retailers for acquisition of prescription drugs. The study found benzodiazepine and opioid dependence in sub sample of addiction treatment seekers. The results have implications for drug policy and intervention strategies for preventing and treating drug use disorders.