ICD-10 Diagnostic Criteria For Research Research Articles

Association between depression and subjective cognitive complaints in 47 low- and middle-income countries

People with depression and subjective cognitive complaints (SCC) may be at particularly high risk for developing dementia. However, to date, studies on depression and SCC are limited mainly to single high-income countries. Thus, the aim of the present study was to investigate the association between depression and SCC in adults from low- and middle-income countries (LMICs). Cross-sectional, community-based data were analyzed from the World Health Survey. Two questions on subjective memory and learning complaints in the past 30 days were used to create a SCC scale ranging from 0 (No SCC) to 100 (worse SCC). ICD-10 Diagnostic Criteria for Research was used for the diagnosis of subsyndromal depression, brief depressive episode, and depressive episode. Multivariable linear regression was conducted to explore the associations. Data on 237,952 individuals aged ≥18 years [mean (SD) age 38.4 (16.0) years; females 50.8%] were analyzed. After adjustment for potential confounders (age, sex, education, anxiety), compared to no depressive disorder, subsyndromal depression (b-coefficient 7.91; 95%CI = 5.63–10.18), brief depressive episode (b-coefficient 10.37; 95%CI = 8.95–11.78), and depressive episode (b-coefficient 13.57; 95%CI = 12.33–14.81) were significantly associated with higher mean SCC scores. The association was similar in all age groups (i.e., 18–44, 45–64, and ≥65 years), and both males and females. All depression types assessed were associated with worse SCC among adults in 47 LMICs. Future longitudinal studies are needed to investigate whether older people with depression and SCC are at higher risk for dementia onset in LMICs.

Effectiveness and tolerability of eight-week treatment with dosulepin hydrochloride in patients with major depressive disorder not responding to four consecutive weeks of treatment with single selective serotonin reuptake inhibitor

Background: Though manageable, major depressive disorder remains an underdiagnosed and undertreated condition. The objective of this study was to assess the effectiveness and safety of 8 weeks of treatment with the tricyclic antidepressant dosulepin hydrochloride in patients with depressive episodes not responsive to 4 consecutive weeks of treatment with a single selective serotonin reuptake inhibitor (SSRI).Methods: Patients diagnosed with depressive episode without psychotic symptoms (by ICD-10 diagnostic criteria for research), mini-mental state examination score of ≥24, and not responsive to four weeks of treatment with SSRIs (<50% reduction in depressive symptoms) were enrolled. The main outcome measures were mean change in the Hamilton depression, Hamilton anxiety, and insomnia severity index scores at Week 8 compared to baseline. Adverse events were recorded for safety assessment.Results: A total of 94 patients were enrolled, of which, 90 (95.7%) patients completed the study. Compared to baseline, 8 weeks of treatment significantly changed the HAM-D score by -12.7 (p<0.0001), HAM-A score by -8.3 (p<0.0001), and ISI score by -10.5 (p<0.0001). One patient reported anemia and was withdrawn from the study. Dry mouth and insomnia followed by headache, blurred vision, and drowsiness were the most commonly reported side effects as measured with the antidepressant side-effects checklist. Most side effects were of mild intensity and were related to study medication.Conclusions: Eight weeks of treatment with dosulepin hydrochloride resulted in significant and clinically relevant improvements in depression, anxiety, and insomnia symptoms in Indian patients with MDD.

CLINICAL AND SOCIO-DEMOGRAPHIC CORELATES IN PATIENTS OF DEPRESSION WITH SUICIDAL BEHAVIOUR.

Background: Suicidal behaviour is frequently seen in context of depression. Few studies have demonstrated sociodemographic distinction between depression with and without suicidal behaviour. This study compares various psycho-socio-demographic factors associated with depression in context of suicidal behaviour. Materials And Methods: 60 depression patients with suicidal behaviour and 60 depression patients without suicidal behaviour were compared using a specially designed intake proforma, ICD-10 diagnostic criteria for research,Hamilton Rating Scale for Depression-17 (HAMD-17). Results: Depression with suicidal behaviour had more females, married, Hindu, literate, low socioeconomic status, urban locality, nuclear family samples, with earlier age of onset of illness. The total HAM-D scores were signicantly higher in the depression with suicidal behaviour group. Conclusions: Sociodemographic parameters are intricated crucially with suicidality.The present study identies female gender, nuclear family, urban background, unemployment and literacy to be an independent risk factor for suicidality. Suicidal behaviour increases with amount of time spent in depressive illness. Hence socio-demographic factors can be helpful as indicators of suicidal behaviour with depression.

A Study of Substance Use In Children And Adolescents In Community Setting

Background: Substance abuse problems can be described as developing through a set of progressive stages. The adolescent period, it self is more vulnerable for beginning of various substance abuse. Adolescents usually begin to use legal drugs like tobacco, alcohol and then cannabis and other illicit drugs. Objective: To determine the socio-demographic profile of substance using children and adolescents in a community setting. Methods: 150 families were selected using systematic sampling with random start from a well-defined community. The study was carried out in two phases. In phase I 74 families were identified who had children in this age group 10-19 yrs. There were total of 141 children in this age group. They were further screened for substance use through interview of parents and children. In Phase II, Children who had been found to have used some psychoactive substance were taken in the case study group. Similar number of children who were not using any psychoactive substance was selected for control group from the same 150 families. Both the study group children and control group children were evaluated in detail for Sociodemographic information & nature and extent of substance use by using ICD-10 Diagnostic Criteria For Research. Results: The mean age of the both groups was comparable and males predominated (60.5%) in both group. In both groups, educational level was similar but there was higher number of children who were currently attending school in the control group. Majority of school drop-outs were seen from the study group. (57.9% as compared to 28.9% in the control group). This was statistically significant. ). The prevalence of substance use was found to be around 27%. In our study the most commonly used substance was tobacco & Mishri was the most common form used. Chewing tobacco, cigarette and gutkha were various other tobacco containing products used. Further, Mishri was more commonly used by females, while cigarette and gutkha were more commonly used by males. Of the 23 tobacco dependent children 20 were above the age of 16 years. This finding was statistically significant. (P < 0.05). Only the males were found to use alcoholic beverages and all these boys were above the age of 16 years, Beer was the most common form used. Conclusion: Study findings can be used to generate awareness in the community regarding antecedents of substance abuse and the problems arising from it. Community based-longitudinal studies are needed to understand multiple factors influencing alcohol use and recommend targeted preventive measures.

Gender Differences in Clinical Characteristics and Comorbidities in Bipolar Disorder: a Study from South India.

The clinical features and course of bipolar disorder differ between women and men; however, studies are limited in Indian population. The objective of this study was to identify gender differences in patients with bipolar disorder. This was a cross-sectional, hospital-based observational study conducted over a period of 25months. The sample consisted of 110 males and 90 females with a diagnosis of bipolar disorder according to ICD-10 Diagnostic Criteria for Research. Socio-demographic and clinical details were collected using semi-structured proforma. All patients were evaluated on Mini International Neuropsychiatric Interview Plus, Presumptive Stressful Life Events Scale and Clinical Global Impression. Sample consisted of 55% men and 45% women. The total number of episodes was similar between genders, however, the number of manic episodes (p = 0.004) was significantly more in males and the number of depressive (p = 0.003) and mixed episodes (p = 0.018) were significantly more in females. Majority of males had first episode of mania, whereas, first episode in females were mostly depressive (p < 0.001). Comorbid physical disorders were seen in 61.1% females and 40% males. Bipolar disorder subtype, episode types and number varied across gender. Co-morbid hypothyroidism, migraine, and obesity are seen more often in women and substance use was higher in men.

The prognostic role of catatonia, hallucinations, and symptoms of schizophrenia in acute and transient psychosis

To examine the prospective temporal stability of acute and transient psychotic disorders (ATPDs) and analyze whether there are clinical, psychopathological, or sociodemographic characteristics that predict ATPD diagnostic stability. We conducted a prospective, 2-year, observational study of patients presenting a first-episode ATPD. A multivariate logistic regression model was developed to identify independent variables associated with ATPD diagnostic stability. Well-established predictive factors of diagnostic stability, as well as all the psychopathological features included in the ICD-10 Diagnostic Criteria for Research (DCR) descriptions of ATPD, were analyzed. Sixty-eight patients with a first episode of ATPD completed the study with a diagnostic stability rate as high as 55.9% (n=38) at the end of the follow-up period. Multivariate analysis revealed that diagnostic stability was independently significantly associated with the baseline presence of motility disturbances (OR=6.86, 95% CI=1.10-42.62; P=0.039), the absence of hallucinations (OR=5.75, 95% CI=1.51-21.98; P=0.010), and the absence of schizophrenic features (OR=7.13, 95% CI=1.38-36.90; P=0.019). A symptom checklist assessing these psychopathological features would enable early identification of those subjects whose initial ATPD diagnosis will remain stable over time.

The prognosis of out-patient alcohol treatment among parents with childcare responsibility.

Despite expansive knowledge on the detrimental effects of growing up with parents with alcohol use disorders (AUDs), little is known about the prognosis of alcohol treatment among parents with childcare responsibility. This observational cohort study aimed to examine the prognosis of patients with and without childcare responsibility, in a conventional out-patient alcohol treatment clinic. A consecutive AUD sample (N = 2201), based on ICD-10 Diagnostic Criteria for Research, was assessed with the European Addiction Severity Index during the clinical routine, at treatment entry and conclusion. Data on addiction severity, treatment course and drinking outcomes were derived, and adjusted odds ratios (AORs) were calculated with logistic-regression models. Drinking outcomes were compared in an intention-to-treat analysis, including all patients in a logistic regression with inverse probability weighting. Patients with childcare responsibility (aged <18 years) had a less severe addiction profile and lower drop-out rate compared with patients without children or with children living out-of-home. They were also more likely to improve on all drinking-related outcomes, including abstinence (AOR 2.68, 95% CI 1.82-3.95), number of drinking days (AOR 2.45, 95% CI 1.50-4.03) and excessive drinking days (AOR 4.66, 95% CI 2.36-9.17); and those with children living out-of-home had better outcomes on abstinence (AOR 1.59, 95% CI 1.08-2.34) than patients without children. Childcare responsibility among out-patients was associated with better treatment course and outcomes than those without or not living with their children. This knowledge can help guide clinical practice, effectuate interventions and inform social authorities.

Comorbid social phobia does not predict the outcome in alcohol use disorder outpatient treatment

BackgroundSocial phobia (SP) is one of the most prevalent anxiety disorders among patients entering treatment for alcohol use disorders (AUD). However, few studies have examined the association between SP and alcohol-related treatment outcomes in naturalistic settings. AimsThe aims of this study were to estimate the prevalence of co-morbid SP and to investigate the impact of the co-morbidity on the treatment course, dropout rates and treatment outcomes in a large sample of AUD patients treated in an outpatient alcohol treatment clinic. MethodsThe study was conducted as an observational cohort study. A consecutive sample of 3.197 treatment-seeking outpatients, with an AUD diagnosis according to the ICD-10 Diagnostic Criteria for Research, was assessed by means of the Addiction Severity Index at treatment start and at treatment conclusion. ResultsApproximately 15% of the patients suffered from SP when entering treatment and patients with and without SP did not differ on the treatment course, compliance or dropout rates. SP did not predict any alcohol-related treatment outcomes either, where no association was found on change scores for abstinence, drinking days and days with excessive drinking relative to AUD patients without co-morbidity. ConclusionAUD patients with and without co-morbid SP were equally likely to achieve benefits when treated similarly with evidence-based pharmacological and psychosocial approaches in a naturalistic setting.

Suicidality, self-stigma, social anxiety and personality traits in stabilized schizophrenia patients &amp;ndash; a cross-sectional study

Background and aimPatients who have schizophrenia are more prone to suicidal behavior than the general population. This study aimed to find connections between suicidality and self-stigma, hope, and personality traits in patients with schizophrenia.MethodsForty-eight stabilized outpatients with schizophrenia attended this cross-sectional study. Patients were diagnosed by the Mini International Neuropsychiatric Interview (MINI) using the ICD-10 research diagnostic criteria. The assessments included Positive and Negative Syndrome Scale, objective and subjective Clinical Global Impression, Liebowitz Social Anxiety Scale, Beck Depression Inventory-second edition, Internalized Stigma of Mental Illness, the Temperament and Character Inventory, and Adult Dispositional Hope Scale.ResultsThe individual rate of suicidality (suicidal index from MINI) strongly positively correlated with self-stigma, level of depression, social anxiety, and harm-avoidance, and negatively correlated with hope, self-directedness, and stigma resistance.ConclusionIndividuals with additional symptoms of depression, social anxiety, trait-like anxiety, and self-stigma should be carefully monitored for suicidal ideation. On the opposite side, patients with sufficient hope, self-esteem, and goal-directed attitudes are less likely to have suicidal thoughts and may potentially be role models in group rehabilitation programs, motivating more distressed colleagues and showing them ways to cope.

Prevalence of School Non-attendance Among Children and Adolescents Being Managed for Neuropsychiatric Conditions at a Mental Health Facility in Lagos, Nigeria

Education is vital to the development of the skills and talent in every child. Children with neuropsychiatric conditions (NPCs) additionally require schooling to help them overcome some of those impairments that result from their neuropsychiatric condition. The aim of this study was to determine the psychiatric and neurological conditions that were most frequently associated with school non-attendance (SNA) among children and adolescents attending a child mental health facility of the Federal Neuropsychiatric Hospital, Yaba in Lagos, Nigeria. The cross-sectional descriptive study involved 443 participants who were selected using systematic random sampling from among the children and adolescents attending the outpatient clinic of the above stated facility. The questionnaire consisted of a sociodemographic section and the child’s schooling history. A proforma was used to collect clinical data about the participants and each child’s condition was diagnosed using the ICD-10 research diagnostic criteria. Prevalence of SNA among the sample was 28.0%. Of the sixteen childhood neuropsychiatric conditions diagnosed among participants, SNA was found to be commonest among children with autistic spectrum disorders (58.5%) and severe depressive disorders in that order. Significantly more of the children suffering from epilepsy comorbid with mild psychiatric symptoms attended school when compared with children with primarily psychiatric disorders. The presence of NPCs comorbid with other mental or neurological conditions tended to significantly increase SNA. In conclusion, SNA is most common among children with autistic spectrum disorders. An awareness of this situation will help to recommend and plan appropriate schooling curriculum and placement for these children and influence policies regarding formulations of special needs schools. Also, collaboration of healthcare professionals with education administrators may help to ensure the provision of individualized education curriculum that will aid more children with NPCs to participate in schooling during their schooling years.

Life events in past one year in alcohol-dependent patients presenting with relapse

ABSTRACTObjective: Stressful life events may be an important factor in relapse in alcohol-dependent patients. This study was carried out to examine the life events in past one year in alcohol-dependent patients presenting with relapse.Methods: Thirty consecutive patients, aged 18 to 60 years, ICD-10 Diagnostic Criteria for Research for alcohol dependence syndrome, with current relapse were assessed on Severity Alcohol Dependence Questionnaire (SADQ) to measure alcohol dependence severity level and Presumptive Stressful Life Events Scale (PSLES) to identify life events in past one year prior to the relapse.Results: The mean number of life events among patients in past one year was 3.06 (SD 1.81). The mean number of undesirable life events was significantly higher than desirable events (p < .001). The most common life event was financial loss or problems (43%), followed by large loan and marital conflict (27%).Conclusion: There were a mean of three life events in the year preceding relapse in patients with alcohol dependence. Psychosocial treatment targeting stressful life events could be useful adjunct in the management of alcohol dependence.

Primary care Screening Questionnaire for Depression: reliability and validity of a new four-item tool.

BackgroundUnidentified depression in primary care is a public health concern, globally. There is a need for brief, valid and easily administered tools in primary care.AimsTo estimate reliability and validity of the newly developed Primary care Screening Questionnaire for Depression (PSQ4D), a four-item tool, with ‘yes’ or ‘no’ options.MethodPSQ4D was administered verbally (time required, <1 min) by primary care physicians to adult outpatients (n=827) in six primary care settings in Kerala, India. A psychiatrist evaluated each patient on the same day, using ICD-10 Diagnostic Criteria for Research, based on unstructured clinical interview.ResultsThe Cronbach’s alpha for internal consistency reliability was 0.80; kappa coefficient for test–retest reliability was 0.9 and that for interrater reliability was 0.72. At a score ≥2, sensitivity was 0.96, specificity was 0.87, positive predictive value was 0.74, negative predictive value was 0.98, positive likelihood ratio was 7.4 and negative likelihood ratio was 0.05.ConclusionsWhen physician administered, PSQ4D has good reliability. At a cut-off score of ≥2, it has high sensitivity and specificity to identify depressive disorder in primary care.Declaration of interestNone.Copyright and usage© The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.

Prevalence of depression and past suicide attempt in primary care.

It is known that persons who die by suicide commonly visit a primary care physician (PCP) shortly before the fatal act.There is little information on history of suicide attempt in depressed patients who consult PCPs for non-mental health indications.This information is important because past history of suicide attempt is a known predictor of future suicide risk. To estimate the prevalence of depression among outpatients in primary care and to determine the prevalence and determinants of past suicide attempt among them. This cross-sectional study was conducted in six primary care settings, both public and private, in Kerala, India. A psychiatrist evaluated adult outpatients (n=827), diagnosed depression using ICD-10 Diagnostic Criteria for Research, and elicited history of suicide attempt. Overall depression prevalence was 27.2% and was higher in women. Past suicide attempt was identified in 6.9% (95% CI, 5.17-8.63%) of all outpatients; higher in women (9.2%) than men (3.6%). Among the depressed, 21.3% had previously attempted suicide; while this figure was 1.5% in the non-depressed. The prevalence of current depression was 81% (severe depression, 61%) in patients reporting past suicide attempts. In univariate analyses, female gender, perceived financial stress, and being depressed were significantly associated with past suicide attempts. In multivariate analysis, current depression was the largest predictor of past suicide attempt (adjusted odds ratio, 14.3; 95% CI, 6.60-31.07). Depression and suicide attempt are both common in primary care. Depression is the single most important predictor of suicide attempt.

Insomnia and PTSD one month after wildfires: evidence for an independent role of the “fear of imminent death”

Objective: The relationship of insomnia with Post-Traumatic Stress Disorder (PTSD) one month after wildfires and more specifically with the experience of ‘fear of imminent death’ were investigated.Methods: Ninety-two randomly chosen victims of wildfires in the Greek province of Ilia, were assessed through a specifically designed semi-structured psychiatric interview comprising of questionnaires and scales to measure psychopathology, as well as psychosocial and environmental parameters. PTSD was set according to ICD-10 research diagnostic criteria, while insomnia was assessed with the Athens Insomnia Scale (AIS).Results: The presence of insomnia was identified in 63.0% of the victims. 46.7% of the participants were diagnosed with PTSD in the first post-disaster month, while 51.1% of the total sample experienced ‘fear of imminent death’. The majority of sleep complaints were significantly more frequent in subjects with PTSD. Female gender, PTSD, older age, and ‘fear of imminent death’ were independently associated with insomnia.Conclusions: The findings of the present study indicate that the diagnosis of insomnia, as well as, certain specific insomnia complaints were more frequent in female victims of wildfires who have experienced ‘fear of imminent death’ and have developed PTSD.

Prevalence of spontaneous dyskinesia in first episode, drug naive schizophrenia, and its relation to the positive and negative symptoms of schizophrenia

This study aims to assess the prevalence of abnormal involuntary movement in never medicated patients with schizophrenia and to find its relation with demographic variables, and with the positive and negative symptoms of schizophrenia; this study also aims to assess the topography of the dyskinesia. Socio-demographic data of 100 consecutively selected patients who fulfilled the ICD-10 Diagnostic Criteria for Research were collected in a 12-month period. These patients were rated with the Positive And Negative Syndrome Scale (PANSS) and Abnormal Involuntary Movement Scale (AIMS). Patients were labeled as having spontaneous dyskinesia if they fulfilled the criteria of Schooler and Kane which needs a score of two (mild) in at least two areas or score of three (moderate) or four (severe) in one area. Fifty two per cent of the study samples were male and 48% were female with mean age of 30.72 years with standard deviation of 8.7 years. Sixteen per cent of the patients had dyskinesia when examined with AIMS. However, only 14% fulfilled the Schooler and Kane's criteria for spontaneous dyskinesia. A strong correlation was found between the presence of dyskinesia and negative symptoms of schizophrenia. 57.1% of these 14 patients had dyskinesia located in their oral and facial region. Seventy one per cent of these patients with dyskinesia had no awareness of their involuntary movements. Spontaneous dyskinesia, negative symptoms, and lack of awareness of the abnormal involuntary movement can be taken as one of the presenting symptoms of schizophrenia.

A factor analytical study report on mania from Nepal.

Background and Objectives:Phenomenological studies on mood disorder are rare in Nepal which prompted us to undertake the current factor analytical study of mania.Materials and Methods:It was a cross-sectional descriptive study for which we did purposive sampling technique according to certain inclusion and exclusion criteria. The study sample consists of fifty patients, who fulfilled the International Classification of Diseases, Tenth Edition (ICD-10) diagnostic criteria for Manic Episode and/or Bipolar Affective Disorder-current episode mania. Tools used were ICD-10 Diagnostic Criteria for Research, Young's Mania Rating Scale (YMRS), and Brief Psychiatric Rating Scale (BPRS). Principal component factor analysis was applied to the 35 symptoms taken from YMRS and BPRS.Results:Factor analysis revealed the presence of four main factors, which explained 51.082% of the total variance. These are “pure mania” which isolated 11 manic symptoms, “dysphoric mania” which isolated five depressive symptoms, “hostile mania” which isolated six symptoms, and the fourth factor, we called it “delirious mania,” isolated four symptoms.Conclusion:The identified factors and subtypes are a useful conceptualization of atypical features among patients with acute mania. Further validation studies are required to determine whether the identified subtypes are of clinical and theoretical importance.

The effect of co-morbid depression and anxiety on the course and outcome of alcohol outpatient treatment: A naturalistic prospective cohort study

Background: Studies examining the effect of alcohol treatment among patients with alcohol use disorders (AUD) and co-morbid depression and/or anxiety are few and show inconsistent, but mainly negative drinking outcomes. Aims: To describe the prevalence of anxiety and depression among Danish patients seeking treatment for an AUD, and to investigate the influence of psychiatric co-morbidity on the course and effect of treatment. Method: A consecutive sample of 363 outpatients with an AUD diagnosis according to the ICD-10 Diagnostic Criteria for Research was assessed by the means of the Addiction Severity Index at treatment start and 276 (76%) followed up after 1 year. Results: 15.7% of the patients suffered from depression and 12.7% from anxiety at baseline. Both patients with or without co-morbidity had improved on drinking outcome measures at follow-up with medium to large effect sizes. No difference was found between patients with and without co-morbidity. Conclusion: In contrast to the majority of prior studies, this study provides evidence that depression and anxiety do not have an effect on alcohol treatment. However, because of the naturalistic setting, a number of limitations should be taken into consideration interpreting the results.

Suicidality and Self-stigma in Neurotic Spectrum Disorder – Cross Sectional Study

About 90% of persons who commit suicide suffer from mental illness. Numerous studies have tried to determine the predictive factors justifying the use of measures to prevent suicide in vulnerable patients. Unfortunately, even though the risk factors are known, there is no reliable way to anticipate the long-term suicide potential in a given patient. Aim of our study was to found connection between self- stigma, and level of suicidality in neurotic spectrum disorders. It is a cross-section study of inpatients with pharmacoresistant patients hospitalized at the psychotherapeutic ward of the Department of psychiatry, University hospital Olomouc. Data were gathered from 198 probands. Patients were diagnosed according ICD-10 research diagnostic criteria. There were used ISMI, BDI-II, objective and subjective CGI, Morin sleep scale, DES and MADRS item 10 (suicidality) for the assessment. There were no differences in suicidality rates between different level of education, status of employment and living or no living with the partner, and between the gender. Level of self-stigma highly significantly correlated with suicidality in patients with neurotic spectrum disorders. There was also a statistically significant correlation of suicidality and dissociation More attention should be paid to issue of self-stigma throughout neurotic patients, especially those with suicidal thoughts and tendencies.

Self-stigma and Suicidality in Patients with Neurotic Spectrum Disorders

Introduction About 90% of persons who commit suicide suffer from mental illness. The risk is particularly high in depression, psychosis, agitation, severe anxiety disorder, post-traumatic stress disorder, hypochondriasis and borderline personality disorder. Method Aim of our study was to found connection between self-stigma, and level of suicidality in neurotic spectrum disorders. It is a cross-section study of inpatients with pharmacoresistant patients hospitalized at the psychotherapeutic ward of the Department of psychiatry, University hospital Olomouc, Czech Republic. Results . Data were gathered from 198 probands. Patients were diagnosed according ICD-10 research diagnostic criteria. There were used ISMI, BDI-II, objective and subjective CGI, Morin sleep scale, DES and MADRS item 10 (suicidality) for the assessment. Level of self-stigma highly significantly correlated with suicidality in patients with neurotic spectrum disorders. Conclusion More attention should be paid to issue of self-stigma throughout neurotic patients, especially those with suicidal thoughts and tendencies.

Caregiver burden and disability in somatization disorder

ObjectiveAuthors assessed disability and caregiver burden in patients with somatization disorder (SOM-D), and compared it with that in patients with schizophrenia and chronic depression. MethodsThe sample consisted of 30 patients diagnosed as SOM-D as per ICD 10 Diagnostic Criteria for Research (ICD-10-DCR), and 30 age- and gender-matched patients each of schizophrenia and depression, who served as comparison groups. Disability and caregiver burden were assessed using WHO's Disability Assessment Schedule (WHO-DAS) and the Family Burden Assessment Schedule (FBAS) respectively. Functioning and severity of illness were assessed on the Global Assessment of Functioning scale (GAF) and Clinical Global Impression scale (CGI) respectively. ResultsSeverity of illness in patients with SOM-D was comparable to that in the comparison groups. Patients with SOM-D scored higher on total disability on WHO-DAS than the patients with schizophrenia and depression, though scores on family burden were comparable. Disability in patients with SOM-D was more in females, less educated, older and those working at home, compared to the other demographic groups. ConclusionPatients with SOM-D suffer considerable disability due to illness and impose significant burden on their caregivers, comparable to that seen in severe mental illnesses like schizophrenia and chronic depression.