Incidence Of Mental Disorders Research Articles

Aspectos psicossociais e relação com sedentarismo entre trabalhadores hidroviários

Introduction: Epidemiological studies have shown a progressive increase in the incidence of mental disorders in the world population in recent decades. According to the World Health Organization (2001), the common mental disorders (CMD) affect about 30% of the professionals in activity. Objective: to describe a possible relationship between psychosocial aspects and sedentarism among waterway workers. Material and method: this is a cross-sectional observational study. The subjects of the survey were the employees of shipping company located in the state of Rio de Janeiro. The data collection was developed during the year 2012. The total number of participants was 430 workers. The instrument used was a self-filled questionnaire containing sociodemographic, labor and lifestyle aspects. The study was submitted and approved by the Ethics Committee of the Antonio Pedro University Hospital, under number 260/11 in compliance with resolution 422/2012. Results: the overall prevalence of CMD was 10.0%, a relatively low percentage when compared to other studies with workers. However, the prevalence of CMD among workers who did not practice physical activities was 79.1%. There was no significance for other psychosocial aspects related to sedentarism. Conclusion: The prevalence of CMD among waterways that do not practice regular physical activity presented an extremely expressive value when compared to the global prevalence found. When it comes to the practice of physical exercises, individuals who do not practice regular physical activities have a higher rate of common mental disorders. The important contribution of physical activity to the general well-being of the organism is widely recognized by the scientific community. It is fundamental to train health service workers about the signs and symptoms of psychic suffering so that they consider the importance of the work situation as one of the determining factors in the health-disease process.

Issues of prevention of suicidal behavior in the Armed Forces of the Russian Federation

The issues of prevention of suicidal incidents in the Armed Forces of the Russian Federation are considered. The analysis of suicide prevalence among military personnel of various categories and their prevailing causes for the period from 2013 to 2017 is indicated. Indicates a change in the percentage ratio of various categories of military personnel who committed suicide, with a steady increase in the proportion of privates and sergeants serving in military service under the contract (from 24,6% in 2011 to 57,4% in 2017). It was established that among the servicemen under the contract family and everyday reasons for suicide prevailed, while conscripts were military professional. A comparison was also made of the long-term (2007-2017) dynamics of suicide rates and the incidence of mental disorders among military personnel, and certain patterns were identified. Thus, in the group of officers and ensigns, a significant correlation was noted between the long-term dynamics of suicide rates with neurotic (r=0,74) and addictive disorders (r=0,86), as well as general mental morbidity (r=0,83), and for conscripts, with personality disorders (r=0,79) and organic mental disorders (r=0,71). A comparison of the long-term dynamics of the overall incidence of mental disorders and the suicide rate among conscripts also showed a positive correlation (r=0,69). Analyzed the system of prevention of suicidal incidents in military personnel, which currently exists and proposed measures for its improvement, including the areas of activity of officials for the prevention of suicidal incidents in the military. It also indicates the need to shift the focus from specific prevention (direct detection and prevention of suicidal actions in military personnel with mental disorders) to non-specific (prevention of general mental distress and suicidal tendencies in mentally healthy people).

KEHAMILAN DENGAN GANGGUAN JIWA

Pregnancy is a dramatic episode of the biological and psychological changes and adaptations of a woman who never experienced it. The incidence of mental disorders in pregnancy was lower than postpartum and outside of pregnancy with 10 - 15% on post partum 10-15% and 2-7% beyond pregnancy. However Ohara reported that 10% of pregnant women was eligible if diagnosed with major and minor depression. There are two phases of pharma- cological management is described in the guidelines panel: the acute phase, symptoms are treated, drug dosage adjusted to prevent the adverse effects and patient given counseling, severe phase, patients were monitored at an effective dose to prevent relapse . In the maintenance phase, patients at risk for relapse is often still treated with medicines. Reported here the case of a female patient aged 31 years diagnosed with G2P1A0H1 term gravid 37- 38 weeks + bipolar affective disorder, current episode manic with psychotic symptoms. Patients have been known to suffer from a mental disorder since 2000 and has been submitted to psychiatry ward for as much as 9 times. Trigger disorder is unknown at this time, the patient suddenly angry for no apparent reason. Patients treated with pharmacotherapy of haloperidol 2x2 mg, roboransia and psychotherapy. Treatments including consideration of the patient to provide pharmacological therapy in a minimun dosage and psychotherapy to effectively reduce teratogenic risk to the fetus. Patients have been known to suffer from a mental disorder since 2000 and has been submitted to psychiatry ward for as much as 9 times. Trigger disorder is unknown at this time, the patient suddenly angry for no apparent reason. Patients treated with pharmacotherapy of haloperidol 2x2 mg, roboransia and psychotherapy. Treatments including consideration of the patient to provide pharmacological therapy in a minimun dosage and psychotherapy to effectively reduce teratogenic risk to the fetus. Patients have been known to suffer from a mental disorder since 2000 and has been submitted to psychiatry ward for as much as 9 times. Trigger disorder is unknown at this time, the patient suddenly angry for no apparent reason. Patients treated with pharmacotherapy of haloperidol 2x2 mg, roboransia and psychotherapy. Treatments including consideration of the patient to provide pharmacological therapy in a minimun dosage and psychotherapy to effectively reduce teratogenic risk to the fetus.Keywords: Mental disorders, bipolar affective disorder, pregnancy, psychotherapy

Determination of mental status of the university students and related risk factors

Abstract University time is one of the most challenging periods of a person’s life. It’s also peak period of many mental illnesses. Mental disorders are the most important cause of disability in people aged 10-24 and contribute to 45% of the disease burden. The aim of this study is to determine the frequency of mental illness of university students in the research population and to assess the possible risk factors. This study is a cross-sectional study. 345 students systematically selected by population weighting method were included in the study. Dependent variable of the study is depression, generalized anxiety, bipolar disorder and presence of psychotic symptoms. Mental disorders were evaluated using the CIDI and the DSM-5 Oriented Diagnostic Interview Form. 30.1% of the students had depression, 25.2% had generalized anxiety disorder, 9% had bipolar disorder and 2.9% had psychotic symptoms. The mean age of the participants is 20.4 ± 1.6. According to the binary logistic regression analysis, mother with mental problems, sexual abuse, person with special needs in family, pessimistic personality were found as risk factors for depression. Female gender, stay in a dormitory, poor economic condition of the family, mother with mental problems, alcohol/substance use of parent, pessimistic personality, lack of confidence were risk factors for generalized anxiety disorder. Alcohol use was risk factor for bipolar disorder. Poor academic achievement, having the family excluded by society were risk factors for psychotic symptoms. Average income level was a protective factor for bipolar disorder. Approximately one out of every 3 students use alcohol, and one out of every 20 students found to be at risk by using drugs. The incidence of mental disorders in university students is high. Many factors play a role in the emergence of mental problems. Early recognition of mental disorders, effective control and intervention studies are highly valuable in universities. Key messages The social negative attitude developed against psychiatric diseases and patients has a direct effect on the prevention, early recognition and treatment of mental disorders. University students should be seen as a risky group for substance use, policies should be developed to prevent substance use at universities immediately.

DESCRIPTION OF ELDERLY MENTAL STATUS IN WORK AREA PUSKESMAS PAMPANG MAKASSAR

Introduction:mental status of elderly is an emotional or cognitive state in the elderly is shown by the behavior of the stand. Mental health problems are very important for the elderly and often occurs in the elderly. The incidence of mental disorders in the elderly status is very high. paired mental status in elderly pose a variety of problems that can affect physical health, psychological, social and quality of life of the elderly so that the necessary nursing services for the early detection of mental status disorders that occur among the elderly. Method: The study design quantitative descriptive survey method. Samples numbered 97 people were selected using cluster random sampling. Primary data was collected by questionnaire the Mini Mental Status Examination (MMSE). Result:T he study of 97 respondents showed that 55.7% had normal mental status, impaired mental status light there are 29.9% and 14.4% of elderly with impaired mental status severe. Based propporsi elderly who suffer from mental status of the most widely experienced by women (52.4%), greater in very old age (100%), greater in elderly unmarried (100%), greater in elderly are not in school ( 70.6%), greater in elderly with a history of self-employed work (44.7%), and greater in the elderly with a history of rheumatic disease (61.1%). Conclusions: Mental status of elderly in Puskesmas Kota Makassar Pampang mostly normal. Therefore, elderly mental health need to be detected early to avoid the impact of mental disorders in the elderly.

KARAKTERISTIK PENDERITA SKIZOFRENIA PADA PASIEN RAWAT JALAN DI POLIKLINIK JIWA RSUD H. ANDI SULTHAN DG. RADJA KABUPATEN BULUKUMBA

Schizophrenia is a severe mental disorder that affects more than 21 million people worldwide. According to (Ministry of Health, 2013) the prevalence of severe mental disorders, such as schizophrenia, is 1.7 per 1000 residents or around 400,000 people. Schizophrenia is caused by multifactorial factors that are related to each other. The purpose of this study was to find out the factors associated with the incidence of mental disorders in H.AUD Hospital. Sulthan with Radja Bulukumba in 2018. This study uses Cross sectional design with a population of 554 people and a sample of 84 people. The sample used in this study is non probability sampling with purposive sampling technique. Based on statistical analysis using frequency distribution data The results of this study are based on the age of Schizophrenia sufferers more in adulthood, the sex of Schizophrenic patients is obtained by men as many as 40 people (50%), and women as many as 40 respondents (50%), Job Schizophrenia sufferers are more unemployed (82.5%) and those who work are 17.5%, the education level of Schizophrenics is higher in high school education (33.8%) and junior and PT education is equal to 13, 8%, The marital status of schizophrenics sufferers with mental disorders is more with marital status (61%), there are more conflicts in families with schizophrenia who do not have a family conflict (85%). Farewell events of Schizophrenia sufferers more than no parents (85%), Socio-economic status of schizophrenics in economic status less than 66 people (82.5%, Parenting schizophrenic parents democratic parenting 75 people or 93.8 %. It is expected that the results of this study may be used as scientific reading material in the library and can also be used as reference material that examines similar problems.

The Effect of the Treatment at a Pain Clinic on the Patients' Assessment of Their Pain Intensity and the Incidence of Mental Disorders in the form of Anxiety, Depression, and Aggression.

The aim of the study was to analyze the effect of the treatment given to patients in a pain clinic on their assessment of pain intensity and the incidence of emotional disturbances in the form of anxiety, depression, and aggression. The study was conducted from January 2014 to April 2018 among patients under the care of two Warsaw pain clinics. The study tools were the Hospital Anxiety and Depression Scale—Modified Version (HADS-M) and the Numerical Rating Scale (NRS). The project enrolled 325 patients, with women comprising 60.62% of patients, and the age bracked of 65–79 years comprising 39.38% of patient. The major reasons for attending the pain clinic were osteoarticular pain (44.92%) and neuropathic pain (42.77%). The therapy applied lowered the patients’ pain intensity (4.98 vs. 3.83), anxiety (8.71 vs. 8.12), aggression (3.30 vs. 3.08), and the overall HADS-M score (18.93 vs. 17.90), which shows that the treatment of both the pain symptoms and the associated emotional disturbances in the form of anxiety and aggression was effective. Sex is a factor affecting pain intensity. The level of mental disorders was influenced by the sex and age of the patients and how long they had been treated in the pain clinics.

Predictive validity of objective measures of physical fitness for the new onset of mental disorders in adolescents and young adults.

To systematically review evidence that objectively assessed level of physical fitness is associated with future risk of adverse mental health outcomes during the peak age range for onset of adult mental disorders. Searches of Electronic databases (EBSCOhost, SPORTDISCUS, EMBASE, MedLINE, Cochrane database, CINAHL, PsychInfo, and Dissertation Abstracts), supplemented by hand searches of journals, conference proceedings and citations. Random-effects meta-analysis models were used to pool the intervention effects. Eight studies of adolescents and young adults were included in the qualitative review and six studies derived from four independent cohorts were included in the statistical analyses. Most publications reported on large samples (including >1 million), but male conscripts were over-represented in the study cohorts; quality of included studies was modest, and heterogeneity was significant. Meta-analytic estimates were conducted for different adverse mental health outcomes, but all showed an inverse association between fitness and incidence of mental disorders or suicidality. Overall, higher level of physical fitness was associated with lower rates of onset of mental health problems (odds ratio: 0.59; 95% confidence intervals: 0.54, 0.65). All eligible studies were undertaken since 2010, suggesting this is an emerging but unfinished field of research. The study design and methodological limitations indicate that the reported results should be treated with caution. However, if the meta-analytic findings are reliably replicated for new cohorts of males and females, they have implications for research into the prevention of non-communicable diseases, as our review suggests that interventions should target physical and mental health in equal measure.

Effectiveness of cognitive behavioral therapy on generalized anxiety disorder in college and graduate students: Literature review

There has been a significant increase in the incidence of mental disorders in young adults and often been neglected due to social stigma. However, due to the increased awareness, there has been increased demand for services and counseling centers which often have long waiting lists. Due to the limited resources available, the effectiveness of the therapy method to provide “best” available treatment is needed. In this literature review, the effectiveness of cognitive behavioral therapy (CBT) on generalized anxiety disorder in college and graduate students, a systematic review and meta-analysis of randomized controlled trials (RCTs) and two RCTs are included. The selected studies suggested significant improvement in general anxiety disorder in college or graduate students by providing CBT. The literature reviewed indicates improvement in generalized anxiety in graduate students' population by CBT, limited studies have been conducted specifically to this population, and since young adults constitute majority of the world population suggesting economic growth, there is a need for more research on the effectiveness of the therapy in this specific population per se.

СТРУКТУРА ЗАБОЛЕВАНИЙ, ОБУСЛОВИВШИХ ИНВАЛИДНОСТЬ СРЕДИ ДЕТЕЙ ГОРОДА ДУШАНБЕ

Objective: To analyze the dynamics and structure of the morbidity that caused disability in children living in Dushanbe. Methods: Summary reports provided by the City’s Informational Department and Medical Statistics of Dushanbe (medical form № 31) for 2014-2018 were retrospectively analyzed. Results: The analysis showed that there is a tendency to increase from year to year those who are on the dispensary account. There is a close correlation (r=0.95; p<0.005) between children under observation and children taken on dispensary records with the first established disability. The largest number (more than a third) of children with disabilities falls on the third age corridor (age 5-9 years) with a tendency to increase. The first place in the structure of diseases of children aged 1-4, 5-9 and 10-14 years, which caused the occurrence of disability, are occupied by diseases of the nervous system, then there are mental disorders, the third congenital anomalies and chromosomal abnormalities. In the structure of congenital anomalies (malformations) and chromosomal disorders are dominated by congenital heart defects, much less – Down’s syndrome. The study found that less than half of children with disabilities (41.6%) were disabled who received inpatient treatment, most of them under the dispensary supervision of narrow specialists of Urban Health Centers, i.e. received outpatient treatment. The hospital was arranged at home for 12.3% of immobile children. Rehabilitation centers for rehabilitation treatment were used by 9.7% of children. Conclusion: A study of the dynamics of age disability revealed the largest number of children of preschool age, namely 5-9 years, a little less – children aged 10-14 years. Disability by adolescence, in the fifth group, decreases slightly. The importance of diseases of the nervous system increases in the third age group (5-9 years) and has some tendency to decline by adolescence (15-17 years). The incidence of mental disorders, congenital abnormalities (developmental malformations) and chromosomal disorders also increases with age and is approximately the same quantitative expressions until adolescence. Keywords: Child disability, child morbidity, morbidity structure, age groups, age dynamics.

Mental disorders associated with recent cancer diagnosis: Results from a nationally representative survey

BackgroundReceiving a diagnosis of cancer may be associated with increased risk of mental disorders. Yet, in this context, no factor predicts the onset of a mental disorder besides the diagnosis of cancer itself. If patients with a history of mental disorder are at particular risk is unknown. MethodsData were derived from a large national sample of the US population. Face-to-face surveys were conducted on 36309 adults during 2012–2013 period. Data were used to examine the associations among the past-year prevalence of mental disorders (according to the Diagnostic and Statistical Manual of Mental Disorders-5), the treatment-seeking rates and a recent cancer diagnosis. Data were analysed according to the antecedents of mental disorder in participants and according the presence of a recent cancer diagnosis. ResultsParticipants recently diagnosed with cancer (n = 1300) were significantly at higher risk to present suicide attempt (adjusted odds ratio [AOR] = 3.52; 95% confidence interval [CI] = 1.23–10.04), post-traumatic stress disorder (AOR = 2.25; 95% CI = 1.71–2.96), bipolar disorder (AOR = 2.22; 95% CI = 1.46–3.38) and drug use disorder (AOR = 1.64; 95% CI = 1.13–3.39). The prevalence of most of the mental disorders considered was significantly higher for participants with a history of mental disorder compared with participants without such a history. Conversely, a recent diagnosis of cancer was not associated with significant differences in the incidence of mental disorders in participants with no history of mental disorder. ConclusionsPatients with a history of mental disorder receiving a cancer diagnosis are at high risk of relapse and should be closely monitored.

Contradicciones en Salud Mental: Estigma, Alfabetización en Salud Mental y Revelación (o no) del Diagnóstico de un Desorden Mental.

Las dolencias mentales afectan a un porcentaje de la población (25 %) que no se corresponde ni con los conocimientos que la población general tiene de ellas ni con los recursos (4% PIB) que invertimos en atenderlas en el sistema sanitario. Esta contradicción, o discrepancia, es evidente desde hace tiempo en la literatura de sociología médica. Analizamos en este artículo tres conceptos emparentados para comprender esa contradicción: son los de alfabetización en salud mental, estigma de las dolencias mentales y el de revelar o no el diagnóstico de una dolencia mental. Existe poca sino nula repercusión de estos tres conceptos en el ámbito de habla en castellano. Con este artículo intentamos solventar ausencia.

Positive Mental Health from the perspective of Iranian society: A qualitative study.

Background: According to the World Health Organization, mental health relates, not only to the absence of mental disorder, but also to Positive Mental Health. Studies have shown that promoting positive mental health, not only reduces the prevalence and incidence of mental disorders, but also affects the process of treatment and reduces related burden. However, this concept has different interpretations in different cultures, and in many societies, mental health is still considered the absence of mental illness. Thus, the present study was conducted to provide an in-depth understanding of Iranian adults` perspective towards the concept of positive mental health. Materials and Methods: In the present qualitative study, eight focus group discussions (6 to 8 adults in each session) were held consisting of 30 to 60 year-old men and women from Tehran. Data were analyzed in "DeDoose" qualitative software using content analysis. Results: According to the data obtained, participants found no difference between positive mental health and mental health, mostly equating it to the absence of mental disorders and having positive energy, peace in and satisfaction with life. According to the results, positive mental health has four domains of emotional/psychological, spiritual, social, and life skills. Conclusion: Understanding an individual's positive mental health concepts culturally and providing appropriate community based programs can significantly promote the mental health of the community.

Positive Mental Health from the perspective of Iranian society: A qualitative study

Background: According to the World Health Organization, mental health relates, not only to the absence of mental disorder, but also to Positive Mental Health. Studies have shown that promoting positive mental health, not only reduces the prevalence and incidence of mental disorders, but also affects the process of treatment and reduces related burden. However, this concept has different interpretations in different cultures, and in many societies, mental health is still considered the absence of mental illness. Thus, the present study was conducted to provide an in-depth understanding of Iranian adults` perspective towards the concept of positive mental health. Materials and Methods: In the present qualitative study, eight focus group discussions (6 to 8 adults in each session) were held consisting of 30 to 60 year-old men and women from Tehran. Data were analyzed in "DeDoose" qualitative software using content analysis. Results: According to the data obtained, participants found no difference between positive mental health and mental health, mostly equating it to the absence of mental disorders and having positive energy, peace in and satisfaction with life. According to the results, positive mental health has four domains of emotional/psychological, spiritual, social, and life skills. Conclusion: Understanding an individual’s positive mental health concepts culturally and providing appropriate community based programs can significantly promote the mental health of the community.

Positive Mental Health from the perspective of Iranian society: A qualitative study.

Background: According to the World Health Organization, mental health relates, not only to the absence of mental disorder, but also to Positive Mental Health. Studies have shown that promoting positive mental health, not only reduces the prevalence and incidence of mental disorders, but also affects the process of treatment and reduces related burden. However, this concept has different interpretations in different cultures, and in many societies, mental health is still considered the absence of mental illness. Thus, the present study was conducted to provide an in-depth understanding of Iranian adults` perspective towards the concept of positive mental health. Materials and Methods: In the present qualitative study, eight focus group discussions (6 to 8 adults in each session) were held consisting of 30 to 60 year-old men and women from Tehran. Data were analyzed in "DeDoose" qualitative software using content analysis. Results: According to the data obtained, participants found no difference between positive mental health and mental health, mostly equating it to the absence of mental disorders and having positive energy, peace in and satisfaction with life. According to the results, positive mental health has four domains of emotional/psychological, spiritual, social, and life skills. Conclusion: Understanding an individual's positive mental health concepts culturally and providing appropriate community based programs can significantly promote the mental health of the community.

Mental Disorders and Consumption of Psychoactive Substances in Women: Epidemiological and Clinical Aspects in the Service of Psychiatry of the Donka National Hospital Guinea, Conakry

Introduction: The use of psychoactive substances (PPS) is a public health problem for vulnerable populations, particularly women and those with mental disorders. Objectives: In this work, our objectives were to determine the frequency of mental disorders and consumption of psychoactive substances in women, to describe their socio-demographic profile, to identify the psychoactive substances consumed, to identify the different types of mental disorders and to describe the clinical aspects of mental disorders induced by the consumption of psychoactive substances in these women. Methodology: This was a retrospective study, of a descriptive type with a duration of 5 years (from 1 January 2009 to 31 December 2013). Data collection lasted three months. Included in this study were all records of hospitalized or outpatient patients in the Mental Disorders and Psychoactive Substance Use Service. Results: The incidence of mental disorders and psychoactive substance use was 10.51%. The age groups 20-29, 30-39 were the most represented are respectively 55.49%, 31.87% with an average age of 29.5 years and extremes of 10-49 years. Singles were the most affected with 91.76% of cases. The majority was in the informal sector and the secondary level was the most affected with 40.11%, 56.04%, respectively. The most commonly used psychoactive substances were cigarettes (3.30%) and alcohol (2.20%). The alcohol and cigarette association was the most frequent, 45.60%. Depression was the most prevalent type of disorder with 35.71%. Occasional consumption was the most common mode of consumption with 84.62%, followed by 15.38% of regular consumption or dependence. Conclusion: This retrospective study did not identify all aspects of women's psychoactive substance use, yet a general population survey could better capture the magnitude of this phenomenon.

Utilization of Mental Healthcare Services among Refugees: Past, Present and Future

There has been an increasingly large number of refugees in the U.S. and worldwide. Compared to the general population, historically, refugees presented a higher prevalence and incidence of mental disorders due to their traumatic/stressful experiences. However, the unmet needs of mental healthcare among refugees remain significant. The purpose of this study is to systematically review the current literature and identify the challenges that refugees were facing to receive mental healthcare in western countries as well as clinical and non-clinical ap- proaches that may effectively address their mental healthcare needs. A total of 79 peer-reviewed journal articles, reports, and book chapters published between 1985 and 2018 and obtained from major databases were included in the final analysis. Data were extracted and synthesized into categories of barriers for refugees to utilizing mental healthcare in the U.S. and other western countries, and effectiveness of current approaches to address refugees’ mental illnesses. Results indicated that the vast majority of barriers existed in both U.S. and other western countries were common. In response, four themes emerged to improve refugees’ utilization of mental healthcare, including adopting effective westernized trauma-focused mental health treatment; recognizing traditional and culturally relevant mental health coping mechanism; overcoming existing practical barriers within both refugee communities and western mental healthcare systems; emphasizing comprehensive/integrative mental healthcare models. Future endeavor should focus more on systematically integrating planned cultural competency training and education into existing curriculum, strengthening the quality of mental healthcare research with refugees, and advocating for funding support for mental healthcare services, training, and research.

Incidence and predictors of mental health disorder diagnoses among people who inject drugs in a Canadian setting.

Limited attention has been given to the predictors of mental health diagnoses among people who inject drugs (PWID) in community settings. Therefore, we sought to longitudinally examine the prevalence, incidence and predictors of mental disorder diagnosis among a community-recruited cohort of PWID. Data were derived from two prospective cohort studies of PWID (VIDUS and ACCESS) in Vancouver, Canada between December 2005 and May 2015. We used multivariable extended Cox regression to identify factors independently associated with self-reported mental disorder diagnosis during follow-up among those without a history of such diagnoses at baseline. Among the 923 participants who did not report a mental disorder at baseline, 206 (22.3%) reported a first diagnosis of a mental disorder during follow-up for an incidence density of 4.29 [95% confidence interval (CI) 3.72-4.91] per 100 person-years. In the multivariable analysis, female sex [adjusted hazards ratio (AHR) = 1.74, 95% CI 1.29-2.33], experiencing non-fatal overdose (AHR = 2.33, 95% CI 1.38-3.94), accessing any drug or alcohol treatment (AHR = 1.68, 95% CI 1.24-2.27), accessing any community health or social services (AHR = 1.53, 95% CI 1.02-2.28) and experiencing violence (AHR = 1.60, 95% CI 1.12-2.29) were independently associated with a mental disorder diagnosis at follow-up. We observed a high prevalence and incidence of mental disorders among our community-recruited sample of PWID. The validity and implication of these diagnoses for key substance use and public health outcomes are an urgent priority.

SOCIALLY SIGNIFICANT DISEASES IN WOMEN IN CORRECTIONAL FACILITIES OF THE RUSSIAN FEDERATION

To study the epidemic situation of socially significant diseases in women in correctional facilities of the Russian Federation, models for calculating expected total (cumulative) incidence. There is more than 10 times the total incidence of mental disorders and behavioral disorders (35,179.6 per 100,000 women and 2,764.9 per 100,000 population), the frequency of positive HIV test results by the method of immune blotting (24,836.2 and 426.3 per 100,000 women), the incidence of tuberculosis (394.9 and 34.2 per 100,000 women). There is a tendency to increase the incidence of women in correctional facilities by HIV infection, hypertension, diabetes, malignant neoplasms, reduce the incidence of sexually transmitted infections, viral hepatitis B, C.

EFFECTS OF SYNTHETIC DISEASE-MODIFYING ANTIRHEUMATIC DRUGS, BIOLOGICAL AGENTS, AND PSYCHOPHARMACOTHERAPY ON THE MENTAL DISORDERS IN PATIENTS WITH RHEUMATOID ARTHRITIS

Mental disorders (MDs) of the anxiety-depressive spectrum (ADS) and cognitive impairment (CI) are characteristic of the majority of patients with rheumatoid arthritis (RA); however, the effects of disease-modifying antirheumatic drugs (DMARDs), biological agents (BAs), and their combinations with psychopharmacological drugs (PPDs) on these abnormalities have been insufficiently studied. Objective: to investigate trends in the incidence of MDs in RA patients receiving different treatment regimens.Subjects and methods. The investigation included 128 RA patients (13% men and 87% women) who fulfilled the 1987 American College of Rheumatology criteria; their mean age was 47.4±0.9 years; the median duration of RA was 96 [48; 228] months. RA activity was found to be high, moderate, and low in 48, 56, and 24 patients, respectively. DAS28 averaged 5.34±0.17. 80% of the patients received DMARDs. MDs were diagnosed based on ICD-10 coding, by using a semi-structured interview and scales, such as the Hospital Anxiety and Depression Scale, the Hamilton Anxiety Scale, and the Montgomery-Asberg Depression Rating Scale. Clinical and psychological procedures were used to diagnose CI. At the study inclusion stage, ADS disorders were detected in 123 (96.1%) patients; CI was found in 88 (68.7%). Forty-one (32.1%) patients were diagnosed with major depression (an obvious or moderate depressive episode), 53 (41.4%) patients had minor depression (a mild depressive episode and dysthymia), and 29 (22.6%) had anxiety disorders (ADs) (adjustment disorders with anxiety symptoms, as well as generalized anxiety disorder). The dynamics of MDs was estimated in 112 (87.5%) of the 128 patients and in 83 (64.8%) at one- and five-year follow-ups, respectively. The following groups were identified according to the performed therapy: 1) synthetic DMARDs (n = 39); 2) synthetic DMARDs + PPDs (n = 43); 3) BAs + DMARDs (n = 32); 4) BAs + DMARDs + PPDs (n = 9).Results and discussion. In Group 1, the frequency of major depression increased insignificantly from 25% to 32.2 and 33.3% (p = 0.36) at one- and five-year follow-ups, respectively; that of minor depression decreased from 51% to 48.4 (p = 0.5) and 50% (p = 0.6) respectively; the number of patients with ADs declined significantly from 24% to 3.2 (p = 0.018) and 4.2% (p = 0.021), respectively. The frequency of CI rose from 63.5% to 64.5 and 81.8%, respectively (p = 0.12). In Group 2, the frequency of major depression decreased from 43 to 19% (p = 0.049) at one-year follow-up; and none of the patients was found to have ADS disorders at five-year follow-up (p < 0.001); the frequency of minor depression dropped from 38% to 23.8 and 7.1% at one-year (p = 0.35) and five-year (p = 0.002) follow-ups, respectively; the frequency of ADs fell from 19% to 4.8 (p = 0.044) and 0% (p = 0.012), respectively. The frequency of CI decreased insignificantly from 80.9% to 76.2 (p = 0.39) and 61.5% (p = 0.061), respectively. In Group 3 treated with BAs, the frequency of major depression increased statistically insignificantly from 31.2% to 37.9 (p = 0.39) and 42.8% (p = 0.28) at oneand five-year follow-ups, respectively; the frequency of minor depression rose insignificantly from 37.5% to 48.3 (p = 0.28) and 52.4% (p = 0.21), respectively; and that of ADs dropped from 25 to 0% at one-year (p = 0.003) and five-year (p = 0.011) follow-ups. Moreover, the frequency of CI increased from 75% up to 79.3 (p = 0.46) and 90% (p = 0.16) at one- and five-year follow-ups respectively. In Group 4, the frequency of major depression decreased significantly from 66.7 to 22.2% (p = 0.076) and complete regression (p = 0.004) at one- and five-year follow-ups, respectively; that of minor depression increased slightly from 11.1 to 33.3% (p = 0.28) due to the transformation of major depression into minor one at one- and five-year follow-ups, respectively; the frequency of ADs fell from 22.2% to zero at 5 years; and the incidence of CI declined 66.7 to 57.1% (p = 0.54).Conclusion. Synthetic DMARDs had no effect on the ADS disorders and CI in patients with RA; BAs promoted the regression of ADs and did not affect the progression of depression and CI. A combination of DMARDs and BAs used at the adequate dose of PPDs for the same period led to the regression of ADS disorders and the reduction in the frequency of CI.