Mini International Neuropsychiatric Interview Version Research Articles

Depression among Women Diagnosed with Breast Cancer: A Study from North India

Abstract Introduction: Major depressive disorder is a major mental health problem and is the fourth most important cause of loss of disability-adjusted life years worldwide. Aim: The study aimed to assess the association of depression among women diagnosed with breast cancer. Methodology: A descriptive, cross-sectional study was done on 102 females diagnosed with breast cancer. Women were recruited using purposive sampling technique. Patients were evaluated on Mini International Neuropsychiatric Interview Version 6.0.0 to screen other psychiatric comorbidities. Hamilton depression 17-item, rating scale was used to measure severity of depression. Results: The prevalence of depression was 47.05% in women diagnosed with breast cancer. Majority of the patients (54.1%) had mild depression. Correlations of clinical and Sociodemographic variables with parameters of depression were not significant. Conclusions: Depression is commonly associated psychiatric morbidity in patients diagnosed with breast cancer. The severity of depression is independent of the sociodemographic and clinical variables of patients with breast cancer.

The CORE-10 in screening for current mental health problems and severe mental illness in prisoners.

Few mental health screening tools are validated for prisoners. Existing tools do not guide referral between primary and secondary care pathways. This study aimed to assess performance of the CORE-10 in screening any current mental health problem and current severe mental illness (SMI) in prisoners. CORE-10 ratings were compared with mini international neuropsychiatric interview (MINI) version 6.0 ratings and current practice outcomes for 150 male prisoners. Receiver operating curve (ROC) analyses were used to estimate the likelihood with which CORE-10 ratings matched MINI ratings, yielding "area under the curve" statistics. ROC analyses suggested a strong relationship between CORE-10 screen scores and the more detailed assessment both in identifying any problem (AUC 0.85) and severe mental illness (AUC 0.76). Sensitivity was 0.88 and 0.83, and specificity was 0.64 and 0.61, respectively. Retest reliability was moderate (ICC=0.83). The CORE-10 identified many cases of "any problem" and of severe illness also identified by the MINI who had not been referred to clinical services in routine practice. This study provides evidence for the potential of the CORE-10 for improving appropriate referrals for prisoners to mental health services.

Psychiatric Disorders and Quality of Life in Egyptian Patients with Chronic Immune Thrombocytopenic Purpura: A Single Center Study.

The impact of chronic immune thrombocytopenic purpura (ITP) on the psychological health and quality of life is evident among children and adolescents. We aimed to describe psychological disorders and assess quality of life in children with chronic ITP and compared their results with their healthy peers. A cross-sectional comparative study was carried out in a tertiary care university-affiliated hospital during a period from November, 2015 till April, 2018. We enrolled 119 children with chronic ITP and compared with 220 healthy peers. Relevant demographic and clinical data were collected and statistically analyzed. Quality of life for both patients and control groups was measured using pediatric quality of life inventory version 4 (Arabic one). Also psychiatric evaluation of both groups was done using Arabic version of Mini-International Neuropsychiatric Interview for Children (Mini-KID). Majority of patients (90.7%) exhibited mucocutaneous bleeding. Most of patients (61.3%) did not need any definitive treatment for chronic ITP while 38.6% received second line therapy. About one-third of the patients needed rescue medications to control active bleeding. The scores of all sub-scales of Peds QL 4.0 were significantly decreased among patients group when compared to their healthy peers (P < 0.001). General anxiety disorder and oppositional defiant disorders were the commonest psychiatric disorders among children with chronic ITP. Quality of life in children with chronic ITP is markedly impaired with occurrence of a variable spectrum of psychiatric disorders among the studied patients.

Psychological victimization in teen dating and suicide risk among Moroccan secondary school students : Fez city as a case study

Introduction The exposure to psychological abuse has a serious impact on victims’ self-esteem and mental health, especially if it occurs in adolescence. Teenagers become at higher risks of developing suicidal ideation and attempts. In this regard, this study aimed at investigating the association between psychological victimization among Moroccan adolescents in dating relationships and suicide risk. Methods Data were collected using anonymous self- administered questionnaires distributed among a sample of 407 Moroccan students in private and public secondary schools in Fez city. Suicide risk was surveyed using The MINI International Neuropsychiatric Interview version 5.0. Statistical analyses were performed using SPSS 20.0. Results The average age of participants was 16.67 ± 1.71, and 47.2 % of respondents were females. Nearly 28 % of students were in middle school. Concerning parents’ education, about 34.3 % of participants’ fathers had completed primary education, while most mothers (40 %) were illiterate. The vast majority of students (92 %) lived with both parents and 41.5 % were from families of low income. Psychological victimization and suicide risk were significantly associated OR = 2.18 ; 95 % CI (1.39–3.40), and psychological victimization was more prevalent among males (55.9 %) than among females (44.1 %). Nevertheless, the psychological victimization in females was highly associated with suicide ideation OR = 2.65 ; 95 % CI (1.70–4.13), and with suicide attempts OR = 1.82 ; 95 % CI (1.11–2.97). Conclusion The fact that both male and female daters were highly affected by psychological violence and that female victims were at higher suicide risk entails the integration of psychological assistance inside Moroccan schools.

The Mini-International Neuropsychiatric Interview is useful and well accepted as part of the clinical assessment for depression and anxiety in primary care: a mixed-methods study

BackgroundPsychiatric complaints are common among primary care patients, with depression and anxiety being the most frequent. Diagnosis of anxiety and depression can be difficult, potentially leading to over- as well as under-diagnosis. The diagnostic process can be facilitated by incorporating structured interviews as part of the assessment. One such instrument, the Mini-International Neuropsychiatric Interview (MINI), has been established and accepted in psychiatric care. The purpose of this study was to explore the experiences and perceptions of the paper-and-pen version of MINI version 6.0 among patients and staff in primary care centers in Sweden.MethodsThe MINI was introduced at three primary care centers and was conducted by either therapists or general practitioners. Patients presented with symptoms that could suggest depression or anxiety disorders. The duration of the interview was recorded. The experiences and perceptions of 125 patients and their interviewers were collected using a structured questionnaire. Global satisfaction was measured with a visual-analog scale (0–100). Semi-structured interviews were conducted with 24 patients and three therapists, and focus groups were held with 17 general practitioners. Qualitative content analysis was used for the interviews and focus groups. The findings across the groups were triangulated with results from the questionnaires.ResultsThe median global satisfaction with the MINI was 80 for patients and 86 for interviewers. General practitioners appreciated that the MINI identified comorbidities, as one-third of the patients had at least two psychiatric diagnoses. The MINI helped general practitioners attain a more accurate diagnosis. Patients appreciated that the MINI helped them recognize and verbalize their problems and did not find it intrusive. Patients and interviewers had mixed experiences with the yes-no format of the MINI, and the risk of subjective interpretations was acknowledged. Patients, general practitioners and therapists stated that the MINI contributed to appropriate treatment. The MINI assessment lasted 26 min on average (range 12 to 60 min).ConclusionsThe paper-and-pen version of the MINI could be useful in primary care as part of the clinical assessment of patients with problems suggestive of depression or anxiety disorders. The MINI was well accepted by patients, general practitioners and therapists.

Access to Pharmacotherapy Amongst Women with Bipolar Disorder during Pregnancy: a Preliminary Study.

Bipolar disorder among pregnant women has deleterious effects on birth and child outcomes and is currently under-detected, not addressed effectively, or exacerbated through inappropriate treatment. The goal of this study was to identify perspectives of pregnant and postpartum women with bipolar disorder on barriers and facilitators to psychiatric treatment during pregnancy. In-depth interviews were conducted with pregnant and postpartum women who scored ≥ 10 on the Edinburgh Postnatal Depression Scale and met DSM-IV criteria for bipolar disorder I, II or not otherwise specified using the Mini International Neuropsychiatric Interview version 5.0. Interviews were transcribed, and resulting data were analyzed using a grounded theory approach to identify barriers and facilitators to bipolar disorder treatment access in pregnancy. Participant identified barriers included perception that psychiatric providers lack training and experience in the treatment of psychiatric illness during pregnancy, are reluctant to treat bipolar disorder among pregnant women, and believe that pharmacotherapy is not needed for psychiatric illness during pregnancy. Facilitators included participants' perception that providers' acknowledge risks associated with untreated or undertreated psychiatric illness during pregnancy and provide psycho-education about the risks, benefits and alternatives to pharmacotherapy. Psychiatric providers are critically important to the treatment of bipolar disorder and need knowledge and skills necessary to provide care during the perinatal period. Advancing psychiatric providers' knowledge/skills may improve access to pharmacotherapy for pregnant women with bipolar disorder.

Alcohol Use Disorders and Immigration up to the Third Generation in France: Findings from a 39,617-Subject Survey in the General Population.

In the United States, first-generation immigrants (FGIs) show lower prevalence rates of alcohol use disorders (AUDs) than the native population, although they experience more psychosocial risk factors. This epidemiological phenomenon is called an "immigrant paradox." No previous study has investigated whether immigrants also exhibit a reduced risk of AUDs in Europe. In a study of the general population in France, we have assessed the adjusted risk of AUDs between nonimmigrants and FGIs, second-generation immigrants (SGIs), and third-generation immigrants (TGIs). A cross-sectional survey based on face-to-face interviews was conducted among 39,617 French subjects recruited using a quota-sampling strategy. The sociodemographic data collected helped determine the subjects' immigration status. The AUD assessment was performed using the Mini International Neuropsychiatric Interview (version 5.0.0). A multivariable logistic regression model was used to define the independent risk factors for AUDs with backward selection. The overall prevalence of AUDs in the sample was 4.34%. AUDs were diagnosed in 3.82% of the native population versus 5.84% of the immigrant population: 4.67% of FGIs, 5.71% of SGIs, and 6.63% of TGIs (p<0.0001). The multivariable model showed that FGIs did not have a significantly different risk of AUDs compared to the native population (p=0.5936), whereas SGIs (odds ratio [OR]=1.18; 95% confidence interval [CI] [1.01 to 1.39]; p=0.0496) and, to a greater extent, TGIs (OR=1.38; 95% CI [1.17 to 1.63]; p=0.0002) had a significantly greater risk of AUDs. The area under the curve of the model was 0.753. Relative to French natives, a generational risk gradient for AUDs was found in the immigrant subjects, with a similar risk of FGIs, and an increased risk of SGIs and TGIs. In terms of the risk of AUDs, no "immigrant paradox" existed in French population. These results are in line with other recent findings, suggesting that the "immigrant paradox" is rarely found in Europe regarding many health-related issues.

Socio-demographic characteristics, clinical profile and prevalence of existing mental illness among suicide attempters attending emergency services at two hospitals in Hawassa city, South Ethiopia: a cross-sectional study

BackgroundSuicide is a major public health problem worldwide. It contributes for more than one million deaths each year. Since previous suicidal attempt was considered as the best predictor of future suicide, identifying factors behind suicidal attempt are helpful to design suicide prevention strategies. The aim of this study was to assess socio-demographic characteristics, clinical profile and prevalence of existing mental illness among patients presenting with suicidal attempt to emergency services of general hospitals in South Ethiopia.MethodsWe conducted a cross-sectional study on patients presenting with complications of suicidal attempt to emergency departments of two general hospitals in Hawassa city from November, 2014 to August, 2015. Data was collected using semi-structured questionnaire which contained socio-demographic and clinical variables. The Mini International Neuropsychiatric Interview version 5 (MINI PLUs) was used to assess the prevalence of existing mental illness among study participants. Data was entered and analyzed using IBM SPSS statistics 21 software package.ResultsA total of 96 individuals were assessed, of whom 56 (58.3%) were females. The mean age of study participants was 21.5 (8.0) years. The majority, 75 (78.1%), of the study participants were aged below 25 years. Ingesting pesticide poisons and corrosive agent were used by the majority to attempt suicide. Mental illness was found in only three (3.1%) of the study participants. Impulsivity (the time between decision to attempt suicide and the actual attempt of less than 5 min) was reported by 30 (31.2%) of the study participants, of whom 18 (60%) were males. Males were found three times more likely to attempt suicide impulsively than women (COR = 3.0, 95% CI 1.2–7.3). Quarreling with family members, facing financial crisis, and having unplanned and unwanted pregnancy were reported by the majority of study participants as immediate reasons to attempt suicide.ConclusionsThe presence of stressful life events and impulsivity behind suicidal behavior of the younger generation implies that designing suicide prevention strategies for this group is crucial. Moreover, further research is needed to systematically examine the relationship between the presence of mental illness and suicidal attempt with a larger sample size and more robust methodology.

Prevalence of psychiatric morbidity in a community sample in Western Kenya

BackgroundAbout 25% of the worldwide population suffers from mental, neurological and substance use disorders but unfortunately, up to 75% of affected persons do not have access to the treatment they need. Data on the magnitude of the mental health problem in Kenya is scarce.The objectives of this study were to establish the prevalence and the socio-demographic factors associated with mental and substance use disorders in Kosirai division, Nandi County, Western Kenya.MethodsThis was a cross sectional descriptive study in which participants were selected by simple random sampling. The sampling frame was obtained from a data base of the population in the study area developed during door-to-door testing and counseling exercises for HIV/AIDS. Four hundred and twenty consenting adults were interviewed by psychologists using the Mini International Neuropsychiatric Interview Version 7 for Diagnostic and Statistical Manual 5th Edition and a researcher-designed social demographic questionnaire.ResultsOne hundred and ninety one (45%) of the participants had a lifetime diagnosis of at least one of the mental disorders. Of these, 66 (15.7%) had anxiety disorder, 53 (12.3%) had major depressive disorder; 49 (11.7%) had alcohol and substance use disorder. 32 (7.6%) had experienced a psychotic episode and 69 (16.4%) had a life-time suicidal attempt. Only 7 (1.7%) had ever been diagnosed with a mental illness. Having a mental condition was associated with age less than 60 years and having a medical condition.ConclusionA large proportion of the community has had a mental disorder in their lifetime and most of these conditions are undiagnosed and therefore not treated. These findings indicate a need for strategies that will promote diagnosis and treatment of community members with psychiatric disorders. In order to screen more people for mental illness, we recommend further research to evaluate a strategy similar to the home based counseling and testing for HIV and the use of simple screening tools.

Development and analysis of the factor structure of parents' internalized stigma of neurodevelopmental disorder in child scale

Background: Parents of children suffering from neurodevelopmental disorders, frequently face public stigma which is often internalized and leads to psychological burden. However, there is a lack of data on the perceptions of internalized stigma among parents of children with neurodevelopmental disorders, especially from lower-middle-income countries like India. Aims: This study aims to develop an adapted version of the Internalized Stigma of Mental Illness (ISMI) scale for use in parents of children suffering from neurodevelopmental disorders and to explore the factor structure of this instrument through exploratory factor analysis (EFA). Settings and Design: A cross-sectional study was conducted in an outpatient setting in a tertiary care hospital in India. Materials and Methods: A total of 105 parents of children suffering from neurodevelopmental disorders (according to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition) were recruited for the study after screening for psychiatric disorder using Mini International Neuropsychiatric Interview version 6.0. A modified 16-item scale was constructed Parents' Internalized Stigma of Neurodevelopmental Disorder in Child (PISNC) scale and applied on 105 parents of children suffering from neurodevelopmental disorders, after translation to Hindi and back-translation, in keeping with the World Health Organization's translation-back-translation methodology. Statistical Analysis: EFA was carried out using principal component analysis with orthogonal (varimax) rotation. Internal consistency of the Hindi version of the scale was estimated in the form of Cronbach's alpha. Spearman–Brown coefficient and Guttman split-half coefficient were calculated to evaluate the split-half reliability. Results: The initial factor analysis yielded three-factor models with an eigenvalue of >1 and the total variance explained by these factors was 62.017%. The internal consistency of the 16-item scale was 0.91 indicating good inter-item correlation. Approximately 39.4% of the parents reported some form of Internalized stigma. Conclusions: The results revealed that the PISNC scale has high internal consistency and that it is made up of three distinctive factors: social withdrawal and alienation, stereotype endorsement, and discrimination experience. These factors although similar, are not identical, to the factors that underlie the ISMI scale.

A Study on Quality of Life and Psychopathology in Couples with Infertility

Patients with infertility show considerable distress along with significant psychiatric morbidity and lower quality of life than others without infertility. The current study aimed at exploring the psychiatric morbidity and quality of life in couples with infertility while comparing gender differences among those with infertility. The sample was 31 couples attending the infertility clinic who were interviewed and screened using the Mini International Neuropsychiatric Interview version 6.0.0 and the WHO Quality of life brief questionnaire. 45.16% of the total study population showed some psychiatric disorder. The quality of life (QOL) scores in couples with infertility and psychiatric morbidity was lower than those without any psychopathology. No major difference across gender was observed except in the social domain QOL scores where females had better scores (p = 0.017). Addressing psychopathology in couples with infertility is must in clinical practice with an aim to improve their overall quality of life.

Accuracy of anxiety and depression screening tools in heart transplant recipients

PurposeThe aim of this study was to assess the validity and reliability of psychological screening tools in outpatient heart transplant recipients. MethodsForty-eight heart transplant recipients completed the Patient Health Questionnaire 9-item scale (PHQ-9), Generalized Anxiety Disorder 7-item Scale (GAD-7), Kessler Psychological Distress 10-item Scale (K-10) and Medical Outcomes Short Form 36-item Health Survey. A structured psychological interview (Mini International Neuropsychiatric Interview Version 6) was conducted after completion of the questionnaires. Internal consistency, criterion validity and construct validity of the PHQ-9, GAD-7 and K-10 were evaluated. ResultsInternal consistency supported the reliability of the screening tools. The optimal cut-off on the PHQ-9 for depression was 10 (sensitivity=0.86; specificity=0.93). A score of 6 on the GAD-7 maximized sensitivity (0.75) and specificity (0.89) for anxiety. A score of 17 on the K-10 was the optimal cut-off for diagnosis of either anxiety or depression (sensitivity=0.83; specificity=0.84). Increasing scores on the screening tools were associated with lower health-related quality of life. ConclusionPsychometric analyses support the reliability and validity of the PHQ-9, GAD-7 and K-10 as screening tools for detection of anxiety and depression in heart transplant recipients.

Psychometric properties of the mini-social phobia inventory (Mini-SPIN) in a large online treatment-seeking sample

The Mini-Social Phobia Inventory (Mini-SPIN) is a brief, three-item measure designed as a screening tool for social anxiety disorder (SAD). This study investigated the Mini-SPIN’s psychometric properties in a series of trials of Internet-delivered treatment. Participants were 993 people seeking Internet-delivered cognitive behavioural therapy for a range of anxiety and mood disorders. Participants completed the Mini-SPIN, and were diagnosed using the Mini International Neuropsychiatric Interview Version 5.0.0 (MINI). They also completed measures of depression, general anxiety, panic, neuroticism and general impairment. The Mini-SPIN’s ability to discriminate between people with and without SAD, within a large sample of people seeking treatment for a range of psychological disorders, was assessed at initial assessment and three-month follow-up. The Mini-SPIN’s criterion group validity, internal consistency, test–retest reliability, construct validity and responsiveness to treatment were also examined. Results demonstrated that the Mini-SPIN has an excellent ability to discriminate between those with and without SAD in a highly comorbid clinical sample, and also has good criterion group validity. The Mini-SPIN also exhibited excellent internal consistency, good test–retest reliability, and was responsive to treatment. These results highlight the Mini-SPIN’s potential as an efficient and reliable measure of SAD in heterogenous populations.

Internet-based cognitive behavioural therapy (iCBT) for posttraumatic stress disorder versus waitlist control: study protocol for a randomised controlled trial.

BackgroundThis randomised controlled trial (RCT) with two parallel arms will evaluate the efficacy of an internet-delivered six-lesson 10-week cognitive behavioural therapy (iCBT) intervention for posttraumatic stress disorder (PTSD). It will also investigate the association between changes in PTSD symptoms, intolerance of uncertainty (IU) and emotion regulation.Methods/DesignPatients with PTSD will be recruited via the research arm of a not-for-profit clinical and research unit in Australia and randomised to a treatment group or waitlist control group. The minimum sample size for each group (alpha 0.05, power 0.80 for a g of 0.47) was identified as 72, but 10 % more will be recruited to hedge against expected attrition. PTSD diagnosis will be determined using the PTSD module from the Mini International Neuropsychiatric Interview version 5.0.0. The PTSD Checklist – Civilian version (PCL-C) will be used to measure PTSD symptoms (the primary outcome measure), with the Intolerance of Uncertainty Scale 12-item version (IUS-12) and the Emotion Regulation Questionnaire (ERQ) used to measure intolerance of uncertainty and emotion regulation, respectively. The PCL-C will be administered to the treatment group before each lesson of the PTSD program and at 3-month follow-up. The IUS-12 and ERQ will be administered before lessons 1 and 4, at post-treatment and at 3-month follow-up. The waitlist control group will complete these measures at week 1, week 5 and week 11 of the waitlist period. PTSD program efficacy will be determined using intent-to-treat mixed models. Maintenance of gains will be assessed at 3-month follow-up. Mediation analyses using PROCESS will be used to examine the association between change in PTSD symptoms over treatment and change in each of IU and emotion regulation ability in separate analyses.DiscussionThe current RCT seeks to replicate previous efficacy findings of iCBT for PTSD in a formally assessed PTSD sample from the general population. Findings may point to future lines of enquiry for the role of IU and emotion regulation in the mechanism of PTSD symptom change during CBT.Trial registrationAustralian New Zealand Clinical Trials Registry: ACTRN12614001213639, registered 18 November 2014. This trial protocol is written in compliance with the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) guidelines.

Treatment satisfaction in the CTN cocaine use reduction with buprenorphine study

The aim of this study was to assess the validity and reliability of psychological screening tools in outpatient heart transplant recipients.Forty-eight heart transplant recipients completed the Patient Health Questionnaire 9-item scale (PHQ-9), Generalized Anxiety Disorder 7-item Scale (GAD-7), Kessler Psychological Distress 10-item Scale (K-10) and Medical Outcomes Short Form 36-item Health Survey. A structured psychological interview (Mini International Neuropsychiatric Interview Version 6) was conducted after completion of the questionnaires. Internal consistency, criterion validity and construct validity of the PHQ-9, GAD-7 and K-10 were evaluated.Internal consistency supported the reliability of the screening tools. The optimal cut-off on the PHQ-9 for depression was 10 (sensitivity = 0.86; specificity = 0.93). A score of 6 on the GAD-7 maximized sensitivity (0.75) and specificity (0.89) for anxiety. A score of 17 on the K-10 was the optimal cut-off for diagnosis of either anxiety or depression (sensitivity = 0.83; specificity = 0.84). Increasing scores on the screening tools were associated with lower health-related quality of life.Psychometric analyses support the reliability and validity of the PHQ-9, GAD-7 and K-10 as screening tools for detection of anxiety and depression in heart transplant recipients.

Study of Psychiatry Morbidity Following Traumatic Long Bone Injury

&lt;strong&gt;Background:&lt;/strong&gt; Limb fractures due to traumatic injury cause pain, prolonged discomfort, loss of function and immobility and are expected to produce adverse psychological effects. However, there is paucity of work regarding psychopathology following bone trauma in India. &lt;strong&gt;Aim:&lt;/strong&gt; To evaluate the psychiatric morbidity amongst patients with Traumatic long bone injury (fracture). &lt;strong&gt;Design:&lt;/strong&gt; Cross sectional study &lt;strong&gt;Setting:&lt;/strong&gt; Dr Vasantrao Pawar Medical College, Nashik-Maharashtra. &lt;strong&gt;Method:&lt;/strong&gt; The study was carried out amongst 100 randomly selected patients in the age group of 18- 65 yrs who had sustained long bone injury (fracture). Patients were evaluated 4-6 weeks after the trauma over a period of 18 months. All patients were screened using Mini International Neuropsychiatric Interview version 6.0.0. Statistical Analysis was done using the EPI-INFO software. &lt;strong&gt;Result:&lt;/strong&gt; Long bone fracture patients had a high prevalence of Major depressive disorder (23%). Axis I psychiatric diagnosis shows significant association with age, marital status and education (p&amp;lt;0.05). The commonest cause of injury was road traffic accidents among males (n=58) and it was statistically significant. (p&amp;lt;0.05). Axis I psychiatric diagnosis was found more in road traffic accidents 18 (54.5%) and individuals with closed and lower limb fracture 26 (78.78%). &lt;strong&gt;Conclusion:&lt;/strong&gt; In view of occurrence of psychopathology following long bone trauma. Orthopaedic surgeons need to be aware of these conditions so that they should refer patients for psychiatric evaluation and appropriate treatment.

Study of Psychiatry Morbidity Following Traumatic Long Bone Injury

Background: Limb fractures due to traumatic injury cause pain, prolonged discomfort, loss of function and immobility and are expected to produce adverse psychological effects. However, there is paucity of work regarding psychopathology following bone trauma in India. Aim: To evaluate the psychiatric morbidity amongst patients with Traumatic long bone injury (fracture). Design: Cross sectional study Setting: Dr Vasantrao Pawar Medical College, Nashik-Maharashtra. Method: The study was carried out amongst 100 randomly selected patients in the age group of 18- 65 yrs who had sustained long bone injury (fracture). Patients were evaluated 4-6 weeks after the trauma over a period of 18 months. All patients were screened using Mini International Neuropsychiatric Interview version 6.0.0. Statistical Analysis was done using the EPI-INFO software. Result: Long bone fracture patients had a high prevalence of Major depressive disorder (23%). Axis I psychiatric diagnosis shows significant association with age, marital status and education (p<0.05). The commonest cause of injury was road traffic accidents among males (n=58) and it was statistically significant. (p<0.05). Axis I psychiatric diagnosis was found more in road traffic accidents 18 (54.5%) and individuals with closed and lower limb fracture 26 (78.78%). Conclusion: In view of occurrence of psychopathology following long bone trauma. Orthopaedic surgeons need to be aware of these conditions so that they should refer patients for psychiatric evaluation and appropriate treatment.

Risk factors for an anxiety disorder comorbidity among Thai patients with bipolar disorder: results from the Thai Bipolar Disorder Registry.

BackgroundThe aim of the study was to determine in a clinical setting the risk factors for current anxiety disorder (AD) comorbidity among Thai patients with bipolar disorder (BD), being treated under the Thai Bipolar Disorder Registry Project (TBDR).MethodsThe TBDR was a multisite naturalistic study conducted at 24 psychiatric units (ie, at university, provincial mental, and government general hospitals) between February 2009 and January 2011. Participants were in- or out-patients over 18 years of age who were diagnosed with BD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Instruments used in this study included the Thai Mini International Neuropsychiatric Interview version 5; Thai Montgomery–Åsberg Depression Rating Scale (MADRS); Thai Young Mania Rating Scale; Clinical Global Impression of Bipolar Disorder-Severity (CGI-BP-S), CGI-BP-S-mania, CGI-BPS-depression, and CGI-BP-S-overall BP illness; and the Thai SF-36 quality of life questionnaire.ResultsAmong the 424 BD patients, 404 (95.3%) had BD type I. The respective mean ± standard deviation of age of onset of mood disturbance, first diagnosis of BD, and first treatment of BD was 32.0±11.9, 36.1±12.2, and 36.2±12.2 years. The duration of illness was 10.7±9.0 years. Fifty-three (12.5%) of the 424 participants had a current AD while 38 (9%) had a substance use disorder (SUD). The univariate analysis revealed 13 significant risks for current AD comorbidity, which the multivariate analysis narrowed to age at first diagnosis of BD (odds ratio =0.95, P<0.01), family history of SUD (odds ratio =2.18, P=0.02), and having a higher current MADRS score (odds ratio =1.11, P<0.01).ConclusionA diagnosis of AD comorbid with BD is suggested by early-age onset of BD together with a higher MADRS score and a family history of SUD. The likelihood of AD comorbidity decreases by 5% with each passing year; early-age onset of BD is a risk while later age onset is protective. Our results underscore how SUD within the family significantly contributes to the risk of an AD comorbidity.

Validation of the Greek version of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E)

The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) was developed as a screening tool for symptoms of major depressive episodes in people with epilepsy. Our study describes the development, validation, and psychometric properties of the Greek version of the NDDI-E. A consecutive sample of 101 patients with epilepsy, eligible to participate in the study, has been assessed using the Mini International Neuropsychiatric Interview version 5.0.0 and the NDDI-E. All patients had no major difficulties in understanding or answering the questions of the Greek version. Cronbach's alpha coefficient was 0.74. Receiver operating characteristic analysis showed an area under the curve of 91% (95% CI=83%–99%; SE: 0.040, p<0.001). At a cutoff score of greater than 15, the NDDI-E showed a sensitivity of 91%, a specificity of 81%, and a negative predictive value of 97%.

Stressors in attempted suicide by poisoning: a sex comparison.

To identify stressors in attempted suicide by poisoning and to analyze differences between men and women. This quantitative, comparative, cross-sectional study evaluated 110 patients aged between 14 and 78 years. The following instruments used were: standardized Mini International Neuropsychiatric Interview (MINI) version 5.0.0 and an interview form specifically designed for the study. 70% of the suicide attempters were female; mean age was 28.1 years; 98.2% presented at least one psychiatric disorder. Among the stressors assessed, significant differences were observed between men and women for: not having a spouse, 72.7% among men and 54.5% among women; attempted suicide planning, 66.7% among men and 46.8% among women; being under the influence of alcohol during the attempted suicide, 51.5% among men and 26.0% among women; harmful use of alcohol, 42.4% in men and 22.1% in women; sexual abuse, 22.1% in women and 6.1% in men. Women presented a three times higher number of attempted suicides by poisoning. The identification of stressors with significant differences between sexes in the high-risk population here described can help define and organize strategies aimed at suicide prevention. Similar studies should be conducted in the general population.