New-onset Psychiatric Disorders Research Articles

Increase in presentations with new-onset psychiatric disorders in a psychiatric emergency department in Berlin, Germany during the second wave of the COVID-19 pandemic - a retrospective cross-sectional study.

While numerous studies have identified an increase in symptoms of depression as well as anxiety and distress due to the COVID-19 pandemic, relatively few studies have investigated the new-onset of psychiatric diseases during the pandemic. This study focuses on the number of psychiatric new-onset diagnoses in a psychiatric emergency department (pED) in Berlin, Germany during the second wave of the pandemic (i.e. from 09/15/2020 to 03/01/2021 = COVID-19-period) compared to pre-pandemic times (09/15/2019 to 03/01/2020 = control period). We focused on diagnostic subgroups and performed logistic regression analysis to investigate potential risk groups based on covariables such as age, gender, homelessness, attending in police custody and familial relationship. Overall, there was a 59.7% increase in new-onset psychiatric diagnoses during the COVID-19-period. Increases in the following diagnoses were observed: new-onset of substance-related and addictive disorders (+192.5%), depressive disorders (+115.8%), schizophrenia spectrum and psychotic disorders (+113.3%) and anxiety disorders (+63.6%). These diagnostic subgroups, together with attending in police custody, were found to predict pED presentations with new-onset during the COVID-19-period. Interestingly, in the group of new-onset psychiatric diseases in the COVID-19-period, higher amounts of job loss and living alone as well as a relative decrease in familial relationships were observed. COVID-19 infections and post-COVID-19 syndrome are unlikely to have played a substantial role in the increase of new-onset diseases in this study. Conclusion: Our findings underline the role of indirect factors in new-onset of psychiatric diseases during the pandemic and should be a caveat for future pandemic control policies.

Rheumatoid arthritis and the risk of postpartum psychiatric disorders: a Nordic population-based cohort study

BackgroundPostpartum psychiatric disorders (PPD) are common complications of childbirth. A common explanation for their development is that the psychological, hormonal, and immune changes associated with pregnancy and parturition may trigger psychiatric symptoms postpartum. Rheumatoid arthritis (RA) is characterized by abnormalities in the activity of the hypothalamic–pituitary–adrenal axis and of the immune system, but its association with PPD is unknown. We analyzed whether women with RA before childbirth have an increased risk of PPD.MethodsWe conducted a large population-based cohort study including mothers of singleton births in the Danish (1995–2015), Finnish (1997–2013), and Swedish Medical Birth Registers (2001–2013) (N = 3,516,849). We linked data from the Medical Birth Registers with data from several national socioeconomic and health registers. Exposure was defined as having a diagnosis of RA before childbirth, while the main outcome was a clinical diagnosis of psychiatric disorders 90 days postpartum. We analyzed the association between RA and PPD using Cox proportional hazard models, stratified by a personal history of psychiatric disorders.ResultsAmong women without a history of psychiatric disorders, the PPD incidence rate was 32.2 in the exposed and 19.5 per 1000 person-years in the unexposed group; women with RA had a higher risk of overall PPD than their unexposed counterparts [adjusted hazard ratio (HR) = 1.52, 95% confidence intervals (CI) 1.17 to 1.98]. Similar associations were also observed for postpartum depression (HR = 1.65, 95% CI 1.09 to 2.48) and other PPD (HR = 1.59, 95% CI 1.13 to 2.24). Among women with a history of psychiatric disorders, the incidence rate of overall PPD was 339.6 in the exposed and 346.6 per 1000 person-years in the unexposed group; RA was not associated with PPD. We observed similar associations between preclinical RA (RA diagnosed after childbirth) and PPD to those corresponding to clinical RA.ConclusionsRheumatoid arthritis was associated with an increased PPD risk in women without, but not in those with a psychiatric history. If our findings are confirmed in future studies, new mothers with RA may benefit from increased surveillance for new-onset psychiatric disorders postpartum.

Elevated risk for new-onset psychiatric disorders in vulnerable populations harboring gut-brain axis dysfunction in a large US study of medical records

Elevated risk for new-onset psychiatric disorders in vulnerable populations harboring gut-brain axis dysfunction in a large US study of medical records

Comorbidity of long COVID and psychiatric disorders after a hospitalisation for COVID-19: a cross-sectional study

ObjectivesLong COVID is a major public health issue. Whether long COVID is comorbid with psychiatric disorders remains unclear. Here, we investigate the association between long COVID, psychiatric symptoms and psychiatric...

Predicting New-Onset Psychiatric Disorders Throughout the COVID-19 Pandemic: A Machine Learning Approach.

The investigators estimated new-onset psychiatric disorders (PsyDs) throughout the COVID-19 pandemic in Italian adults without preexisting PsyDs and developed a machine learning (ML) model predictive of at least one new-onset PsyD in subsequent independent samples. Data were from the first (May 18-June 20, 2020) and second (September 15-October 20, 2020) waves of an ongoing longitudinal study, based on a self-reported online survey. Provisional diagnoses of PsyDs (PPsyDs) were assessed via DSM-based screening tools to maximize assessment specificity. Gradient-boosted decision trees as an ML modeling technique and the SHapley Additive exPlanations technique were applied to identify each variable's contribution to the model. From the original sample of 3,532 participants, the final sample included 500 participants in the first wave and 236 in the second. Some 16.0% of first-wave participants and 18.6% of second-wave participants met criteria for at least one new-onset PPsyD. The final best ML predictive model, trained on the first wave, displayed a sensitivity of 70% and a specificity of 73% when tested on the second wave. The following variables made the largest contributions: low resilience, being an undergraduate student, and being stressed by pandemic-related conditions. Living alone and having ceased physical activity contributed to a lesser extent. Substantial rates of new-onset PPsyDs emerged among Italians throughout the pandemic, and the ML model exhibited moderate predictive performance. Results highlight modifiable vulnerability factors that are suitable for targeting by public campaigns or interventions to mitigate the pandemic's detrimental effects on mental health.

Perinatal mental healthcare in Northern Ireland: challenges and opportunities.

Perinatal mental health is a vital component of public mental health. The perinatal period represents the time in a woman's life when she is at the highest risk of developing new-onset psychiatric disorders or relapse of an existing mental illness. Optimisation of maternal mental health in the perinatal period is associated with both short- and long-term benefits not only for the mother, but also for her infant and family. However, perinatal mental health service provision remains variable across the world. At present in Northern Ireland, 80% of women do not have access to specialist community perinatal mental health services, and without access to a mother and baby unit, mothers who require a psychiatric admission in the postnatal period are separated from their baby. However, following successful campaigns, funding for development of specialist perinatal mental health community teams has recently been approved. In this article, we discuss the importance of perinatal mental health from a public health perspective and explore challenges and opportunities in the ongoing journey of specialist service development in Northern Ireland.

Increased maternal new-onset psychiatric disorders after delivering a child with a major anomaly: a cohort study.

The birth of a child with a major congenital anomaly may create chronic caregiving stress for mothers, yet little is known about their psychiatric outcomes. To evaluate the association of the birth of a child with a major congenital anomaly with subsequent maternal psychiatric risk. This Danish nationwide cohort study included mothers who gave birth to an infant with a major congenital anomaly (n=19220) between 1997 and 2015. Comparators were randomly selected mothers, matched on maternal age, year of delivery and parity (n=195399). The primary outcome was any new-onset psychiatric diagnosis. Secondary outcomes included specific psychiatric diagnoses, psychiatric in-patient admissions and redeemed psychoactive medicines. Cox models were used to estimate hazard ratios (HRs), adjusted for socioeconomic and medical variables. Mothers of affected infants had an elevated risk for a new-onset psychiatric disorder vs. the comparison group (adjusted HR, 1.16, 95% CI 1.11-1.22). The adjusted HR was particularly elevated during the first postpartum year (1.65, 95% CI 1.42-1.90), but remained high for years, especially among mothers of children with multiorgan anomalies (1.37, 95% CI 1.18-1.57). The risk was also elevated for most specific psychiatric diagnoses, admissions and medicines. Mothers who give birth to a child with a major congenital anomaly are at increased risk of new-onset psychiatric disorders, especially shortly after birth and for mothers of children with more severe anomalies. Our study highlights the need to screen for mental illness in this high-risk population, as well as to integrate adult mental health services and paediatric care.

Psychiatric Diseases in Pregnancy

The exacerbation of pre-existing psychiatric conditions and the development of a new-onset psychiatric disorder during pregnancy directly affects the care of pregnant women. Depression and anxiety are highly prevalent in reproductive age women and may be exacerbated in the perinatal and postpartum periods. Post-traumatic stress disorder is another common condition seen in this population and may worsen under the stress of pregnancy, delivery, and childrearing. Substance abuse is also pervasive in this population, requiring obstetricians to have a thorough understanding of how to manage and treat pregnant women with dependence disorders. Psychiatric conditions and substance abuse often co-exist. These and other disorders present significant risk to the mother and fetus. It is essential therefore for obstetric care providers to understand how to screen for, diagnose, and treat psychiatric disorders during pregnancy and in the postpartum period. This review contains 4 tables, and 58 references. Keywords: perinatal depression, postpartum depression, postpartum psychosis, anxiety in pregnancy, substance abuse in pregnancy, post-traumatic stress disorder in pregnancy, eating disorders in pregnancy, pregnancy screening

Psychiatric Diseases in Pregnancy

The exacerbation of pre-existing psychiatric conditions and the development of a new-onset psychiatric disorder during pregnancy directly affects the care of pregnant women. Depression and anxiety are highly prevalent in reproductive age women and may be exacerbated in the perinatal and postpartum periods. Post-traumatic stress disorder is another common condition seen in this population and may worsen under the stress of pregnancy, delivery, and childrearing. Substance abuse is also pervasive in this population, requiring obstetricians to have a thorough understanding of how to manage and treat pregnant women with dependence disorders. Psychiatric conditions and substance abuse often co-exist. These and other disorders present significant risk to the mother and fetus. It is essential therefore for obstetric care providers to understand how to screen for, diagnose, and treat psychiatric disorders during pregnancy and in the postpartum period. This review contains 4 tables, and 58 references. Keywords: perinatal depression, postpartum depression, postpartum psychosis, anxiety in pregnancy, substance abuse in pregnancy, post-traumatic stress disorder in pregnancy, eating disorders in pregnancy, pregnancy screening

Psychiatric Diseases in Pregnancy

The exacerbation of pre-existing psychiatric conditions and the development of a new-onset psychiatric disorder during pregnancy directly affects the care of pregnant women. Depression and anxiety are highly prevalent in reproductive age women and may be exacerbated in the perinatal and postpartum periods. Post-traumatic stress disorder is another common condition seen in this population and may worsen under the stress of pregnancy, delivery, and childrearing. Substance abuse is also pervasive in this population, requiring obstetricians to have a thorough understanding of how to manage and treat pregnant women with dependence disorders. Psychiatric conditions and substance abuse often co-exist. These and other disorders present significant risk to the mother and fetus. It is essential therefore for obstetric care providers to understand how to screen for, diagnose, and treat psychiatric disorders during pregnancy and in the postpartum period. This review contains 4 tables, and 58 references. Keywords: perinatal depression, postpartum depression, postpartum psychosis, anxiety in pregnancy, substance abuse in pregnancy, post-traumatic stress disorder in pregnancy, eating disorders in pregnancy, pregnancy screening

Psychiatric Diseases in Pregnancy

The exacerbation of pre-existing psychiatric conditions and the development of a new-onset psychiatric disorder during pregnancy directly affects the care of pregnant women. Depression and anxiety are highly prevalent in reproductive age women and may be exacerbated in the perinatal and postpartum periods. Post-traumatic stress disorder is another common condition seen in this population and may worsen under the stress of pregnancy, delivery, and childrearing. Substance abuse is also pervasive in this population, requiring obstetricians to have a thorough understanding of how to manage and treat pregnant women with dependence disorders. Psychiatric conditions and substance abuse often co-exist. These and other disorders present significant risk to the mother and fetus. It is essential therefore for obstetric care providers to understand how to screen for, diagnose, and treat psychiatric disorders during pregnancy and in the postpartum period. This review contains 4 tables, and 58 references. Keywords: perinatal depression, postpartum depression, postpartum psychosis, anxiety in pregnancy, substance abuse in pregnancy, post-traumatic stress disorder in pregnancy, eating disorders in pregnancy, pregnancy screening

Inflammatory bowel disease and new-onset psychiatric disorders in pregnancy and post partum: a population-based cohort study

ObjectivePatients with inflammatory bowel disease (IBD) have an elevated risk of mental illness. We determined the incidence and correlates of new-onset mental illness associated with IBD during pregnancy and post...

Serum polyunsaturated fatty acids and risk of psychiatric disorder after acute coronary syndrome: A prospective cohort study

BackgroundAround 20% of patients with acute coronary syndrome (ACS) develop depression. Furthermore, some observational studies revealed baseline polyunsaturated fatty acids (PUFAs) may affect the prognosis of depression after ACS. This prospective cohort study examined the association between psychiatric disorder and PUFAs after ACS. MethodsSubjects were ACS patients admitted to a Tokyo teaching hospital. Psychiatric morbidity as a primary endpoint was measured using structured interview 3 months after admission. At admission, serum n-3 and n-6 PUFAs were measured by gas chromatography and patients were interviewed to evaluate medical information. Multiple logistic regression analysis was performed to calculate odds ratios (ORs) and 95% confidence intervals to examine the association between PUFAs at baseline and psychiatric disorder after ACS. ResultsBetween March 2014 and August 2016, 100 patients completed the follow-up assessment. Eleven patients (11%) showed some form of new-onset psychiatric disorder at 3 months, mainly depressive episode (major, 5; minor, 1) and PTSD (full, 1; partial, 2). Psychiatric disorder was predicted by serum linoleic acid level (OR=3.96) and Hospital Anxiety and Depression Scale total score (OR=1.34) at baseline. No significant associations were seen with other PUFAs. LimitationsThe results were obtained from a single hospital and based on a small number of participants. There might be some patients with new-onset psychiatric disorder among the refused patients. ConclusionsPsychiatric disorder incidence in ACS patients might be lower in Japan than in Western countries. Reduced intake of linoleic acid-containing foods might prevent depression or PTSD after ACS.

Risk of psychiatric disorders following gastroesophageal reflux disease: A nationwide population-based cohort study

BackgroundRecent studies have shown that the peripheral inflammation may cause the up-regulation of central nervous system inflammation and therefore possibly plays a vital role in the pathophysiology of subsequent psychiatric disorders. ObjectiveWe explored the relationship between gastroesophageal reflux disease (GERD) and the subsequent development of psychiatric disorders including schizophrenia as well as bipolar, depressive, anxiety, and sleep disorders. MethodsWe investigated patients who were diagnosed with GERD according to the data in the Taiwan National Health Insurance Research Database. A comparison cohort comprised patients without GERD who were matched according to age and sex. The incidence rate and the hazard ratios (HRs) of subsequent new-onset psychiatric disorders were calculated for both cohorts, based on the diagnoses of psychiatrists. ResultsThe GERD cohort consisted of 3813 patients, and the comparison cohort comprised 15,252 matched control patients without GERD. The risks of depressive disorder (HR=3.37, 95% confidence interval [CI]=2.49–4.57), anxiety disorder (HR=2.99, 95% CI=2.12–4.22), and sleep disorder (HR=2.69, 95% CI=1.83–3.94), were higher in the GERD cohort than in the comparison cohort. In addition, the incidence of newly diagnosed depressive, anxiety, and sleep disorders remained significantly increased in all of the stratified follow-up durations (0–1, ≥1year). ConclusionsGERD may increase the risks of subsequent depressive, anxiety, and sleep disorders. These psychiatric disorders have a negative effect on people's quality of life. Clinicians should pay a particular attention to psychiatric comorbidities in GERD patients.

New-onset psychiatric disorders after corticosteroid therapy in systemic lupus erythematosus: an observational case-series study.

The objective of this study was to clarify the incidence, clinical characteristics, and courses of new-onset psychiatric manifestations after corticosteroid therapy in patients with systemic lupus erythematosus (SLE), including possible ways of differentiating between corticosteroid-induced psychiatric disorders (CIPDs) and central nervous system manifestations of SLE (CNS-SLE). We prospectively followed for 8 weeks 139 consecutive episodes in 135 in-patients who had a non-CNS-SLE flare treated with corticosteroids. Psychiatric events were evaluated once a week using DSM-IV criteria. We then conducted a post hoc etiological analysis of any newly developed psychiatric events during this follow-up period. In the 8 weeks of corticosteroid administration, new psychiatric events occurred in 20 (14.4 %) of the 139 episodes. The mean dosage of corticosteroids administered was prednisolone at 0.98 (range 0.24-1.39) mg/kg/day. Of the 20 psychiatric events, 14 (10.1 %) were suitable for the strict definition of CIPDs, accompanied by mood disorders in 13 (depressive in 2, manic in 9, and mixed in 2) and psychotic disorder in one. Two (1.4 %), both presenting delirium, were diagnosed as CNS-SLE on the basis of evidence of abnormal CNS findings even before psychiatric manifestations, all of which improved in parallel with these patients' recoveries through augmentation of immunosuppressive therapy. The other four events (2.9 %) could not be etiologically identified. This study suggests that corticosteroid therapy triggers CIPDs and CNS-SLE in patients with SLE. Delirium may be suggestive of CNS-SLE, while mood disorders may be more suggestive of CIPDs. Electroencephalographic abnormalities may possibly be predictive of CNS-SLE.

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

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

Giant Cell Arteritis Presenting as Depressed Mood and Headache in an Elderly Patient

Giant cell arteritis (GCA) is an autoimmune disorder characterized by the inflammation of medium to large vessels. Although classic descriptions have centered on features such as vision loss, headaches, fevers, and jaw claudication, there is increasing recognition of more atypical manifestations. We report a case of GCA in a 77-year-old male patient initially presenting with depressed mood and headache. His psychiatric symptoms promptly responded to treatment with corticosteroids without the use of antidepressants. This case adds to the literature that GCA may initially present with affective or psychotic symptoms and highlights the need for clinicians to consider GCA in the differential diagnosis for new-onset psychiatric disorders in the elderly.

Predictors of psychiatric disorders in combat veterans

BackgroundMost previous research that has examined mental health among Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) combatants has relied on self-report measures to assess mental health outcomes; few studies have examined predictors of actual mental health diagnoses. The objective of this longitudinal investigation was to identify predictors of psychiatric disorders among Marines who deployed to combat in Iraq and Afghanistan.MethodsThe study sample consisted of 1113 Marines who had deployed to Iraq or Afghanistan. Demographic and psychosocial predictor variables from a survey that all Marines in the sample had completed were studied in relation to subsequent psychiatric diagnoses. Univariate and multivariate logistic regression were used to determine the influence of the predictors on the occurrence of psychiatric disorders.ResultsIn a sample of Marines with no previous psychiatric disorder diagnoses, 18% were diagnosed with a new-onset psychiatric disorder. Adjusting for other variables, the strongest predictors of overall psychiatric disorders were female gender, mild traumatic brain injury symptoms, and satisfaction with leadership. Service members who expressed greater satisfaction with leadership were about half as likely to develop a mental disorder as those who were not satisfied. Unique predictors of specific types of mental disorders were also identified.ConclusionsOverall, the study’s most relevant result was that two potentially modifiable factors, low satisfaction with leadership and low organizational commitment, predicted mental disorder diagnoses in a military sample. Additional research should aim to clarify the nature and impact of these factors on combatant mental health.

Neuroimaging Correlates of Novel Psychiatric Disorders After Pediatric Traumatic Brain Injury

To study magnetic resonance imaging (MRI) correlates of novel (new-onset) psychiatric disorders (NPD) after traumatic brain injury (TBI) and orthopedic injury (OI). Participants were 7 to 17 years of age at the time of hospitalization for either TBI or OI. The study used a prospective, longitudinal, controlled design with standardized psychiatric assessments conducted at baseline (reflecting pre-injury function) and 3 months post-injury. MRI assessments including diffusion tensor imaging (DTI)-derived fractional anisotropy (FA), volumetric measures of gray and white matter regions, volumetric measures of lesions, and cortical thickness were conducted. Injury severity was assessed by standard clinical scales. The outcome measure was the presence of an NPD identified during the first 3 months after injury. There were 88 participants (TBI, 44; OI, 44). NPD occurred more frequently in the TBI (21/44; 48%) versus the OI (6/44; 14%) group (Fisher's exact test, p = .001). NPD in TBI participants was not related to injury severity. Multivariate analysis of covariance of the relationship between FA in hypothesized regions of interest (bilateral frontal and temporal lobes, bilateral centrum semiovale, bilateral uncinate fasciculi) and NPD and group (TBI versus OI) was significant, and both variables (NPD, p < .05; group, p < .001) were jointly significantly related to FA. NPD was not significantly related to volumetric measures of white or gray matter structures, volumetric measures of lesions, or cortical thickness measures. Lowered white matter integrity may be more important in the pathophysiology of NPD than indices of gray matter or white matter atrophic changes, macroscopic lesions, and injury severity.

Bifrontal Meningioma Presenting as Postpartum Depression with Psychotic Features

The use of neuroimaging is of uncertain value in the routine evaluation of new-onset psychiatric disorders. We present the case of an apparent postpartum depression with psychosis in a woman with a history of childhood acute lymphoblastic leukemia (ALL) treated with central nervous system (CNS) radiation. Neuroimaging during an inpatient psychiatric hospitalization revealed a large bifrontal meningioma. Patients treated with CNS radiation for childhood cancer may be a subset of patients in whom neuroimaging is warranted in the setting of new-onset psychosis.