Pattern Of Psychiatric Morbidity Research Articles

Psychiatric morbidity following miscarriage in Hong Kong

Objective The aim of this study is to examine the pattern of psychiatric morbidity up to 3 months following miscarriage and to identify the risk factors of post-miscarriage depressive disorder among Chinese women in Hong Kong. Method This is a longitudinal cohort study. Women were interviewed immediately after miscarriage to collect psychiatric and sociodemographic data. Three months later, 161 subjects (89%) were assessed by a 12-item General Health Questionnaire (GHQ-12) and the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) as screening and diagnostic instruments, respectively. Results Three months after miscarriage, 10% of subjects suffered depressive disorder, 1.2% were diagnosed with anxiety disorder not otherwise specified, and another two subjects each suffered obsessive compulsive disorder (0.6%) and posttraumatic stress disorder (0.6%), respectively. Risk factors of post-miscarriage depression included younger age, history of infertility and past history of depression. Conclusions Given the local annual figure of more than 7000 first-trimester miscarriages, about 900 local women suffer post-miscarriage psychiatric disorder each year. This finding may prompt general hospitals in Hong Kong to screen for post-miscarriage psychiatric disorders, particularly depression.

Chronology and Patterns of Psychiatric Morbidity in Substance-Dependent and Medical Patients

Chronology and Patterns of Psychiatric Morbidity in Substance-Dependent and Medical Patients

Psychiatric morbidity in arsonists referred for forensic psychiatric assessment in Sweden

Little is known about the pattern of psychiatric morbidity in arsonists referred for psychiatric evaluation, and how this compares with other violent offenders. Furthermore, there is uncertainty around whether there are differences in the psychiatric morbidity of female and male arsonists. We investigated all arsonists referred for an inpatient forensic psychiatric examination in Sweden over a five-year period (1997–2001). Diagnostic information was collected on 214 arsonists, of whom 155 were men and 59 women. Principal and comorbid DSM-IV psychiatric diagnoses in these arsonists were compared with those of 2395 other violent offenders who received forensic psychiatric examinations over the same period. We found the most common Axis I diagnoses for individuals convicted of arson and referred for forensic psychiatric evaluation were psychotic illnesses and substance use disorders. Compared with other violent offenders referred for forensic psychiatric examinations, arsonists were more likely to be diagnosed with a learning disability and, in the men, Asperger's syndrome. The pattern of psychiatric morbidity in these arsonists did not appear to differ between women and men. We conclude that the treatment needs of arsonists with psychiatric morbidity primarily relate to psychotic illnesses and substance use disorders. In addition, forensic psychiatric services could consider the involvement of learning disability expertise in meeting treatment needs.

PSYCHIATRIC INPATIENTS;

To explore the pattern and prevalence of inpatient psychiatricmorbidity and to see how it differs from the pattern of psychiatric morbidity in community. Design: The details of all inpatients from the case register developed for a health information system was included in study Setting: In Departmentof Psychiatry and Behavioral Sciences, Bahawal Victoria Hospital, Bahawalpur. Period: From 1998-2003. Results: Atotal of 5426 patients were admitted in the six year. There was a slight difference of 0.8% in total number of males andfemales cases (i.e., 2764 males Vs 2662 females). Overall difference reported in the present study, in mean ages ofmales and females was 3.45 years (i.e., males = 31.85 Vs females = 28.40). Mean stay of patients in ward is 10-12days. Most patients were admitted with Conversion disorder 24% followed by Schizophrenia 23%, Depressive disorder20%, Drug Dependence 10%, Bipolar Disorder 7%. The patients with Neurotic Disorder and Organic Disorder werebelow 5%. Conclusion: The study showed that overall general pattern of inpatient psychiatric morbidity is in line withpattern of psychiatric morbidity in community and the partial variance can be explained in terms of social variables, asthis variance exist even across studies within community samples.

Psychopathology in adolescent and young adult criminal offenders (15–21 years) in Sweden

This study examined rates of psychopathology among adolescent and young adult serious offenders referred to pre-sentence forensic psychiatric services and compared patterns of psychiatric morbidity with adult forensic referrals and age-matched general psychiatric inpatients. In Sweden, criminal offenders can be referred for an extensive court-ordered pre-sentence inpatient forensic psychiatric examination (FPE). Data on all 3,058 of these offenders (90% male, mean age = 35.3 years) during 1997-2001 were obtained from the National Board of Forensic Medicine. We compared DSM-IV psychiatric diagnoses across age bands 15-17 years (N = 60), 18-21 years (N = 300) and 22 years and older (N = 2,698). Comparative data by age bands were also obtained for inpatient diagnoses among individuals admitted to general psychiatric hospitals. Compared with the adult forensic psychiatric examinees, those aged 15-17 years and 18-21 years had higher rates of depression, and childhood and developmental disorders but lower rates of psychosis, bipolar disorder, and substance use disorders. Compared with general psychiatric inpatients, offenders aged 15-17 years had higher prevalences of depression and attention-deficit or disruptive disorders and lower ones of alcohol and drug misuse disorders. There are significant differences in patterns of psychiatric morbidity in adolescent and young adult offenders that come into contact with psychiatric services compared with older offenders and adolescent psychiatric inpatients. This suggests that the development of health services addressing the psychiatric needs of younger offenders needs to draw on information on their specific mental health needs.

Psychiatric morbidity pattern in a child guidance clinic

Background: There is a paucity of Indian studies on psychiatric morbidity in children. Present work was undertaken in a child guidance clinic in armed forces. Methods: Retrospective analysis of 213 patients who attended a child guidance clinic was done. Results: Majority (n=138) were boys. 55.9% were referred from paediatric outpatient department while medical officers in periphery referred 38.5%. The diagnoses was mental retardation in 30.97%, behavioral and emotional disorders in 23.06% and neurotic, stress related and somatoform disorders in 15.98% cases.

Psychiatric morbidity and pattern of dysfunctions in patients with leprosy

BACKGROUND: Leprosy, being a chronic infectious disease with profound social stigma, remains associated with high psychological mortidity. PURPOSES: To find out the pattern of psychiatric morbidity in leprosy patients and the relationship of various factors with the morbidity. METHODS: Ninty patients attending leprosy clinic were randomly chosen for the study group alongwith 40 patients suffering from acute skin problem other than leprosy as control group. The socio-demographic data were recorded in semi-structural proforma; all patients were given Goldbery Health Questioneaire (GHQ). Patients having GHQ score >2 was assessed by Disability Assessent Questionaire (DAQ). The psychiatric diagnoses was made according to ICD-10 by W ho0 and physical deformity by W ho 0 Disability Scale. FINDINGS: The mean GHQ score of the study grant was 3.44 and that of control group was 1.62. The mean DAQ score was 45.13. Psychiatric disorder was seen in 44.4% and 7.5% of study group and control group respectively. The psychiatric illness was generalised anoxidy disorder (GAD) (27.8%). CONCLUSIONS: Leprosis highly associated with psychiatric mobidity. LIMITATIONS: The findings can not be generalised due to small sample size and clinic-based data.

Lifetime risk and persistence of psychiatric disorders across ethnic groups in the United States

Recent research in the United States has demonstrated striking health disparities across ethnic groups. Despite a longstanding interest in ethnic disadvantage in psychiatric epidemiology, patterns of psychiatric morbidity across ethnic groups have never been examined in a nationally representative sample. Ethnic differences in psychiatric morbidity are analyzed using data from the National Comorbidity Survey (NCS). The three largest ethnic groups in the United States--Hispanics, Non-Hispanic Blacks and Non-Hispanic Whites were compared with respect to lifetime risk and persistence of three categories of psychiatric disorder: mood disorder, anxiety disorder, and substance use disorder. Where differences across ethnic groups were found in lifetime risk, socially disadvantaged groups had lower risk. Relative to Non-Hispanic Whites, Hispanics had lower lifetime risk of substance use disorder and Non-Hispanic Blacks had lower lifetime risk of mood, anxiety and substance use disorders. Where differences were found in persistence of disorders, disadvantaged groups had higher risk. Hispanics with mood disorders were more likely to be persistently ill as were Non-Hispanic Blacks with respect to both mood disorders and anxiety disorders. Closer examination found these differences to be generally consistent across population subgroups. Members of disadvantaged ethnic groups in the United States do not have an increased risk for psychiatric disorders. Members of these groups, however, do tend to have more persistent disorders. Future research should focus on explanations for these findings, including the possibility that these comparisons are biased, and on potential means of reducing the disparity in persistence of disorders across ethnic groups.

Predictors of Types of Help Provided to People Using Services for Mental Health Problems: An Analysis of the Australian National Survey of Mental Health and Wellbeing

Using the 1997 National Survey of Mental Health and Wellbeing, this study examined the types of mental health help provided to those Australians who use mental health services. We also sought to identify the extent to which sociodemographic factors, patterns of psychiatric morbidity and type of health practitioner seen were associated with receiving different types of mental health help. Multiple logistic regressions were undertaken to identify predictor variables associated with receiving information, medication, psychological therapy, practical help and help looking after oneself or one's home. A total of 25 predictor variables provided in the National Survey were considered including age, sex, marital status, labour force status, geographical location, education, psychological symptoms, neuroticism, diagnoses of affective, anxiety and substance-abuse disorders and self-identified depression, anxiety and substance abuse. The type of practitioner seen for mental health reasons was also considered. Of the sociodemographic factors, age was the most consistently associated with receiving particular types of help. Younger respondents were more likely to have received information whereas older patients reported receiving more medication. As might be expected, the type and severity of psychiatric morbidity and the category of health professional seen were also associated with receiving particular types of mental health help. There are relatively few predictor variables that suggest possible bias in the types of help provided. Age group of recipient is an important exception. Our findings suggest that older recipients of mental health care are not provided the range of mental health treatments offered younger people who present with similar problems.

Geriatric psychiatric morbidity in rural northern India: implications for the future.

This was an epidemiological study funded by the Indian Council of Medical Research and conducted in a representative rural geographical area in northern India. The study aimed to determine the pattern of psychiatric morbidity in those aged 60 years or above and to ascertain the causative/contributory role of biosociodemographic factors, if any. Three groups of subjects formed the sample: the geriatric psychiatrically ill and non-ill and the nongeriatric psychiatrically ill. The prevalence of psychiatric morbidity was found to be much higher in the geriatric group (43.32%) than in the nongeriatric group (4.66%). The psychiatric morbidity pattern consisted of neurotic depression, manic-depressive psychosis depression, and anxiety state in descending order of frequency. Socially, economically, and educationally disadvantaged subjects were found to be more psychiatrically ill. The data indicate that by the year 2000, there will be about 28 million psychiatrically ill geriatric persons in the country requiring the attention of health policy planners. The implications of these findings in light of the available services for psychiatrically ill geriatric persons have been discussed and future directions identified.

Psychiatric disorders in candidates for surgery for epilepsy.

To provide a descriptive analysis of the prevalence and pattern of psychiatric morbidity among 300 consecutive epileptic patients refractive to treatment and admitted during a six year period for evaluation of their candidature for surgery. Patients underwent detailed observation of their seizure and standardised psychiatric assessment. Patients were considered to be refractory to treatment if they continued to manifest seizures with an average frequency of at least once every month even with polytherapy using up to three different anti-convulsants for a period of at least two years. Of the 300 patients, 231 had a temporal lobe focus, 43 had a non-temporal lobe focus, and 26 patients had a generalised and multifocal seizure onset. With the DSM-III-R criteria 142 (47.3%) patients emerged as psychiatric cases. A principal axis I diagnosis was made in 88 (29.3%), and an axis II diagnosis (personality disorder) in another 54 (18.0%) patients. The most common axis I diagnosis was anxiety disorders (10.7%). A schizophrenia-like psychosis was seen in 13 (4.3%). Most patients with personality disorders showed dependent and avoidant personality traits. There was a significantly higher psychotic subscore on the present state examination in the temporal than with the non-temporal group of patients. These findings were not significant when compared with patients with a generalised and multifocal seizure disorder. There were no significant findings between the different seizure focus groups on the neurotic subscores. The findings with regard to laterality of seizure focus and the neurotic or psychotic subscores were not significant.

Pattern of psychiatric morbidity in children attending a general psychiatric unit.

Patterns of psychiatric morbidity were studied retrospectively in children who attended the psychiatric outpatient clinic of a general hospital over a period of two years (January 1991-December 1992). Three hundred and eighty six children attended the clinic during this period. Twenty three percent of the children were diagnosed as mental retardation, whereas epilepsy was the diagnosis in 21% cases. A formal psychiatric diagnosis could be made only in less than half of the cases. The findings are discussed in terms of public awareness about child psychiatric disorders.

The pattern of psychiatric morbidity in a Victorian urban aboriginal general practice population.

Victorian Aboriginal people, most of whom live an urban lifestyle, form a distinct cultural group within the wider Victorian community. This paper describes a unique psychosocial study of urban Aboriginal adults attending a general practitioner at the Victorian Aboriginal Health Service in Fitzroy. The frequency and nature of psychiatric disorders among survey respondents is reported, together with a discussion of the association between this morbidity and certain sociodemographic variables.

Patterns of psychiatric morbidity in a genito-urinary clinic. A validation of the Hospital Anxiety Depression scale (HAD).

The prevalence of psychiatric disorder (by DSM-III criteria) in a population attending a genito-urinary clinic was found to be 31%. The performance of the Hospital Anxiety Depression (HAD) scale as a screening questionnaire for psychiatric disorder was assessed. Case definition by a score of 8 or more on either of the anxiety or depressive subscales produced optimal results, giving sensitivities of 82% and 70%, and specificities of 94% and 68%, for depressive and anxiety disorders respectively.

Pattern of psychiatric morbidity and alcohol dependence in patients with alcoholic liver disease.

Fifty-six male patients with alcoholic liver disease were evaluated for the presence and severity of alcohol dependence and psychiatric illness using a severity of alcohol dependence questionnaire and research diagnostic criteria, respectively. Forty-three (76.7%) patients were found to be dependent; 26 (46.4%) moderately, and 17 (30.3%) severely. Patients with alcoholic hepatitis were significantly (P less than 0.05) more often found to be dependent than patients with alcoholic cirrhosis. Psychiatric morbidity was observed in 42 (75%) of the patients with alcoholic liver disease and 15 (26.7%) of the nonalcoholic cirrhotics. The difference was highly significant (P less than 0.01). The commonest disorders in patients with alcoholic liver disease were neuroses (33.0%), followed by affective disorders (26.8%). It was, however, not possible to ascertain whether psychiatric disorders antedated alcoholism or were secondary to it. Detection of moderate to severe dependence on alcohol and psychiatric morbidity in about three-fourths of the patients with alcoholic liver disease warrants an increased awareness and a multidisciplinary approach for the management of these patients.

Patterns of psychiatric morbidity in Victoria, Australia, in relation to changes in diagnostic criteria 1848?1978

Psychiatric records dating back to 1848 (when Yarra Bend, the first mental asylum in Victoria, Australia, was opened) were used to determine admission patterns of Victorian psychiatric institutions. Whilst the overall rate of admissions per 100,000 of population has remained constant up to the early 1950s the diagnosis of mania, which was one of the most prevalent in the 19th century, has almost disappeared as a cause for admission to psychiatric institutions. On the other hand, there has been an evident increase in admissions with depressive illness (in the past recorded as melancholia) and especially with schizophrenia (previously recorded as dementia praecox and/or delusional insanity). Modified DSM III criteria were used to assess retrospectively the diagnostic decisions made. Whilst past diagnoses of schizophrenia would be supported today, only 2.5% diagnoses of mania made in the mid to late 19th century would be confirmed today. With the decline in the number of patients with a diagnosis of mania the percentage agreement between the original and DSM III diagnosis increased to 70% in the 1950s. Changes noted in diagnostic habits were related to the development of psychiatry.

Psychiatric symptom patterns of chronic epileptics attending a neurological clinic: a controlled investigation.

The psychiatric morbidity of chronic epileptic out-patients unknown to psychiatric agencies was assessed using two questionnaire measures of psychopathology (GHQ and CCEI). Nearly half of the epileptics were classified as probable psychiatric cases. Psychiatric morbidity was both more prevalent and more severe in this group than in a comparison group of chronic neurological out-patients. Depression, anxiety and hysterical symptomatology were the commonest characteristics of psychiatrically impaired epileptics. The type and severity of epilepsy were found to influence both the degree and pattern of psychiatric morbidity. Contrary to previous findings, age of onset had no relation to psychopathology.

Pattern of psychiatric morbidity among the patients admitted in a private psychiatric clinic

Background: Mental health problem is a major public health issue in the world across the developed and developing countries. However, data in most of the developing countries including Bangladesh are scarce. In Bangladesh, socio-political situation is insecure and unstable with poverty and vulnerable to natural disaster which causes psychiatric morbidity. The pattern of psychiatric morbidity in private clinic is quite different from that in government hospital. Objective: This study was aimed to assess the diagnostic pattern of psychiatric morbidity among the admitted patients in a private psychiatric clinic. Methodology: The study was carried out in a 20 bedded private psychiatric clinic in the heart of Dhaka city. All the information including longitudinal histories of patients was recorded in files and the diagnosis was confirmed by psychiatrist. Admission and discharge notes were recorded in register. Socio-demographic parameters and family history of mental illness were collected from the record file of individual patient. Results: Among 304 patients 184 (60.53%) were males and 120 (36.47%) were females. More than 50% of patients were in the age group of 18 to 37 years. Most common psychiatric disorders were schizophrenia and other psychotic disorders (39.4%), mood disorder (18.75%), borderline personality disorder (3.6%), conduct disorder (2.3), somatoform disorder (1.6%), anxiety disorder (0.7%), organic psychiatric disorder (2%), impulse control disorder (1.3%) and adjustment disorder (0.7%). Conclusion: Major forms of psychiatric disorders are common both in urban and rural areas of Bangladesh. Keywords: Psychiatric morbidity doi: 10.3329/bjms.v8i1.3186 Bangladesh Journal of Medical Science Vol.8 No. 1-2; 2009 23-28

Psychiatric Morbidity Pattern in a Health Camp in Eastern Nepal

Introduction: Health camp is a strategy of mental health service delivery. The present study was conducted to find out psychiatric morbidity pattern seen in camp in a village of eastern Nepal. Method: Information about all relevent variables of the cases seen by a psychiatrist team in a specialty camp were recorded in a particular record-book. We used the ICD-10 for the diagnosis of mental and behavioral disorders. The data recorded were analysed using descriptive statistical measures. Result: Of 160 cases analysed, 106 (66.25%) were female. The most common age groups were 35-39 (20%), 20-24 (11.25%) and 40-44 (11.25%). The most common psychiatric diagnoses in the Nepalese camp setting were depressive, somatoform and anxiety disorders. Primary headaches and seizure disorders were also common. Four cases (2.5%) were acutely severe and were in the immediate need of intervention. Conclusion: Most common psychiatric diagnoses were mood, somatoform and anxiety disorders in Nepalese camp setting. Some require urgent attention and admission. This indicates a need for regular mental health camp programs in our set up. Keywords: Health camp; mental health service; Nepal; Psychiatric morbidity DOI: 10.3126/hren.v8i3.4213Health Renaissance, September-December 2010; Vol 8 (No.3);186-191