Presence Of Psychiatric Comorbidity Research Articles

Psychiatric implications of anti-seizure medications in epileptic population

Background and objectiveEpilepsy is a prevalent neurological disorder that affects a significant number of individuals globally. This condition is associated with a high occurrence of psychiatric comorbidities, which can significantly affect the quality of life of individuals affected. The aim of this study was to investigate the association between antiseizure therapies and the likelihood of psychiatric comorbidities in individuals with epilepsy.MethodologyData for this study was gathered from the Neurology referral center in Islamabad, Pakistan. A standardized questionnaire was utilized to gather data from 120 individuals diagnosed with epilepsy. The survey consisted of inquiries regarding the management of seizures, the utilization of anti-seizure medications, and the presence of psychiatric comorbidities. The data was analyzed using the Statistical Package for the Social Sciences (SPSS).ResultsThe findings indicated that individuals who were using multiple antiseizure medications had a notably higher likelihood of having psychiatric comorbidities in comparison to those who were on mono therapy (p = 0.010). suggests that patients with unsuccessful seizure control are more probable to have psychiatric comorbidities as compared to those with good seizure control (p = 0.029).ConclusionTo conclude poor seizure control and poly therapy are associated with increased risk of psychiatric comorbidities.

Association between telomere length with alcohol use disorder and internalizing/externalizing comorbidities in a Brazilian male sample

BackgroundShortening telomere length (TL) is an important ageing marker associated with substance use disorder (SUD). However, the influence of psychiatric and clinical comorbidities and alcohol-related outcomes has not been much explored in the context of TL in individuals with alcohol use disorder (AUD) and may be a source of heterogeneity in AUD studies. Therefore, our aim was to investigate the influence of AUD, alcohol-related outcomes, and common psychiatric comorbidities on TL in men with AUD and healthy controls (HC). MethodsMen with AUD (n = 108, mean age = 52.4, SD = 8.6) were recruited in a detoxification unit, and HC (n = 80, mean age = 50.04, SD = 9.1) from the blood bank, both located in Brazil. HC had no current or lifetime diagnosis of any substance use disorder. Psychiatric comorbidities were assessed using SCID-I. TL ratio was measured in triplicates using quantitative multiplex PCR. ResultsTelomere length did not differ between individuals with AUD and HC (p = 0.073) or was associated with AUD-related outcomes, trauma, or clinical comorbidities. Individuals with externalizing disorders had longer TL when comparing with those with internalizing disorders (p = 0.018) or without comorbidity (p = 0.018). ConclusionOur findings indicate that TL was influenced by the presence of psychiatric comorbidity rather than case or control status. These results were adjusted for potential confounders, such as age.

Asthma: a respiratory pathology with a high risk for mental health

The subjective experience of asthma can be accompanied by significant emotional suffering. The presence of psychiatric comorbidities in asthma is common and worsens the prognosis of asthma. Bidirectional relationships between psychiatric disorders and asthma via inflammatory mechanisms are highlighted. Systematic screening for the most common psychiatric comorbidities such as depression, anxiety disorders and post-traumatic stress disorder is recommended. A multidisciplinary collaboration with a mental health specialist in the presence of psychiatric comorbidity has proven necessary to improve the quality of life and both the somatic and psychiatric prognosis of patients suffering from asthma.

Psychiatric Comorbidities and Schizophrenia in Youths With Attention-Deficit/Hyperactivity Disorder

The association between attention-deficit/hyperactivity disorder (ADHD) and schizophrenia has received increased attention; however, evidence on the association between psychiatric comorbidities and subsequent schizophrenia in patients with ADHD is limited. To investigate the risk of being diagnosed with schizophrenia in children and adolescents with ADHD considering the presence of psychiatric comorbidity. This was a population-based, retrospective cohort study using the Health Insurance Review and Assessment claims database from January 1, 2007, to December 31, 2019. Participants were children and adolescents aged 5 to 19 years who received an ADHD diagnosis between January 1, 2010, and December 31, 2018, in the nationwide claims data of Korea. Data were analyzed from January 2010 to December 2019. The presence of psychiatric comorbidity was assessed from diagnosis records within 1 year before ADHD diagnosis. Comorbidities were further categorized according to the number of comorbidities and specific comorbid disorders. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% CIs, examining the association between psychiatric comorbidities and the risk of being diagnosed with schizophrenia. Furthermore, the occurrence of psychiatric comorbidity during the follow-up period was explored among patients without psychiatric comorbidity at baseline. A total of 211 705 patients with newly diagnosed ADHD were included. A total of 157 272 patients (74.3%) were male, and the age of 5 to 9 years showed the highest distribution (115 081 patients [54.4%]). Patients with psychiatric comorbidity had a significantly higher risk of being diagnosed with schizophrenia than those without (adjusted HR, 2.14; 95% CI, 2.05-2.23). The association between schizophrenia and psychiatric comorbidity became progressively greater with the increasing number of comorbidities. Several individual psychiatric disorders showed an association with development of schizophrenia, with ASD, intellectual disability, tic disorder, depression, and bipolar disorder being the top 5 disorders most associated. Furthermore, 3244 patients (73.8%) without psychiatric comorbidities experienced the emergence of other psychiatric disorders before schizophrenia occurrence. In this retrospective cohort study involving children and adolescents with ADHD, the presence of psychiatric comorbidity in patients with ADHD was associated with an increased risk of being diagnosed with schizophrenia, with an increased risk observed in multiple comorbidities and a wide variety of comorbidities. These findings highlight the significance of assessing and managing psychiatric comorbidities in patients with ADHD to decrease subsequent schizophrenia risk and allow for early intervention.

Parkinson Hastalarında Nöropsikiyatrik Semptomlar

Many physical, cognitive and psychological symptoms can be seen in neurological diseases. Parkinson's disease (PD) is a neurological disorder arising from the degeneration of neurons, is characterized by motor and non-motor symptoms. Along with motor symptoms, psychiatric symptoms that are included in non-motor symptoms can also be seen in PD. PD symptoms, genetic predisposition, side effects of pharmacological treatments, psychosocial factors; can cause psychiatric conditions such as anxiety, depression, impulse control disorder, and psychosis. It has been determined that the most common psychiatric disorder in PD is depression, followed by anxiety. Although the presence of psychiatric comorbidities in PD is high, it is often overlooked by clinicians during the diagnosis and treatment process. These factors should be taken into account in the diagnosis process and treatment strategies of Parkinson's patients should be structured in a multifactorial manner.

New-onset addictions in patients with alcohol dependence: A cross-sectional study

BackgroundIndividuals who are addicted to one addiction are at an increased risk for developing another new addiction. New-onset addictions among patients with alcohol dependence needs to be considered for more effective treatment of alcohol dependence. MethodsIn this cross-sectional study, Japanese outpatients with alcohol dependence were assessed using a comprehensive, originally designed questionnaire to determine whether they were addicted to substances or behaviors other than alcohol. The prevalence rates of new-onset addictions were compared between alcohol-dependent patients who had abstained from alcohol for a year or more and those who had not. Multiple regression analysis was performed to examine the association between the number of new-onset addictions and the demographic and clinical characteristics. ResultsOne hundred and nine outpatients with alcohol dependence (54.6±11.0 years; 97 men) participated in the study. The prevalence of new-onset addictions was 41.3%. No significant differences were found in the prevalence of new-onset addictions between the patients who had abstained for a year or more and those who had not. Multiple regression analysis revealed that the number of new-onset addictions was positively associated with the presence of psychiatric comorbidity (β = 0.24; p = 0.02) and use of benzodiazepines (β = 0.20; p = 0.04) with a R2 of 0.153. ConclusionAlcohol dependent patients with characteristics such as psychiatric comorbidity and use of benzodiazepines should be given more attention to the development of new-onset addictive behaviors. On the other hand, those behaviors could be acceptable for harm-reduction unless excessive and loss of control.

Quality of life, depression and anxiety in children and adolescents with CKD and their primary caregivers.

Chronic kidney disease (CKD) requires long-lasting treatments and severe changes in the routine of children, which may favor a low quality of life (QoL) and damage to their mental health and that of their primary caregivers (PC). The present study aimed to investigate the presence of anxiety and depression and to analyze the QoL of children and adolescents diagnosed with CKD at stages 3, 4, and 5, and their PC. We carried out an observational case-control study with 29 children and adolescents and their PC as the case group and 53 as the control group. International instruments, validated for the Brazilian population, were used: Child Anxiety Inventory (STAI-C), Pediatric Quality of Life Inventory (PEDSQL), Child Depression Inventory (CDI), Beck Anxiety and Depression Inventory (BAI; BDI), and the WHOQOL-bref. The study identified statistically significant differences in the PEDSQL total score (control group, 72.7 ± 19.5; case group, 63.3 ± 20.6; p = 0.0305) and in the psychosocial (control group, 70.5 ± 20.5 and case group, 61.4 ± 19.7; p = 0.0420) and school health dimensions (control group, 72.9 ± 21.0 and case group, 55.2 ± 19.8; p = 0.0003) and the presence of psychiatric comorbidity (depression and anxiety symptoms) in the case group (p = 0.02). As for PC, the study showed statistical significance for the prevalence of depression (p = 0.01) and anxiety (p = 0.02) symptoms. Patients with CKD have lower QoL indices and more psychiatric comorbidities, and their PC are affected by the disease, with higher indices of depression and anxiety.

Associations between psychiatric comorbid disorders and executive dysfunctions in hypocretin-1 deficient pediatric narcolepsy type1

Objective/BackgroundPsychiatric symptoms and cognitive deficits add significantly to impairment in academic achievement and quality of life in patients with narcolepsy. The primary aim of this study was to evaluate the prevalence of psychiatric disorders and executive dysfunctions, secondly to explore the association between psychiatric comorbidity, executive dysfunctions, subjective and objective sleep measures, and severity of cerebrospinal fluid (CSF) hypocretin-1 deficiency in pediatric narcolepsy type 1 (PNT1). Patients/MethodsCross-sectional study of 59 consecutively included PNT1 patients (age: 6-20 years; 34:25 girls: boys; 54/59 H1N1 (Pandemrix®)-vaccinated). Core narcolepsy symptoms including subjective sleepiness, polysomnography and multiple sleep latency test results, CSF hypocretin-1 levels, psychiatric disorders (by semistructured diagnostic interview Kaufmann Schedule for Affective Disorders and Schizophrenia Present and Lifetime version (KSADS)), and executive dysfunction (by Behavior Rating of Executive Function (BRIEF)) were assessed. Results52.5% of the patients had one or more psychiatric comorbid disorder, and 64.7% had executive dysfunction in a clinically relevant range, with no sex difference in prevalence, while older age was associated with poorer executive function (p=0.013). Having any psychiatric comorbid disorder was associated with poorer executive functions (p=0.001). CSF hypocretin-1 deficiency severity was significantly associated with presence of psychiatric comorbidity (p=0.022) and poorer executive functions (p=0.030), and poorer executive functions was associated with subjective sleepiness (p=0.009). ConclusionsThe high occurrence of, and association between, psychiatric comorbidity and executive dysfunction underlines the importance of close attention to both these comorbidities in clinical care of NT1.

The Relationship Between Somatization and Depression Types: Comparison of Unipolar Depression and Bipolar Depression

Objective: Somatic symptoms are more likely to be present in depression and anxiety, which causes to waste medical resources due to excessive hospital addmissions. It has been observed that the unclarity of qualitative and quantitative characteristics of somatization depending on the type of depression influences clinical practice less than expected. In the present study, it was aimed to determine the hallmarks of somatic symptoms in depression groups and to investigate the factors that might have an effect on somatic symptoms.
 Method: One hundred consecutive patients (50 with Bipolar Depression (BD), 50 with Unipolar Depression (UD)) who met the criteria participated in the study. Patients were assessed for depressive symptoms with Montgomery Asberg Depression Scale and for somatic symptoms with Bradford Somatic Symptom Inventory. Clinical features were obtained by the clinician via Sociodemographic Data Form.
 Results: It was found that no significant difference in somatization characteristics between the depression groups. (p> .05). Somatic symptom severity was higher in the UD group in the presence of psychiatric comorbidity (p= .013), but not in BD. Another prominent finding was that the severity of depression was noted the only predictor of severe somatization.
 Conclusion: The results show that increased somatic symptoms are associated with the severity of depression, suggesting treatment of depression with somatization rather than differential diagnosis should be primary concern.

(209) Sexual Knowledge, Attitude and Practices in Women Attending OBG Out Patient Department and Its Effect on Sexual Dysfunctions

Abstract Introduction In India, despite significant advances in the prevention and treatment of sexual dysfunctions, the majority of these have focused on male sexual dysfunction disorders. There is still a paucity of literature that adequately explains the relationship between sexual knowledge and attitudes of women and female sexual dysfunctions. Furthermore, physiological events such as pregnancy, childbirth, breastfeeding, menopause, and ageing have a significant impact on sexual well-being, particularly when co-morbid psychiatric illnesses are present. The prevalence of these interactions and their relationship with female sexual dysfunctions are being explored which have consequences in the prevention and treatment of female sexual dysfunctions Objective 1. To assess sexual health knowledge and attitudes regarding sexual practices in women attending Obstetrics and Gynecology Out Patient Department. 2. To assess presence and extent of sexual dysfunctions in these women 3. To evaluate for presence of co-morbid psychiatric conditions Methods Hospital based cross-sectional study with a sample size of 220 women in the category of pregnant, nulliparous and perimenopause/ menopause/ post menopause with age range from 18 to 65 years. Pregnancy carrying high risk and women nearing term were excluded from the study. After a detailed history regarding their socio-economic data, each of them were handed out questionnaires. The SKAQ-II (Sexual knowledge and attitude questionnaire), which was standardized using Indian population assessed their sexual knowledge and attitude, the Female Sexual Functioning Index scale (FSFI) evaluated sexual dysfunction and the presence of psychiatric comorbidities was assessed with the M.I.N.I PLUS scale. Results 93% of the women had an adequate amount of knowledge regarding sexual practice and 83.2% had liberal attitude. Level of sexual knowledge and attitude was positively correlated with presence of sexual dysfunction, with the prevalence of latter being 65.5% with 63% of pregnant women having sexual dysfunction and 77.8% of menopausal women having sexual dysfunction. Rural women had lower levels of sexual knowledge and conservative attitude towards sexual practice, leading to more sexual problems. Around one-fourth of women reported psychiatric morbidities with majority suffering from depression. Conclusions Women with greater sexual knowledge and a liberal mindset towards sexual practices tend to have lower levels of sexual dysfunction. Rural women tended to have lower levels of sexual knowledge and poor attitude towards sexual practice. There was no association found between religious attitudes. Most dysfunctions were reported by the menopausal age group. Sexual issues were more common in the domains of desire, lubrication, orgasm and pain. A positive correlation was noted between sexual dysfunction and kind of housing, leading to lack of intimacy being an important contributing factor. Disclosure No

Case series: expanding diagnostic markers in postorgasmic illness syndrome.

Postorgasmic illness syndrome (POIS) is a rare condition in which individuals develop generalized and flu-like symptoms after ejaculation. Several mechanisms and treatments for this disorder have been proposed but many questions remain. We sought to present a summary of literature to date and highlight common symptoms, associated features, comorbidities, and laboratory findings in a clinical sample of patients with POIS. We conducted a retrospective chart review of 6 patients with POIS in our clinic and presented compiled results. We identified newly described non-flu-like presentations, onset of symptoms with high states of arousal without ejaculation, and presence of psychiatric comorbidity in a majority of patients. We did not identify a postorgasm allergic response with bloodwork available. POIS remains a poorly understood condition that likely comprises a number of different clinical entities. Further research on a larger clinical sample is necessary to better characterize POIS and understand its biological and psychological basis.

Predictors of treatment response to serotonin and noradrenaline reuptake inhibitors in fibromyalgia.

Fibromyalgia (FM) is often comorbid with anxiety and depression. Serotonin and noradrenaline reuptake inhibitors (SNRIs) are used in the treatment of FM, depression, and anxiety, but they are ineffective in a substantial number of patients. Recently, it has been reported that FM is associated with impaired glucose metabolism. The aim of the study was to explore the associations between insulin resistance, psychiatric comorbidities, and treatment response to SNRIs in patients with FM. A total of 59 patients with FM and 30 healthy controls (HCs) were recruited. The study patients were classified as treatment‑nonresponsive if the SNRI treatment resulted in a reduction in reported pain by less than 30%. All participants were examined by a physician and completed self‑report questionnaires. Blood samples were drawn to assess fasting glucose and insulin levels and to calculate the Homeostatic Model Assessment of Insulin Resistance (HOMA‑IR) values. Multivariable logistic regression models were constructed to analyze the associations between insulin resistance, psychiatric comorbidies, and the lack of response to treatment with SNRIs. The SNRI nonresponders (FM [T-]) had higher body mass index (BMI), fasting insulin level, and HOMA‑IR values than the responders (FM [T+]) and HCs. The FM [T+] patients did not significantly differ from HCs in terms of BMI, levels of fasting glucose and fasting insulin, and HOMA‑IR values. Depression, anxiety, and personality disorders were significantly more prevalent in the FM [T-] than in the FM [T+] group. Insulin resistance, depression, anxiety, and personality disorders were identified as the predictors of nonresponse to SNRI treatment. The effect of BMI on the lack of response to SNRIs was fully mediated by insulin resistance. Increased values of certain clinical and metabolic parameters (BMI, fasting glucose, fasting insulin, HOMA‑IR) as well as the presence of psychiatric comorbidities could affect the response to treatment with SNRIs in the patients with FM.

Which Clinical and Demographic Factors are Related to Incarceration in Male Patients With Antisocial Personality Disorder?

Antisocial Personality Disorder (APD) is a condition largely represented in detention centers where can reach a prevalence of 60% in male prisoners. The objective of this study is to identify the clinical and demographic factors that differentiate subjects with APD and hosted in penitentiary with respect to those are treated in outpatient psychiatric clinics. We recruited 65 male patients affected by APD, whose 26 were followed up in community mental health services and 39 were serving their sentence in a detention center located in Monza. Socio-demographic and clinical data were obtained through a review of the clinical charts, and interviews with patients or their relatives (if available). We performed descriptive analyses on the total sample, then we compared the two groups identified by the type of setting (outpatient clinic vs. penitentiary) by independent sample t tests (quantitative variables) or χ2 tests (qualitative ones). For qualitative variables odds ratios (ORs) were also calculated. Outpatients with APD (with respect to those hosted in the detention center) resulted: to be older (p = .02), to be less likely married (p = .01), to have more pre-onset psychiatric comorbidity (p = .05), to have more pre-onset substance poly-misuse (p = .01), to have more previous psychiatric hospitalizations (p < .01), and to be less likely to have received lifetime psychotherapy (p < .01). Globally, the results of this study show how the presence of psychiatric comorbidity or substance abuse (with the probable access to psychiatric services) before the onset of APD prevents imprisonment. This aspect is even more surprising when we consider that the two groups of patients show no differences in the frequency of crimes. Future research will have to confirm if early mental health care can really limit the access to penitentiary of subjects affected by APD.

MENTAL DISORDERS AND LIVER TRANSPLANTATION: A 2-YEAR COHORT STUDY.

Psychosocial assessment is a key component in evaluation for liver transplantation and may affect survival rates and outcomes. The primary aim of this study was to investigate the impact of previous mental disorders and impulsivity on the 2-year surviving rate after liver transplantation. We performed a prospective cohort study assessing end-stage liver disease individuals with and without psychiatric comorbidities for 2 years post-transplant. Psychiatric diagnosis was carried out through Mini-Plus 5.0.0 and impulsivity by using Barratt Impulsiveness Scale in the pre-transplant phase. We followed patient's status for 2 years after transplantation. The main outcome was death. We used a logistic regression to evaluate the association of psychiatric comorbidities with death and performed a survival analysis with Kaplan-Meier and Cox regression models. Between June 2010 and July 2014, 93 out of 191 transplant candidates received transplants. From the 93 transplant patients, 21 had psychiatric comorbidities and 72 had not. 25 patients died during the study. The presence of psychiatric comorbidities (P=0.353) and high impulsivity (P=0.272) were not associated to 2-year post transplant death. This study found no evidence that the presence of mental disorders and impulsivity worsened prognosis in post-liver transplantation.

Mental illness and socio-economic situation of women and men diagnosed with gambling disorder (GD) in Sweden - nationwide case-control study.

The present study aimed to compare men and women with gambling disorder (GD) regarding presence of psychiatric comorbidity and socio-economic vulnerability, and to examine whether these factors appear before or after the gambling disorder. This is a retrospective case-control study, based on registers from The National Board of Health and Welfare and Statistics Sweden. A total of 3592 adults with GD were matched with two controls based on age and gender, including a total of 10776 individuals in the study. The study included psychiatric comorbidity through the presence of relevant diagnostic codes or pharmacological codes, and socio-economic vulnerability data through the presence of unemployment, social welfare payments and sickness/activity/rehabilitation compensation. Time between GD and psychiatric comorbidity/socio-economic vulnerability was calculated by subtracting dates between diagnoses/first incidence of socio-economic vulnerability factor and GD diagnosis. Women with GD were more likely to have a psychiatric comorbidity, compared to men. Overall, women were also more likely to receive their psychiatric diagnosis prior to GD diagnosis, while men were more likely to receive the diagnoses concurrently. Social welfare payments, and sickness support were more common among women, while there was no difference in unemployment between genders. Women were also more likely to receive sickness/activity/rehabilitation compensation prior to GD, than men who were more likely to receive these types of support after GD diagnosis. In conclusion, women appear to be at higher risk of psychiatric comorbidity and socio-economic vulnerability alongside GD. They are in general also more likely to receive have their psychiatric and psycho-social problems identified prior to GD, than men who are more likely to receive diagnoses concurrently.

Complex polypharmacy in bipolar disorder: Results from a real-world inpatient psychiatric unit

BackgroundMultiple medications are frequently prescribed to patients with bipolar disorder (BD). The aim of the present study was to identify sociodemographic and clinical characteristics associated with complex polypharmacy in patients affected by BD. Methods556 patients with BD were included. A semi-structured interview was used to collect sociodemographic and clinical characteristics, as well as pharmacological treatment. Participants were divided in two groups, abased on the use of complex polypharmacy (i.e., a combination of 4 or more psychotropic medications). Differences between the two groups were evaluated with t-test and chi-squared test. A stepwise logistic regression was then applied to identify factors significantly associated with complex polypharmacy. ResultsPatients with BD and complex polypharmacy were more likely to be single and unemployed. Moreover, earlier age at onset, longer duration of illness, higher number of hospitalizations, higher prevalence of medical and psychiatric comorbidity, and the use of illicit substances (except heroin) were associated with complex polypharmacy. In the logistic regression model, single status, older age, number of hospitalizations, and the presence of psychiatric comorbidities were regarded as factors significantly associated with complex polypharmacy. ConclusionsOur findings reflect the need to develop clear guidelines for the long-term management of BD, especially when pharmacological discontinuation is needed.

Knowledge of epilepsy, quality of life, and psychiatric comorbidities in Lebanese adults with epilepsy

IntroductionPeople with epilepsy (PWE) face a variety of psychosocial challenges. A lack of knowledge of epilepsy, a high level of depression and anxiety and a low quality of life (QoL) are among the major problems that affect most PWE. The objective of this study was to examine the association of sociodemographic characteristics, clinical factors and knowledge of epilepsy with the level of QoL, and the presence of psychiatric comorbidities. MethodA cross-sectional study was conducted in Lebanon. The PWE were recruited from neurologists’ clinics in Beirut and its suburbs. A questionnaire translated into Arabic was used and composed of four parts: sociodemographic factors, clinical characteristics, psychosocial characteristics (QoL, psychiatric disorders), and knowledge epilepsy scale. Backward logistic regression models were developed, the associations were estimated by odds ratio (OR), and the level of significance was set at p ≤ 0.05. ResultsFour hundred and four PWE were recruited in this study. About a half of PWE had controlled epilepsy (46.3 %) and 40.3 % had epilepsy for less than 5 years. The QoL was low for 38.6 % of PWE and 30.2 % had psychiatric comorbidities. More than half of PWE had a good level of knowledge (71.5 %). Controlled epilepsy (OR = 1.8; 95 %CI: 1.2–2.9), and good knowledge about epilepsy (OR = 5.5; 95 %CI: 3.4–9.1) were associated with better QoL. Patients on polytherapy with anti-seizure drugs (OR = 0.6; 95 %CI: 0.4–0.9), experienced side effects of anti-seizure drugs (OR = 0.6; 95 %CI: 0.4–0.9) and with psychiatric comorbidities (OR = 0.6; 95 %CI: 0.3–0.9) had a lower QoL. A high number of nonpsychiatric comorbidities (OR = 2.5; 95 %CI: 2.0–3.1) and a polytherapy increased the risk of having psychiatric comorbidities (OR = 1.8; 95 %CI: 1.1–2.8). ConclusionsGood knowledge of epilepsy and the absence of psychiatric comorbidities are important predictors of good QoL in Lebanese PWE. Educational programs are needed to reduce misconceptions about epilepsy and improve mental health of PWE.

Influence of psychiatric co-morbidity on health-related quality of life among major trauma patients.

The purpose of this study was to compare 1-year post-discharge health-related quality of life (HRQL) between trauma patients with and without psychiatric co-comorbidity. A retrospective single-center cohort study identified all severely injured adult trauma patients admitted to a Level 1 trauma center between 2018 and 2019. Bivariate analysis compared patients with and without psychiatric co-morbidity, which was defined as prior diagnosis by a healthcare provider or acute psychiatric consultation for new or chronic mental illness. HRQL metrics included the EuroQol-5D-5L (EQ-5D) questionnaire, visual analogue scale (EQ-VAS), and overall index score. A multiple linear regression model was utilized to identify predictors of EQ-5D index scores. Analysis of baseline characteristics revealed significantly greater rates of substance abuse, severe extremity injuries, inpatient morbidity, and hospital length-of-stay among patients with psychiatric illness. At 1-year follow-up, patients with psychiatric co-morbidity had lower median EQ-5D index scores compared to the control group (0.71, interquartile range [IQR] 0.32 vs. 0.79, IQR 0.22, p = 0.03). There were no differences between groups in individual EQ-5D dimensions, nor in EQ-VAS scores. Presence of psychiatric co-morbidity was not found to independently predict EQ-5D index scores in the linear regression model. Instead, Injury Severity Score (standardized regression coefficient [SRC] - 0.15, 95% confidence interval [CI] - 0.010 to - 0.001) and American Society of Anesthesiologists Physical Status score (SRC - 0.13, 95% CI - 0.08 to - 0.004) predicted poor HRQL 1-year after injury. Psychiatric co-morbidity does not independently predict low HRQL 1year after injury. Instead, lower HRQL scores among patients with psychiatric co-morbidity appear to be mediated by baseline health status and injury severity.

Assessing response, remission and treatment resistance in patients with Obsessive-Compulsive Disorder with and without Tic Disorders: results from a multicenter study

IntroductionObsessive Compulsive Disorder (OCD) and Tic Disorder (TD) are two highly disabling, comorbid and difficult-to-treat conditions. DSM-5 acknowledged a new “tic-related” specifier for OCD, i.e., Obsessive-Compulsive Tic-related Disorder (OCTD), which may show poor treatment response.ObjectivesThe aim of the present study was to evaluate rates and clinical correlates of response, remission and resistance to treatment in a large multicentre sample of OCD patients with versus without tics.Methods398 patients with a DSM-5 diagnosis of OCD with and without comorbid TD was assessed from ten psychiatric departments across Italy. Treatment response profiles in the whole sample were analysed comparing the rates of response, remission and treatment-resistance as well as related clinical features. Multivariate logistic regressions were performed to highlight possible treatment response related factors.ResultsLater ages of onset of TD and OCD were found in the remission group. Moreover, significantly higher rates of psychiatric comorbidities, TD, and lifetime suicidal ideation and attempts were associated to the treatment-resistant group, with larger degrees of perceived worsened quality of life and family involvement.ConclusionsWhile remission was related to later ages of OCD and TD onset, specific clinical factors, such as early onset and presence of psychiatric comorbidities and concomitant TD, predicted a worse treatment response, with a significant impairment in quality of life for both patients and their caregivers. These findings suggest a worse profile of treatment response for patients with OCTD.DisclosureNo significant relationships.

Increased Risk for Substance Use-Related Problems in Mild Intellectual Disability: A Population-Based Cohort Study

IntroductionIntellectual disability (ID) has been linked to substance use-related problems (SUP). However, previous research is limited by the small sample sizes, lack of general population comparison and have not accounted for familial confoundings. The role of other psychiatric comorbidities also remains unknown.ObjectivesTo examine the risk of SUP in individuals with mild-ID and assess whether the associations depend on other psychiatric comorbidities, controlling for potential familial confounding.MethodsPopulation-based cohort study of individuals born in Sweden 1973-2003. We identified 19,078 individuals with mild-ID, 953,900 reference individuals from the general population, and 20,722 full-siblings of individuals with mild-ID. Conditional logistic regression models were used to compare individuals with mild-ID to the general population and their full-siblings regarding the risk of SUP, including alcohol and substance use disorders, alcohol and substance-related somatic diseases, substance-related crime, and substance-related death. Analyses were repeated stratified by the presence of psychiatric comorbidities.ResultsIndividuals with mild-ID had increased risks of any SUP (adjusted OR [95%CI]: 1.41 [1.35, 1.47]), compared to the general population, including alcohol-related somatic diseases (3.27 [1.92, 5.59]), alcohol (2.05 [1.91, 2.22]) and drug-use disorder (1.79 [1.69, 1.91]), and alcohol (1.36 [1.19, 1.49]) and drug-related crime (1.27 [1.19, 1.36]). The risk of SUP for individuals with mild ID was particularly elevated with comorbid mood (3.74 [3.47, 4.04]), anxiety (3.30 [3.09, 3.53]) and attention-deficit/hyperactivity disorders (2.61 [2.44, 2.80]). Increased risk of SUP remained significant when controlling for familial confounding.ConclusionsIndividuals with mild-ID, especially those with other psychiatric comorbidities, are at increased risks of SUP.DisclosureNo significant relationships.