Presence Of Psychiatric Illness Research Articles

Psychiatric morbidity among patients on treatment for tuberculosis at a tertiary referral hospital in Western Kenya.

Mental disorders account for nine percent of the overall global burden of disease and are among the top ten leading causes of disability. Mental illness and tuberculosis share risk factors including poverty, overcrowding, stigma, poor nutrition, substance use and retro-viral disease co-infection. Presence of mental illness in tuberculosis delays health-seeking, affects drug adherence, increases cost of treatment, prolongs disease duration, lowers quality of life, and increases mortality. Early diagnosis, linkage, and treatment of psychiatric morbidity among patients with tuberculosis would improve outcomes for both. This study thus aimed to determine the prevalence and factors associated with psychiatric morbidity among patients on treatment for tuberculosis at a low- middle- income country. A cross-sectional study carried out at the tuberculosis clinic at Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya. 367 participants on TB treatment were interviewed using Mini-International Neuropsychiatric Interview (MINI) tool. The key outcome was presence of psychiatric illness. Pearson's Chi-square and logistic regression were used to assess relationships at bivariate and multivariate level respectively. Majority of the respondents were male (61.3%) and overall median age was 33 years. About half of participants (48.5%) had at least one psychiatric illness. Common disorders were alcohol use disorder (30.3%), depression (23.4%), substance use disorder (12.8%) and suicidality (8.2%). Odds of 'any psychiatric illness' were increased by being male (aOR = 1.92; P = 0.04), being separated or divorced (aOR = 6.86; P = 0.002), using alcohol (aOR = 3.2; P<0.001), having been previously treated for tuberculosis (aOR = 2.76; P = 0.01), having other medical comorbidities (aOR = 4.2; P = 0.004) and family history of mental illness (aOR = 2.4; P = 0.049). Almost half of the patients on treatment for tuberculosis had at least one psychiatric illness. Introduction of protocols for screening for mental illness and integration of mental health services with tuberculosis care would aid prompt diagnosis, referral, and quality of care.

Mental health and help-seeking of parents of children with psychiatric illness

Background: A child with significant mental health problems evokes significant stress for the parent. We interviewed parents about their help-seeking experiences for the child's problem and assessed them for common mental health problems. Objectives: To study parental mental health in the presence of psychiatric illness in their child and to document pathways of care traversed before reaching the Psychiatrist Materials and Methods: After Institutional Ethics Committee's permission, we assessed the parents of 35 children coming to child psychiatry Out-patient Department. A semi-structured proforma and Depression Anxiety Stress Scale–21 (DASS-21) were used. A descriptive analysis of continuous and nominal variables was done, followed by comparative statistics. Results: Thirteen out of 35 parents (37.14%) had significant mental health problems,10 of them were moderate to severe. Distressed parent often had a child above 12 years of age (7 out of 10). Multiple nonmedical help-seeking was common. This was often due to lack of information than due to stigma. More boys than girls were seen in the patient population. Diagnoses in children varied; Neurodevelopment disorders were seen in 45.7%. We found parental mental health was worse in the case of primary psychiatric disorders in children like anxiety and mood disorders than neurodevelopment disorders. Conclusion: A significant number of parents have stress-related and neurotic symptoms after the onset of psychiatric illness in their child. Fathers who have significant mental health issues should be cared for. We can routinely screen for parental psychopathology in child psychiatric cases for better outcomes and to provide better family support.

Brain-Based Predictions of Psychiatric Illness–Linked Behaviors Across the Sexes

BackgroundIndividual differences in functional brain connectivity can be used to predict both the presence of psychiatric illness and variability in associated behaviors. However, despite evidence for sex differences in functional network connectivity and in the prevalence, presentation, and trajectory of psychiatric illnesses, the extent to which disorder-relevant aspects of network connectivity are shared or unique across the sexes remains to be determined. MethodsIn this work, we used predictive modeling approaches to evaluate whether shared or unique functional connectivity correlates underlie the expression of psychiatric illness–linked behaviors in males and females in data from the Adolescent Brain Cognitive Development Study (N = 5260; 2571 females). ResultsWe demonstrate that functional connectivity profiles predict individual differences in externalizing behaviors in males and females but predict internalizing behaviors only in females. Furthermore, models trained to predict externalizing behaviors in males generalize to predict internalizing behaviors in females, and models trained to predict internalizing behaviors in females generalize to predict externalizing behaviors in males. Finally, the neurobiological correlates of many behaviors are largely shared within and across sexes: functional connections within and between heteromodal association networks, including default, limbic, control, and dorsal attention networks, are associated with internalizing and externalizing behaviors. ConclusionsTaken together, these findings suggest that shared neurobiological patterns may manifest as distinct behaviors across the sexes. Based on these results, we recommend that both clinicians and researchers carefully consider how sex may influence the presentation of psychiatric illnesses, especially those along the internalizing-externalizing spectrum.

Psychological concern among ortho trauma patients: A narrative review

Injury pertaining to musculoskeletal system might be unexpected to the victim both physically and mentally. Injured person might be unprepared to be bombarded with sudden hospital visit, painful procedures and dependence on others. Presence of psychiatric illness might just aggravate the anxiety symptoms and make the prognosis poor.

Abstract 14807: Effect of Psychiatric Illnesses on the Stress Induced Cardiomyopathy Readmission

Introduction: Stress-induced cardiomyopathy (SIC) is a form of transient non-ischemic cardiomyopathy that is precipitated in the setting of acute emotional or physical stress. Postulated hypothesis implicated catecholaminergic excess and a role of the brain-heart axis behind its pathogenesis. The impact of different psychiatric illnesses on the outcomes of SIC is not clear. Method: We conducted a retrospective study using National Readmission Database (NRD) from 2011 to 2019 using ICD-10-CM (International Classification of Diseases, 10th Edition, Clinical Modification) and ICD-9-CM codes to identify the admissions with the discharge diagnosis of SIC and stratified them based on the presence of psychiatric illnesses. The primary outcome was six-month readmission and predictors of readmission. Result: We included a total of 98,721 admissions with a diagnosis of SIC. Among them, 12.9% had major depression, 1.8% had bipolar disorder, 17.6% had an anxiety disorder, and 0.6% had schizophrenia. Overall, patients with psychiatric illnesses were younger. Patients with psychiatric illnesses had a higher burden of comorbidities. Patients with schizophrenia had higher in-hospital mortality. Patients with psychiatric illnesses had a higher likelihood of getting readmitted within six months (p&lt;0.001). The significant independent positive predictors of readmission within 6 months were history of diabetes [odds ratio (OR):1.21, confidence interval (CI):1.16-1.26], heart failure (OR:1.31, CI:1.26-1.36), CKD/ESRD (OR: 1.44, CI:1.37-1.51), AF (OR: 1.25, CI:1.20-1.31), anemia (OR:1.24, CI: 1.15-1.34), peripheral arterial disease (OR: 1.25, CI:1.18-1.33), chronic obstructive pulmonary disease (OR: 1.35, CI:1.29-1.40), and prior stroke (OR: 1.10, CI: 1.02-1.18). Conclusion: We witnessed that psychiatric illnesses were associated with a higher likelihood of six-month readmission in patients with SIC.

PARENTAL STRESS IN PATIENTS WITH SCHIZOPHRENIA SPECTRUM DISORDER

Objectives: This study aimed to determine the prevalence of parental stress in patients with schizophrenia spectrum disorder and the contributing factors. Methods: This is a cross-sectional study involving 115 patients with schizophrenia spectrum disorder who were attending an outpatient psychiatric clinic, recruited through universal sampling. Those who fulfilled the selection criteria and gave informed consent were selected. Socio-demographic data, perceived parenting capacity, children’s data, and illness data were obtained from the patient during interview as well as from the clinical notes. Presence of parental stress and severity of psychiatric symptoms were measured using Parental Stress Scale (PSS) and Brief Psychiatric Rating Scale (BPRS) respectively. Descriptive analysis was performed, followed by univariate analysis and multiple logistic regression analysis, using International Business Machines (IBM®) Statistical Package for Social Science (SPSS) version 24. Results: 60 out of 115 participants (52.2%) had parental stress. Factors associated with parental stress include ethnicity (p=0.032), total household income (p=0.004), parenting children with mental or learning disability (p=0.022), perceived financial inadequacy (p=0.049), perceived food inadequacy (p=0.049), and presence of psychiatric symptoms (p=0.001). Ethnicity, total household income, parenting children with mental or learning disability, and presence of psychiatric illness were the predictors for parental stress among patients with schizophrenia spectrum disorder. Conclusion: Parental stress is prevalent in this group. Hence, health care professionals should be able to identify the risk factors and to provide them with necessary support

Study on the undergraduate interns of a medical college in eastern India: the knowledge, attitude and practice regarding COVID-19 pandemic preparation

Background: With the rapid propagation of the SARS-COV-2 or COVID-19 pandemic, the healthcare facility around the world has been stretched a large extent. To keep the green supply chain to the healthcare resources ready for the battle, sufficient knowledge, proper attitude and adequate practices are of paramount necessity. Aims and Objectives: The study was done to the knowledge, practice and attitudes towards COVID-19 pandemic preparedness among the undergraduate medical interns of a tertiary care teaching center in Eastern India. Materials and Methods: Semi-structured proforma for socio-demographic details and KAP Questionnaire for COVID-19 preparedness were circulated among the Interns. Interaction among the subsets of the KAP scale as well as their association with different socio-demographic variables were studied. Results: Out of the 138 subjects participated in the study the KAP parameters were not significantly different based on the socio-demographic factors barring presence of better practices among the female interns and less score on knowledge and attitude in presence of Psychiatric illness. It was seen that better practice was significantly correlated with knowledge mean score. Conclusion: The study implied that training on the updated knowledge along with exposure to simulated environment with scheduled supervision to reflect the behavior of the interns was of great importance so that in extreme situation, the less experienced resources could also come handy into utilization if needed.

English

BACKGROUND Chronic kidney disease (CKD) is a major health issue to be discussed in this current era due to its increasing prevalence. The burden due to chronic kidney disease is very high especially in low and middle income countries. The prevalence of psychiatric morbidity is high in patients undergoing haemodialysis. The presence of psychiatric illness increases the risk of hospitalisation and mortality in patients with end stage renal disease. This study was conducted to assess the psychiatric morbidity of patients with chronic kidney disease on maintenance haemodialysis. METHODS Descriptive research design was used for the study. The sample of the study consisted of 180 patients above the age of 18 years with chronic kidney disease undergoing maintenance haemodialysis. A specially designed pro-forma, ICD 10 symptoms check list, and ICD 10 diagnostic criteria for research are the tools used for the study. RESULTS Most of the patients were from 41 - 50 years age group (27.8 %) with a mean age of 47.43 and majority were males (74.4 %). 45.6 % patients had plan for renal transplant and 62.2 % patients were on twice weekly haemodialysis. The primary diagnosis was chronic glomerulonephritis in 33.9 % and diabetic nephropathy in 32.8 % of study participants. 11.7 % of study participants had IgA nephropathy and 9.4 % of study participants had ischemic renal failure. 23.9% of participants were found to have psychiatric morbidity. The most common psychiatric illness was depression which was reported in 15.0 % of study population. 6.1 % of participants had adjustment disorder, 2.2 % had anxiety disorder and 0.6 % had psychosis. The mean duration of dialysis was 2 years in patients with psychiatric illness. CONCLUSIONS A male preponderance was found in the study population. High psychiatric morbidity is found among patients undergoing haemodialysis and depression is the most common psychiatric disorder identified. KEYWORDS Psychiatric Morbidity, Haemodialysis

Psychosis risk individuals show poor fitness and discrepancies with objective and subjective measures

Exercise is a promising intervention for individuals at clinical high-risk for psychosis (CHR). However, these youth may not be reliable reporters on fitness. There have been no investigations that utilized objective fitness assessment in this population. The present study objectively characterizes the level of fitness in CHR youth, compares the accuracy of self-report measures to objective fitness indices, and explores clinical factors that may influence the accuracy of self-reported measures of fitness. Forty CHR individuals completed an exercise survey and objective indices of fitness (i.e., VO2max and BMI). Forty healthy volunteers completed objective indices of fitness and a structured clinical interview ruling out the presence of psychiatric illness. CHR youth showed greater BMI and lowered VO2max compared to healthy volunteers. In the CHR group, self-report items (perceived fitness) did not reflect objective indices of fitness, whereas specific exercise behaviors (intensity of exercise) showed stronger correlations with objective fitness measurements. Exploratory analyses suggested that symptoms (grandiosity and avolition) related to errors in self-perception. Results indicate that CHR individuals are less fit than controls as indexed by objective measures of fitness and that it is important to consider unique population clinical characteristics when employing self-report data.

Prevalence and predictors of psychological response during immediate COVID-19 pandemic.

AimCOVID‐19 pandemic has created a serious psychological impact worldwide since it has been declared. This study aims to investigate the level of psychological impacts of the COVID‐19 pandemic on the Turkish population and to determine related factors.MethodsThe study was carried out by an online questionnaire using the virtual snowball sampling method. The sociodemographic data were collected on the following subjects: participants’ experience on any signs of infection within the last month, the history of COVID‐19 contact‐treatment‐quarantine, level of compliance with precautionary measures, the sources of information and level of knowledge about the pandemic process and their belief levels on the knowledge they acquire. Besides, the questions that take place in the Depression, Anxiety and Stress Scale‐21 (DASS‐21), and Impact of Events Scale‐Revised (IES‐R) were asked to participants.ResultsOf the 3549 participants, anxiety was found in 15.8%, depression in 22.6%, stress in 12.9%, and psychological trauma in 20.29% based on moderate and above levels. Female gender, young age, higher education level, being single, high monthly income, presence of psychiatric illness, a large number of people living together, having any signs of infection, and contact history with COVID‐19 infected person or contaminated object are identified as risk factors that may increase psychological impact. Compliance with the rules was found to reduce the risk of psychological response.ConclusionsThe risk factors for the psychological impact of the COVID‐19 pandemic, and acknowledging these factors can help to formulate the interventions to reduce the stress levels of the population.

Psychiatric morbidity among patients attending a rural non-communicable disease clinic

Abstract Background The presence of psychiatric illness among patients with physical illnesses leads to poor treatment adherence, poor lifestyle, increased cost of treatment, poor quality of life, worsening of physical illness, work absenteeism, increased hospital visits, poor self-care and higher mortality. The study evaluated the prevalence of cognitive impairment and psychiatric morbidity in non-communicable disease patients. The study highlights that NCD patients should be provided information about the development of cognitive impairment in order to prevent it. Methods It was a cross-sectional study conducted among the patients attending the non-communicable disease clinic of a rural community health centre run in collaboration with the Postgraduate Institute Medical Education and Research (PGIMER), Chandigarh. We registered 124 patients after obtaining written informed consent. Instruments: Hindi Mental Status Examination (HMSE), Patient Health Questionnaire-9, Generalized anxiety disorder-7 (GAD-7) scale. Analysis of covariance was applied to see the relationship between the domain of the HMSE and NCDs. Results The mean age of the participants was 55.5 years (SD-11.9, Range-26-90). A little more than one third (N = 48, 38.7%) were diagnosed with hypertension only, one-sixth (N = 22; 17.7%) were diagnosed with diabetes mellitus only, and 54 (43.5%) patients were diagnosed with both hypertension and diabetes mellitus. A slightly more than one-third of the study participants were diagnosed with depressive disorder (N = 44, 35.5%), and 29% (N = 36) of the participants were diagnosed with an anxiety disorder. About one-fourth of patients with NCD have cognitive impairment and 39.51% have psychiatric morbidity. Conclusions The prevalence of cognitive impairment is higher among patients of NCD with psychiatric morbidity. Patients with NCDs should be routinely screened for cognitive functioning and provided information about the development of cognitive impairment. Key messages Because of high prevalence of cognitive impairment and psychiatric morbidity in NCD patients, patients should be provided information to prevent it. There is a need to screen NCD patients routinely for cognitive functioning, and provide them information to prevent cognitive impairment.

Suicide attempt among adolescent in Tamil Nadu: A case-control study

Introduction: Suicide is a complex social issue and a serious global health problem. Its incidence among adolescents is increasing. Understanding of risk factors helps early detection and prompt treatment of high-risk youngsters. Materials and Methods: It was a hospital-based case-control study carried out among 60 adolescent suicide attempters and 60 of their normal counterparts for the period of one year. Pretested structured questionnaire was used to collect information. Ethical principles were followed throughout the study. SPSS version 24 was used to do the analysis. Odd's ratio (OR) and its 95% confidence interval (CI) were calculated as a measure of the strength of association between risk factors and suicide attempts. Results: Among the study participants, 70% were in the age group of 16 – 18 years and 45% were males. The identified risk factors for suicide attempt were, presence of psychiatric illness (OR-7.8; 95% CI: 3.3-19), substance abuse among family members (OR-4.3; 95% CI: 2-9.3), family history of attempted suicide (OR-7.2; 95% CI: 1.5-3.3), family history of completed suicide (OR-3.6; 95% CI: 1.2-1.1) and residence at rural areas (OR-2.8; 95% CI: 1.2 – 6.3). Suicide intent score was significantly correlated with various standard scoring tools for stress and depression among cases. Conclusion: The established risk factors should be considered in creating an effective intervention program and strategies with intersectoral collaboration and coordination to prevent suicide among high-risk adolescents. Keywords: Adolescent, Attempted suicide, Case-control study, Risk factors.

HOUT-29. THE INFLUENCE OF PSYCHIATRIC ILLNESS ON OUTCOME AND CANCER CARE RECEIVED IN PATIENTS WITH GLIOMAS

Abstract BACKGROUND Data related to the prevalence of different psychiatric disorders and their impact on survival and compliance in patients with glioma is scarce and mostly anecdotal. We aimed to study the prevalence of psychiatric disorders in glioma patients and the possible influence on compliance with cancer care and outcome. METHODS We performed a retrospective, observational study and compared compliance with medical care and outcome in patients who had or did not have a psychiatric illness at time of diagnosis. Kaplan-Meier method was used to compare survival between groups. RESULTS We identified 22 subjects (M=13, F=9) with intracranial glioma with psychiatric diagnosis and 22 matched control subjects (M=13, F=9) without psychiatric illness. Psychiatric diagnoses included depression (12%), anxiety disorder (6%), Adjustment disorder &amp; substance use problems (2% each), bipolar disorder (1%) and panic attacks (1%). Psychiatric diagnoses were predating tumor diagnosis in 9/22 (41%) subjects and occurred around tumor diagnosis in 11/22 (50%) patients. The time of diagnosis with psychiatric illness was unknown in 2/22 (9%) of cases. Tumor diagnoses were glioblastoma in 50%, anaplastic astrocytoma in 9%, anaplastic oligodendroglioma in 13%, oligodendroglioma in 4%, and astrocytoma in 9% of cases. MedianOS was not reached for cases with psychiatric illness (not reached due to censoring) but was 4.2 years (95% CI 1.1 – 7.4) in controls (p=0.263). Subjects with psychiatric illness had an increased risk (OR 7.5, 95% CI 0.81 -68.8) of poor compliance with cancer care (medication, clinic and MRI follow-up compliance) compared to controls (p=0.046). CONCLUSION A variety of psychiatric conditions were observed in patients with glioma and presence of psychiatric illness may influence compliance with treatment and follow-up. Studies with larger population and longer follow-up are warranted to clarify true association between psychiatric conditions and compliance and survival.

English

BACKGROUND : Tuberculosis ranks alongside Human Immunodeficiency Virus as a leading cause of death worldwide. Psychiatric disorders in chronic medical illnesses have been found to be associated with poor compliance in previous studies. Poor compliance in tuberculosis can have drastic consequences including emergence of drug resistance. In this study, we have attempted to study the prevalence of psychiatric disorders in tuberculosis at a tertiary care centre in Chennai. AIMS & OBJECTIVES : 1. To assess the prevalence of psychiatric illnesses in people undergoing treatment for tuberculosis. 2. To assess the association between psychiatric comorbidity and different sociodemographic factors (age, gender, education) and tuberculosis disease related factors. 3. To assess the relationship between psychiatric co-morbidity and negative behavioural factors like history of defaulting. METHODS : Ours is a cross sectional study conducted at the Department of Thoracic Medicine in Government Kilpauk Medical College, Chennai. A total of 106 patients were interviewed and examined. RESULTS : We observed that 61.32% of the patients had at least one psychiatric illness. When alcohol and substance use disorders were included, the prevalence was 84.90%. About 62.6% had depressive disorder. Anxiety disorders were found in 23.5%, alcohol dependence syndrome in 59.43%, and nicotine dependence syndrome in 40.59%. We also found significant relationships between the following: male gender and presence of psychiatric illnesses, joint family and presence of psychiatric illnesses, dyspnoea grade 3 or more and presence of psychiatric illnesses, AUDIT score of 8 or more and presence of psychiatric illnesses, and, dyspnoea grade 3 or more and severity of depression. CONCLUSION : Effective identification and management of the highly prevalent psychiatric illnesses and substance use disorders can help improve the tuberculosis services.

O12.1. EXAMINING THE NEUROBIOLOGICAL IMPACT OF CHILDHOOD TRAUMA: AN IMPORTANT ROLE FOR FRONTAL AND INSULAR REGIONS

BackgroundChildhood trauma may increase the risk for psychiatric illness by its negative impact on brain development. Studies investigating the association between childhood trauma and deviations in gray matter volume have shown inconsistent findings, often restricted by a region-of interest approach with a sole focus on the amygdala and hippocampus and without controlling for the presence of psychiatric illness.MethodsFirst, using a whole-brain approach in a large cross-diagnostic sample (n=554) of healthy individuals and patients with a bipolar type-I or psychotic disorder, we investigated the neurobiological correlates of childhood trauma by evaluating gray matter volume. Follow-up analyses were conducted to evaluate the effect of psychiatric illness. Second, we investigated to what extent these trauma-related structural correlates could be observed in both groups separately (healthy individuals versus patients). Participants were recruited as part of three different studies, all conducted in the University Medical Center Utrecht (the Netherlands) between 2007 and 2016. We included 554 participants: 220 healthy individuals without a psychiatric history, 250 patients with a bipolar-I disorder and 84 patients with a psychotic disorder. Childhood trauma was evaluated with the Childhood Trauma Questionnaire (CTQ-SF). Anatomical T1 MRI scans were acquired at 3T. FreeSurfer was used to assess regional brain morphology.ResultsIn the total sample, childhood trauma severity was associated with bilateral reductions in frontal and insular gray matter volumes. In the right hemisphere, medial orbitofrontal and superior frontal volume reductions were related to childhood trauma. These associations remained when adjusting for psychiatric illness, with the exception of the right superior frontal subregion. However, when evaluating both groups separately, these structural correlates of childhood trauma were mainly observed in patients. Healthy controls did show trauma related reductions in right medial orbitofrontal region, while this association was not significant in the patient group.DiscussionOur results suggest that gray matter reductions in the frontal and insular regions are important neurobiological correlates of childhood trauma. For future research, a whole brain approach should be applied, as cortical rather than subcortical areas may be the main correlate of childhood trauma contributing to the development of psychopathology.

Incidence and Outcomes of the Psychiatric Population among Acute Trauma Victims

Psychiatric illnesses (PI) are common, and they negatively affect medical/surgical diseases. Reasons include presentation delays, altered immune responses, and provider prejudice. Traumatic injuries, also common, remain leading causes of death. We hypothesized that pretrauma PI negatively affects trauma care and outcomes. We performed a 10-year review of patients age ≥ 18 years with PI vs without PI (non-PI), including socioeconomics, Injury Severity Score (ISS), hemodynamics, and medical comorbidities including DSM-defined psychiatric illnesses. Potential provider bias was measured by time to CT, operating room, or ICU, and placement in rehabilitation. Among 23,220 trauma admissions, PI patients (n = 559) were younger (50.7 vs 53.1 years, p = 0.004), white (94% vs 86.6%, p < 0.001), and less likely to have private insurance (12.3% vs 17.3%, p < 0.001). With respect to physiologic response, PI had lower ISS (9.5 vs 10.5, p = 0.015) but more likely tachycardic (44% vs 37.4%, p = 0.002). PI were less likely to have nonpsychiatric medical comorbidies (43.8% vs 54.6%, p < 0.001). However, among those with a comorbidity, PI patients had a greater average number of comorbidities (5.5 vs 1.2, p < 0.001). With respect to trauma-related care, no difference existed in time to first CT, time to first operative procedure, or ICU placement. Further, there was no difference in discharge to either home or rehabilitation facilities. Adjusting for age, sex, and ISS, pre-trauma PI did not affect the risk of death (odds ratio1.4, 95% CI 0.92 to 2.4). Pre-trauma PI patients had more medical comorbidities and, despite lower ISS, more likely presented with tachycardic responses. Despite PI patients having worse overall health status, and counter to other observations in nontrauma medical conditions, the presence of PI did not affect delivery of trauma care. Our findings support the effectiveness of standardized American College of Surgeons trauma care systems.

Risk Factors for Domestic Violence in Women and Predictors of Development of Mental Disorders in These Women.

Based on the hypothesis that women who exposed to physical violence had lower education and income levels than those who did not, and those who got married earlier and had marriage with unwanted people had higher psychiatric disorders, the aims of this study were to determine risk factors for domestic violence and predictors of psychiatric impairment in women exposed to domestic violence. We used random selection method and included 400 married women above 18 years of age living in Adiyaman province. Socio-demographic data and exposure to physical violence and sexual coercion for participants were evaluated by a structured questionnaire. Depression scores of the women were evaluated by Beck Depression Inventory (BDI) and anxiety scores were evaluated by Beck Anxiety Inventory (BAI). Suicidal ideas of the subjects were evaluated by 17 item Suicide Intent Scale and their suicide plans, attempts, thoughts, and risk of recurrence were evaluated by 4 item Suicidal Behavior Questionnaire. 65,5% of the women (n=262) reported no violence, 19,3% (n=77) reported violence only from their spouses, 5,2% (n=21) reported violence from people other than spouse, and 10% (n=40) reported physical violence from both their spouses and other people. Logistic regression analysis showed that employment status of spouses, presence of medical/psychiatric illness in spouses, the acceptance of the view that 'Husbands can sometimes beat' by women and presence of psychiatric illness in women predicted domestic violence against these women from their spouses. Logistic regression analysis also revealed that education level, and presence of physical or sexual violence from their spouses predicted development of psychiatric disorders in women survivors of domestic violence. This study showed that opinion of women about domestic violence, presence of a psychiatric disorder in women, employment status of spouse, and presence of a medical/psychiatric illness in spouse predicted physical violence against these women. In addition, education level of women, and presence of domestic violence from their spouses predicted development of psychiatric disorder. Knowing the factors that trigger physical violence and related psychiatric impairments is really important for development of preventive and therapeutic interventions.

Is BDNF a Nonspecific Marker for Psychiatric Disease

Brain-derived neurotrophic factor (BDNF) is a potential marker both for the presence of psychiatric illnesses and for changes in clinical status, particularly mood disorders. Particularly intriguing are the increases in BDNF associated with neurogenesis and clinical improvement. Investigators conducted the first “transdiagnostic” study of BDNF in 236 consecutively admitted psychiatric inpatients (mean age, 45; 57% female) and …

Sleep Disturbances and Suicide Risk.

Suicide occurs in the presence of psychiatric illness, and is associated with biological, psychological, and social risk factors. Insomnia symptoms and nightmares appear to present elevated risk for suicidal ideation, attempts, and death by suicide. Failure to account for the presence of psychopathology and frequent use of single item assessments of sleep and suicidal ideation are common methodological problems in this literature. Preliminary research, addressing these issues, suggests that subjective sleep complaints may confer independent risk for suicidal behaviors.

Assessment of depression and anxiety symptoms in chronic obstructive pulmonary disease patients: A case–control study

BackgroundCOPD patients have to deal not only with the physical consequences of the disease, but they must also deal with the psychological consequences of COPD. Anxiety and depression are highly prevalent co morbidities in COPD. ObjectiveTo assess the symptoms of depression and anxiety in COPD patients and to correlate between the severity of the anxiety and depression with the severity of the COPD. Subjects and methods80 COPD patients were assessed using SCID for establishing psychiatric diagnosis, Beck depression inventory for assessment of the severity of depressive symptoms, Hamilton anxiety scale for the severity of anxiety symptoms, Spirometry and arterial blood gases for assessing the severity of COPD; and were matched to 80 healthy controls. ResultsThe patient group showed higher statistically significant difference in the presence of psychiatric illness (55%, p=0.001), anxiety level (22.5%, p=0.06), depression level (42.5%, p=0.0001), and substance abuse (15%, p=0.035). Anxiety and depressive scores were significantly associated with the severity of COPD (p<0.001). Anxiety score correlated with age (r=−0.267), and PaO2 (r=0.326). Depression score correlated with FEV1 (r=−0.262). ConclusionThis study proves the association between COPD and symptoms of anxiety and depression. The severity of anxiety and depression were correlated with the severity of COPD and the presence of lower PaO2. Age, sex, duration of illness and previous ICU admission or mechanical ventilation did not correlate with depression or anxiety symptoms.