Prevalence Of Disorders In Patients Research Articles

Prevalence of temporomandibuar joint disorders in patients with otologic complaints

Prevalence of temporomandibuar joint disorders in patients with otologic complaints

Are Menopausal Women with Epilepsy at Higher Risk for Mood Disorders and Suicide Risk? (P01.043)

Objective: To compare the prevalence of mood and anxiety disorders and suicide risk in premenopausal and menopausal women with epilepsy. Background The risk for mood and anxiety disorders during the menopause period among women with epilepsy have not been systematically investigated. The prevalence of psychiatric disorders in patients with epilepsy is higher than the general population. During the menopausal transition women are at increased risk for depression. Thus, we hypothesize that psychiatric co-morbidities are higher in menopausal women with epilepsy as well. Design/Methods: Women with epilepsy admitted to the Cleveland Clinic Epilepsy Monitoring Unit were invited to participate. Subjects were interviewed by a psychiatrist or neurologist using the Mini-International Neuropsychiatry Interview (MINI), which is a validated and standardized psychiatric diagnostic interview. The study was IRB approved. Statistical analysis was descriptive as the study is on going. Results: Fifty five women with epilepsy participated. Subjects had a mean age of 39 year (19-67); 80% were Caucasian. Epilepsy classification includes temporal lobe (32%), extra temporal (23%), undefined focal epilepsy (36%), generalized (5%), and multifocal (2%). Average seizure frequency was 77 per 6 months and the average age of epilepsy onset was 24. In regards to AED, majority of patients were on polytherapy (84%). Based on MINI, 27% women met criteria for major depressive disorder (MDD), 9% generalized anxiety disorder (GAD), and 34.5% had suicidal ideation. Compared to premenopausal women, menopausal women experienced a higher prevalence of MDD (34.7% vs. 22%), GAD (13% vs. 6%), and suicide ideation (39% vs. 31%). Conclusions: This study suggests that menopausal women with epilepsy have a higher prevalence of MDD, GAD, and suicide ideation compared with premenopausal women. Further investigation on the psychiatric effects of menopause in this population is needed to increase awareness and enhance quality of patient care. Disclosure: Dr. Patel has nothing to disclose. Dr. Foldvary-Schaefer has received personal compensation for activities with Jazz Pharma and UCB Pharma. Dr. Foldvary-Schaefer has received research support from UCB Pharma, CleveMed, and Lundbeck. Dr. Jehi has nothing to disclose. Dr. Tesar has nothing to disclose. Dr. Viguera has nothing to disclose.

Prevalence of Primary Headache Disorders in Patients with Cerebrovascular Accidents (A Study from a University Hospital of North India) (P04.256)

Prevalence of Primary Headache Disorders in Patients with Cerebrovascular Accidents (A Study from a University Hospital of North India) (P04.256)

Corticothérapie prolongée et troubles anxieux et dépressifs. Étude longitudinale sur 12 mois

To date, there is little data in the literature describing the anxiety and depressive disorders iatrogenic to corticosteroids. These disorders are common, underestimated, with potentially serious consequences that may jeopardize the patient's prognosis; their management is not consensual. The objective of our work is to determine the prevalence of anxiety and depressive disorders induced by corticosteroids, assessing their accountability to the corticosteroids and studying their risk factors. We conducted a prospective longitudinal study over 12months evaluating the prevalence of anxiety and depressive disorders in patients followed for chronic skin diseases treated with prolonged corticosteroid-therapy. Our patients were assessed using standardized instruments: the Mini International Neuropsychiatric Interview (MINI), the Hamilton Anxiety Scale (HAS) and the Beck Depression Inventory (BDI). Of 54patients included, our study showed a high prevalence of anxiety and depressive disorders estimated at 27%. These disorders were divided into depressive disorder in 16% of cases, and anxiety disorder in 11% of cases. The early onset of these disorders was found during the first weeks of treatment. According to the Beck Depression Inventory (BDI), depression was moderate in 67% of cases; severe with suicide attempts in 22% of cases, and mild in 11% of cases. According to the Hamilton Anxiety Scale (HAS), anxiety was mild in 33% of cases and moderate in 67% of cases. The disorders observed were mainly distributed into: 33% deep pemphigus, 27% lupus, 13% bullous pemphigoid and 13% dermatomyositis. In this study the statistically significant risk factors are dose of corticosteroids and personal psychiatric history of the patient; in addition, there is a high prevalence of disorders in patients whose age exceeds 40years, female gender, and patients treated for deep pemphigus. The evolution after pharmacological treatment and supportive psychotherapy was favorable in most patients. The psychiatric examination prior to prescription of long-term corticosteroid-therapy use should be standard practice to identify patients at risk, discuss the treatment modalities, and provide comprehensive care.

Mental Disorders in Obese Patients with and without Metabolic Syndrome

The authors sought to evaluate lifetime prevalence of mental disorders in patients affected by metabolic syndrome compared with patients affected by central obesity alone. One hundred eighty-six (63.5%) patients affected by central obesity and 107 (36.5%) affected by metabolic syndrome according to ICF criteria were interviewed by means of SCID I and SCID II. Axis I and axis II lifetime prevalence were respectively 53.8% and 30.1% among patients with central obesity, 50.5% and 28% among patients with metabolic syndrome, differences which were not significant. No statistically significant differences were found between groups as far as each single axis I and II diagnostic category was considered. Metabolic syndrome is not associated with a higher risk of mental disorders compared to central obesity alone.

Stellenwert von Gerinnungsstörungen bei Patienten mit Epistaxis

Epistaxis can have a variety of different local or systemic causes. It is the cardinal symptom of von Willebrand disease (VWD), the most frequent congenital bleeding disorder with a prevalence of approximately 1%. The usual routine coagulation screening tests (PT, APTT, platelet count) are not sufficient to diagnose VWD, factor XIII (FXIII)-deficiency or platelet dysfunction. A prospective study was conducted implementing enhanced coagulation screening for bleeding disorders in a total of 100 inpatients admitted for epistaxis. A bleeding disorder was found in 13%. In eight patients VWD was diagnosed, in six patients FXIII-deficiency was found, and in one patient both. The prevalence of bleeding disorders in patients with epistaxis is higher than in the general population. Epistaxis can be the primary symptom of chronic inflammatory disease or malignant disease. A thorough anamnesis is necessary and in cases of doubt additional testing for underlying disorders is recommended.

Problemy lecheniya patsientov s morbidnym ozhireniem

The article describes evidence-based approaches to treatment of morbid obesity, including surgical interventions designated for bodyweight reduction and provides comparative analysis of efficacy and safety of lifestyle interventions, medical treatment and various types of bariatric surgery. Detailed description of diagnosis, treatment and prevention of post-surgical vitamin and mineral deficiencies is given. Special attention is paid to high prevalence of mental disorders in patients with morbid obesity, their role in its development, their influence on outcomes of surgical intervention and potential patient dissatisfaction with its results. Necessity of thorough selection of patients for bariatric surgery is emphasized, with assessment of their mental state and proper organization of subsequent life-long follow-up after operation

Prevalence of all relevant eating disorders in patients waiting for bariatric surgery: A comparison between patients with and without eating disorders

To study the prevalence of all relevant eating disorders in 157 obese patients waiting for bariatric surgery. Another aim was to explore for possible differences between gender, and those with and without ED. The dependent variables were: socio-demographic characteristics, BMI, obesity onset, and obesity-related somatic diseases. ED was assessed using the self-report questionnaire, "Eating Disorders in Obesity" (EDO). The patients answered a questionnaire that targeted socio-demographic and health information. Subgroups were based on the patients responses to items on the EDO: 1 patient (0.6%) with Bulimia Nervosa (BN), 6 (3.8%) with Eating Disorder Not Otherwise Specified (EDNOS), 21 (13.4%) with Binge Eating Disorder (BED), and 23 (14.6%) with Binge Eating (BE). The patients in the EDNOS group were those who lacked one criterion of the BN diagnosis. The patients in the BE group lacked one criterion of the BED diagnosis. Twenty-eight (17.8%) fulfilled the DSM-IV-TR criteria for ED. When patients with BE were added, 51 patients (32.5%) were identified with ED or sub-threshold ED. In the explorative part of the study, no gender differences in socio-demographic variables, BMI, obesity onset, and obesity-related somatic diseases emerged. With the exception of age, no differences were found in these variables between those with and without ED. Employing all relevant eating disorders and binge eating symptoms (BE) for this population identified patients with pathological eating behaviors, which are not detected in previous studies measuring only BED and BE.

M1168 Gastro-Oesophageal Mechanisms of Recurrent Postprandial Vomiting in Young Patients With Joint Hypermobility Syndrome and Autonomic Dysfunction

Introduction We have recently demonstrated a high prevalence of functional GI disorders in patients with joint hypermobility syndrome.1 These patients frequently have autonomic nerves dysfunction and may present with recurrent vomiting, severe dyspepsia and constipation. We aimed to characterise the OGJ mechanisms underlying recurrent postprandial vomiting in a series of consecutive patients with joint hypermobility syndrome and/or autonomic dysfunction. Methods Twelve patients (mean age=25.5 years, 9 females, 3 males) referred for gastro-oesophageal motility testing due to recurrent postprandial vomiting were studied during fasting and postprandial periods using combined high-resolution manometry-impedance. Eating disorders, neurologic and other organic gastrointestinal disorders were previously excluded. Median duration of postprandial vomiting was 17 months. Using Beighton Hypermobility Score, 7/12 patients were diagnosed with Joint Hypermobility Syndrome (JHS). In five of these patients we found autonomic dysfunction symptoms. Combined stationary HRM-impedance (Sandhill Scientific) was performed in semirecumbent position. The protocol included 10 single wet swallows, 2 multiple rapid swallows sequences, a semisolid standard meal followed by 30 min postprandial monitoring. Chicago Classification 2009 was used to classify oesophageal motility disorders. Results Hiatus hernia was diagnosed in 4/12 patients. Normal oesophageal motility was observed in 6/12 patients and the remaining patients had intermittent hypotensive peristalsis. All patients vomited after the standard meal. Nausea preceding vomiting was present in only 5/12 patients. Aerophagia, objectively detected by impedance, was a major feature, found in 8/12 patients. However, only 4 patients had an impedance pattern of belching-liquid regurgitation. The majority of patients had objective abdominal straining (detected with HRM as abrupt, low amplitude, simultaneous increase in gastro-oesophageal pressure) followed by liquid intra-oesophageal retrograde flow with high proximal extent. Conclusion JHS was present in a significant proportion of these young patients with recurrent postprandial vomiting. Aerophagia was a significant consistent finding in these patients. We hypothesise that patients with JHS and oesophago-gastro-intestinal involvement may perceive early postprandial mild gastric discomfort (probably due to liquid accumulation in the gastric cardiac region) and develop an aerophagic behaviour to alleviate their discomfort by belching. Subsequently, straining to belch is associated with vomiting.

Metabolic abnormalities in patients with nephrolithiasis: comparison of first-episode with recurrent cases in Southern Iran

Metabolic disorders are one of the etiologic factors in renal stone formation. The aim of present study was to evaluate prevalence of metabolic disorders in patients with renal stone. From 572 patients referring to our urologic clinics, 376 patients participated in the study. Patients were divided to first time stone former (group A) and recurrent renal stone (group B). Twenty-four hour urine specimens were obtained for urinary calcium, oxalate, magnesium, citrate, uric acid, phosphor and 24-h urine volume. Venous blood samples were obtained evaluating serum phosphate, uric acid, and calcium. The prevalence of each metabolic disorder was detected, and two groups were compared regarding metabolic disorders. The prevalence of renal stone in male patients was 63.04% versus 36.96% in female patients (P < 0.05). The most common abnormality observed in patients was low 24-h urine volume (58.24%) followed by hypercalciuria (17.18%) and hyperuricosuria (15.15%). Hyperuricemia was found in 6 first time stone former patients and 14 patients with recurrent renal stone (P = 0.04). There was no statistically significant difference between group A and B in other metabolic abnormalities (P > 0.05). Low 24-h urine volume was the most common abnormalities in patients with nephrolithiasis in our region. Metabolic evaluation must be performed in all patients with renal stone even those with first time stone formation.

The prevalence of comorbid anxiety disorders in outpatients with schizophrenia

Objective. The purpose of this study was to determine the prevalence of lifetime anxiety disorders in patients with schizophrenia in Sanliurfa, Turkey, and to assess the association between comorbidity and several demographic and clinical variables. Methods. Eighty-two outpatients diagnosed with schizophrenia were recruited for the study. They were assessed by means of the Structured Clinical Interview for DSM-IV axis I Disorders-Clinician Version (SCID-I-CV), Anxiety Disorder Module, the Positive and Negative Syndrome Scale (PANSS), the Hamilton Anxiety Rating Scale (HARS), and the Global Assessment of Functioning Scale (GAF). Results. Fifty-five (67.1%) were diagnosed with at least one lifetime comorbid anxiety disorder. The most common anxiety disorder was obsessive-compulsive disorder (39.0%), followed by social phobia (13.4%). We found patients with a diagnosis of schizophrenia with comorbid anxiety disorders had shorter duration of illness than those without such comorbid conditions. Atypical antipsychotics were more commonly prescribed to treat these patients. Conclusion. As comorbidity of anxiety disorders is relatively prevalent among patients with a diagnosis of schizophrenia, special attention to this issue should be paid when interviewing these patients.

M1810 Prevalence of Functional Gastrointestinal Disorders in Patients with Ineffective Esophageal Motility

M1810 Prevalence of Functional Gastrointestinal Disorders in Patients with Ineffective Esophageal Motility

Prevalência de transtornos psiquiátricos em pacientes em hemodiálise no estado da Bahia

INRODUÇÃO: Limitações da qualidade de vida dos pacientes com insuficiência renal crônica (IRC) em programa de hemodiálise estão associadas a maior prevalência de transtornos psiquiátricos. O diagnóstico precoce e preciso pode contribuir na elaboração de estratégias de tratamento. OBJETIVO: Estudar a prevalência e o padrão dos transtornos psiquiátricos em pacientes hemodialisados, identificando variáveis relacionadas com sua ocorrência. MÉTODOS: Foram estudados 244 pacientes e analisadas as variáveis associadas à ocorrência de transtornos psiquiátricos. Os pacientes foram avaliados através do Mini-International Neuropsychiatric Interview (MINI). RESULTADOS: Pelo menos um diagnóstico psiquiátrico foi apresentado por 91 pacientes (37,3%). Os de ocorrência mais freqüente foram distimia (17,6%), risco de suicídio (16,4%) e episódio depressivo maior (8,6%). O sexo feminino apresentou maior risco de transtornos psiquiátricos (razão de chance [RC] = 2,77; intervalo de confiança [IC] 95%: 1,42-5,41). Os pacientes viúvos, separados e solteiros apresentaram maior risco de transtornos psiquiátricos do que os casados (RC= 5,507;IC95%:1,348-22,551). Aqueles com menos de dois anos em diálise apresentaram risco maior (RC = 2,075; IC 95%: 1,026-4,197). Os pacientes com clearance fracional de uréia (Kt/V) abaixo de 0,9 tiveram maior chance de apresentar transtornos psiquiátricos (RC = 3,955; IC 95%: 1,069-11,012). CONCLUSÕES: A prevalência de transtornos psiquiátricos foi alta. Os transtornos afetivos foram os mais freqüentes. Nas mulheres e naqueles com Kt/V baixo, o risco foi maior. Nos pacientes casados e naqueles com mais de dois anos em tratamento o risco foi menor.

Psychiatric disorders in patients admitted to emergency department wards

Even though psychiatric problems are commonly observed in patients attending emergency departments (ED), to our knowledge, there are no studies about the prevalence of mental disorders in patients admitted to ED wards. In the present study we evaluated the psychiatric disorder morbidity in patients admitted to ED wards for physical problems. General Health Questionnaire-30 (GHQ-30) was submitted to 556 patients admitted to the ED ward. All GHQ-30 positive (score > 4) and one third (randomly selected) of the GHQ-30 negative (score < 5) patients underwent the Mini International Neuropsychiatric Interview (MINI-IV), a structured interview to diagnose mental disorders according to DSM-IV criteria. Patients with positive and negative scores to GHQ-30 were 293 (52.7 per cent) and 263 (47.3 per cent) respectively. A total of 351 patients underwent the MINI-IV. In the total sample the extrapolated prevalence was 44.4 per cent for all mental disorders, 21.7 per cent for Anxiety Disorders, 10.2 per cent for Depressive Disorders, 9.7 per cent for Adjustment Disorders and 3.2 per cent for Alcohol Dependence. In only 53 patients (9.8 per cent) the diagnoses at discharge was a mental disorder and in 32 patients (5.7 per cent) a psychiatric consultation was requested. In conclusion, a high rate of Anxiety and Depressive Disorders was found in patients admitted to the ED ward, but in most of these patients the mental disorders were not recognized by the emergency physicians. Copyright © 2001 John Wiley & Sons, Ltd.

Comorbid psychiatric disorders in cancer patients in acute inpatient treatment and medical rehabilitation

An association between mental disorders, especially affective and anxiety disorders, and cancer has been reported in many clinical studies with inpatients. However, no data exist about the prevalence of mental disorders in patients undergoing acute care or rehabilitation treatment for cancer in Germany. The present study investigated 4-week, 6-month and lifetime prevalence rates of comorbid mental disorders in cancer. 256 patients from 2 rehabilitation clinics and 2 acute care hospitals were examined with standardized screening scales for psychological burden (GHQ-12, HADS) and quality of life (SF-36). Somatic parameters and interventions were assessed through standardized medical records from the attending oncologists. In the second-stage examination a subsample of 120 patients were interviewed with standardized clinical interview (CIDI) in order to obtain DSM-IV diagnoses of mental disorders. 44% (acute care) and 49% (rehabilitation) of the patients have high GHQ scores (cut-off > 4). Furthermore, more than 20% of the cancer patients have elevated scores on the HADS subscales depression and anxiety (cut-off > or = 11). Prevalence rates of mental disorders in the rehabilitation sample are 34% for the 4-week (vs. 24% in the acute care sample), 45% for the 6-month period (vs. 38%), and 79% for lifetime (vs. 49% in the acute care sample). The most frequent current disorders are affective (13% rehabilitation vs. 11% acute care) and anxiety disorders (17% in both samples). The rates of affective and anxiety disorders are much higher than the frequency of these disorders in recent epidemiological studies of the normal population in Germany. The high psychosocial burden expressed by the patients and the frequency of depressive and anxiety disorders emphasize the importance of (1) effective diagnostic strategies to recognize mental disorders, and (2) specialized psychosocial services in oncology, which provide psychological support and effective interventions for cancer patients in acute care and rehabilitation.

Psychotherapy services and the prevalence of mental disorders in urban and rural areas.

This study addresses the issue of need for and provision of psychotherapy care in urban and rural areas. In the first part, prevalence of mental disorders based on epidemiological field studies in the county of Traunstein and the city of Mannheim are discussed. Among patients of general practitioners the prevalence of mental disorders was slightly higher in Mannheim than in Traunstein. Concerning the provision of care, results of a questionnaire survey of a random sample of 1542 nonmedical counsellors or psychotherapists in Traunstein, Mannheim and the metropolitan area of West Berlin are presented. The rate of nonmedical therapists/100,000 inhabitants was the same for Traunstein and Mannheim. A more detailed analysis of their service capacity revealed that it was by 17% to 20% higher for Mannheim than for Traunstein; the prevalence of mental disorders in patients of general practitioners was shown to be about 10% higher in Mannheim than in Traunstein. Under the assumption that there is a linear relationship between prevalence and need for care, there appears to be a slight, but not marked undersupply of services by doctors and nonmedical counsellors or psychotherapists in Traunstein as compared to Mannheim. In comparison, the districts of West Berlin were classified into those with high and those with a low percentage of blue collar workers. The rate of nonmedical counsellors or psychotherapists in the "upper class" districts in West Berlin was almost four times higher than that for the "lower class" districts of West Berlin, in Mannheim and Traunstein. The rate/100,000 for the service capacity of nonmedical counsellors or psychotherapists in the "upper class" districts of West Berlin was much higher, and in the "lower class" districts of West Berlin much lower, than in Traunstein or Mannheim. Our data show that there are some discrepancies in the provision of care between rural and urban areas, which however are not large when Traunstein is compared with Mannheim; there were however, substantial discrepancies in the provision of care between cities (Mannheim and West Berlin) and between districts within the same city (West Berlin).