Prevalence Of Major Psychiatric Disorders Research Articles

Outcomes following burn injury in intensive care patients with major psychiatric disorders

AimsPatients with psychiatric comorbidity have been shown to experience high rates of burn injury. Burn epidemiology, etiology, and outcomes have been sparsely documented for patients with major psychiatric disorders. The aim of this study was to analyze the epidemiologic characteristics and outcomes in intensive care burn patients with pre-existing and acute major psychiatric disorders . MethodsA retrospective study was performed including intensive care burn patients admitted between March 2007 and December 2020. Demographic, clinical and epidemiological data were collected and analyzed. Major psychiatric co-morbidities were collected according to ICD-9 and ICD-10 classifications. Patients were stratified according to F-diagnoses. ResultsA total of 1325 patients were included. 16.6 % of all patients had one or more major psychiatric disorders- 9.3 % with anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders, 9.2 % with mood (affective) disorders, 3.5 % with schizophrenia and other non-mood psychotic disorders, and 1.8 % with disorders of adult personality and behavior. Patients with major psychiatric disorders presented with significantly higher burn severity, reflected by higher abbreviated burn severity index (ABSI) scores (5.9 vs. 5.3, p < 0.001) and larger total body surface area (TBSA) affected (15.9 vs. 12.5 %, p = 0.002). Burned TBSA ≥ 30 and inhalation injuries were observed more frequently in patients with MDP, however without statistical significance. They also experienced prolonged hospital length-of-stay (LOS) (25.5 vs. 16.3 days, p < 0.001), prolonged intensive care unit LOS (14.8 vs. 7.7 days, p < 0.001), underwent surgical interventions (3.5 vs. 2.3, p < 0.001) and mechanical ventilation more frequently (34.1 % vs. 16.5 %, p = 0.43) and had significantly longer ventilation durations (73.5 vs. 31.2 h, p = 0.002). Mortality rates were lower compared to patients without major psychiatric disorders (5.9 vs. 8.1, p < 0.001). ConclusionsThe prevalence of major psychiatric disorders in burn patients is considerably high. Patients with psychiatric comorbidities were found to have greater burn severity, prolonged total hospital and ICU LOS, underwent surgical interventions and mechanical ventilation more frequently and had prolonged ventilation duration. Our results highlight the importance of identifying burn patients with major psychiatric disorders who may necessitate additional resources and require extensive inpatient psychiatric care and counseling.

Epidemiological profile of psychiatric illnesses in the province of Taza, Morocco: case of a study on a schizophrenic sub-population in the Ibn Baja Hospital

AimThe objective of this study is to assess the prevalence of major psychiatric disorders and to plot some characteristics of the schizophrenic sub-population in the study area.MethodsWe present the results of a retrospective study on psychiatric illnesses listed at the level of the psychiatric department at the Ibn Baja Hospital in the province of Taza (Morocco), involving a sample of 3803 patients aged 18 years and over between 2006 and 2016.ResultsThe results obtained show that the average age of our sample is 33 ± 10.5 years and that schizophrenia is the most pronounced psychiatric disorder with a prevalence of 69.9%, followed by bipolar disorder (8.4%), manic state (8.3%), major depression (5.8%), epilepsy (3.7%), dementia (2.5%), and drug addiction (1.5%). The predominance of the workforce for all psychiatric disorders was significantly in favor of males (P = 0 .000) with an M/F sex ratio of 4.9. Most patients were from urban areas 77.1%, compared with 22.9% from rural areas, with a predominance of males (P<0.001). Schizophrenia disease is the most predominant in the region with a prevalence of 1.6% and affects 83% of men versus 17% of women with a M/F sex ratio value of 5.6 in favor of men (P = 0.000).ConclusionIn our region of study, as everywhere else in the world, the prevalence of psychiatric diseases on the one hand, and schizophrenia on the other hand, seems to be worrying, thus requiring more vigilance on the part of public health workers in general and mental health workers.

A Central Clearing Clinic to Provide Mental Health Services for Refugees in Germany.

Objective: To determine migration related distress pattern in refugees and feasibility of a de novo established, central low-threshold outpatient clinic serving more than 80,000 newly arrived refugees in the metropole of Berlin.Methods: In an observational cohort study the relative prevalence of major psychiatric disorders by age, place of living within berlin, language and region of origin were assessed in a refugee cohort from 63 nationalities speaking 36 languages.Findings: Within 18 months, a total of 3,096 cases with a mean age of 29.7 years (11.7) have been referred from all 12 districts and 165 of 182 subdistricts of Berlin to the CCC. 33.7% of the patients were female. The three most frequent diagnoses were unipolar depression (40.4%), posttraumatic stress disorder (24.3%), and adjustment disorder (19.6%).Conclusion: The present data gives insight into the distribution of mental disorders in a large sample of refugees and provides evidence that a CCC is an effective service to quickly and broadly provide psychiatric consultations and thus to overcome classical barriers refugees usually experience in the host communities. In Berlin, Germany, and Europe treatment resources for this population should focus on stress and trauma related disorders.

Prevalence of DSM-IV Major Psychiatric Disorders among North Korean Defectors in South Korea.

ObjectiveThe aim of this study was to estimate the prevalence of major psychiatric disorders among North Korean defectors (NKD) settled in South Korea. MethodsThe study population consisted of 294 North Korean defectors, aged 18 to 64 years settled in South Korea for 3 years or less. Between June 1, 2016 and October 31, 2016, face-to-face interviews were conducted using the North Korean version of the WHO-Composite International Diagnostic Interview (NK-CIDI) to diagnose DSM-IV psychiatric disorders. ResultsThe lifetime prevalence of any DSM-IV psychiatric disorders was 62.2% in NKD and 25.0% in the general Korean population. The prevalence of specific disorders in NKD and general Korean population was as follows: 22.3% and 4.9% for major depressive disorder (MDD), 12.2% and 1.4% for post-traumatic stress disorder (PTSD), 18.0% and 4.8% for nicotine dependence, and 14.5% and 11.2% for alcohol abuse. The incidence of every single psychiatric disorder varied in each country. For instance, the generalized anxiety disorder, specific phobia, and alcohol use disorder occurred more frequently in North Korea whereas PTSD was more prevalent in other countries. ConclusionThe prevalence of psychiatric disorders among NKD was quite higher than in the general population of South Korea.

Incarcerated people in prisons: A public health priority in resource-poor settings

Brazil has the third largest prison population on the planet. In this situational framework, Brazil's state prisons experience brutal riots. Here we show that, the risks of prison violence are exacerbated by a lack of opportunities for inmates once they've entered the penal system. Prisoners in Brazil do not have adequate access to healthcare services and neither is properly reached by the healthcare system. Overcrowding makes it hard for prison authorities to keep rival factions separate. The identification of the presence of mental problems when the individuals are admitted to prisons is a necessary task that may guide the adoption of measures to reduce suffering beyond the penalty of deprivation of freedom. The burden of psychiatric disorders in the prisoner's population is not known. The prevalence of major psychiatric disorders is high. Regardless of whether mental disorders are the cause or consequence of prison, it is elucidated that the stressing factors inherent to the inmate condition do not contribute to the prevention of mental disorders.

Severe mental illness and substance use disorders in prisoners in low-income and middle-income countries: a systematic review and meta-analysis of prevalence studies

SummaryBackgroundAlthough more than two thirds of the world's incarcerated individuals are based in low-income and middle-income countries (LMICs), the burden of psychiatric disorders in this population is not known. This review provides estimates for the prevalence of severe mental illness and substance use disorders in incarcerated individuals in LMICs.MethodsFor this systematic review and meta-analysis, we searched 17 electronic databases to identify prevalence studies of psychiatric disorders in prison populations in LMICs, published between January, 1987, and May, 2018. We included representative studies from general prison samples, providing information about four major psychiatric diagnoses: psychosis, major depression, alcohol use disorders, and drug use disorders. We pooled data from studies using random-effects meta-analyses and assessed the sources of heterogeneity by meta-regression. We extracted general population estimates from the Global Burden of Diseases 2016 database to calculate comparative prevalence ratios. This study is registered with PROSPERO, number CRD42015020905.FindingsWe identified 23 publications reporting prevalence estimates of severe mental illness and substance use disorders for 14 527 prisoners from 13 LMICs. In this population, the estimated pooled 1 year prevalence rates for psychosis were 6·2% (95% CI 4·0–8·6), 16·0% (11·7–20·8) for major depression, 3·8% (1·2–7·6) for alcohol use disorders, and 5·1% (2·9–7·8) for drug use disorders. We noted increased prevalence at prison intake and geographic variations for substance use disorders. For alcohol use disorders, prevalence was higher in the southeast Asian region than in the eastern Mediterranean region; and drug use disorders were more prevalent in the eastern Mediterranean region than in Europe. Prevalence ratios indicated substantially higher rates of severe mental illness and substance use disorders among prisoners than in the general population (the prevalence of non-affective psychosis was on average 16 times higher, major depression and illicit drug use disorder prevalence were both six times higher, and prevalence of alcohol use disorders was double that of the general population).InterpretationThe prevalence of major psychiatric disorders is high in prisoners in LMIC compared with general populations. As these findings are likely to reflect unmet needs, the development of scalable interventions should be a public health priority in resource-poor settings.FundingCONICYT of the Chilean government and the Wellcome Trust.

Severe Mental Illness and Substance Use Disorders in Prisoners in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis of Prevalence Studies

Background: Although more than two thirds of prisoners are based in low- and middle-income countries (LMIC), the burden of psychiatric disorders is not reliably known. This review provides estimates for the prevalence of severe mental illness and substance use disorders in incarcerated individuals in LMIC. Methods: Systematic literature searches were conducted in 17 electronic databases identifying prevalence studies of psychiatric disorders in prison populations, published between January 1987 and May 2018. We pooled prevalences using random-effects meta-analyses and assessed the sources of heterogeneity by meta-regression. We extracted general population estimates from the Global Burden of Diseases 2016 database to calculate prevalence ratios. The review was registered in PROSPERO (CRD42015020905). Findings: We identified 23 publications reporting estimates for 14,527 prisoners. The pooled one-year prevalence rates were estimated to be 6·2% (95% CI 4·0-8·6) for psychosis, 16·0% (95% CI 11·7-20·8) for major depression, 3·8% (95% CI 1·2-7·6) for alcohol use disorders, and 5·1% (95% CI 2·9-7·8) for drug use disorders. We found elevated prevalences at prison intake and geographic variations for substance use disorders. Prevalence ratios indicated substantially higher rates among prisoners than in the general population. Interpretation: The prevalence of major psychiatric disorders is high in prisoners in LMIC. As these findings are likely to reflect unmet needs, the development of scalable interventions should be a public health priority in resource-poor settings. Funding: This work was funded by CONICYT of the Chilean government (FONDECYT Regular grant number 1160260 to APM) and The Wellcome Trust (grant number 202836/Z/16/Z to SF). Declaration of Interest: We declare no competing interests.

Frequency of Major Psychiatric Disorders in Patients with HIV in Health Care Centers of Rafsanjan and Kerman in 2012

Background: Psychiatric disorders are common in HIV-infected patients and for sure have direct impact on both prevention and management of diseases in these patients. In this research, the prevalence of major psychiatric disorders including mood, anxiety, and psychotic disorders in HIV-infected patients of Rafsanjan and Kerman health care centers were determined.&#x0D; Materials and Methods: Eighty three HIV-infected patients were interviewed by a psychiatrist in above-mentioned health centers and their information was registered through a standard CIDI questionnaire (version 2.1) and was statistically analyzed.&#x0D; Results: In this study, Out of 83 participants, 71 cases (85.5%) were males and 12 (14.5%) were females. Their age range was from 21 to 62 years old. Sixty-nine cases (83.1%) were diagnosed with at least one major psychiatric disorder and 14 cases (16.9%) with none. Among the HIV-infected patients, 54 cases (65.1%) suffered from a mood disorder, 21 (25.3%) had psychotic and 41 (49.4%) had anxiety disorders.&#x0D; Conclusion: The current study showed that major psychiatric disorders were more common in HIV-infected patients in comparison to normal communities, so on-time diagnosis and therapy and proper management of these problems could be truly a promising step in global control of HIV in this part of Iran.

The association between armed conflict, violence and mental health: a cross sectional study comparing two populations in Cundinamarca department, Colombia

BackgroundExposure to violence in general and to armed conflict in particular has been consistently associated with an increased prevalence of mental illness. Colombia has sustained an internal armed conflict for decades and is considered one of the most violent countries in the world. However, certain areas have been more exposed to the conflict than others.MethodsThis is a cross sectional study comparing two communities from different villages in the department of Cundinamarca, Colombia. One, Guasca, was directly impacted by armed conflict. The other one; Guatavita has never been affected by armed conflict. We applied two different instruments: the PHQ scale and a short standardized interview in order to estimate the prevalence of major psychiatric disorders and their link to violent events. Forty-two volunteers from each village were evaluated through a personal interview using these two instruments.FindingsOf the population surveyed in Guatavita, 2.4% reported direct exposure to violence compared to 23.8% from Guasca. In the population exposed directly to violent events, the prevalence of all disorders was greater than in the non-exposed population with an OR of 1.46 (95% CI 0.3809 - 5.5989) for anxiety; 4.54 (95% CI 1.1098 - 18.5984) for depression; 6.0 (95% CI 1.2298 - 30.2263) for somatization disorder; and 4.4 (95% CI 1.2037 - 16.0842) for alcohol abuse.InterpretationThere is a statistically significant association between the history of armed conflict, violence and the presence of mental illnesses, particularly depression, somatization disorder and alcohol abuse. Special attention should be paid to the detection, prevention and treatment of these disorders when dealing with populations exposed to violence and to armed conflict in particular.

Letter

Back to table of contents Previous article Next article LetterFull AccessLetterJifeng Cai Ph.D.Yan Gu Ph.D.Shuqiao Yao M.D., Ph.D.Jifeng Cai Ph.D.Search for more papers by this authorYan Gu Ph.D.Search for more papers by this authorShuqiao Yao M.D., Ph.D.Search for more papers by this authorPublished Online:1 Sep 2010https://doi.org/10.1176/ps.2010.61.9.947AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail Screening for Personality Disorders Among Chinese Prison InmatesTo the Editor: Although only about one-third of the world's inmates live in Western countries, 99% of available data from prison surveys are derived from Western populations ( 1 ). Such disparity underscores the need for greater forensic psychiatric research in non-Western populations. We surveyed 2,961 inmates of five prisons in South China. Seventy-four percent (N=2,189) were men, and the mean±SD age was 30.0±9.9. We used the Personality Diagnostic Questionnaire–4+ (PDQ), the reliability and validity of which have been thoroughly confirmed in Chinese populations ( 1 ). Written informed consent was obtained. Data analyses were conducted with SPSS, version 13.0. Group differences were examined with t tests or Mann-Whitney U tests, depending on the nature of the data. Using a cutoff score of 4 or 5, depending on the personality disorder, we found rates of personality disorders ranging from 8% (N=240) to 67% (N=1,981). Borderline personality disorder and antisocial personality disorder were most common—52% (N=1,552) and 67% (N=1,981), respectively. Fazel and Danesh ( 2 ) systematically reviewed 62 studies on the prevalence of major psychiatric disorders among delinquents and found that approximately 65% (N=1,925) had a personality disorder, of which antisocial personality disorder was most common (47%, N=1,392) ( 1 ). One possible explanation for the higher prevalence of antisocial personality disorder in our study (67%) may be the poor economic status and low level of education of Chinese inmates. These factors have been linked to personality formation. Another explanation may be related to the large proportion of male inmates in our study. Rates of antisocial personality disorder were higher among male inmates than among female inmates in our sample (72% compared with 53%). The larger proportion of males resulted in a higher rate of antisocial personality disorder and higher average scores for the PDQ antisocial subtype. Among the 2,961 inmates, 42% (N=1,235) were violent offenders. We found that inmates with a history of violent behavior scored higher than nonviolent inmates on PDQ scales for antisocial, borderline, schizotypal, and depressive personality disorder. [A table comparing scores of inmate subgroups is available as an online supplement to this letter at ps.psychiatryonline.org .] These findings are consistent with those of a previous study, which found that antisocial and borderline personality disorders among men were correlated with violent conduct ( 3 ). Furthermore, the presence of antisocial personality traits among inmates with a history of violence has been consistently associated with an increased likelihood of violent reoffending ( 4 ). In a study of female offenders by Putkonen and colleagues ( 5 ), 81% of those who committed repeat offenses had a personality disorder diagnosis. In our sample, repeat offenders had significantly higher scores than first offenders on antisocial, depressive, and paranoid personality disorder scales (see online table). Thus personality disorder may have considerable predictive validity. A prison sentence should offer inmates an opportunity to receive psychiatric assessment and treatment that they may not have had access to outside prison. Furthermore, assessment and treatment may help prevent repeat offenses. Sadly, because of a lack of resources, this opportunity is often unavailable, and providing it remains a challenge for the Chinese government.Acknowledgments and disclosuresThis study was funded by grant 20060400892 from the Postdoctoral Science Foundation of China and grant 2007RS4032 from the Science Foundation of Hunan Province.The authors report no competing interests.Dr. Cai and Dr. Gu are affiliated with the Department of Forensic Science, School of Basic Medical Sciences, and Dr. Yao is with the Medical Psychological Research Center, all at Central South University, Changsha, Hunan, China.

Prevalence of psychiatric disorders among older adults in long-term care homes: a systematic review

The population of older adults in long-term care (LTC) is expected to increase considerably in the near future. An understanding of the prevalence of psychiatric disorders in LTC will help in planning mental health services for this population. This study reviews the prevalence of common psychiatric disorders in LTC populations. We searched electronic databases for studies on the prevalence of major psychiatric disorders in LTC using medical subject headings and key words. We only included studies using validated measures for diagnosing psychiatric disorders or psychiatric symptoms. Our review focused on the following psychiatric disorders: dementia, behavioral and psychological symptoms of dementia (BPSD), major depression, depressive symptoms, bipolar disorder, anxiety disorders, schizophrenia, and alcohol use disorders. We also determined the prevalence of psychiatric disorders in the U.S. LTC population using data from the 2004 National Nursing Home Survey (NNHS). A total of 74 studies examining the prevalence of psychiatric disorders and psychological symptoms in LTC populations were identified including 30 studies on the prevalence of dementia, 9 studies on behavioral symptoms in dementia, and 26 studies on depression. Most studies involved few LTC facilities and were conducted in developed countries. Dementia had a median prevalence (58%) in studies while the prevalence of BPSD was 78% among individuals with dementia. The median prevalence of major depressive disorder was 10% while the median prevalence of depressive symptoms was 29% among LTC residents. There were few studies on other psychiatric disorders. Results from the 2004 NNHS were consistent with those in the published literature. Dementia, depression and anxiety disorders are the most common psychiatric disorders among older adults in LTC. Many psychiatric disorders appear to be more prevalent in LTC settings when compared to those observed in community-dwelling older adults. Policy-makers and clinicians should be aware of the common psychiatric disorders in LTC and further research into effective prevention and treatments are required for this growing population.

Santé mentale et déterminants sociaux

Introduction Social disparities in health is becoming a topic of major importance. Recent studies presents data on social differences in morbidity on various diseases. This paper shows how mental health disorders prevalences are strongly linked to sociological variables. It is based on the data of the research-action entitled « Mental Health in General Population: images and realities (MHGP) » carried out by the World Health Organisation Collaborative Centre (Lille, France) and the Direction of research, studies, assessment and statistics (Drees) of the French Ministry of Health, in a sample of 36 000 French subjects over 18 years old, between 1999 and 2003. Objectives The MHGP Survey is an international multisite study aimed at assessing the prevalence of major psychiatric disorders in the general population, as well as describing the representations attached to insanity, mental illness and depression, and the related care. It allows the analysis of the impact of professional situation on prevalence data in a large sample. Methods The MHGP Survey was carried out in 47 French public sites between 1999 and 2003. A face-to-face questionnaire was used to interview a representative sample of French metropolitan subjects, aged 18 and over, non-institutionalized and homeless. These subjects were recruited using quota sampling for age, gender, socio-professional and education levels, according to data from the 1999 national French population census. Representations of insane, mentally ill and depressive persons were explored by a specific questionnaire with open and semi-open questions. Psychiatric diagnoses were identified using the Mini International Neuropsychiatric Interview (MINI); including: mood disorders, anxiety disorders, alcohol and drug disorders, psychotic disorders and suicidal risk. A national database was then constituted by pooling data from all sites, weighted for age, gender, level of education, socio-professional level and work status to be representative of the French general population. Prevalence rates of mental disorders are very similar to those observed in other studies. Social disparities were analysed mainly using the work status categories, comparing employed people and unemployed people (unemployed, retired, students, housewife). Results Results show that mental disorders and suicidal risk are not fairly distributed between the various social categories. Half of unemployed people suffers from at least one mental disorder, whereas less than a third of employed people. For example, the prevalence of mood disorders is more than twice higher in unemployed (23,6%) than in employed (11,7%). Suicidal risk is specially high in unemployed people (22%) and students (15%). As in other pathologies and in causes of death, presence of mental disorder or suicidal risk negatively correlates with social status. Prevalence of mental disorders is higher in unemployed people and unskilled workers than in executives, managers and intellectual professions. Social disparities in mental health do not distinguish with those in health in general. Therefore, the issue of search for the causes of disparities is similar to that for any disparity in health.

« Santé Mentale en Population Générale : Images et Réalités (Smpg) » : Présentation de La méthodologie d’enquête

Introduction Mental Health is a Public Health issue, however, access to relevant treatment often does not meet the population needs. Patients, their relatives, as well as Mental Health professionals are still victims of a high stigmatization process. Whatever the countries and the cultural settings, public beliefs and attitudes towards mental illness (insanity) and mentally ills (insane people) play a major role in the ranking of priorities given to Mental Health national prevention and care policies. This paper presents the methodology of the research-action entitled « Mental Health in General Population : images and realities (MHGP) » carried out by the World Health Organisation Collaborative Centre (Lille, France) and the Direction of research, studies, assessment and statistics (Drees) of the French Ministry of Health, in a sample of 36 000 French subjects over 18 years old, between 1999 and 2003. Objectives The MHGP Survey is an international multisite study aimed at : - Describing, in the general population, the representations attached to insanity, mental illness and depression, and the related care - Assessing the prevalence of major psychiatric disorders in the general population ; - Rising awareness about Mental Health issues among various social groups: social workers, local elected, care professionals, by including them in the research-action procedure ; - Promoting the development of Community Psychiatry, following WHO main Guidelines. Methods About 900 individuals were recruited in 47 centres in metropolitan France between 1999 and 2003 according to the following criteria: i) informed consent to take part in the study, ii) age over 18 yrs, iii) not residing in a care institution and not homeless. Subjects were selected by quota sampling stratified by age, gender, educational and occupational level with the general population of the general population of the centre as sampling frame. The quotas were defined on the basis of the 1999 national population census. The data was collected by 1700 nursing students using a 50-item structured questionnaire administered in face-to-face interviews ; mean length 40 minutes. The interviewers received a special 3-day training course. The assessment included a specially developed questionnaire enabling description of representations of insane, mentally ill and depressed individuals ; the Mini International Neuro-psychiatric Interview (Sheehan and Lecrubier) ; a specific questionnaire on care consumption in case of positive MINI diagnosis and a sociodemographic questionnaire. In each centre, a team of supervisors (psychiatric staff) coordinated the interviews and the data collection ; the local elected and the social and care networks were given information about the research and the results. The results of the local study were systematically presented to the general population, the local elected and the social and care professionals. Prevalence rates of mental disorders are very similar to those observed in other studies. Results on social representations and public beliefs in general population can compare with the international data available. MHGP research-action remains the first study of this scale on the topic of Mental Health in France, combining representations and prevalences description. It allowed the development of anti-stigma actions at a national and local level.

Parole Revocation Among Prison Inmates With Psychiatric and Substance Use Disorders

Parole Revocation Among Prison Inmates With Psychiatric and Substance Use Disorders

Prevalence of major psychiatric disorders in a cohort of oldest old in Brazil: The Pietà study

consensus discussion. Results: 639 individuals (55.3% of the total oldestold population) were fully evaluated, being 408 women (63.8%) and 231 men(36.2%),aged81.1 65.2years,withmeanschoolingof2.6 62.8years. Dementia was diagnosed in 176 subjects, (prevalence¼27.5%), while CIND was identified in 166 (prevalence¼26.0%). Among dementia patients, only 39 cases (6.1%) had a previous diagnosis of this condition. Patients with dementia were significantly older (p<0.0001) and less educated (p¼0.001). Prevalence of dementia was also higher in women, although the difference was not statistically significant (p¼0.06). CIND prevalence was similar in both genders. When compared with the cognitively healthy individuals (n¼227),CINDsubjectsweresignificantlyolder(p¼0.004),buthadasimilar schooling. A previous history of depression was more frequent among dementia (p¼0.002) and CIND (p¼0.007) patients. Conclusions: Prevalence of CIND and dementia was high in this oldest-old population, although dementia was highly under-diagnosed. Age and previous history of depression were associated with both diagnoses, while low education dementia was associated only with dementia.

Trends in the Use of Psychotropic Drugs in Taiwan: A Population-Based National Health Insurance Study, 1997-2004

Trends in the Use of Psychotropic Drugs in Taiwan: A Population-Based National Health Insurance Study, 1997-2004

Section II: The Research: Article Summaries and Commentaries Hypothesis 1. Depression is a risk factor for the development of type 2 diabetes.

Eaton WW, Armenian HA, Gallo J, Pratt L, Ford DE: Depression and risk for onset of type II diabetes: a prospective population-based study. Diabetes Care 19:1097–1102, 1996 Early studies using diagnostic interviews to extract lifetime histories of depression in diabetic subjects indicated that first episodes of major depression typically preceded the diagnosis of type 2 diabetes. A 13-year follow-up of participants in the Epidemiologic Catchment Area (ECA) by Eaton et al. provided some of the first longitudinal evidence that depression might be a risk factor for the development of diabetes. The ECA, a landmark study in psychiatric epidemiology, documented the prevalence of major psychiatric disorders in the United States. Its primary findings were summarized in Psychiatric Disorders in America by Robins and Regier.7 A structured interview, the Diagnostic Interview Schedule (DIS), was developed for the ECA study. It enabled trained lay interviewers to assess the symptoms that were used to diagnose psychiatric disorders such as major depression according to the American Psychiatric Association's official criteria. The DIS determines whether the subject has ever met the criteria for each disorder and, if so, when the most recent episode occurred. The subjects in the analyses by Eaton et al. were classified according to whether they had ever had a major depressive episode before their ECA interview, regardless of whether they were depressed at the time of the interview. Utilizing the lifetime diagnosis of depression as a predictor of diabetes made it especially important to take age at enrollment into account. Older subjects had had more time to develop depression, diabetes, or both compared to younger subjects. However, individuals who already had diabetes at enrollment in the ECA were excluded from the analysis. Thus, age at enrollment influenced both inclusion in the sample and the participants' likelihood of ever having been depressed. …

Bipolar disorder among an isolated island community in Ethiopia

Background: Psychiatric data on population groups of geographic and social isolates are rare, but can potentially give insights into factors of aetiological importance. The Zeway islanders have lived in geographic and cultural isolation for over three centuries. Aim: To determine the prevalence of major psychiatric disorders among the adult population of Zeway islands. Methods: A three stage screening design that included the use of structured interview instruments (CIDI and SCAN), key informants, and clinical assessment by psychiatrists was employed for case identification. Results: Prevalence of bipolar disorders among the adult population ( n=1691) was 1.83% ( n=31) with 66% of the cases originating from one of the islands that constitutes only 17.33% of the study population. Only one subject was identified with schizophrenia. Conclusions: A pattern of differential prevalence for bipolar disorders and schizophrenia appears to exist in this isolated population, which also seems shared by other isolated population groups. The high prevalence of bipolar disorders with clustering of cases on one island may represent an environmental or genetic factor of etiologic relevance that deserves further exploration.

Standardized assessment of substance-related, other psychiatric, and comorbid disorders among probationers.

This study examined the prevalence of alcohol- and substance-related disorders in a random sample of 627 adult probationers in Illinois. The investigation also explored the prevalence of major psychiatric disorders and their co-occurrences with alcohol and substance use disorders. To detect the presence of psychiatric disorders, researchers employed standardized assessment tools based on Diagnostic and Statistical Manual of Mental Disorders criteria. Overall, results showed that probationers had significantly higher rates of psychiatric disorders, substance use disorders, and co-occurring disorders compared with persons in the general population. In light of these findings, probation administrators are urged to invest more resources in treating drug use, mental illness, and codisorders, the latter of which is associated with a higher risk of violent behaviors.

The prevalence of depressive disorders in the united kingdom

Background: The prevalence of major psychiatric disorders in the general population is difficult to pinpoint owing to widely divergent estimates yielded by studies employing different criteria, methods, and instruments. Depressive disorders, which represent a sizable mental health care expense for the public purse, are no exception to the rule. Methods: The prevalence of depressive disorders was assessed in a representative sample ( n = 4972) of the U.K. general population in 1994. Interviews were performed over the telephone by lay interviewers using an expert system that tailored the questionnaire to each individual based on prior responses. Diagnoses and symptoms lists were based on the DSM-IV. Results: Five percent (95% confidence interval = 4.4–5.6%) of the sample was diagnosed by the system with a depressive disorder at the time of the interview, with the rate slightly higher for women (5.9%) than men (4.2%). Unemployed, separated, divorced, and widowed individuals were found to be at higher risk for depression. Depressive subjects were seen almost exclusively by general practitioners (only 3.4% by psychiatrists). Only 12.5% of them consulted their physician seeking mental health treatment, and 15.9% reported being hospitalized in the past 12 months. Conclusions: The study indicates that mental health problems in the community are seriously underdetected by general practitioners, and that these professionals are highly reluctant to refer patients with depressive disorders to the appropriate specialist.