Prevalence Of Psychiatric Comorbidities Research Articles

A Clinic-Based Study in Treatment-Seeking Adolescent Inhalant Users in India: Implications for Management

ABSTRACTAn exploratory study was conducted on 23 consecutive treatment-seeking adolescent inhalant users at a tertiary drug dependence treatment center in India. Sociodemographic, clinical parameters and neuropsychological functioning were assessed using semi-structured interview, Composite International Diagnostic Interview (CIDI 3.0) for diagnosis, checklist for health damage and withdrawal symptoms, Malin's Intelligence Scale for Indian Children (MISIC), Memory for Design test and Stroop test. Routine biochemical testing and urinary hippuric acid level for recent inhalant use, measured using Gas Liquid Chromatography with Nitrogen Phosphorous Detector (GLC-NPD) was conducted. All participants were urban males (mean age 16 [SD = 1.8] years), who used either ink eraser fluid (87%) or glue (13%). Most participants experienced inhalant withdrawal (80%) and revealed high prevalence of psychiatric co-morbidity (52%), behavioral problems (43.5%), and neuropsychological deficits. Biochemical analysis validated recent (1–3 days) toluene exposure in 69.6% of participants, consistent with self-report. Management plans should take these issues into consideration.

Sex differences in comorbidity at diagnosis of multiple sclerosis: A population-based study.

Objective:To determine the prevalence of comorbidity in the multiple sclerosis (MS) population at the time of MS diagnosis. We also compared the prevalence of comorbidity in the MS population to that in a matched cohort from the general population.Methods:Using population-based administrative health data from 4 Canadian provinces, we identified 23,382 incident MS cases and 116,638 age-, sex-, and geographically matched controls. We estimated the prevalence of hypertension, diabetes, hyperlipidemia, heart disease, chronic lung disease, epilepsy, fibromyalgia, inflammatory bowel disease, depression, anxiety, bipolar disorder, and schizophrenia at MS diagnosis using validated case definitions. We compared the populations using rate ratios.Results:Of the MS cases, 16,803 (71.9%) were female. The most prevalent comorbidity was depression (19.1%). Compared to the matched population, all comorbidities except hyperlipidemia were more common in the MS population. Relative to the matched populations, the prevalence of hypertension was 16% higher for women with MS and 48% higher for men with MS, thus there was a disproportionately higher prevalence of hypertension in men with MS than women. Men with MS also had a disproportionately higher prevalence than women with MS for diabetes, epilepsy, depression, and anxiety.Conclusions:Comorbidity is more common than expected in MS, even around the time of diagnosis. The prevalence of psychiatric comorbidity is particularly high and highlights the need for clinical attention to this issue. The observed sex-specific differences in the burden of comorbidity in MS, which differ from those in the matched population, warrant further investigation.

Disruptions in cortico-subcortical covariance networks associated with anxiety in new-onset childhood epilepsy.

Anxiety disorders represent a prevalent psychiatric comorbidity in both adults and children with epilepsy for which the etiology remains controversial. Neurobiological contributions have been suggested, but only limited evidence suggests abnormal brain volumes particularly in children with epilepsy and anxiety. Since the brain develops in an organized fashion, covariance analyses between different brain regions can be investigated as a network and analyzed using graph theory methods. We examined 46 healthy children (HC) and youth with recent onset idiopathic epilepsies with (n = 24) and without (n = 62) anxiety disorders. Graph theory (GT) analyses based on the covariance between the volumes of 85 cortical/subcortical regions were investigated. Both groups with epilepsy demonstrated less inter-modular relationships in the synchronization of cortical/subcortical volumes compared to controls, with the epilepsy and anxiety group presenting the strongest modular organization. Frontal and occipital regions in non-anxious epilepsy, and areas throughout the brain in children with epilepsy and anxiety, showed the highest centrality compared to controls. Furthermore, most of the nodes correlating to amygdala volumes were subcortical structures, with the exception of the left insula and the right frontal pole, which presented high betweenness centrality (BC); therefore, their influence in the network is not necessarily local but potentially influencing other more distant regions. In conclusion, children with recent onset epilepsy and anxiety demonstrate large scale disruptions in cortical and subcortical brain regions. Network science may not only provide insight into the possible neurobiological correlates of important comorbidities of epilepsy, but also the ways that cortical and subcortical disruption occurs.

Pattern and Prevalence of Psychiatric Comorbidity in Patients with Essential Hypertension in Port Harcourt, Nigeria

Essential hypertension, a non communicable disease, is assuming an epidemic dimension, of the nature of a communicable condition. It, predominantly affects the physical, social and psychological well-being of the middle to elderly age group, with the former incidentally contributing over 50% of Nigeria workforce, hence interfering with the nation’s economic well- being . Although few of such studies have been done in this environment, hypertensionhas been variously cited to be commonly associated with psychiatric comorbidity. The aim of this study, therefore, was to determine the pattern and prevalence of psychiatric co-morbidity among subjects with essential hypertension attending the out patient clinic of the University of Port Harcourt Teacing Hospital (UPTH). In this cross-sectional study, following ethical approval from the appropriate committee of the hospital and informed consent from the participants, 360 subjects making up the study group were recruited based on the study’s inclusion exclusion criteria, after a Pilot Study (In addition, the hypertensives were screened for HIV infection and also investigated for other chronic medical illnesses). Subjects were further administered with the study’s instruments including the socio-demorgraphic questionnaire, GHQ-12 and WHOCIDI. The data were analyzed using the SPSS version 20. Confidence interval was set at 95% while P- value of less than 0.05 was considered statistically significant. The study found a 64.4% (n=232) rate of psychiatric comorbidity among the hypertensive patients with depressive illness the highest with 73(29.4%). This was followed by GAD with 16.1%, sexual dysfunction 9.0%, mixed anxiety and depression 7.8%, substance abuse 2.3%, dysthymia 0.3%, while panic without agoraphobia and personality disorders 0.9% each. Severity of hypertension correlated positively with psychiatric comorbidity. The study found that psychiatric co-morbidity among the hypertensive patient is common in UPTH. It therefore becomes imperative that the intervention measures for chronic disorders of these natures should include a well planned, elaborate and articulated neuropsychiatric evaluation for an effective and holistic management of these patients.

Prevalence of psychiatric comorbidities in chronic obstructive pulmonary disease patients.

Introduction:Psychiatric disorders, especially anxiety and depression have been reported to have an increased prevalence in chronic obstructive pulmonary disease (COPD) patients, but there is a paucity of data from India.Aims and Objectives:Aim of our study is to study the frequency of psychiatric comorbidities in COPD patients and their correlation with severity of COPD, as per global initiative for obstructive lung disease guidelines.Materials and Methods:This study was conducted in outpatient department of a tertiary care hospital (King George's Medical University). A total of 74 COPD patients were included in this study and compared with 74 controls. The diagnosis and severity of COPD were assessed by spirometry. Psychiatric comorbidities were assessed using the Mini International Neuropsychiatric Interview questionnaire.Results:The frequency of psychiatric comorbidities was significantly higher (P < 0.05) in COPD patients (28.4%) as compared to controls (2.7%). As regards to severity, the frequency was significantly increased in severe and very severe COPD. The frequency of psychiatric comorbidities in COPD patients increased significantly with the increase in duration of symptoms being present in 67% of patients with duration of symptoms more than 10 years and only 23% of patients with duration of symptoms ≤5 years.Conclusion:The frequency of psychiatric comorbidities is increased in COPD patients as compared to controls. We recommend that all patients with COPD should be screened for psychiatric comorbidity, if any.

Differences in the burden of psychiatric comorbidity in MS vs the general population.

Objective:We aimed to compare the incidence and prevalence of psychiatric comorbidity in the multiple sclerosis (MS) population and in controls matched for age, sex, and geographic area.Methods:Using population-based administrative health data from 4 Canadian provinces, we identified 2 cohorts: 44,452 persons with MS and 220,849 controls matched for age, sex, and geographic area. We applied validated case definitions to estimate the incidence and prevalence of depression, anxiety, bipolar disorder, and schizophrenia from 1995 to 2005. We pooled the results across provinces using meta-analyses.Results:Of the MS cases, 31,757 (71.3%) were women with a mean (SD) age at the index date of 43.8 (13.7) years. In 2005, the annual incidence of depression per 100,000 persons with MS was 979 while the incidence of anxiety was 638, of bipolar disorder was 328, and of schizophrenia was 60. The incidence and prevalence estimates of all conditions were higher in the MS population than in the matched population. Although the incidence of depression was higher among women than men in both populations, the disparity in the incidence rates between the sexes was lower in the MS population (incidence rate ratio 1.26; 95% confidence interval: 1.07–1.49) than in the matched population (incidence rate ratio 1.50; 95% confidence interval: 1.21–1.86). Incidence rates were stable over time while prevalence increased slightly.Conclusions:Psychiatric comorbidity is common in MS, and more frequently affected the MS population than a matched population, although the incidence was stable over time. Men with MS face a disproportionately greater relative burden of depression when they develop MS than women.

Reliability and validity of the Hospital Anxiety and Depression Scale in an emergency department in Saudi Arabia: a cross-sectional observational study.

BackgroundDepression and anxiety are prevalent psychiatric comorbidities that are known to have a negative impact on a patient’s general prognosis. But screening for these potential comorbidities in a hospital’s accident and emergency department has seldom been undertaken, particularly in Saudi Arabia and elsewhere in the Middle East. The Hospital Anxiety and Depression Scale (HADS) has been extensively used to evaluate these psychiatric comorbidities in various clinical settings at all levels of health care services except for the accident and emergency department. This study therefore aimed to assess the reliability and validity of the HADS for anxiety and depression among patients at a hospital accident and emergency department in Saudi Arabia.MethodsThis cross-sectional observational study was conducted from January to December 2012. The participants were 257 adult patients (aged 16 years and above) who presented at the accident and emergency department of King Khalid University Hospital, Riyadh, Saudi Arabia, who met our inclusion criteria. We used an Arabic translation of the HADS. We employed factor analysis to determine the underlying factor structure of that instrument in assessing reliability and validity.ResultsWe found the Arabic version of the HADS to be acceptable for 95 % of the subjects. We used Cronbach’s alpha coefficient to evaluate reliability, and it indicated a significant correlation with both the anxiety (0.73) and depression (0.77) subscales of the HADS, thereby supporting the validity of the instrument. By means of factor analysis, we obtained a two-factor solution according to the two HADS subscales (anxiety and depression), and we observed a statistically significant correlation (r = 0.57; p < 0.0001) between the two subscales.ConclusionThe HADS can be used effectively in an accident and emergency department as an initial screening instrument for anxiety and depression. It thus has great potential as part of integrated multidisciplinary care.

P044. Anger expression in chronic daily headache patients with and without psychiatric comorbidity.

Background Previous studies suggest the high prevalence of psychiatric comorbidity in chronic daily headache (CDH) patients. In particular, CDH patients showed higher frequency of anxiety and depressive disorders than episodic migraineurs [1,2]. However, negative affect emotions (like depression, anxiety and anger) influence the course and impact of headache within the normal range of affective experience, not simply when an Axis I disorder is present [3]. In the literature it is reported that individuals with headache are more likely to hold their anger-in than controls. Individuals who hold anger-in experience an increased pain severity, failure to express anger leads to more disability [4,5]. Anger levels in headache are supposed to be related to anxiety and depression [6,7], but one study showed that headache patients hold their anger-in more than controls, even after controlling for depression and anxiety [8]. The aim of this study was to investigate if anger expression levels in CDH patients are related to psychiatric comorbidity.

Comorbidity, knowledge and attitude towards sex among patients with Dhat syndrome: A retrospective study.

This study aimed to assess the knowledge about sex, attitude towards sex, prevalence of psychiatric comorbidity and relationship of the comorbidity with onset of symptoms of Dhat syndrome. Treatment records of 264 patients diagnosed with Dhat syndrome were reviewed for clinical profile including psychiatric comorbidity and sexual dysfunction and information on sexual knowledge and attitude using Sex Knowledge and Attitude Questionnaire (SKAQ-II). None of the patients gave all the correct responses on the SKAQ-II. Poor knowledge about sexual matters was not limited to the semen formation only, but also involved other aspects of sexuality, like masturbation, relationship of pregnancy with orgasm in women, breast feeding and pregnancy, relationship of sexual desire with addictive drugs and sexually transmitted diseases can be cured by having sex with a virgin girl. Higher level of education showed significant association with better sexual knowledge and liberal attitude. There was significant positive correlation between sexual knowledge and attitude. About half (51.9%) of patients had at least one comorbid psychiatric disorder and/or sexual dysfunction. Among the psychiatric disorders, depressive disorders were the most common and premature ejaculation was the most common comorbid sexual dysfunction. Among those with comorbidity, symptoms of Dhat syndrome preceded the onset of other disorders. Patients with Dhat syndrome have high rates of comorbidity and poor sexual knowledge and less liberal attitude, which was not only limited to loss of semen but also involves other spheres of sexuality. Accordingly psychoeducation in patients of Dhat syndrome should not be limited to addressing the myths and lack of knowledge about semen formation, but also should address poor sexual knowledge on all the aspects related to sexuality and the negative attitude towards sex.

Psychiatric comorbidity in depressed HIV-infected individuals: common and clinically consequential

ObjectiveTo report on the prevalence of psychiatric comorbidity and its association with illness severity in depressed HIV patients. MethodsAs part of a multi-site randomized controlled trial of depression treatment for HIV patients, 304 participants meeting criteria for current Major Depressive Disorder (MDD) were assessed for other mood, anxiety and substance use disorders with the Mini-International Neuropsychiatric Interview, a structured psychiatric diagnostic interview. We also assessed baseline adherence, risk, and health measures. ResultsComplicated depressive illness was common. Only 18% of participants experienced MDD with no comorbid psychiatric diagnoses; 49% had comorbid dysthymia, 62% had ≥1 comorbid anxiety disorder, and 28% had a comorbid substance use disorder. Self-reported antiretroviral adherence did not differ by the presence of psychiatric comorbidity. However, psychiatric comorbidity was associated with worse physical health and functioning: compared to those with MDD alone, individuals with ≥1 comorbidity reported more HIV symptoms (5.1 vs. 4.1, P=.01), and worse mental health-related quality of life on the SF-12 (29 vs. 35, P<.01). ConclusionFor HIV patients with MDD, chronic depression and psychiatric comorbidity are strikingly common, and this complexity is associated with greater HIV disease severity and worse quality of life. Appreciating this comorbidity can help clinicians better target those at risk of harder-to-treat HIV disease, and underscores the challenge of treating depression in this population.

Prevalence of psychiatric co-morbidity in treatment-seeking problem gamblers: A systematic review and meta-analysis.

Objective:The aim of this paper was to systematically review and meta-analyse the prevalence of co-morbid psychiatric disorders (DSM-IV Axis I disorders) among treatment-seeking problem gamblers.Methods:A systematic search was conducted for peer-reviewed studies that provided prevalence estimates of Axis I psychiatric disorders in individuals seeking psychological or pharmacological treatment for problem gambling (including pathological gambling). Meta-analytic techniques were performed to estimate the weighted mean effect size and heterogeneity across studies.Results:Results from 36 studies identified high rates of co-morbid current (74.8%, 95% CI 36.5–93.9) and lifetime (75.5%, 95% CI 46.5–91.8) Axis I disorders. There were high rates of current mood disorders (23.1%, 95% CI 14.9–34.0), alcohol use disorders (21.2%, 95% CI 15.6–28.1), anxiety disorders (17.6%, 95% CI 10.8–27.3) and substance (non-alcohol) use disorders (7.0%, 95% CI 1.7–24.9). Specifically, the highest mean prevalence of current psychiatric disorders was for nicotine dependence (56.4%, 95% CI 35.7–75.2) and major depressive disorder (29.9%, 95% CI 20.5–41.3), with smaller estimates for alcohol abuse (18.2%, 95% CI 13.4–24.2), alcohol dependence (15.2%, 95% CI 10.2–22.0), social phobia (14.9%, 95% CI 2.0–59.8), generalised anxiety disorder (14.4%, 95% CI 3.9–40.8), panic disorder (13.7%, 95% CI 6.7–26.0), post-traumatic stress disorder (12.3%, 95% CI 3.4–35.7), cannabis use disorder (11.5%, 95% CI 4.8–25.0), attention-deficit hyperactivity disorder (9.3%, 95% CI 4.1–19.6), adjustment disorder (9.2%, 95% CI 4.8–17.2), bipolar disorder (8.8%, 95% CI 4.4–17.1) and obsessive-compulsive disorder (8.2%, 95% CI 3.4–18.6). There were no consistent patterns according to gambling problem severity, type of treatment facility and study jurisdiction. Although these estimates were robust to the inclusion of studies with non-representative sampling biases, they should be interpreted with caution as they were highly variable across studies.Conclusions:The findings highlight the need for gambling treatment services to undertake routine screening and assessment of psychiatric co-morbidity and provide treatment approaches that adequately manage these co-morbid disorders. Further research is required to explore the reasons for the variability observed in the prevalence estimates.

Addiction and Other Psychiatric Disorders in a Population of Portuguese Prisoners.effects in Violent Crime and Addiction Severity.

Objectives Addiction, depression, anxiety and antisocial personality disorder may share common biological mechanisms and changes in impulsivity may contribute to the characterization of different clinical phenotypes. Our aim was to identify diagnostic profiles in a sample of inmates in a Portuguese prison. Methods We examined a sample recruited at Pacos de Ferreira Penitentiary Centre (n=89). Diagnosis was performed using the International Neuropsychiatric Interview (MINI). Six Version of Addiction Severity Index – European version (EuropASI) and the Psychopathy Checklist –Revised (PCL-R) were used to assess the severity of drug addiction and the presence of psychopathy. Results Drug misuse was found in 61.8% of the studied subjects according to MINI. A high prevalence of psychiatric comorbidity was detected, with antisocial personality disorder (70.9%), depression (30.9%), and anxiety (32.7%) being the most common disorders. The total PCL-R score was 24. 1 (SD 8.8), 36 prisoners presented a diagnosis of psychopathy (PCL-R>30). The presence of depression in addicted individuals is associated with a lower severity of dependence (p 30) increases (OR = 3.87, p Conclusions Psychiatric disorders and addiction were successfully evaluated. Depression is associated with a lower addiction severity. The different types of psychiatric diagnoses produce a modulation in the frequency of violent crimes. The prevalence of psychiatric comorbidity underscores the advantages of a structured psychiatric assessment in prison inmates in order to provide the best treatment.

Prevalence of Substance Use Disorder and Psychiatric Comorbidities

Prevalence of substance use disorder and psychiatric comorbidities Introduction The substance use disorder (SUD) is one of the most common disorders in adolescence. The lifetime prevalence is 3% to 32%. Alcohol and tobacco are the most used licit substance and cannabis is the most commonly used illicit substance. Studies indicate that approximately 75% of patients with SUD have psychiatric comorbidities such as conduct disorder, attention-deficit/hyperactivity disorder (ADHD) and affective d isorder. Adolescents with SUD and comorbid mental disorder have high risk for continuing problems in adulthood. The costs of treating SUD and a psychiatric comorbidity is twice as high when treated separately. Objective To find the prevalence of psychiatric comorbidities in adolescentes with SUD. Methods The diagnostic instrument Kiddie-Schedule for Affective Disorders and Schizophrenia for School aged Children 6-18years (K-SADS-PL) was used to identify SUD and all psychiatry disorders in adolescents admitted to a clinic for SUD treatment. Results In a sample of 30 adolescents with SUD, 8 adolescents (26,6%) has ADHD comorbid and 14 (46,6%) has conduct cisorder comorbid. Four (13,3%) patients has affective disorder comorbid. Conclusion Early diagnosis of a psychiatry comorbidity can improve the treatment in adolescence and prevent further complications such as legal and medical problems, suicide, learning difficulties, school dropout, unemployment and interpersonal relationship problems.

Repetitive Negative Thinking and Psychological Distress in Fibromyalgia

Excessive and repetitive negative thinking (RTN) about past experiences or worries about the future is present across a large range of psychological disorders and appears to be involved in the maintenance of emotional problems. Studies have supported that RNT is characterized by the same process across disorders and can be reliably distinguished from other forms of recurrent cognitions and functional forms of repeated thinking, leading Harvey and colleagues (2004) to propose it as a definite transdiagnostic process. As a transdiagnostic phenomenon, RNT is underexplored in fibromyalgia (FM), a highly prevalent syndrome characterized by chronic, medically unexplained widespread musculoskeletal pain that causes significant disability. FM is associated with a high prevalence of psychiatric co-morbidity, mostly anxiety and depression, and a large variety of psychological processes. In these patients, cognitive processes and cognitions may play an important role as mediating mechanisms between FM and psychological distress. The content of RNT in patients with FM may be related with excessive monitorization of pain and other physical signs, leading to higher pain intensity and more pain-related fear-avoidance behaviour. In this way, persistence on RNT works as a maladapative coping strategy, impairing emotional regulation and perpetuating psychological distress. Improvement in the understanding of the cognitive processes implicated in FM that could be targeted in cognitive interventions may have positive results in reducing the burden of the syndrome.

Efficacy and Safety of Varenicline to Treat Nicotine Dependence in a Smokers Population with High Prevalence of Psychiatric Comorbidities

Introduction Smokers with psychiatric comorbidities are prevalent in our current practice. Varenicline (Champix) is a first line pharmacotherapy indicated to treat nicotine addiction. Aim To assess efficacy and safety of varenicline in current practice of a smoking cessation center treating smokers with high prevalence of psychiatric disorders. Material and method 128 smokers with concurrent stable psychiatric, respiratory or cardiovascular disorders (study group) and 124 healthy smokers (control group) were treated with varenicline and counseling, for 12 weeks to stop smoking. Abstinence rate was assessed in both groups at 12 weeks. Varenicline safety, cessation profile and compliance to treatment were monitored in psychiatric disorders smokers compared to other co-morbidities and to controls. Results 54.6 % smokers with comorbidities (12/22 cardiovascular, 14/30 respiratory, 44/76 psychiatric) and 33.8 % healthy smokers successfully quit smoking. Withdrawal symptoms and adverse effects picture did not differ significantly between groups. The figure shows compliance to treatment and number of adverse events in healthy and psychiatric, respiratory and cardiovascular disease smokers. Compliance to treatment (%) Adverse effects (n) 2 weeks 4 weeks 8 weeks 12 weeks Healthy smokers (n=124) 80.6 80.6 77.4 72.5 11 Smokers with psychiatric disorders (n=76) 97.3 94.7 86.8 86.8 14 Smokers with respiratory disorders (n=30) 83.3 70 56.6 40 8 Smokers with cardiovascular disorders (n=22) 100 72.7 59 59 8 Conclusions Smokers with psychiatric co-morbidities achieved a higher abstinence rate, compared to respiratory and cardiovascular disease smokers and to control group. Varenicline proved comparable safety in both study and control groups.

A Study on Prevalence of Psychiatric Comorbidity in Female Patients with Breast Cancer

Background: The growing awareness of the psychological impact of the diagnosis and treatment of cancer on quality of life has created the need for deeper insights into the adjustment process, its disorders, and effective strategies for the treatment of psychiatric morbidity. Objectives: The study was conducted to find out the prevalence of psychiatric comorbidity among the female breast cancer patients admitted in Surgery or Radiotherapy units of a tertiary care hospital. Material & Methods: The sample was taken from sixty female non pregnant, non lactating breast cancer patients consenting for study admitted in Guru Gobind Singh Medical College, Faridkot aged between 18-60 years. The patients for study were screened by General Health Questionnaire (GHQ 12). After screening the patients who were found to have positive psychological stress, were further interviewed individually and final diagnosis was made on the basis of DSM-IV-TR criteria for mental disorders. Results: The number of patients with psychiatric morbidity was found in 45% of breast cancer patients. The clinical diagnosis as per DSM-IV criteria's in majority of the patients (59.25%) was Adjustment Disorder. Major Depressive disorder was found in 22.2% patients. Generalised Anxiety Disorder was found in 14.8% patients. Somatoform Disorder was found in 3.7% patients. More number of patients with advanced stage of cancer (21) were found to be having diagnosable psychiatric illness than patients with early stage of cancer (6). Conclusions: The results of the study have implications for clinical training, practice and policy initiatives. Integrating mental health into general health care, effective mass media coverage, networking between mental health-professionals and other health professionals, community-based health services are required.

A Study on Prevalence of Psychiatric Comorbidity in Female Patients with Breast Cancer

Background: The growing awareness of the psychological impact of the diagnosis and treatment of cancer on quality of life has created the need for deeper insights into the adjustment process, its disorders, and effective strategies for the treatment of psychiatric morbidity. Objectives: The study was conducted to find out the prevalence of psychiatric comorbidity among the female breast cancer patients admitted in Surgery or Radiotherapy units of a tertiary care hospital. Material & Methods: The sample was taken from sixty female non pregnant, non lactating breast cancer patients consenting for study admitted in Guru Gobind Singh Medical College, Faridkot aged between 18-60 years. The patients for study were screened by General Health Questionnaire (GHQ 12). After screening the patients who were found to have positive psychological stress, were further interviewed individually and final diagnosis was made on the basis of DSM-IV-TR criteria for mental disorders. Results: The number of patients with psychiatric morbidity was found in 45% of breast cancer patients. The clinical diagnosis as per DSM-IV criteria's in majority of the patients (59.25%) was Adjustment Disorder. Major Depressive disorder was found in 22.2% patients. Generalised Anxiety Disorder was found in 14.8% patients. Somatoform Disorder was found in 3.7% patients. More number of patients with advanced stage of cancer (21) were found to be having diagnosable psychiatric illness than patients with early stage of cancer (6). Conclusions: The results of the study have implications for clinical training, practice and policy initiatives. Integrating mental health into general health care, effective mass media coverage, networking between mental health-professionals and other health professionals, community-based health services are required.

Prevalence of psychiatric co-morbidity among patients attending dental OPD and the role of consultation-liaison psychiatry in dental practice in a tertiary care general hospital.

Background:Psychiatric co-morbidities are frequent among patients attending dental OPD, some of which go unrecognized and hence untreated.Aims:The present study has been carried out to detect the psychiatric co-morbidities among dental patients and determine the scope of consultation-liaison (C-L) psychiatry in a rural teaching hospital regarding comprehensive management of the patients.Settings and Design:This cross-sectional, descriptive type study was conducted in a multi-speciality tertiary care teaching hospital in the northern part of West Bengal, India.Materials and Methods:One hundred patients attending the dental OPD were randomly included in the study and every patient was consecutively referred to psychiatry department for assessment, during the period from 1st November 2013 to 30th April 2014. All referred patients were clinically examined and psychiatric co-morbidity was assessed by the help of General Health Questionnaire (GHQ)-28 and Mental Status Examination.Statistical analysis used:The data were subjected to statistical package for social sciences (SPSS), version 16, and statistically analyzed using Cross tab and Chi test. P <0.05 was considered to be statistically significant.Results:The commonest dental illness was dental caries (22%). More than two-third of the patients had psychiatric co-morbidity according to GHQ-28 total score. Sixty-eight patients were diagnosed to have mental disorder on mental status examination. Somatoform disorder (25%) was the commonest type of mental disorder, followed by mixed anxiety and depression (14%).Conclusions:This study has pointed the need for psychological examination of patients visiting dental specialty with unexplained physical symptoms. Such patients can be identified and treated, provided a psychiatric consultation service exists.

Psychiatric morbidity and quality of life in skin diseases: A comparison of alopecia areata and psoriasis.

Background:Alopecia areata (AA) and psoriasis are associated with various psychiatric comorbidities. Both greatly affect the quality of life (QOL) of patients and psychiatric comorbidities can further worsen it. Thus there is need to recognise psychiatric comorbidities and treat them in these patients.Aims:To determine the psychiatric morbidity and the QOL in these patients to study the factors affecting them.Methodology:50 patients each of psoriasis and AA were included. 50 people accompanying these patients served as control group. They were diagnosed for psychiatric disorders by clinical interview. Scales used were severity of alopecia tool for AA, psoriasis area and severity index for psoriasis, WHO-QOL scale, Hamilton Rating Scale for anxiety and depression.Results:22% and 38% patients in AA and psoriasis group respectively suffered from psychiatric disorder, depression was present in 18% and 24% of patients and 4% and 12% had anxiety disorders in respective groups. The control group had only 6% of psychiatric comorbidities. QOL scores had negative correlation with Hamilton-A, Hamilton-D and severity of psoriasis scores and they were statistically significant but not with severity of AA.Conclusion:Thus AA and psoriasis patients had more prevalence of psychiatric comorbidities and it had bearing on their QOL.

Anxiety and Depression in Tuberculosis Can Create Impact on Quality of Life of Patient

Objective: Despite TB being a major burden in terms of nation’s health, social life and economy and growth, it has to be considered for the psychological effects that it bears on individual life. The resulting drastic consequences showing as poor treatment compliance, increasing Mycobacterium strain resistance to first line anti TB drugs, declining health outcome etc. Our study had determined to take a step in revealing a more competent approach in getting a world free of tuberculosis, by estimating the prevalence of psychiatric co morbidities in patients with TB and to comprehend their effects on patient’s quality of life. Our aim was to assess the prevalence of depression and anxiety in tuberculosis and its influence on individual perception of well being in patients attending outpatient clinic in Karachi, Pakistan. Method: A total of 140 subjects were addressed, 70 of each TB and control. “Hospital Anxiety and Depression scale” (HAD) and “Flanagan Quality of Life scale” was used to assess anxiety and depression and quality of life in these two populations respectively. Result: About 37.1% patients diagnosed with TB were labeled as having anxiety and depression according to HAD scale. However the study has shown that the area of an individual life that experienced dramatic effects included perception towards health, relationship with partner, parents, sibling, friends, work as in job or in home, participation in society, attitude towards learning and increasing awareness, understanding about one’s strength and weaknesses and expressing oneself creatively. Conclusion: Parameters of quality of life that do play a key role in establishing quality including perception relating to health, relationships with spouse, siblings or friend, occupational role and recreation both participatory as well as passive; were found to be dramatically influenced by TB. This entirely enlightens the significance of timely counseling and health education in TB control program for alleviation of mental and social suffering seen in such a high rise.