Prevalence Of Psychiatric Comorbidities Research Articles

Diagnostic Concordance between Research and Clinical-Based Assessments of Psychiatric Comorbidity in Anorexia Nervosa.

The literature has reported poor concordance in the assessment of psychiatric conditions, and inhomogeneity in the prevalence of psychiatric comorbidities in Anorexia Nervosa (AN). We aimed to investigate concordance level between clinicians' and researchers' diagnoses of psychiatric comorbidity in AN and differences in eating and general psychopathology between patients with and without psychiatric comorbidity assessed by clinicians versus researchers. A clinical psychiatrist interviewed 122 patients with AN; then a researcher administered the Structured and Clinical Interview for DSM-5 (SCID-5). Participants completed the Eating Disorder Examination Questionnaire (EDE-Q), the State-Trait Anxiety Inventory (STAI), and the Beck Depression Inventory (BDI). The agreement between clinicians and researchers was poor for all diagnoses but obsessive-compulsive disorder and substance use disorder. Patients with comorbid disorders diagnosed by researchers reported more severe eating and general psychopathology than those without SCID-comorbidity. The differences between patients with and without comorbidities assessed by a clinician were smaller. Two approaches to psychiatry comorbidity assessment emerged: SCID-5 diagnoses yield a precise and rigorous assessment, while clinicians tend to consider some symptoms as secondary to the eating disorder rather than as part of another psychiatric condition, seeing the clinical picture as a whole. Overall, the study highlights the importance of carefully assessing comorbidity in AN.

Homicidal ideation and psychiatric comorbidities in the inpatient adolescents aged 12-17.

Adolescents with a homicidal tendency is a growing concern in the United States. Studies in the past have showcased the relationship between homicidal ideation (HI) and psychiatric illnesses, but very limited information is available on the adolescent and inpatient population. We aim to evaluate the prevalence of demographic characteristics and psychiatric disorders in adolescents with and without HI. Adolescent (age 12-17) population admitted to the hospital with the diagnosis of homicidal ideation was identified from the 2016-2018 National Inpatient Sample Dataset (NISD). Patients without HI were defined as the control group. The prevalence of psychiatric comorbidities between the groups was compared by applying the Rao-Scott adjusted chi-square test. We used multivariable logistic regression to generate odds ratio (OR) of homicidal ideation as an outcome; we adjusted age, sex, race, socioeconomic status, substance use disorders, alcohol use disorders, and psychiatric comorbidities. A total of 18,935 patients (mean age: 14.5) with HI diagnosis were identified in this study. Majority of the patients were male subjects in the HI group compared to the control group (58.7 vs. 41.2%, p < 0.001). Racially, HI was more prevalent in white race (56.0 vs. 52.6%, p < 0.001) and black race (22.3 vs. 17.8%, p < 0.001), compared to Hispanic race (14.9 vs. 21.3%, p < 0.001). Major depression (Odds ratio [OR]: 2.66, p < 0.001), bipolar disorder (OR: 3.52, p < 0.001), anxiety disorder (OR: 1.85, p < 0.001), ADHD, and other conduct disorders (OR: 4.01, p < 0.001), schizophrenia (OR: 4.35, p < 0.001) are strong predictors of HI. Suicidality was prevalent in 66.9% of patients with HI. We found a higher prevalence of psychiatric illnesses such as depression, anxiety, and bipolar disorder in adolescents with homicidal ideation in the inpatient setting. White and black races were more prevalent in patients with homicidal ideation. Further large-scale longitudinal research studies are warranted to establish the correlation between psychiatric disorders and homicidal ideation among adolescents.

Physical and psychiatric comorbidities among patients with severe mental illness as seen in Uganda.

While psychiatric and physical comorbidities in severe mental illness (SMI) have been associated with increased mortality and poor clinical outcomes, problem has received little attention in low- and middle-income countries (LMICs). This study established the prevalence of psychiatric (schizophrenia, bipolar affective disorder, and recurrent major depressive disorder) and physical (HIV/AIDS, syphilis, hypertension and obesity) comorbidities and associated factors among 1201 out-patients with SMI (schizophrenia, depression and bipolar affective disorder) attending care at two hospitals in Uganda. Participants completed an assessment battery including structured, standardised and locally translated instruments. SMIs were established using the MINI International Neuropsychiatric Interview version 7.2. We used logistic regression to determine the association between physical and psychiatric comorbidities and potential risk factors. Bipolar affective disorder was the most prevalent (66.4%) psychiatric diagnoses followed by schizophrenia (26.6%) and recurrent major depressive disorder (7.0%). Prevalence of psychiatric comorbidity was 9.1%, while physical disorder comorbidity was 42.6%. Specific comorbid physical disorders were hypertension (27.1%), obesity (13.8%), HIV/AIDS (8.2%) and syphilis (4.8%). Potentially modifiable factors independently significantly associated with psychiatric and physical comorbidities were: use of alcohol for both syphilis and hypertension comorbidities; and use of a mood stabilisers and khat in comorbidity with obesity. Only psychiatric comorbidity was positively associated with the negative outcomes of suicidality and risky sexual behaviour. The healthcare models for psychiatric care in LMICs such as Uganda should be optimised to address the high burden of psychiatric and physical comorbidities.

Burden of Psychiatric Disorders in Moyamoya Disease: A National Inpatient Perspective From 2007-2014.

Objective: Moyamoya disease is a cerebrovascular illness that causes progressive stenosis of the intracranial internal carotid arteries and their proximal branches, increasing the risk of stroke. Moyamoya disease is associated with a small number of neuropsychiatric symptoms. The objective of this study was to investigate psychiatric comorbidities and trends in patients with Moyamoya disease in the United States.Methods: US National Inpatient Sample data from 2007 to 2014 were used for analyses in this cross-sectional study. The frequency of psychiatric and nonpsychiatric disorders among adult patients with known Moyamoya disease was assessed. Baseline demographics included in the analysis and diagnostic codes used to identify psychiatric disorders were determined. Categorical and continuous data were assessed using Pearson χ2 test and Mann-Whitney U test, respectively. All analyses were conducted using SPSS version 22.0.Results: The prevalence of psychiatric comorbidities was 38.7% (7,861/20,289). The most common psychiatric disorders were mood disorders (17.8%) and anxiety disorders (8%). Psychosis and drug abuse were present in 4.4% and 4.1% of patients, respectively. Approximately 1 in 4 patients (22.2%) with Moyamoya disease had previously been screened for mental health or substance abuse. The rate of suicide or self-inflicted injury was 0.8%.Conclusions: The impact of Moyamoya disease on mental health services is expected to grow, as the condition's prevalence is increasing at a rate of approximately 1.5- to 2-fold. A multidisciplinary approach between neurology, psychiatry, and primary care can improve screening and management of comorbid psychiatric disorders.

Psychiatric comorbidity and psychosocial stressors among people initiating HIV care in Cameroon.

BackgroundPsychiatric comorbidity, the presence of two or more mental health disorders, has been associated with suboptimal HIV treatment outcomes. Little is known about the prevalence of psychiatric comorbidity among people with HIV (PWH) in sub-Saharan Africa.MethodsWe conducted interviews with PWH initiating HIV care in Cameroon between June 2019 and March 2020. Depression, anxiety, post-traumatic stress disorder (PTSD), and harmful drinking were dichotomized to represent those with and without symptoms of each. Psychiatric comorbidity was defined as having symptoms of two or more disorders assessed. Moderate or severe household hunger, high anticipatory HIV-related stigma, low social support, and high number of potentially traumatic events were hypothesized as correlates of psychiatric comorbidity. Bivariable log binomial regression models were used to estimate unadjusted associations between psychosocial stressors and psychiatric comorbidity.ResultsAmong 424 participants interviewed, the prevalence of psychiatric comorbidity was 16%. Among those with symptoms of at least one mental health or substance use disorder (n = 161), the prevalence of psychiatric comorbidity was 42%. The prevalence of psychiatric comorbidity was 33%, 67%, 76%, and 81% among those with symptoms of harmful drinking, depression, anxiety, and PTSD, respectively. Among individuals with symptoms of a mental health or substance use disorder, a high number of potentially traumatic events (prevalence ratio (PR) 1.71 [95% CI 1.21, 2.42]) and high anticipatory HIV-related stigma (PR 1.45 [95% CI 1.01, 2.09]) were associated with greater prevalence of psychiatric comorbidity.ConclusionPsychiatric comorbidity was common among this group of PWH in Cameroon. The effectiveness and implementation of transdiagnostic or multi-focus mental health treatment approaches in HIV care settings should be examined.

Impact of resilience on disease severity and psychiatric comorbidities in patients with fibromyalgia

BackgroundResilience is the process of adjusting successfully in the face of adversity, trauma, threats, or severe stress, such as serious health problems. It is one of the factors that affect recovery from psychiatric disorders. It was suggested that fibromyalgia patients have low resilience. This study aimed to assess the impact of resilience on disease severity and psychiatric comorbidities in patients with fibromyalgia.ResultsWe found that patients with fibromyalgia had a significantly lower resilience and higher prevalence of psychiatric comorbidities than the control group (P < 0.05). Also, fibromyalgia patients with high disease severity had a significantly lower resilience and a higher percentage of psychiatric problems than those with a better disease state (P = 0.0001). Also, there was a significant negative correlation of resilience with disease severity (as assessed by the FIQ score), visual analog scale (VAS) of anxiety, and VAS of depression (P = 0.0001).ConclusionResilience significantly impacts the severity and psychiatric comorbidities in patients with fibromyalgia. So, enhancing and improving resilience must be considered in the management protocols of fibromyalgia patients.

A Study on the Parenting Styles and Parental Stress of Parents of (Attention Deficit Hyperactivity Disorder) ADHD Children

Background: There are several steps involved in deciding if a child has ADHD. No single test is available to diagnose ADHD and many other problems such as depression, anxiety, sleep problems and certain types of learning disabilities can also have similar symptoms. One of the process involves doing a medical examination, including hearing and vision tests, to rule out other problems with symptoms like ADHD. Diagnosis of ADHD includes a checklist for rating ADHD symptoms and taking a history of the child from parents, teachers, and sometimes, the child itself. Aim &amp; Objectives: To know the prevalence of psychiatric co-morbidities in ADHD and to assess parental stress and parenting style among parents of children having ADHD.Material &amp; Methods:A total of 78 children (6 to 18 years of age) and their parents were selected for the completion this study. The study was carried out in the Department of Psychiatry, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi. Bivariate table and chi-square/Fisher Exact test were used. Correlation test has also been applied to know the association between demographic variables and their responses. Conclusions:We conclude that specific scales of the CBCL may help to identify specific comorbidities within ADHD cases in the primary care setting.

PREVALENCE OF PSYCHIATRIC COMORBIDITIES IN PATIENTS WITH DEPRESSION

Objective: The aim of the study was to study the prevalence of psychiatric comorbidities in patients of depression. Methods: The present cross-sectional study was conducted among 60 patients of depression. All the patients were evaluated for sociodemographic profile and Mini International Neuropsychiatric Interview was administered to evaluate, identify, and diagnose the most common psychiatric comorbidities as per its modules. Results: Results showed that 65.0% of patients had psychiatric comorbidities and 35.0% had no psychiatric comorbidity. About 53.3% patients had psychiatric comorbidity of generalized anxiety disorder, 23.3% patients had psychiatric comorbidity of suicidality, 11.7% had panic disorders, 6.7% had alcohol use disorders, and 5.0% had substance use disorders (SUDs) (non-alcoholic). No statistically significant association was found in prevalence of different psychiatric comorbidities among sociodemographic characteristics of age, gender, region, religion, family type, educational status, and occupational groups. However, statistically significant association was seen among alcohol use disorders in different gender groups and occupational groups. Conclusion: Our study showed the highest prevalence of psychiatric comorbidity of generalized anxiety disorder and then suicidality, panic disorders, alcohol use disorders, and least prevalence of SUDs. No statistically significant association was found between sociodemographic characteristics and psychiatric comorbidities except association of alcohol use disorders with gender and occupational groups. There is a paucity of research exploring relationship of specific psychiatric comorbidities in depressive patients in India. Data of our study will contribute to enrich the Indian specific data on psychiatric comorbidities in depression and help formulate appropriate management strategies.

Prevalence of Anxiety Disorders in Chinese Children with Autism Spectrum Disorder in Hong Kong

Background: Autism spectrum disorder (ASD) is a pervasive neurodevelopmental disorder. Children with ASD are faced with various challenges considering their lifelong neurodevelopmental disabilities. Comorbid psychiatric disorders are found to be prevalent among children with ASD. Anxiety disorders are one of the most prevalent psychiatric comorbidities in this population and have been associated with debilitating psychosocial impairment. Objective: This study aimed to examine the prevalence of comorbid anxiety disorders among Chinese school-age children diagnosed with ASD in a child and adolescent psychiatry outpatient clinic in Hong Kong. Methods: This cross-sectional study was conducted at the Yaumatei Child and Adolescent Mental Health Service specialist outpatient clinic from August 2019 to April 2020. The sample consisted of one hundred thirty-two subjects aged 6 to &lt;12 years who were diagnosed with ASD. The Developmental, Dimensional and Diagnostic Interview were administered to confirm the diagnosis of ASD. The National Institute of Mental Health Diagnostic Interview Schedule for Children-Version 5, parent version was administered for the assessment of comorbid anxiety disorders. Results: The one-year prevalence rate of any anxiety disorder was 28.8%. The most common anxiety disorder was specific phobia (22.7%), followed by social anxiety disorder (13.6%), separation anxiety disorder (3.8%), generalized anxiety disorder (3.8%) and selective mutism (1.5%). No subjects were diagnosed with panic disorder or agoraphobia. Conclusion: Anxiety disorders are prevalent among Chinese school-age children with ASD in Hong Kong. Early recognition and identification of comorbid anxiety disorders are necessary in the diagnostic process of ASD.

Non epileptic attack disorder, Psychiatric co morbidities and their outcomes: NEAD &amp; Psychiatric Comorbidity

Background: NEAD is a common presentation in epilepsy clinics and is often misdiagnosed. This study was therefore planned to understand the prevalence of psychiatric co morbidities in patients diagnosed as NEAD and to study the outcome of both the conditions over 6 months with pharmacotherapy and supportive psychotherapy.&#x0D; Material &amp; Method: 71 patients of NEAD were enrolled and assessed on SCID 1 to diagnose psychiatric co morbidity with rating of severity of anxiety &amp; depression on HDRS &amp; HARS.&#x0D; Patients were divided into Groups A &amp; B depending on the presence or absence of existing co-morbid psychopathology respectively and were followed up over 6 months to assess outcomes. Psychiatric medication was given to Group A patients and both groups received supportive psychotherapy on follow up.&#x0D; Results: Group A had 50 patients with psychiatric co morbidity and Group B included 21 patients. Depressive disorders were common psychopathology and follow up at 3&amp; 6 months revealed a reduction in the total mean scores of HARS and HDRS from baseline. Outcome of NEAD at the end of 6 months revealed 100% reduction in 28% and 50% reduction in 15 – 16% of both group patients.&#x0D; Conclusions: There are very few Indian studies on short or long term outcomes of NEAD and there is a need to create awareness among the treating physicians regarding the impact of associated psychiatric co morbidities which would affect the prognosis of NEAD.

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BACKGROUND:There is a paucity of systematic data on prevalence of various psychiatric comorbidity and QOL in patients with Hematological cancers.AIM:To assess psychiatric comorbidity and QOL in Hematological cancer patients undergoing treatment in a tertiary health care center.MATERIAL AND METHODS:This cross sectional observational study comprises of a sample size of 31 patients of both the sexes with various haematological cancers. Semi structured sociodemographic proforma was administered. Further MINI was applied to screen the presence of psychiatric comorbidity in these patients. HADS and WHO QOL Bref were applied to analyse the prevalence and severity of anxiety, depression and Quality of life. Data was analysed using appropriate statistical tools.RESULTS:The prevalence of Psychiatric comorbidities was found to be 64.52% (n=20) in sample population. Prevalence of depression was 19.35%(n=6), dysthymia 09.68% (n=3), panic disorder 9.68%(n=3), PTSD 3.23%(n=1), GAD 09.68% (n=3) and adjustment disorder in 16.13%(n=5) of the participants. Poor overall quality of life (Mean= 2.25, S. D=± 1.35), and perception of health (Mean=1.67, S.D = ± 0.90.) was reported by participants.CONCLUSION:This study shows that patients with Hematological cancers are at a higher risk of developing psychiatric comorbidities. The QOL of life was also significantly decreased in such patients who were suffering from Hematological cancers.

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Background:• Psoriasis being a chronic relapsing skin condition is often found difficult to manage. Psychological factors might be playing a role in frequent relapses. According to one study Prevalence of psychiatric co morbidity varies from 40-70%.Psoriasis can have a profound impact on a patient’s quality of life.Most of the data available on psychiatric morbidity is from west. Present study was planned to know the Psychiatric morbidity, their demographics and quality of life (QoL) in patients with psoriasis.Aim: • To determine the prevalence of Psychiatric morbidity in patients with Psoriasis.• To assess the quality of life in Psoriasis patients Methods:• 70 consecutive patients diagnosed as having psoriasis attending Dermatology OPD at a tertiary care centre were assessed by using MINI-PLUS and DQLI.Results:• Data were analyzed using statistical software called SPSS V.20.61% of patients with psoriasis were found to have psychiatric co-morbidity. Major Depressive disorder (26%), Adjustment disorder with depressed mood (10%) and Adjustment disorder with anxiety (8%), Nicotine dependence(8%), Dysthymia (4%), Alcohol dependence (4%) and Social Phobia (1%) were found in the sample. The mean DLQI score was 13.8.QoL was impaired in young patients, single, having medium level education.Conclusion.• Psoriasis has a negative impact in the quality of life in patients with psoriasis, especially in younger and single patients. This study also revealed that there is a strong association of various psychosocial stress factors like Loneliness, Marital stress and Disgust towards skin appearance with psychiatric co-morbidity.

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BACKGROUND:Very often clinicians forget or overlook mental illnesses in patients diagnosed with some neurological disorders and hence the mental illness continues to remain under-recognized and also under treated. Psychiatric co morbidities are common to be present or develop over time in patients with neurological disorders as they have an increased risk for development of cognitive, behavioral, psychosocial disorders.AIM:To find out prevalence of psychiatric co morbidity in patients attending neurology opd.METHODOLOGY:Study was conducted in department of Neurology, IMS and SUM Hospital, Bhubaneswar during the first and follow up visit. Twenty five patients each of confirmed diagnosis of headache, stroke, epilepsy and musculoskeletal pain were enrolled in study after their written informed consent. Patients were put to screening using the GMHAT Questionnaire, responses were noted and provisional diagnosis was made. Patients were assessed for anxiety and depression using HAM-A and HAM-D scale respectively in the same sitting.RESULTS:The GMHAT questionnaire revealed that 68% with headache, 72% of musculoskeletal pain, 80% who had stroke and 56% with epilepsy had psychiatric comorbidity. HAM A scale showed that 20% with headache, 24% with musculoskeletal pain,12% who had stroke and 12% with epilepsy had anxiety as co morbidity. HAM D scale showed 40% who had stroke, 28% of headache, 20% with musculoskeletal pain and 28% with epilepsy had depression as co morbidity.CONCLUSION:Results revealed depression and anxiety as the most frequently encountered psychiatric co morbidity in the study patients.

Psychiatric comorbidity and quality of life in patients with bipolar disorder

Psychiatric comorbidity in patients with bipolar disorder (BD) has been associated with an earlier onset, rapid cycling, worsening severity and outcome, and increased suicidality. Patients with BD have been reported to have poor quality of life (QOL) even during remission. Estimate the prevalence of psychiatric comorbidity and assess the QOL in patients with BD, and find the associated sociodemographic and clinical variables. This cross-sectional study was done in a general hospital psychiatric unit on 100 patients (both inpatients and outpatients) with DSM-IV-TR BD in partial or complete remission. Patients were assessed using a semi-structured pro forma, Mini International Neuropsychiatric Interview 6.0 - Hindi version, Hamilton Rating Scale for Depression or Young Mania Rating Scale and World Health Organization QOL instrument, short-form (WHOQOL-BREF), Hindi Version. Sixty-one percent of the sample had at least one psychiatric comorbidity, and the commonest comorbid disorders were substance use disorders (SUD) (30%) and anxiety disorders (AD) (28%). Male gender was identified as a predictor for comorbidity in BD. The mean QOL-BREF score was 85.96 ± 14.35. Poor QOL was associated with older age at onset of comorbidity, multiple comorbidities, mixed episodes, rapid cycling, partial remission, and increased severity of depression while patients with current hypomanic symptoms were found to have better QOL. BD with comorbidity had worse QOL than those without comorbidity. The majority of patients with BD had at least one comorbidity. SUD were the most common comorbid disorders. QOL, already poor in BD patients, was poorer in cases with comorbidity.

Long-Acting Injectable Antipsychotic Treatment in Schizophrenia and Co-occurring Substance Use Disorders: A Systematic Review

Objectives: Co-occurring substance use disorders (SUDs) among individuals with schizophrenia are a prevalent and complex psychiatric comorbidity, which is associated with increased symptom severity, worsened illness trajectory and high rates of treatment non-adherence. Recent evidence suggests that the use of long-acting injectable (LAI) antipsychotics may provide an effective treatment option for individuals with this dual-diagnosis.Methods: A systematic review of the literature was conducted using the databases PubMed, PsychInfo and Google Scholar for English-language studies, investigating the use of LAIs in co-occurring schizophrenia and substance use disorders (SCZ-SUDs).Results: Eight reports [one case study (n = 1), one case series (n = 8), three open-label retrospective studies (n = 75), and three randomized controlled trials (n = 273)] investigated the use of LAI antipsychotics in 357 participants with SCZ-SUDs [alcohol use disorder: 5 studies, n = 282; cocaine use disorder: 5 studies, n = 85; amphetamine use disorder: 1 study, n = 1; cannabis use disorder: 3 studies, n = 160; opioid use disorder: 3 studies, n = 19; methylenedioxymethamphetamine (MDMA) use disorder: 2 studies, n = 9; ketamine use disorder: 1 study, n = 4] and were included in this systematic review. Findings indicate significant improvements in substance use related outcomes across 7 of 8 studies, while in 6 of 8 studies, significant improvements in psychopathology-related outcomes were reported.Conclusions: LAI antipsychotics may be an efficacious intervention option for the treatment of SCZ-SUDs. However, varying methodological rigor, generally small sample sizes and heterogeneity of samples, settings, substances of abuse, tested LAIs and comparators, as well as psychosocial cotreatments and level of reported detail across studies requires that these findings be considered preliminary and interpreted with caution. Further research is required to better understand the effects of LAIs among individuals with SCZ-SUDs.

13.1 Celiac Disease Associated With MENTAL Illness in Children and Correlated Screening Practices

Celiac disease (CD) and non-celiac gluten sensitivity (NCGS) are associated autoimmune manifestations that can lead to psychiatric and neurological disorders, as well as treatment resistance. Mental illness is often the primary expression of CD or NCGS. Up to 85% of patients with histologically proven CD have no gastrointestinal symptoms. Untreated CD can lead to serious behavioral disorders, including a higher suicide risk. Child and adolescent psychiatrists treat such cases daily but may fail to screen for and/or recognize the association. We examine the literature on mental illness associated with CD and NCGS in the pediatric population to inform screening in psychiatry. A literature search using PubMed, Cochrane, and Google Scholar for CD or NCGS-related psychiatric comorbidities in the pediatric population aged 2 to 22 years using the terms “psychiatric,” “celiac,” “gluten,” “child OR adolescent OR pediatric,” and mental illness to include “depression,” “anxiety,” “mood disorders,” “attention deficit hyperactivity disorder,” “psychosis,” and "eating disorders" located 30 relevant articles (19 cohort studies, 2 observational studies, 2 case-control studies, 4 case reports, and 3 systematic reviews). Mental illness symptoms often precede a diagnosis of CD in children; however, we found only 2 articles on screening practices, limited to eating disorders. One study, a small clinical trial, recommended screening patients with severe anorexia nervosa. Another study, a retrospective chart review, surveyed emergency department visits for patients with eating disorders and did not recommend screening for CD. Conversely, a 2019 systematic review stressed the importance of screening for CD in outpatient psychiatric clinics, because the overall prevalence of psychiatric comorbidities is higher in those with CD or NCGS. CD is a common childhood autoimmune disease, with 1 in 100 children being affected. At least 1 out of 3 cases of CD are undiagnosed, suggesting a higher prevalence of mental health disorders linked to CD than expected. More studies are needed to inform screening practices for CD and NCGS in children and adolescents with mental illness. Understanding this association aids clinicians in diagnostic and treatment clarity and could result in mental illness symptom remission with the gluten-free diet.

Magnitude of psychiatric comorbidity in patients with obesity in Northern Indian population

Background and aimsTo determine the prevalence of different psychiatric comorbidities in patients with obesity and study their relationship with the degrees of obesity. MethodsThis cross-sectional study included 151 patients with a BMI≥25 kg/m2. Subjects with diagnosed psychiatric illness, type 2 diabetes mellitus, coronary artery disease or any neurological illness were excluded. Prevalence of psychiatric comorbidities was assessed by MINI screening tool for all major axis 1 disorders including anxiety, eating and mood disorders. The WHOQOL-BREF was used for assessment of well-being, in the four domains, physical, psychological, social and environmental. ResultsFemales constituted 68.6% of the study population. Lifetime diagnosis of any psychiatric illness was present in 24%, higher in females than males [31% vs 9%, p = 0.003]. The WHOQOL-BREF average scores of psychological, physical and environmental domains were significantly lower (p < 0.001) in patients diagnosed with depression as compared to those without. The WHOQOL-BREF average score of only the physical domain were significantly lower in individuals with BMI ≥30 kg/m2 as compared to those with BMI <30 kg/m2. ConclusionsThe burden of undiagnosed psychiatric comorbidity in patients with obesity decreases the quality of life. There is need to screen for psychiatric comorbidities for effective management of obesity.

Prevalence of Psychiatric Comorbidities in Patients with Psoriasis: A Cross-sectional Study from a Tertiary Care Hospital in Eastern India

Prevalence of Psychiatric Comorbidities in Patients with Psoriasis: A Cross-sectional Study from a Tertiary Care Hospital in Eastern India

Increased non-attendance at epilepsy clinic in patients with neuropsychiatric comorbidities: A prospective study

BackgroundIn patients with epilepsy, regular follow-up is vital for adequate seizure control, antiseizure drugs’ (ASDs) side effects, psychiatric comorbidities, and planning for epilepsy surgery. Non-attendance creates barriers to adequate patient care, inefficient allocation of resources, loss of income, and unnecessary emergency department visits due to lack of seizure control. This study aimed to determine the causes and sociodemographic characteristics of the non-attendant population at the Epilepsy Clinic. MethodsA prospective and observational study was carried out on patients treated at the Epilepsy Clinic of the National Institute of Neurology and Neurosurgery (NINN) in Mexico from August 2015 to June 2016. A phone interview was made with all those patients who did not attend the epilepsy consultation. This call incorporated ad hoc questions to meet the objectives of this study. ResultsDuring the study period, 1299 patients had an appointment at the epilepsy clinic, where 233 (17.9%) patients missed their consultation, 123 (52.8%) were male, mean age was 35.9 ± 14.42 years. The most frequent cause of non-attendance was forgetfulness of the appointment in 62 patients (26.6%). Two patients died; no patient was reported to have experienced SUDEP. Non-attendant patients showed statistically significant overall prevalence of psychiatric comorbidities (41.6%), particularly depression, anxiety, and interictal psychosis. ConclusionInformation on non-attendance at various specialist consultations is scarce, and to our knowledge, this is the first study to address non-attendance in patients with epilepsy in Latin America. Improving hospital protocols to reduce non-attendance can increase patient adherence to follow-up, ultimately improving the quality of care in the epilepsy clinic.

Understanding Psychiatric Disorders in Idiopathic and Inherited (Monogenic) Forms of Isolated and Combined Dystonia: A Systematic Review.

The relationship between idiopathic and inherited (monogenic) forms of isolated and combined dystonia and psychiatric disorders remains unclear. In the present review, the authors aimed to provide increased clarity on this association through a systematic review of all controlled quantitative studies using a structured or semi-structured psychiatric interview to diagnose psychiatric disorders in individuals with these conditions. Three databases were searched to identify 20 eligible studies, with a total of 1,275 participants fulfilling inclusion criteria. Eligible articles were quality appraised and divided into four sections (idiopathic forms of dystonia [N=11], early-onset torsion dystonia [N=2], gene mutation positive myoclonus dystonia; DYT-SGCE [N=6], and rapid-onset dystonia-parkinsonism [N=1]). For each study, results were grouped into subcategories (overall psychiatric comorbidity, anxiety disorders, mood disorders, substance misuse, and other [personality disorder and cognitive impairment]). For idiopathic dystonia, higher rates of psychiatric comorbidity, including mood and anxiety disorders, were noted when cases were compared with both healthy control subjects and control groups with a medical comorbidity. However, for major depressive disorder and obsessive-compulsive disorder (OCD) specifically, no differences were seen between groups. Study subjects with DYT-SGCE appeared to be at higher risk of psychiatric comorbidity, major depressive disorder, OCD, and alcohol dependence than control populations. Overall, the prevalence of psychiatric comorbidity appears to be increased in individuals with idiopathic and inherited (monogenic) forms of isolated and combined dystonia compared with control subjects. This finding is not consistent for all comparisons, and further research is required to understand the nature of these associations and the underlying causative etiologies.