Prevalence Of Psychiatric Comorbidities Research Articles

Identification of patients with psychiatric disorders in a surgical unit: a prospective study of risk factors

Background: Many a times, surgical patients suffer from both physical diseases and mental disorders. Psychiatric comorbidity has been reported to be very high (8-53%) in primary health care units in developing countries including India.Methods: This study was conducted among four hundred in-patients in the Department of General Surgery at Armed Forces Medical College, Pune from May 2015 to April 2016. Patients aged 18 and above were included. Patients who were too ill to participate and who did not consent were excluded. The presence or absence of psychiatric illness was assessed using the general health questionnaire (GHQ) 28 questionnaire.Results: The mean age of participants with psychiatric co-morbidities as diagnosed with GHQ 28 was 46.79±12.73 years. The prevalence of psychiatric co-morbidities was more amongst females (76.35%) when compared to males (63.09%) with a statistical significance (95% CI: 2.08-23.61; p<0.05). The prevalence of psychiatric co-morbidities was more amongst participants living in a nuclear family (89.87%) than in a joint family (36.19%) (95% CI: 40.05-65.24; p<0.001). 74.62 % of the participants with psychiatric comorbidities had medical comorbidities as well.Conclusions: There was high prevalence of psychiatric co-morbidities in the participants of this study. We found that more than 2/3rd patients had psychiatric co-morbidity according to GHQ-28 total score, of which most common was found to be somatoform disorders, followed by mixed anxiety and depressive disorders.

Antepartum Drug Dependence and Pregnancy- or Birth-related Complications: A Cross-sectional Study of 19 Million Inpatients.

ObjectiveTo evaluate the demographic characteristics, hospitalization outcomes [severity, length of stay (LOS), and total expense], and comorbidities in pregnant patients with antepartum drug dependence (ADD).MethodsWe used the national inpatient sample (NIS) and included 19,170,561 female patients (age: 12-40 years) hospitalized for pregnancy- or birth-related complications and grouped by co-diagnosis of ADD. We used descriptive statistics and Pearson’s chi-square test for categorical data and independent sample T-test for the continuous data to measure the differences in demographic and hospital outcomes. A logistic regression model was used to evaluate the odds ratio (OR) for medical and psychiatric comorbidities.ResultsThe hospitalizations with ADD declined initially, from 2010 to 2011, followed by an increase of 50% from 2011 to 2014. White pregnant females (77.5%), and those from low-income families (<25th percentile, 37.1 %) had comorbid ADD. Among medical comorbidities, iron-deficiency anemia was the most prevalent condition in pregnant inpatients (12.0% in ADD vs. 9.2% in non-ADD) followed by obesity and hypertension. Depression (12.9%) was the most prevalent psychiatric comorbidity in ADD inpatients followed by comorbid psychosis (three-fold higher odds). Among patients with substance use disorder (SUD), opioid abuse was the most prevalent one (67.3%) followed by cannabis (11.2%), cocaine (5.7%), amphetamine (4.0%), and alcohol (2.4%). Half of the pregnant inpatients with ADD had moderate severity of illness due to pregnancy or birth-related complications with four-fold higher odds [95% confidence interval (CI): 3.67-8.88]. They also had a higher LOS with a mean difference of 0.88 days (95% CI: 0.904-0.865) and had incurred higher total charges, by USD 3,797 (95% CI: 3,927-3,666), per inpatient admission for pregnancy- or birth-related complications compared to non-ADD inpatientsConclusionADD is associated with the worsening of severity of illness in pregnancy- or birth-related complications and requires acute inpatient care that leads to increased healthcare-related economic burden. The integration of SUD services with primary or maternal care is required to improve outcomes in at-risk women in the reproductive age group.

Medical and Psychiatric Comorbidities in Bipolar Disorder: Insights from National Inpatient Population-based Study.

ObjectivesThe objective of this study was to analyze the differences in the prevalence and association of medical and psychiatric comorbidities in bipolar disorder (BD) patients versus the general inpatient population.MethodsA cross-sectional analysis was conducted using the national inpatient sample (NIS). Using the international classification of diseases, ninth revision (ICD-9) diagnostic codes, we extracted the BD inpatients and then obtained information about comorbidities. The odds ratio (OR) of comorbidities in BD inpatients were evaluated using a logistic regression model.ResultsHypertension (31.1%), asthma (11.7%) and diabetes, obesity, and hypothyroidism (11% each) were the prevalent medical comorbidities found in BD inpatients. Hypothyroidism, asthma, and migraine were seen in BD inpatients (OR 1.59, OR 1.37 and OR 1.23; respectively) compared to general inpatients. Drug abuse (33.5%), anxiety disorders (31.8%), and alcohol abuse (18.3%) were the most prevalent psychiatric comorbidities in BD inpatients. They had a seven-fold higher likelihood of comorbid borderline personality disorders compared to general inpatients. Among other psychiatric comorbidities, the odds of the association were higher for drug abuse (OR 4.33), ADHD (OR 3.06), and PTSD (2.44).ConclusionA higher burden of medical and psychiatric comorbidities is seen in BD inpatients compare to the general inpatient population. A collaborative care model is required for early diagnosis and management of these comorbidities to improve the health-related quality of life.

Military Blast-Related Traumatic Brain Injury

This paper aims to review and discuss the epidemiological, neuropathologic, and mechanistic characteristics of blast traumatic brain injury (bTBI) specific to the military population. Military service members have sustained over 383,000 reported incidents of TBI since 2000. In combat, mild bTBI due to explosive attacks comprise the most common type. Identification, treatment, and reporting of bTBI are compounded by the operational demands of combat as well as frequent co-presentation with PTSD and associated injuries. Following primary injury, a secondary metabolic and inflammatory cascade in bTBI leads to an array of symptoms and impairments. Development of screening batteries, sensors, and laboratory assays has sought to advance evaluation and management. bTBI is a widespread, though underreported, injury in service members with significant neurological and cognitive impacts. The highly prevalent traumatic and psychiatric comorbidities incurred in combat must be considered in the approach to management. Further research is needed to improve bTBI detection and facilitate prognosis.

Prevalence of psychiatric comorbidities in diabetic patients who are candidates for therapy with SGLT2 inhibitors: clinical and metabolic characteristics

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Comorbidity Patterns Among Patients With Opioid Use Disorder and Problem Gambling: ADHD Status Predicts Class Membership

Objective: Psychiatric comorbidities are highly prevalent among individuals affected by substance use disorders and those with non-substance-related addictive disorders such as gambling disorder. More recently, the frequent co-occurrence of substance use disorders and attention-deficit hyperactivity disorder (ADHD) has received particular attention. The aim of our study was to identify patterns of psychiatric comorbidity and to examine associations between patient group and ADHD status with class membership. Methods: Participants were patients with opioid use disorder enrolled in opioid maintenance treatment (OMT), either recruited from the community (n = 142; M age = 35.8 years; 38.7% female) or prison (n = 133; M age = 35.7 years; 21.8% female), and patients undergoing treatment for problem gambling (PrG; n = 80; M age = 43.1 years; 20% female). To enable direct comparisons, the following instruments were applied: Mini International Neuropsychiatric Interview, Adult ADHD self-report scale, Wender Utah Rating Scale, and European Addiction Severity Index. We used a latent class analysis (LCA) to identify psychiatric comorbidity patterns and a multinomial logistic regression to examine associations between patient group, ADHD status, age, and gender with class membership. Results: The LCA resulted in a three-class solution: (1) a class of individuals with a relatively low probability of current psychiatric comorbidities, except for a high probability of substance use disorders; (2) a class with markedly increased probabilities of current and recurrent psychiatric comorbidities, especially for major depression; and (3) a class with very low probabilities of psychiatric comorbidities, except for moderate probabilities of substance use disorders and antisocial personality disorder. Both OMT patients recruited from the community and those in prison were less likely than PrG patients to be assigned to the most burdened class with respect to psychiatric comorbidity (class 2). Further, both individuals with ADHD in childhood and those with adult ADHD were more likely members of class 2. Conclusions: PrG patients seem to be at an even higher risk for psychiatric comorbidities compared to OMT patients. Raising awareness among practitioners for the high prevalence of psychiatric comorbidities among patients with gambling disorder and individuals with ADHD is crucial to initiate adequate treatment and to improve response.

Prevalence of Psychiatric Co-Morbidities in Patients with Dementia: A Prospective Study

Prevalence of Psychiatric Co-Morbidities in Patients with Dementia: A Prospective Study

Determinates of depressive disorder among adult patients with cardiovascular disease at outpatient cardiac clinic Jimma University Teaching Hospital, South West Ethiopia: cross-sectional study

BackgroundDepression and heart disease are an important public-health problem. Depression is one of the most prevalent and disabling psychiatric disorders with more than three times increased risk among patients with cardiovascular disorders.ObjectiveTo identify the prevalence and associated factors of depressive disorder among adult patients with cardiovascular disease.MethodsInstitution based cross-sectional study design was used to conduct this study on 293 study participants attending an outpatient cardiac clinic at Jimma University Teaching Hospital. All eligible patients were recruited into the study consecutively. Depression was assessed using patient health questionnaire-9. The patient health questionnaire-9 had a total score of 27, from which 0–4: no/minimal depression, 5–9: mild depression, 10–14: moderately depression, 15–19: moderately severe depression and 20–27 severe depression. The data was feed into Epi-data version 3.1 and lastly exported to SPSS version 21 for analysis. Bivariate analysis was used to analyze the statistical association of covariates of interest with depressive disorder among patients with cardiovascular disease. Then, logistic regression analysis was used as a final model to control confounders. The strength of association was measured by a 95% confidence interval.ResultsA total of 293 adult patients diagnosed with the cardiovascular disease were included in the study with 97% (n = 284) of response rate, 47.2% (n = 134) males and 52.8% (n = 150) females, making female to a male ratio around 1.1:1. The prevalence of depression was 52.8% (n = 150/284). Out of the subjects with depression 52.67% (n = 79), 36.0% (n = 54) and 11.33% (n = 17) were mild, moderate and severe depression, respectively. Variables such as employed, unemployed, physical activity, current cigarette user and poor social support were independently associated with depression in the final model.ConclusionsIn this study, depression was found to be highly prevalent psychiatric comorbidity in adult cardiovascular disease patients.

Concomitant Psychiatric Symptoms in Neurological Outpatients.

To estimate the prevalence of concomitant psychiatric disorders in neurological outpatients and to assess the value of simple screening questionnaires in the identification of psychiatric symptoms, we analyzed a total of 803 patients who visited neurology clinics with neurological symptoms over a six-month period. Using self-reported questionnaires, we assessed psychiatric symptoms, such as stress (Perceived Stress Scale, PSS), depression (Patient Health Question 9, PHQ9), and anxiety (Generalized Anxiety Disorder 7, GAD7). According to the disease subtypes, we analyzed the psychiatric scales based on gender and age group. The prevalence of psychiatric comorbidities was lowest in patients with cerebrovascular disease (CVD) and highest among patients with cognitive decline and epilepsy. The overall prevalence of psychiatric symptoms markedly decreased with age. This decline was statistically significant for all questionnaires (PSS ≥ 14, p for trend = 0.027; PQH9 ≥ 10, p for trend = 0.005; GAD7 ≥ 10, p for trend = 0.002) and was more pronounced in males. Considering the high incidence of undetected psychiatric comorbidities and their associated burden, proactive psychiatric management should be included in neurological care. Psychiatric questionnaires could also be an effective screening tool for identifying psychiatric symptoms accompanying neurological symptoms.

The prevalence of psychiatric disorders in sudden cardiac arrest survivors: A 5-year nationwide inpatient analysis

BackgroundSudden cardiac arrest (SCA) is a major public health challenge in the United States (US). At present, the existence of limited literature on psychological sequelae post-cardiac arrest is a challenge in providing optimal care to survivors. AimThe aim of this study is to determine the prevalence of various psychiatric comorbidities in survivors of SCA. MethodsThe National Inpatient Sample (NIS) dataset was queried to assess the prevalence of psychiatric disorders with gender-based differences and inpatient mortality among adult patients hospitalized with a previous history of SCA using ICD-9 CM codes from 2010 to 2014. ResultsMood disorder (16.4%) was the most prevalent psychiatric comorbidity (including depression; 12.6%) followed by anxiety (10%). Cardiac arrest survivors with psychiatric disorder (CAPD) were often younger (mean 60 ± 16 vs. 64 ± 16 years; p < 0.001), female (53.7% vs. 38.0%; p < 0.001), white patients (75.9% vs. 68.7%; p < 0.001) and the majority were admitted non-electively (85.1% vs. 82.8%, p < 0.001) as compared to cardiac arrest survivors without psychiatric disorder (CANPD). Among the CAPD group, females had a significantly higher frequency of mood disorders (21.8% vs. 12.6%), depression (16.8% vs. 9.5%) and anxiety (14.2% vs. 8.0%) compared to males. The CAPD cohort had a lower all-cause in-hospital mortality (5.7% vs. 9.8%; p < 0.001) as compared to the CANPD group. ConclusionsComorbid psychiatric disorders are prevalent in SCA survivors, especially younger, white, female patients. However, CAPD did not have higher all-cause mortality as compared to CANPD. It is imperative to identify, assess, treat, and monitor high-risk SCA patients for associated psychiatric comorbidities.

Neurocognitive and psychiatric comorbidities of posttraumatic stress disorder among older veterans: A systematic review.

Posttraumatic stress disorder (PTSD) is associated with neurocognitive and psychiatric comorbidities, and older adults experience comorbid illnesses disproportionately. Little is known about the comorbidities of PTSD among older veterans. This systematic review examines the prevalence, incidence, and patterns of neurocognitive and psychiatric comorbidities of PTSD among older veterans and explores the factors associated with these comorbidities. A systematic literature review was performed using PubMed, CINAHL, and PsycINFO databases. The search was limited to peer-reviewed articles published in English from January 1980 to October 2018. Eligible studies examined the comorbid neurocognitive and psychiatric disorders of PTSD among veterans aged 60 and older. Twenty-four studies met the criteria for inclusion. The risk for dementia was higher in veterans with PTSD than those without PTSD; hazard ratios ranged from 1.21 to 1.77. Depressive disorder was the most prevalent psychiatric comorbidity with estimates ranging from 33% to 52.3%, followed by generalized anxiety disorder (14%-15%) and substance use disorders (1.9%-11.3%). Factors consistently associated with PTSD comorbidities included age, combat-related exposures, clinical conditions, and health-related and psychosocial outcomes. Despite heterogeneity in research designs and methodological limitations, this review highlights the need to consider comorbid neurocognitive and psychiatric disorders among older veterans with PTSD in order to individualize care approaches. Future research should incorporate factors associated with neurocognitive and psychiatric comorbidities of PTSD into study designs that can help improve prediction of comorbidity and generate evidence for developing and implementing tailored treatments in older veterans.

Prevalence of Psychiatric Comorbidities in Patients Presenting With Headache

Prevalence of Psychiatric Comorbidities in Patients Presenting With Headache

Psychiatric co-morbidities in Attention Deficit Hyperactive Disorder (ADHD): A Retrospective Clinical chart review from a tertiary hospital in North India

Background: ADHD is one of the most common disorders seen in children and the presenting complaint of the parents is not able to manage the child. ADHD is highly co-morbid with various psychiatric illnesses which further add to diagnostic and management difficulties. Method: The case records of Child Guidance Clinic (CGC) (2012-2017) of Postgraduate Institute of Medical Sciences (PGIMS) Rohtak, Haryana were manually screened to collect information about children with a diagnosis of ADHD. Relevant details were noted and data were analyzed. Results: 436 children were diagnosed with ADHD. Most common age of presentation was 8 years (n=68), with majority of children being males (80%) presenting between 5-7 years of age (44.5%) and belonging to urban background (n=253, 57.76%). The overall prevalence of psychiatric co-morbidities was 35%, with mental retardation being the most common (38.16%) followed by oppositional defiant disorder (27.63%), conduct disorder (16.45%) and seizure disorder (11.84%). Conclusion: Seeing the high co-morbidity, it becomes important to screen all the patients diagnosed with ADHD for psychiatric co-morbidities.

Anxiety spectrum disorders are common in patients with orthostatic tremor

BackgroundOrthostatic Tremor (OT) is a rare movement disorder characterized by a sensation of unsteadiness while standing and associated with high frequency tremors. Patients with OT commonly report a fear of falling and significant limitations in everyday activities. The prevalence of psychiatric comorbidities in OT patients has not been well-studied. MethodsSubjects were evaluated by trained psychiatry researchers using the Mini International Neuropsychiatric Interview (M.I.N.I.). The M.I.N.I is a validated screening tool for psychiatric disorders. A standardized history covering previous psychiatric symptoms and illnesses was also obtained. Results29 OT subjects were evaluated. The mean age was 67.7 years with female preponderance (89.3%). The average disease symptom duration was 18.2 years. 58.6% of the subjects had seen a mental health professional during the course of their OT illness. 24.1% of the subjects had a past history of depression, and 10.3% reported a family history of any psychiatric condition. 37.9% of the subjects screened positive for agoraphobia. Two of 29 subjects (6.9%) were classified as having a current major depressive episode and one subject (3.4%) was at risk for suicide. ConclusionsPsychiatric comorbidities are highly prevalent in OT patients, especially anxiety-spectrum disorders. Further studies are needed to understand if psychiatric disorders appear as a secondary response to the patient's symptoms, or are a primary non-motor manifestation of OT.

Psychiatric Comorbidities in Patients with Alcohol Dependence Syndrome in a Tertiary Care Center: A Cross-Sectional Study

Introduction: The co-occurence of substance abuse and mental illness is well known. Alcoholics are reported to be three times more likely to suffer from another psychiatric disorder. This study aims to observe the prevalence of psychiatric comorbidity in alcohol dependent patients in our setup. Methods: This was a hospital based cross-sectional observational study conducted over a period of three months. Consecutive patients presenting to the out-patient section of Psychiatric department who met the DSM-IV-TR criteria for alcohol dependence were included in the study. They were interviewed using Structured Clinical Interview for DSM-IV-TR (SCID I&amp;II) to assess for comorbidity. Data was analyzed using Statistical Package for Social Sciences (SPSS TM) software. Mann Whitney U test and Chi square or Fisher's Exact tests were used for statistical analysis. Results: Out of 31 patients enrolled, 14 (45.16%) had psychiatric comorbid conditions all of which were Axis I disorders. Anxiety disorder (35.71%) was the most frequent associated disorder followed by depressive disorder (28.57%). The alcohol dependent patients with comorbidity was significantly younger (mean age=35.71±13.60 years) in comparison to those without comorbidity (mean age=42.59±11.15 years). Other socio-demographic parameters were comparable between the two groups. Patients with history of past psychiatric illness and medication were less likely to have comorbidity, which was statistically significant. Conclusion: Psychiatric comorbidity is common in alcohol dependent people. Anxiety disorder and depression were more prevalent entities. Those with past illness and medications were less likely to have comorbidities.

Trends in Prevalence of Psychiatric Comorbidities among Patients with Moderate to Severe Psoriasis

Abstract not available. Disclosures: Study sponsored by Janssen.Copyright 2018 SKIN

Depression treatment use among stroke individuals with depression: A cross-sectional analysis of the Medical Expenditure Panel Survey.

Depression is the most prevalent psychiatric comorbidity among stroke individuals. Despite the effectiveness of antidepressants and psychotherapy, data on the use of these treatments among stroke survivors is limited. The main objective of this study was to document prevalence of antidepressant use, types of antidepressants utilized, and adherence to antidepressants among stroke individuals. Retrospective, cross-sectional data obtained from the Medical Expenditure Panel Surveys (MEPS), for the years 2011, 2013 and 2015, was utilized for this study. Treatment for depression was categorized into three mutually exclusive categories: 1) antidepressants only, 2) antidepressants and psychotherapy (combination), and 3) No treatment. Adherence to antidepressants was measured using the Proportion of Days Covered (PDC) ratio. Adherence between antidepressant only and combination therapy group was compared using Student's t-test. A multinomial logistic regression analysis was used to further examine the association between patient characteristics and likelihood of receiving depression treatment. A total of 759 stroke individuals with comorbid depression were identified. Of these, 51.2% utilized only antidepressants, 12.6% utilized a combination treatment of antidepressants and psychotherapy and 31.7% did not receive treatment for depression. Selective Serotonin Reuptake Inhibitors (SSRI's) was the most commonly used antidepressants in the stroke population. Males (P = 0.04), age group of 40-64 years (P < 0.001), and African Americans (P = 0.02) constituted for the highest proportions of untreated stroke survivors. Among treated stroke individuals, adherence was higher for combination therapy users compared to those using antidepressants only (mean PDC = 65.8 ± 6.89 and 57.6 ± 3.74, respectively). Almost 70% of stroke individuals received some form of treatment for depression and several patient-related factors (gender, age, race, marital status, and comorbidity burden) were associated with the utilization of depression treatment. Future researchers need to investigate the factors responsible for lack of depression treatment in stroke individuals and policy makers should aim for a more patient centered care.

Practical Considerations for the Assessment and Treatment of ADHD in Children with Epilepsy

AbstractAttention deficit hyperactivity disorder (ADHD) is one of the most prevalent psychiatric comorbidities in children with epilepsy, but it is under diagnosed and under treated which can impact the quality of life. Knowledge regarding ADHD characteristics, epilepsy-related risk factors, and associations with specific types of epilepsy provide a base for assessment. Epilepsy-related variables have not consistently predicted ADHD status, so screening and assessment for ADHD in children with epilepsy should be systematic and broad. Different assessment tools and techniques can be helpful including rating scales, diagnostic interviews, and neuropsychological testing. Treatment of ADHD with methylphenidate has been found to be safe and effective including in populations with uncontrolled seizures and coexisting intellectual disability. There are limited data on other medication and behavioral treatments. To improve assessment, diagnosis and treatment, medical provider knowledge, and practices, as well as family barriers to behavioral health should be targeted.

Dravet Syndrome and Psychiatric Comorbidity

AbstractThis is a review of the prevalence of psychiatric comorbidity in patients with Dravet syndrome (DS) and the predictors of psychiatric comorbidity. Symptoms of attention-deficit hyperactivity disorder are most frequently reported in children with DS. Autistic features and “other behavior problems” are also found in a considerable proportion of children. No consistent relationship has been found with intellectual disability level, age of onset of seizures, delay in diagnosis, and seizure frequency. A major limitation of the literature is that formal psychiatric assessment has rarely been applied.

Alcohol Use Disorder and Depression in Patients with Alcohol-Related Seizures

Abstract Both alcohol use disorder and depression are important aspects of health in the general population and among patients with epilepsy. Depression is the most prevalent psychiatric comorbidity in epilepsy, thereby increasing morbidity as well as mortality rate. From our experience, we can see that one third of epilepsy inpatients experience seizures that are alcohol-related. There have been no studies conducted in Latvia about alcohol use disorder and depression in patients with alcohol-related seizures (ARS) and epilepsy. We recruited 108 patients with ARS, 44 of whom had comorbid epilepsy. 75% of patients in our study had depression according to the Hamilton depression scale. Higher score in the Alcohol Use Disorder Identification Test was associated with thoughts of self-harm. Greater consumption of alcohol on a typical day when drinking was associated with a higher risk of alcohol dependence. Of patients without epilepsy, 60% received antiepileptic drugs (AEDs) and 17% even used 2–3 different drugs to overcome ARS. A large part of patients had not been warned by their physician that alcohol provokes seizures. Our data could help to identify greater suicidality risk and alcohol dependence risk cases in patients with ARS, as well as improve care for this group of patients in general.