Prevalence Of Psychiatric Illness Research Articles

Depression severity and verbal comprehension in children and adolescents with a major depressive episode.

Severe depression is a prevalent psychiatric illness in children and adolescents associated with high levels of morbidity, disability, and a high risk of suicidal behavior. Cognitive factors associated with depression severity in juveniles have been poorly reported. We investigated the relationship between depression severity and intelligence quotient (IQ)with its subscales in 65 juveniles (aged 10-17 years) with a current major depressive episode evaluated at the Mood Disorder Program of Bambino Gesù Children's Hospital in Rome. Pearson's correlation analyses were followed by a Benjamini-Hochberg correction and linear multivariable regression model. Depression severity measured with the total score of the Children's Depression Rating Scale-Revised (CDRS-R) was positively associated with the Verbal Comprehension Index (VCI; Pearson's r = 0.309 [0.042-0.534]; p = 0.024). The CDRS-R subscales positively associated with VCI by Pearson's correlation were depressed feelings, suicidal ideation, excessive weeping, and reduced facial expressions. Suicidal ideation was the only factor independently and significantly associated with higher VCI in the multivariable linear regression model. Suicidal ideation was significantly and independently associated with higher verbal comprehension, indicating that depressed juveniles with better verbal ability may be at a greater risk of showing suicidal ideation.

Adrenergic C1 neurons enhance anxiety via projections to PAG.

Anxiety is an emotional state precipitated by the anticipation of real or potential threats. Anxiety disorders are the most prevalent psychiatric illnesses globally and increase the risk of developing comorbid conditions that negatively impact the brain and body. The etiology of anxiety disorders remains unresolved, limiting improvement of therapeutic strategies to alleviate anxiety-related symptoms with increased specificity and efficacy. Here, we applied novel intersectional tools to identify a discrete population of brainstem adrenergic neurons, named C1 cells, that promote aversion and anxiety-related behaviors via projections to the periaqueductal gray matter (PAG). While C1 cells have traditionally been implicated in modulation of autonomic processes, rabies tracing revealed that they receive input from brain areas with diverse functions. Calcium-based in vivo imaging showed that activation of C1 cells enhances excitatory responses in vlPAG, activity that is exacerbated in times of heightened stress. Furthermore, inhibition of C1 cells impedes the development of anxiety-like behaviors in response to stressful situations. Overall, these findings suggest that C1 neurons are positioned to integrate complex information from the brain and periphery for the promotion of anxiety-like behaviors.

Increased forebrain EAAT3 expression confers resilience to chronic stress.

Depression is a disabling and highly prevalent psychiatric illness. Multiple studies have linked glutamatergic dysfunction with the pathophysiology of depression, but the exact alterations in the glutamatergic system that contribute to depressive-like behaviors are not fully understood. Recent evidence suggests that a decreased level in neuronal glutamate transporter (EAAT3), known to control glutamate levels and limit the activation of glutamate receptors at synaptic sites, may contribute to the manifestation of a depressive phenotype. Here, we tested the possibility that increased EAAT3 expression at excitatory synapses could reduce the susceptibility of mice to develop depressive-like behaviors when challenged to a 5-week unpredictable chronic mild stress (UCMS) protocol. Mice overexpressing EAAT3 in the forebrain (EAAT3glo/CMKII) and control littermates (EAAT3glo) were assessed for depressive-like behaviors and long-term memory performance after being subjected to UCMS conditions. We found that, after UCMS, EAAT3glo/CMKII mice did not exhibit depressive-like behaviors or memory alterations observed in control mice. Moreover, we found that EAAT3glo/CMKII mice did not show alterations in phasic dopamine release in the nucleus accumbens neither in long-term synaptic plasticity in the CA1 region of the hippocampus after UCMS, as observed in control littermates. Altogether these results suggest that forebrain EAAT3 overexpression may be related to a resilient phenotype, both at behavioral and functional level, to the deleterious effect of chronic stress, highlighting the importance of neuronal EAAT3 in the pathophysiology of depressive-like behaviors.

Comparison of depression and anxiety in first- versus non-first generation Saudi medical students: A cross-sectional study.

Depression and anxiety are prevalent psychiatric illnesses worldwide. This study aimed to estimate the prevalence of these illnesses and their associated sociodemographic factors among medical students at King Saud University, Riyadh, Saudi Arabia, by comparing first- and non-first-generation students. This cross-sectional study included 367 participants. The study tool, distributed in December 2023, consisted of a questionnaire developed by the research team to assess sociodemographic factors, the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder 7-Item scale (GAD-7). Among the participants, 33.5% had a first-degree relative who attended medical school. The mean GAD-7 score was 8.30 for first-generation students and 7.48 for non-first-generation students, suggesting a trend toward higher anxiety in first-generation students, although the differences between the 2 groups were not statistically significant (P = .170). The mean PHQ-9 score was 9.54 for first-generation and 8.10 for non-first-generation students (P = .042). Women had significantly higher mean scores than men on both the GAD-7 and PHQ-9 (P=<.001). First- and third-year students had the highest mean scores on both the GAD-7 and PHQ-9 (P < .001). A statistically significant (P < .001) association was observed between anxiety and depression. Future research should focus on identifying, developing, and examining interventions that target at-risk groups of medical students. Multicenter studies with more rigorous research methodologies are warranted to validate these results.

Temporal and spatial trend analysis of all-cause depression burden based on Global Burden of Disease (GBD) 2019 study

Depression has been reported as one of the most prevalent psychiatric illnesses globally. This study aimed to obtain information on the global burden of depression and its associated spatiotemporal variation, by exploring the correlation between the global burden of depression and the social development index (SDI) and associated risk factors. Using data from the Global Burden of Disease study from 1990 to 2019, we described the prevalence and burden of disease in 204 countries across 21 regions, including sex and age differences and the relationship between the global disease burden and SDI. The age-standardized rate and estimated annual percentage change were used to assess the global burden of depression. Individuals with documented depression globally ranged from 182,183,358 in 1990 to 290,185,742 in 2019, representing an increase of 0.59%. More patients experienced major depressive disorder than dysthymia. The incidence and disability-adjusted life years of depression were the highest in the 60–64 age group and much higher in females than in males, with this trend occurring across all ages. The age-standardized incidence and adjusted life-years-disability rates varied with different SDI levels. Relevant risk factors for depression were identified. National governments must support research to improve prevention and treatment interventions.

RELATIONSHIP AMONG EXPERIENTIAL AVOIDANCE, COGNITIVE EMOTION REGULATION STRATEGIES, AND DEPRESSION

Depression is a prevalent psychiatric illness and a leading cause of disability worldwide. Experiential Avoidance (EA) and maladaptive cognitive emotion regulation (CER) strategies are significant predictors of depression, yet their interaction remains poorly understood. This study aimed to investigate the relationship between experiential avoidance, CER strategies, and depression, while examining the arbitrating role of maladaptive CER strategies in the association between EA and depression. A purposive sample of N= 354 patients diagnosed with Major Depressive Disorder was recruited from three teaching hospitals. Following research and clinical ethics protocols, measures were administered. Results revealed that participants in the treatment group N=38 demonstrated statistically significant improvement in depression, general health, and quality of life, with sustained effects observed at 9 months post-baseline. Additionally, participants in the treatment group reported higher treatment satisfaction compared to the control group N=38. Spiritual-integrated cognitive-behavioral therapy (CBT) shows promise in alleviating post-partum depression when compared to treatment as usual. Future research should explore the generalizability of these findings and investigate potential mechanisms underlying the effectiveness of spirituality-integrated CBT in treating depression.

Disparities in the Prevalence of Psychiatric Illness in Hawaii's Houseless Population: A Retrospective Chart Review.

In the State of Hawaii, previous research has suggested that minority groups such as Native Hawaiians and Other Pacific Islanders are disproportionately affected by mental health disorders and have less access to mental health services. The purpose of this study was to determine if similar disparities in the prevalence of psychiatric disorders among different ethnic groups are also present among Hawaii's houseless population. A retrospective chart review of records from one of Oahu's major houseless outreach clinics was performed to gather patient demographics and reported histories of psychiatric diagnoses. Reported disease prevalence rates were compared between larger ethnic categories as well as ethnic sub-groups. Results demonstrated higher rates of certain serious mental illnesses among the houseless; however, several other psychiatric diagnoses were unexpectedly found to be less prevalent than in the general population. Additionally, houseless Pacific Islander groups were unexpectedly found to often have disproportionally lower rates of psychiatric diagnoses despite being identified as high risk by other studies. Overall, our findings may indicate unique ethnic trends in the prevalence of mental health disorders among the houseless in Hawaii or may suggest increased social and/or cultural barriers to diagnosis among certain groups that will require more diligent screening and culturally competent care from providers.

Challenges in the Treatment of Psychotic Bipolar Depression.

Psychotic bipolar depression (PBD) is a prevalent yet understudied psychiatric illness, and there are no specific guidelines or Food and Drug Administration-approved medications for its treatment. Recent studies suggest that some antipsychotics and mood stabilizers may be effective in managing bipolar depression; however, their effectiveness for PBD remains unclear. Given the urgent need for more focused research for managing PBD, we conducted a literature review to summarize the existing literature on PBD. We conducted an electronic literature search from the 1960s to 2023, utilizing PubMed, MEDLINE, EMBASE, and Google, and selected studies based on their relevance to PBD. PBD is a complex disorder, with 50%-75% of patients with bipolar disorder exhibiting psychotic features. This likelihood increases among those with a history of psychotic mania. Treatment guidelines often recommend a combination of mood stabilizers, antipsychotics, or electroconvulsive therapy, but they do not specify a first-line treatment. PBD symptoms can be masked by mixed high mood and energy feelings, potentially delaying diagnosis and treatment while increasing suicide risk. Limited research has evaluated outcomes of various treatments for PBD, and despite the lack of evidence for superior efficacy, in clinical practice, antipsychotics are frequently prescribed. Notably, combining an antipsychotic with selective noradrenaline reuptake inhibitors or tricyclic antidepressants may be effective, but including a mood stabilizer is necessary. PBD poses a significant challenge in mental health due to its severity and the lack of consensus on optimal treatment approaches. There is a critical need for more dedicated clinical trials and research to answer key questions about the effective treatment of acute PBD, ideal follow-up care, traits of responders to different therapies, and decision models for subsequent treatments.

Prediction and Validation of Hub Genes Related to Major Depressive Disorder Based on Co-expression Network Analysis.

Major depressive disorder (MDD) is generally among the most prevalent psychiatric illnesses. Significant advances have occurred in comprehension of the MDD biology. However, it is still essential to recognize new biomarkers for potential targeted treatment of patients with MDD. The present work deals with in-depth comparative computational analyses to obtain new insights, such as gene ontology and pathway enrichment analyses and weighted gene co-expression network analysis (WGCNA) through gene expression dataset. The expression of selected hub-genes was validated in MDD patients using quantitative real-time PCR (RT-qPCR). We found that MDD progression includes the turquoise module genes (p-value = 1e-18, r = 0.97). According to gene enrichment analysis, the cytokine-mediated signaling pathway mostly involves genes in this module. By selection of four candidate hub-genes (IL6, NRG1, TNF, and BDNF), RT-qPCR validation was performed. A significant NRG1 downregulation was revealed by the RT-qPCR outcomes in MDD. In MDD patients, TNF and IL6 expression were considerably higher, and no considerable differences were found in the BDNF expression. Ultimately, based on ROC analyses, IL6, NRG1, and TNF had a higher MDD diagnostic performance. Therefore, our study presents information on the intricate association between MDD development and cytokine-mediated signaling, thus providing new rationales to develop new therapeutic approaches.

Can a single dose of psilocybin improve cognitive control in functional dissociative seizures?

Dissociative symptoms can occur in prevalent psychiatric illnesses, and they are particularly frequent in Functional Neurological Disorders which belong to Dissociative Disorders in international classifications. Although the pathophysiology of these disorders remains partially unknown, it has been related to the impairment of cognitive control abilities. Evidence suggest that psilocybin is likely to enhance cognitive control, but no clinical trial has evaluated the value of psilocybin in Dissociative Disorders. We believe that functional/dissociative seizures (previously named psychogenic non-epileptic seizures) constitute a good model for studying the effect of therapeutic interventions on dissociative phenomena. To investigate the effect of psilocybin on cerebral networks, we propose to focus on the circuits associated with cognitive control and their interactions with the processing of emotional information by quantifying changes in the activity of the cognitive control network assessed with functional brain MRI during an emotional Go-No Go task.

Factors associated with the prevalence of psychiatric illnesses in patients seen at the Kamenge neuropsychiatric center

Background: The prevalence of mental illness is increasing worldwide. In low-income countries, health care systems are not able to meet mental health needs. The objective of this study was to identify factors associated with psychiatric illness at the Kamenge neuropsychiatric center.Methods: A cross-sectional analytical study was conducted at the neuropsychiatric center on patients aged 10 years or older who were seen in medical consultations.Results: The prevalence of psychiatric illness was 63.1% (57.44-68.59); the median age was 30 years (23-39); the sex ratio (M/F) was 1.5. In multivariate analysis, factors associated with psychiatric illness were male gender [adjusted OR= 2.33 (1.23-4.40)], illicit drug use [adjusted OR=7.85 (2.09-29.46)], family history of psychiatric illness [adjusted OR=5.83 (1.8-16, 65)], childhood maltreatment [adjusted OR=5.48 (1.8-16.65)], loss of a dear person [adjusted OR=4.01 (1.54-10.45)], family conflict [adjusted OR=2.67 (1.0-7.09)] as risk factors and urban area [adjusted OR=0.114 (0.05-0.23)] as a protective factor.Conclusions: This study identified factors associated with the prevalence of psychiatric illnesses. The results of this study are useful to guide prevention and promotion strategies in mental health.

Racial and Gender Disparities in the Burden of Depression and Anxiety in Patients with Sickle Cell Disease

Introduction: The prevalence of psychiatric illness is up to 35% in sickle cell disease (SCD) patients. Depression in chronically ill patients affects the quality of life and compliance with treatment and regular physician visits. Therefore, we sought to examine racial and gender-based differences in the prevalence of depression and anxiety in SCD. Methods: We investigated the National Inpatient Sample 2019 employing International Classification of Diseases-10 (ICD-10) codes to include adult SCD patients. Multivariate linear or logistic regression was used (for continuous and categorical variables, respectively). The confounders adjusted for in the regression models were: history of MI and stroke, coronary artery disease, sleep disorders, chronic pain disorders, smoking, alcohol, obesity, PTSD, sexual abuse, arthritis, and physical disability, in addition to patient and hospital-level variables. We used Stata, version 14.2, to perform analyses considering 2-sided P< 0.05 as statistically significant. Results: A total of 94,390 patients were included. 15,990 had depression, and 17,792 had anxiety. The prevalence of depression in various racial categories was: 16.94% in whites, 12.32% in blacks, 13.28% in Hispanics, and 5.66% in Asians (P=0.04). Anxiety prevalence was: 18.85% in whites, 11.68% in blacks, 13.28% in Hispanics, and 7.55% in Asians (P<0.01). On multivariate analysis, compared to whites, black had lower odds of depression and anxiety while Hispanics and Asians had similar odds (Table. 1). The prevalence of depression and anxiety in females was 14.10% and 14.12%, respectively. On multivariate analysis, compared to males, females had higher odds of the disease (adjusted odds ratio (aOR): 1.35, 95% confidence interval (CI): 1.18-1.55, P<0.01, and aOR: 1.70, 95% CI: 1.45-1.99, P<0.01, for depression and anxiety, respectively). Conclusion: Females and whites have higher rates of depression and anxiety compared to males and blacks with SCD. However, among racial minority groups other than blacks, the risk was similar to whites. Disease severity, social stigma, barriers in reporting, underdiagnosis, and genetic predisposition could contribute to these observed trends. Further research is needed to establish the factors responsible for these racial and gender differences. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Knowledge and awareness of dental students on attention deficit hyperactivity disorder.

Attention deficit hyperactivity disorder (ADHD) is a prevalent psychiatric illness marked by a short span of attention, impulsive decisions, and behavioral issues. They are vulnerable to trauma and dental problems. The dental health team faces a challenge due to behavioral disorders, cognitive deficiencies, and short attention spans. At all stages of prevention and treatment, the management of these children necessitates various changes in approach. To collect data and analyze the awareness level of dental students toward ADHD. An online portal was used for the survey and distributed to 106 dentistry students with self-structured 10 questions. The findings were gathered through the survey portal, and graphs were drawn to compare the results. The SPSS software version 20.0 was used for statistical analysis. The Chi-square test was used to determine the correlation between the variables. Forty percent of those polled are aware of ADHD, which is a mental health condition characterized by excessively active and impulsive behavior. The symptoms of a child with ADHD are aware to 31.43% of voters. About 30.48% of the respondents know the symptoms of an adult with ADHD. About 29.52% of the respondents were aware of the causes of ADHD. To conclude that most dental undergraduates are not aware of the basic characteristics of ADHD. This means that there should be a spreading of knowledge on the subject. A dental student or dentist must know how to manage a patient diagnosed with ADHD. Careful management and treatment will lead to a satisfied and happy patient. Mismanagement may cause problems in the future for both the dentist and the patient.

Aripiprazole: examining the clinical implications of D2 affinity.

Schizophrenia is a prevalent psychiatric illness, which causes significant financial and social burden on the population overall. The development of second generation antipsychotics, such as Aripiprazole, Risperidone, and Paliperidone, has changed treatment practice for many psychiatrists. Aripiprazole has extremely high binding affinity for the dopamine D2 receptor, which is the receptor thought to be responsible for the antipsychotic effect, although Aripiprazole is not the most potent of the second generation antipsychotics. In theory, Aripiprazole could displace or outcompete other, more potent antipsychotics, prompting decreased antipsychotic effect. We describe a proposed case of this phenomenon, Ms. A. We describe how Aripiprazole may have caused a worsening of psychiatric symptoms by blocking the antipsychotic effects of Paliperidone due to its strong binding affinity for the D2 receptor. Aripiprazole has a high affinity for the D2 receptor, but may have a lesser reduction of psychotic symptoms compared to other antipsychotics. Prescribers should be aware of this potential interaction and carefully consider initiating long-acting injectable forms of Aripiprazole to avoid this phenomenon.

The prevalence of psychiatric illness among cannabis users

This study was conducted in a tertiary hospital's psychiatry unit. Legal edible cannabis (bhang) users for more than a year who attended the OPD and IPD during the study period and met the inclusion criteria (age 18 to 60, no history of physical or psychiatric illness) were included in the investigation with their informed consent. 171 patients were recruited after being assured of the study's confidentiality. Special tests evaluated cannabis dependence and psychiatric conditions. (1) CUDIT-R and (2) DSM-5 updated psychiatric morbidity criteria. Population demographics. Patients with CUDs ranged in age from 18 to 60. The majority were age 21 to 30 (49.7%), followed by 31 to 40 (29.8%), 41 to 50 (12.9%), 20 (5.8%), and 51 to 60. (1.8 percent). Male (93.1%) and female patients were roughly evenly split (7.0 percent). 103 of 171 study patients were married (60.2%), compared to 66 unmarried patients (38.6%) who used bhang more often. 1,2% were divorced. The study considered patients' education levels. Middle schoolers had the highest percentage (22.2%), followed by illiterates and graduates (17.5%), high school (12.9%), and postgraduates (0.6 percent). Lower middle class (40.9%) had the most participants, and upper class had the fewest (2.3 percent).

UK Medical Cannabis Registry: an analysis of clinical outcomes of medicinal cannabis therapy for generalized anxiety disorder

ABSTRACT Objectives Anxiety disorders are one of the most common reasons for seeking treatment with cannabis-based medicinal products (CBMPs). Current pharmacological treatments are variable in efficacy and the endocannabinoid system has been identified as a potential therapeutic target. This study aims to detail the changes in health-related quality-of-life (HRQoL) and clinical safety following CBMP therapy for generalized anxiety disorder. Methods A case series from the UK Medical Cannabis Registry was performed. Primary outcomes included changes from baseline in patient-reported outcome measures (the General Anxiety Disorder Scale (GAD-7), EQ-5D-5L (a measure of health-related quality of life), and Sleep Quality Scale (SQS)) at 1, 3 and 6 months. Statistical significance was defined as p<0.050. Results Sixty-seven patients were treated for generalized anxiety disorder. Statistically significant improvements were observed in GAD-7, EQ-5D-5L Index Value, EQ5D Visual Analog Scale, and SQS scores at 1, 3 and 6 months (p<0.050). Twenty-five (39.1%) patients reported adverse events during the follow-up period. Conclusion This study suggests that CBMPs may be associated with improvements in HRQoL outcomes when used as a treatment for generalized anxiety disorder. These findings must be treated with caution considering limitations of study design; however this data may help inform future clinical studies and practice. Plain Language Summary Anxiety disorders are the most prevalent psychiatric illness type in the United Kingdom, with 8.2 million cases reported in 2010. Generalized anxiety disorder (GAD), the most common anxiety disorder, debilitates, and so reduces the quality of life of those who suffer from the condition. The efficacy of current treatments for GAD varies greatly from person-to-person. The endocannabinoid system in the human body is currently attracting a lot of attention in the scientific community as it can be targeted by chemicals in the cannabis plant to produce therapeutic effects in order to treat GAD. There is, however, a lack of studies investigating the effects of medicinal cannabis in GAD, and so this study aims to explore the drug’s effect on quality of life in patients suffering from GAD. Sixty-seven patients who attended the Sapphire Clinics for medicinal cannabis treatment for GAD were included in the study. The results from this study highlight that medicinal cannabis may improve generalized anxiety disorder, general health-related quality of life, and sleep-specific outcomes at 1, 3, and 6 months after starting treatment. There was also a low number of severe, disabling, and life-threatening adverse events experienced by patients. Although this study explores the effects of medicinal cannabis in a real clinical setting, the results were not compared to other types of treatment. Future studies with a comparator are therefore needed before concluding the true effects of medicinal cannabis in patients with GAD.

Prevalence of Psychiatric Illnesses in Patients Undergoing Oral and Maxillofacial Surgery Procedures in an Outpatient Setting

Mental illness is highly prevalent among adults in the United States, with almost 1 in 5 adults living with some degree of mental illness. Given most of oral and maxillofacial surgery (OMS) procedures are inherently anxiety-generating, the authors sought to determine the burden of psychiatric illness in the population seeking care at an outpatient OMS unit of the University of Cincinnati. The authors hypothesized that psychiatric diagnoses would be common in this population.This is an ongoing retrospective cohort study. Study subjects were identified by searching CPT codes through electronic health records to identify all patients older than 15 years of age who underwent any oral and maxillofacial surgery outpatient procedure in 2018 (January 1 to December 21). Data on demographics, ASA status, presence of psychiatric diagnosis according to DSM-5, type of procedure, and complications were collected by performing a retrospective chart review. A total of 4616 patients were identified for the chosen timeframe. All the duplicates (387 patients) were removed; 252 patients were further removed as they did not meet the inclusion criteria (no procedure performed, < 15 years old). That left a dataset of 3977 patients. So far, complete data extraction has been conducted for 1300 patients who were chosen randomly. Data extraction was conducted by 5 students who were all trained on the procedures for data extraction.Descriptive analysis was conducted and prevalence rates were calculated. Out of total of 1300 patients who were reviewed, 60.9% (792) were females and 39.1% (508) were males. Age range was from 15 to 98 years with a mean age of 34.2 years; 45.2% (588) were Caucasian, 39% (507) were African-American, 0.7% (9) were Asian, 3.1% (40) were Hispanic, 3.3% (43) were other races, and 8.7% (113) were of unknown race; 32.1% (418) of patients were classified as ASA I, 55.6% (723) were ASA II, 11.2% (145) were ASA 3, and 1.1% (14) were ASA IV. Among the total reviewed population through OMS vision, 305 patients were found to have reported psychiatric diagnosis. Further review of medical history of the remaining patients was performed through Epic, and 26 more patients were found to have reported psychiatric diagnosis. A total of 25.5% (331) of patients were found to have a pre-existing psychiatric diagnosis. Out of these patients, 62 had neurogenic disorders, 29 had schizophrenia spectrum disorders, 56 had bipolar disorders, 218 had anxiety and depressive disorders, 82 had substance use and addictive disorders, 5 had personality disorders, and 7 had other disorders. A total of 102 patients had multiple psychiatric diagnosis. Among the 1300 procedures completed, 11.8% (153) of patients experienced postoperative complications and, among these, 24.9% (38) had psychiatric diagnoses.The review shows that psychiatric illnesses are common among the oral and maxillofacial surgery population. This population is also likely to have more complications. The ongoing record review would shed more light in this arena when complete. Prognostic implications of preoperative psychiatric disorders on surgical outcome should be demonstrated prospectively in intervention studies.

COPD AND PSYCHIATRIC ILLNESSES: A STUDY OF EPEDMIOLOGY AND EFFECTS ON MORTALITY

TOPIC: Obstructive Lung Diseases TYPE: Original Investigations PURPOSE: Chronic obstructive pulmonary disease (COPD) is a common respiratory condition that involves persistent respiratory symptoms and airflow limitation. Several studies have shown increased prevalence of psychiatric illness (PI) in patients with COPD; however, prevalence rates vary widely. Hypoxemia in COPD has been associated with increased risk of cognitive and neuropsychiatric impairment while depression was associated with lower treatment adherence in patients with COPD. Despite these associations, studies investigating the effects of PI on COPD mortality and readmission remain inconclusive. This study aims to describe the prevalence of PI in COPD and evaluate the effect of PI on in-hospital mortality and 30-day readmissions using large United States population-based dataset. METHODS: Data were abstracted from the 2010 to 2018 Nationwide Readmissions Database (NRD). Hospitalizations with a primary diagnosis of COPD were identified using Diagnosis Related Groups 190 to 192 and/or All Patients Refined-Diagnosis Related Groups 140; International Classification of Diseases-9/10-Clinical Modification codes were used to identify secondary PI diagnoses of major depression, bipolar disorder, post-traumatic stress disorder, anxiety disorder, somatoform disorder, sleep-related disorders, eating disorders, and/or alcohol use disorder. Multivariable logistic regression models were estimated to evaluate the effect of PI on mortality and 30-day readmissions. All analyses accounted for the NRD sampling design. RESULTS: A total of 6,452,636 hospitalizations with COPD occurred between 2010 and 2018. Of these, 2,160,417 (34%) carried at least one PI diagnosis. The most prevalent PI was anxiety disorder (58%) followed by sleep-related disorders (26%), and major depression (20%); Concomitant PI was more prevalent in hospitalizations in which patients were younger, female, nicotine users, and obese (P-value <0.001).Hospitalizations with concomitant PI had higher adjusted mortality rate [adjusted odds ratio (aOR): 1.07; 95% confidence interval (CI): 1.04-1.10, P-value <0.001], as well as higher 30-day readmission rates [aOR: 1.21, 95% CI: 1.20-1.22, P-value <0.001]. CONCLUSIONS: This study demonstrates that in the United States from 2010 to 2018, approximately one-third of COPD hospitalizations have a concomitant PI that is associated with higher mortality and 30-day readmission rates. CLINICAL IMPLICATIONS: COPD patients with PI should be recognized as a vulnerable population at increased risk for in-hospital mortality and 30-day readmission. Further studies are needed to develop tools and measures that help identify and screen this group of patients. DISCLOSURES: No relevant relationships by Yaman Alali, source=Web Response No relevant relationships by Abedel Rahman Anani, source=Web Response No relevant relationships by Adam Highley, source=Web Response No relevant relationships by Ian Jackson, source=Web Response No relevant relationships by Austin Loranger, source=Web Response No relevant relationships by Ryan Walters, source=Web Response

Psychiatric Morbidities in Inpatients of COVID-19 in Dedicated COVID Hospitals

Objectives: We aimed to assess (a) the prevalence of psychiatric illness in inpatients of COVID-19 and (b) different types of psychiatric morbidities. Materials and Methods: This hospital-based cross-sectional study was done in a dedicated COVID hospital after an Institutional Ethics Committee approval. It was a cross-sectional observational study of all patients admitted from December 2020 to May 2020 after ethical committee clearance. A total of 1535 patients were referred, and 1452 (8.2%) were diagnosed with psychiatric illnesses by using clinical interview and diagnostic questionnaire based on Diagnostic and Statistical Manual for Mental Disorders Fifth Edition criteria. Results: Out of the 17,676 patients admitted during this period, 1,452 (8.2%) patients were diagnosed with psychiatric illness, out of them 1,233 (6.9%) had new onset psychiatric illness. The age (mean±SD) of the patients was 59.75±16.46 years. The majority [959 (66.1%)] of the patients were males and 493 (33.9%) were females. Psychopharmacotherapy and psychological interventions were done to help patients through this crisis. Duration of stay (mean±SD) was 16.86±10.4 days and 636 (43.8%) patients had comorbidities. Conclusion: The prevalence of psychiatric illness was 8.2% in inpatients of COVID-19. Common psychiatric morbidities in COVID-19 inpatients are depression, anxiety disorders, adjustment disorders, and delirium.

Psychiatric Disorders in Adolescents Attending Psychiatry Outpatient Department in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

Introduction: Adolescence is the time when most mental illness begins most of the time these problems are overlooked leading to increased morbidity and mortality. The study is undertaken to find out the prevalence of psychiatric disorders in adolescents attending psychiatry outpatient department in a tertiary hospital. Methods: A descriptive cross-sectional study was done from 1st December 2019 to 29th November 2020 at a tertiary care centre of Kathmandu. Ethical approval (Ref No.: 012-076/077) was taken from the Institution Review Committee. A semi-structured proforma was used for the socio-demographic profile of patients and International Classification of Diseases-10 was used to make the diagnosis. Data were analyzed using Statistical Package for the Social Sciences version 16. Results: A total of 174 adolescents were included in the study. Out of the total cases 141 (81.03%) (75.1-86.8 at 95% Confidence Interval) were diagnosed with psychiatric disorders, among them 73 (51.77%) were males and 68 (48.23%) were females. The common diagnoses were anxiety disorders 63 (36.20%), mood disorders 34 (19.54%), psychotic disorders 26 (14.94%), substance use disorders 8 (4.59%), non-organic sleep disorders 5 (2.87%), behavioral and emotional disorders 3 (1.72%) and mental retardation 2 (1.149%). Conclusions: Prevalence of psychiatric illnesses is high in the adolescent population compared to the similar studies.