Prevalence Of Psychiatric Disorders Research Articles

A Study on Drug Prescribing Pattern in Psychiatry Out-Patient Department from a Tertiary Care Teaching Hospital

Background: Conventional public health statistics, which concentrate on mortality rather than morbidity or dysfunction, severely underrepresent the massive burden of sickness caused by behavioral and psychiatric illnesses. Objective: To determine the prevalence of psychiatric disorders and the patterns of psychotropic drug prescriptions. Materials and Methods: It was a hospital-based prospective observational study was conducted in the Department of Pharmacology & Therapeutics, Sir Salimullah Medical College & Hospital during July’ 2022 to December’ 2022. A total of 765 prescriptions were selected. All patients attending the psychiatry OPD during the period of the study were included and analyzed as per the WHO drug indicators. Results: Clonazepam constitutes 119 (51.74%), Lorazepam 74 (32.17%), and Others 37 (16.09%) of the 230 anxiolytics listed in the table. In 195 antidepressant drugs, 76 (38.97%) were escitalopram, 33 (16.92%) were amitriptyline, 47 (24.10%) were imipramine, and 39 (20%) were other antidepressants. Antipsychotics were detected in 194 patients (21% of the cohort population). This includes Olanzapine (88.36%), Haloperidol (34.54%), Risperidone (14.22%), and Other Antipsychotics (12.89%). Trihexyphenidyl was prescribed to 75 of the 88 study participants, accounting for 85.23% of the total. Prescribing Indicators and it was observed that an average number of drugs per prescription were 2.59±1.37. Average number of Antipsychotics prescribed per prescription was 2.73±1.46. The number of antipsychotic drugs prescribed by generic name was 52.94%. Percentage of injectable drugs prescribed 2.48%, Percentage of the prescriptions containing psychotropic FDC 20.78%, Percentage of psychotropic drugs prescribed from essential drug list 42.75%, Percentage of psychotropic drugs prescribed from hospital pharmacy 62.22%. Conclusion: The most frequently prescribed antidepressant, antipsychotic, and BZD medications were escitalopram, olanzapine, and clonazepam, in that order. Carbamazepine was preferred over lithium as a mood stabilizer.

Advancement in utilization of magnetic resonance imaging and biomarkers in the understanding of schizophrenia

Historically, psychiatric diagnoses have been made based on patient’s reported symptoms applying the criteria from diagnostic and statistical manual of mental disorders. The utilization of neuroimaging or biomarkers to make the diagnosis and manage psychiatric disorders remains a distant goal. There have been several studies that examine brain imaging in psychiatric disorders, but more work is needed to elucidate the complexities of the human brain. In this editorial, we examine two articles by Xu et al and Stoyanov et al , that show developments in the direction of using neuroimaging to examine the brains of people with schizophrenia and depression. Xu et al used magnetic resonance imaging to examine the brain structure of patients with schizophrenia, in addition to examining neurotransmitter levels as biomarkers. Stoyanov et al used functional magnetic resonance imaging to look at modulation of different neural circuits by diagnostic-specific scales in patients with schizophrenia and depression. These two studies provide crucial evidence in advancing our understanding of the brain in prevalent psychiatric disorders.

Psychiatric comorbidity in hospitalized patients evaluated by psychiatric consultation in a Brazilian tertiary hospital: A study protocol

Introduction: The prevalence of mental disorders in the general population has been increasing in recent years, with the incidence of these diseases being even higher in hospitalized populations. The rates of depression in these patients are four to five times higher than in the general population. In this regard, it is important to understand the incidence of psychiatric disorders in different sectors of tertiary hospitals to recognize, locate, and treat the main pathologies and provide better medical care to hospitalized patients. Objective: To assess the prevalence of psychiatric disorders and the demographic profile of patients hospitalized in a tertiary hospital in Brazil who underwent psychiatric consultation. Method: This is an observational, descriptive, analytical, and retrospective study that will be conducted through the collection of patient records via psychiatric consultation, gathering demographic data and hospitalization-related data such as the origin of admission, primary diagnosis, psychiatric diagnosis, proposed treatment, among others. Conclusion: The identified challenges include the underutilization of psychiatric consultations and variability in the protocols adopted. Improving services requires data uniformity and proper diagnosis to optimize hospital care quality and reduce costs.

Temporomandibular Disorders in Psychiatric Outpatients: A Hidden Epidemic?

ABSTRACTBackgroundTemporomandibular disorders (TMD) are a multimodal group of orofacial pain syndromes that rank behind only chronic low back pain in the list of most prevalent musculoskeletal conditions causing pain and disability. Previous studies have recorded high rates of comorbid anxiety, depression, and poor sleep quality among TMD patients.MethodsEighty five outpatients recruited from Rhode Island Hospital's Latino and Portuguese Mental Health Programs completed the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and the Pittsburgh Sleep Quality Index questionnaire (PSQI). The latest meta‐analysis of TMD prevalence in the general population was used for the reference population (n = 3159).ResultsThe most prevalent psychiatric disorders were depressive disorders (75.3%), anxiety disorders (57.6%), and sleep–wake disorders (47.1%). Fifty patients (58.8%) met criteria for TMD, versus 29.3% in the reference population (p < 0.001). In our sample, the PSQI cut‐off for poor sleep was crossed in 96.2% of patients with TMD and 82.9% of those without TMD (p = 0.041).ObjectivesWe sought to establish the prevalence of TMD in a significant sample of psychiatric outpatients, considering their psychiatric diagnoses and sleep quality.ConclusionThe very high prevalence of TMD among patients with depression, anxiety, and sleep disorders reinforces their association and alerts us to the possibility of TMD constituting a widespread, though largely ignored, comorbidity of psychiatric outpatients that may be impacting their mental health outcomes. Further studies are needed to clarify the value of screening this population for TMD and to establish which cases merit treatment.

Psychiatric disorders in children and adolescents with temporal lobe epilepsy: A narrative review.

People with epilepsy (PWE) are at higher risk of psychiatric disorders (PD), disability, and reduced quality of life than the general population, especially in childhood and adolescence and when seizures originate from the temporal lobe. Temporal Lobe Epilepsy (TLE) is the most common type of focal epilepsy and can be due to structural abnormalities, or non-lesional causes, such as genetic variants. The prevalence of PD is approximately 20%-30% in people with epilepsy in general, and from 40% up to 80% in people with TLE. A higher rate of anxiety and depression disorders has been observed in association with TLE than with extra-temporal epilepsy, or idiopathic generalized epilepsy, or other chronic diseases such as diabetes. However, while the association between psychopathology and TLE has been extensively assessed in adults, only a few studies have focused on its expression in children and adolescents. In this review, we describe the prevalence, characteristics, and risk factors for PD in people with epilepsy in general and with TLE, with a specific focus on the pediatric age. In addition, we provide insights into the current knowledge of the pathophysiological bases of psychiatric symptoms in children and adolescents with TLE. PLAIN LANGUAGE SUMMARY: This review examines the frequency and characteristics of psychiatric disorders in people with temporal lobe epilepsy, with a focus on children and adolescents. Similarly to adults, younger people with epilepsy have higher rates of psychiatric disorders, such as depression and anxiety, than healthy peers or children with other chronic illnesses such as diabetes and asthma. Contributing risk factors include epilepsy duration and severity, and the effects of antiseizure medications, as well as psychological challenges, sociocultural influences, and family dynamics. Psychiatric disorders associated with temporal lobe epilepsy are relatively frequent, probably in relation to the critical role that some limbic structures in the temporal lobe, such as the amygdala and hippocampus, play in regulating emotions and behavior.

Screening of the key genes and signaling pathways for schizophrenia using bioinformatics and next generation sequencing data analysis

Schizophrenia is thought to be the most prevalent chronic psychiatric disorder. Researchers have identified numerous proteins associated with the occurrence and development of schizophrenia. This study aimed to identify potential core genes and pathways involved in schizophrenia through exhaustive bioinformatics and next generation sequencing (NGS) data analyses using GSE106589 NGS data of neural progenitor cells and neurons obtained from healthy controls and patients with schizophrenia. The NGS data were downloaded from the Gene Expression Omnibus database. NGS data was processed by the DESeq2 package in R software, and the differentially expressed genes (DEGs) were identified. Gene ontology (GO) enrichment analysis and REACTOME pathway enrichment analysis were carried out to identify potential biological functions and pathways of the DEGs. Protein-protein interaction network, module, micro-RNA (miRNA)-hub gene regulatory network, transcription factor (TF)-hub gene regulatory network, and drug-hub gene interaction network analysis were performed to identify the hub genes, miRNA, TFs, and drug molecules. Potential hub genes were analyzed using receiver operating characteristic curves in the R package. In this investigation, an overall 955 DEGs were identified: 478 genes were remarkably upregulated and 477 genes were distinctly downregulated. These genes were enriched for GO terms and pathways mainly involved in the multicellular organismal process, G protein-coupled receptor ligand binding, regulation of cellular processes, and amine ligand-binding receptors. MYC, FN1, CDKN2A, EEF1G, CAV1, ONECUT1, SYK, MAPK13, TFAP2A, and BTK were considered the potential hub genes. The MiRNA-hub gene regulatory network, TF-hub gene regulatory network, and drug-hub gene interaction network were constructed successfully and predicted key miRNAs, TFs, and drug molecules for schizophrenia diagnosis and treatment. On the whole, the findings of this investigation enhance our understanding of the potential molecular mechanisms of schizophrenia and provide potential targets for further investigation.

Mental Health Care Needs and Access to Care for Adults With Intellectual Disabilities.

Adults with intellectual disabilities (IDs) are at greater risk for psychiatric disorders than the general population. Yet, they have limited access to mental health services. To examine the prevalence of psychiatric disorders in adults with ID. To describe evidence-based interventions for this population, their access to mental health care, and outline opportunities for improved access. This manuscript summarizes literature regarding psychiatric disorders in adults with ID and their access to behavioral health care. We considered articles referencing mental health care for adults with ID. PubMed and a variety of search terms were used. Studies published in English from 2010 to the date of the searches were included. Quantitative and qualitative study designs, review articles, program descriptions, and opinion papers were considered for inclusion. Additional references from the selected articles were also considered. We identified 2864 records. One hundred two records were included, consisting of work commenting on mental health and ID and access to care in the United States. The articles describe increased psychiatric comorbidities in adults with ID. They highlight the few evidence-based interventions for psychiatric comorbidities and the limited access to care. Our mental health care providers generally have minimal training and experience with people with ID, limiting access to appropriate care for these individuals. Improved access could be created by increasing education and experiences with these populations for mental health providers. Aligning policies, financing, and adequate insurance reimbursement to develop a continuum of care will be critical for these individuals.

Composite dietary antioxidant index mediates the effect of epilepsy on psychiatric disorders: results from NHANES 2013-2018.

Psychiatric disorders is a major public health problem and epilepsy contributes significantly to depression. We aimed to explore the relationship between dietary patterns and mental illness in patients with epilepsy. The data presented here are based on the 2013-2018 National Health and Nutrition Examination Survey (NHANES). In this study, the t-test and chi-square tests or one-way analysis of variance (ANOVA) were employed for the analysis of continuous and categorical variables, respectively. Restricted cubic splines (RCSs) with four knots were employed to investigate the linear relationship and trend between the Composite Dietary Antioxidant Index (CDAI) and epilepsy and psychiatric disorders, respectively. In instances where the linear relationship was not deemed to be applicable, the CDAI was categorized into four groups based on quartiles. A logistic regression analysis was employed to investigate the relationship between epilepsy and mental disorders under four distinct models. A mediation analysis was employed to ascertain whether CDAI acted as a mediator in the relationship between epilepsy and mental disorders. Patients with epilepsy had a significantly lower CDAI (p < 0.001) and a significantly higher prevalence of psychiatric disorders (p = 0.02) compared with non-epileptic patients. Mediation modeling showed that CDAI mediated between 3.17 and 5.21% of epilepsy-related psychiatric disorders. In stratified analyses, the prevalence of psychiatric disorders was increased in the second quartile subgroup and the third quartile subgroup of the CDAI dietary index in patients with epilepsy compared with non-epileptic patients. Our findings suggest that patients with epilepsy have a high risk of developing psychiatric disorders and that the Composite Dietary Antioxidant Index (CDAI) plays a key role in mediating the relationship between epilepsy and psychiatric disorders.

Psychiatric Manifestations in the Context of Brain Tumors: Study and Findings

&lt;p dir="ltr"&gt;&lt;span&gt;The increase in the frequency of psychiatric disorders is increasingly observed in patients diagnosed with cancer. Brain tumors are often associated with psychiatric symptoms such as mood symptoms, psychosis, memory problems, personality changes, anxiety, or depression. This study investigates what types of manifestations are present in patients with brain tumors, highlighting the connection with the location of the tumor. We conducted a clinical study on a sample of 91 patients diagnosed with primary brain tumors, hospitalized at the "Prof. Dr. Nicolae Oblu Emergency Clinical Hospital," Iași, Romania, between 2011 and 2023. Demographic data, type, and location of tumors were collected from the patients' medical records. Patients underwent detailed neuropsychological evaluations to identify psychiatric manifestations. Statistical analyses were performed to determine the prevalence of these manifestations and the correlations between tumor location and the severity of psychiatric symptoms. Our results show a significant prevalence of psychiatric disorders among patients with brain tumors, with notable differences between genders and types of manifestations. Organic personality disorders and mixed anxiety and depression disorders were among the most common. Additionally, a correlation was observed between the location of tumors in the frontal lobe and the severity of psychiatric symptoms. Conclusions: The research highlights the increased frequency of psychiatric symptoms in patients with brain tumors, especially when the tumor is located in the frontal lobe. These observations emphasize the relevance of a multidisciplinary approach in the management and treatment of these patients, including both cancer therapy and psychiatric support services.&lt;/span&gt;&lt;/p&gt;&lt;div&gt;&lt;span&gt;&lt;br /&gt;&lt;/span&gt;&lt;/div&gt;

Factors Associated with the Prevalence of Psychiatric Disorders Among Saudi Adults in the Eastern Region and Their Health Implications.

The present study examined the link between sociodemographic variables, anthropometric indices, and psychiatric disorders among patients in Saudi Arabia's Eastern Region (Al-Hassa), as well as health outcomes, including basic hematological and biochemical markers. The patients included 89 females and 79 males with psychiatric disorders, with ages ranging from 19 to 59. Sociodemographic characteristics, anthropometric proxies, and fundamental hematological and biochemical markers were assessed. The sociodemographic characteristics of the patients were poor and varied within and between sexes. This study observed that male psychiatric patients had greater anthropometric proxies, particularly those who were overweight or obese, than females. Most of the patients' hematological and biochemical parameters were below the normal level, with some higher than normal. Moreover, anemia was identified in 40.51% of the male participants in the study, with a higher percentage among those diagnosed with depressive disorders (Dep-d, 57.14%) and schizophrenia spectrum and other psychotic disorders (SsP-d, 32.43%), and 49.44% of the female participants, with a higher percentage among those diagnosed with depressive disorders (52.50%) and other psychotic disorders (46.15%). Furthermore, to confirm the link between sociodemographic variables, anthropometric indices, and psychiatric disorders among patients, the Spearman correlation coefficient and simple regression analysis of such variables was carried out. The results revealed that the majority of sociodemographic characteristics were either favorably or adversely correlated with patients' anthropometrics and type of depression in both sexes. Low sociodemographic characteristics and high anthropometric variables may be risk factors for people with psychotic disorders, which have been linked to negative health consequences.

The effects and mechanisms of chai shao jie yu granules on chronic unpredictable mild stress (CUMS)-induced depressive rats based on network pharmacology.

Chai Shao Jie Yu Granules (CSJY) is a renowned and time-honored formula employed in clinical practice for the management of various conditions, notably depression. Depression, a prevalent psychiatric disorder, poses challenges with limited effective treatment options. Traditional herbal medicines have garnered increasing attention in the realm of combating depression, being perceived as safer alternatives to pharmacotherapy. To explore the effects and mechanisms of CSJY in chronic unpredictable mild stress (CUMS)-induced depression. Rat models of CUMS-induced depression were established, and the rats were randomly allocated into six groups: Control, CUMS, CUMS+Paroxetine (PX), CUMS+CSJY-L, CUMS+CSJY-M, and CUMS+CSJY-H. Throughout the study, the rats' body weight was monitored. Depression-related behaviors were assessed using the sucrose preference test (SPT) and open field test (OFT). High-performance liquid chromatography-mass spectrometry (HPLC-MS) measured monoamine neurotransmitters in the rat cortex and hippocampus. We measured adrenocorticotropic hormone (ACTH), corticosterone (CORT), and corticotropin-release hormone (CRH) levels in rat serum. Additionally, network pharmacology was employed to predict relevant molecular targets and potential mechanisms, followed by in vivo validation. Western blot analysis was conducted to evaluate the protein levels of 5-hydroxytryptamine/serotonin receptor 1A (5-HT1A) and Glutamate (Glu)-related proteins, such as p-GluA1, GluA1, p-GluN1, GluN1, p-GluN2A and GluN2A in the hippocampus. In behavioral assessments, CUMS rats exhibited depressive behaviors, which were ameliorated by CSJY or PX treatment. Moreover, CSJY or PX treatment increased serotonin (5-HT) levels. It reduced the kynurenine/tryptophan (KYN/TRP) and gamma-aminobutyric acid/glutamate (GABA/Glu) in the hippocampus and cortex, as well as reduced serum levels of ACTH, CORT and CRH. Furthermore, CSJY or PX administration enhanced the decreased expression of p-GluN1/GluN1 while upregulating 5-HT1A and p-GluA1/GluA1 levels in the CUMS group. CSJY demonstrated the ability to alleviate depressive behaviors in CUMS-induced depression rats, potentially through the inhibition of the hypothalamic-pituitary-adrenal (HPA) axis, modulation of monoamine neurotransmitters, and glutamatergic neurons. These findings suggest that CSJY could serve as a promising treatment option for depression.

Novel Pharmacologic and Other Somatic Treatment Approaches for Posttraumatic Stress Disorder in Adults: State of the Evidence.

Posttraumatic stress disorder (PTSD) is a highly prevalent psychiatric disorder that can become chronic and debilitating when left untreated. The most commonly recommended first-line treatments for PTSD among adults are individual trauma-focused psychotherapies. Other evidence-based treatments include specific antidepressant medications and non-trauma-focused psychotherapies. Despite the effectiveness of these available treatments, many patients' symptoms do not remit. This has led to the search for novel treatments for PTSD. In this review, the authors critically evaluate the data supporting several emerging pharmacological and other somatic interventions in the categories of medication-assisted psychotherapy, novel medication monotherapy strategies, and neuromodulation, selected because of the salience of their mechanisms of action to the pathophysiology of PTSD (e.g., MDMA-assisted psychotherapy, ketamine, cannabidiol, transcranial magnetic stimulation). The authors also evaluate the evidence for treatments that are the focus of increasing scientific or public interest (i.e., hyperbaric oxygen therapy, stellate ganglion block, neurofeedback). To date, the evidence supporting most novel pharmacological and somatic treatments for PTSD is preliminary and highly variable; however, the data for several specific treatments, such as transcranial magnetic stimulation, are encouraging.

Assessing Attention-Deficit/Hyperactivity Disorder in Post-9/11 Veterans: Prevalence, Measurement Correspondence, and Comorbidity With Posttraumatic Stress Disorder.

Attention-deficit/hyperactivity disorder (ADHD) is common among Veterans but overlapping symptoms with other prevalent psychiatric disorders (e.g., posttraumatic stress disorder [PTSD]) complicate diagnosis. This study aims to (1) assess the prevalence of ADHD, (2) evaluate the correspondence between ADHD self-report measures, and (3) examine the association between ADHD and PTSD in a sample of combat-deployed post-9/11 Veterans. A total of 332 combat-deployed post-9/11 Veterans from VA Boston Healthcare System completed the Clinician-Administered PTSD Rating Scale, 2 ADHD self-report questionnaires (Wender Utah Rating Scale-25 and the Adult ADHD Self-Report Scale v1.1), and report of the presence/absence of a historical ADHD diagnosis. Attention-deficit/hyperactivity disorder status via Wender Utah Rating Scale ([WURS-25] criterion standard) was compared to historical ADHD diagnosis and the ASRSv.1.1 screener. Log-binomial regression models assessed the relationship between ADHD and PTSD. This study was reviewed and approved by the VA Boston Institutional Review Board. In all, 12.7% of the sample met criteria for ADHD per the WURS-25. The WURS-25 demonstrated poor sensitivity with historical ADHD diagnosis (27.7%) but adequate specificity (90.3%). Poor sensitivity (60.7%) and specificity (60.8%) were observed between the WURS-25 and the ASRS-v.1.1. The prevalence of ADHD was 2.5 times as high for Veterans with a history of PTSD (Prevalence Ratio [PR] = 2.53, 95% CI: 1.11, 7.28) and over twice as high for those with current PTSD (PR = 2.19, 95% CI: 1.17, 4.38). Attention-deficit/hyperactivity disorder is prevalent in this sample of Veterans and is associated with an increased risk of current and lifetime PTSD. The low correspondence across self-report ADHD measures illustrates the complexity of assessing ADHD in this highly comorbid population. When evaluating ADHD in Veterans, clinicians should carefully consider alternative and contributory symptom etiologies, such as PTSD, to ensure accurate diagnosis and treatment.

Psychological Characteristics of Fathers of People With Bulimia Nervosa: A Systematic Review.

Bulimia nervosa (BN) is a highly prevalent psychiatric disorder that has negative effects on the physical and psychological health of sufferers. Father-specific factors have been understudied in the context of BN. This systematic review aims to understand the psychosocial and psychopathological features of fathers of people with BN and their associations with the offspring's outcomes. A literature search on APA PsycINFO, ISI Web of Science, PubMed, Google Scholar, ResearchGate, and Open Science Framework yielded 2421 studies. These papers were independently evaluated based on the eligibility criteria. 29 studies were included in this review. The Joanna Briggs Institute Critical Appraisal Tools were used for the assessment of the methodological quality of the eligible studies. Across studies, no significant differences were found in perceptual body-size distortion, self-ideal discrepancy, eating-/weight-/body-related attitudes, several personality and ED traits, and general psychological functioning between fathers of the BN group and those of the comparison groups. However, significant differences were found in certain psychological aspects (e.g., impulse regulation) and ED-associated features (e.g., body dissatisfaction). Finally, significant relationships were found between the fathers' food attitudes, muscularity ratings, personality traits, and substance abuse and their offspring's risk of developing BN, greater body dissatisfaction, ED symptoms, and poor end-of-treatment outcome. Although the existing literature does not seem to strongly suggest a particular paternal factor pertaining to BN, several father-specific variables may be associated with the offspring's BN symptomatology and related characteristics. Further research is necessary to clearly understand paternal features in the context of BN.

Psychiatric Comorbidities in Persons With Epilepsy Compared With Persons Without Epilepsy

Several psychiatric disorders have been found to occur more frequently in persons with epilepsy (PWE) than in persons without epilepsy. To summarize the prevalence of 20 psychiatric disorders in PWE compared with persons without epilepsy. The search included records from inception to February 2024 in Ovid, MEDLINE, Embase, and PsycINFO. Published epidemiological studies examining the prevalence of psychiatric disorders among PWE compared with persons without epilepsy were systematically reviewed. There were no restrictions on language or publication date. Abstracts were reviewed in duplicate, and data were extracted using a standardized electronic form. Descriptive statistics and meta-analyses are presented. Data were recorded on the prevalence of 20 psychiatric disorders among PWE compared with persons without epilepsy. Meta-analyses were performed along with descriptive analyses. The systematic search identified 10 392 studies, 27 of which met eligibility criteria. The meta-analyses included 565 443 PWE and 13 434 208 persons without epilepsy. The odds of most psychiatric disorders studied were significantly increased in PWE compared with those without epilepsy, including anxiety (odds ratio [OR], 2.11; 95% CI, 1.73-2.58); depression (OR, 2.45; 95% CI, 1.94-3.09); bipolar disorder (OR, 3.12; 95% CI, 2.23-4.36); suicidal ideation (OR, 2.25; 95% CI, 1.75-2.88) but not suicide attempt (OR, 3.17; 95% CI, 0.49-20.46); psychotic disorder (OR, 3.98; 95% CI, 2.57-6.15); schizophrenia (OR, 3.72; 95% CI, 2.44-5.67); obsessive-compulsive disorder (OR, 2.71; 95% CI, 1.76-4.15); posttraumatic stress disorder (OR, 1.76; 95% CI, 1.14-2.73); eating disorders (OR, 1.87; 95% CI, 1.73-2.01); alcohol misuse (OR, 3.64; 95% CI, 2.27-5.83) and alcohol dependence (OR, 4.94; 95% CI, 3.50-6.96) but not alcohol abuse (OR, 2.10; 95% CI, 0.60-7.37); substance use disorder (OR, 2.75; 95% CI, 1.61-4.72); autism spectrum disorder (OR, 10.67; 95% CI, 6.35-17.91); and attention-deficit/hyperactivity disorder (OR, 3.93; 95% CI, 3.80-4.08). In this comprehensive study, most psychiatric comorbidities examined were significantly more prevalent in PWE than in those without epilepsy. These findings show the high burden of psychiatric comorbidities in PWE. This, in turn, underscores the need for appropriately identifying and treating psychiatric comorbidity in epilepsy to manage patients effectively and improve quality of life.

Association of multiple sclerosis with psychiatric disorders and homelessness among veterans in the United States Department of Veterans Affairs healthcare system.

To describe and compare the prevalence of psychosocial and psychiatric disorders among veterans with multiple sclerosis (MS) and a propensity-score-matched group of veterans without MS, and to identify sociodemographic and clinical characteristics associated with comorbid psychosocial and psychiatric problems among veterans with MS. Data were linked and extracted from the Veterans Affairs (VA) Homeless Operations Management and Evaluation System and the Corporate Data Warehouse. The total sample comprised 27,342 veterans in the VA healthcare system between January 1, 2022, and June 30, 2023, who met eligibility criteria for an MS diagnosis (n=13,671) and 1:1 propensity-score-matched sample of veterans who did not have MS (n=13,671). MS diagnosis, substance use disorder (SUD), mental illness, and homelessness were defined using standard ICD-10 codes. Covariates included sex, age, Charlson Comorbidity Index (CCI), and VA service-connected disability rating. A higher prevalence of mental illness among veterans with MS (33%) was found compared with those without MS (31%). Multivariable logistic regression models indicated MS was negatively associated with diagnoses of alcohol use disorder, stimulant use disorders, posttraumatic stress disorder, and schizophrenia/schizoaffective disorder but positively associated with diagnoses of cannabis use disorder and major depressive disorder. MS was not significantly related to homelessness. Disparities in psychosocial and psychiatric disorders among veterans with MS are described. This study provides novel insights regarding rates of homelessness, SUD, and mental illnesses among veterans with MS. Interdisciplinary approaches to identification and management of mental illness, SUD, and homelessness among veterans with MS are critically needed.

The effect of reduced activity of prefrontal cortex neurons on sleep rhythm

Abstract. The etiology of depression, a prevalent psychiatric disorder, remains elusive. Depression often manifests as a sleep disturbance. A significant proportion of individuals suffering from depression exhibit various sleep rhythm problems. There occurs a well-established and intricate bidirectional association between sleep rhythm abnormalities and depression. The prefrontal cortex (PFC) has been demonstrated to have a crucial role in the development of depression in recent years. The PFC plays a crucial role in the regulation of several cognitive, emotional, behavioral, and other significant activities. The atypical functioning of the PFC might result in the disruption of the sleep cycle. Unusual neuronal activity in the PFC could play a crucial role in controlling both sleep problems and depression. This paper presents a comprehensive overview of the research methods employed in studying the PFC in animal models. It also investigates the potential neural mechanism by which reduced PFC neuron activity may impact sleep rhythm via the PFC-LH-HPA loop. By doing so, this study offers novel insights and concepts that contribute to a deeper comprehension of the underlying causes of depression. Furthermore, this research introduces a prospective approach for addressing depression and sleep disorders through the manipulation of PFC neuron activity, while also highlighting its medical implications and obstacles.

Prevalence of substance use among a sample of patients attending an outpatient psychiatric clinic in Amman, Jordan

BackgroundThe issue of substance use is increasingly being recognised as a significant global public health concern. In relation to its influence in the Arab world, scholarly investigation continues to be regarded as relatively constrained in scope. We aimed to investigate the prevalence of substance use among patients with psychiatric disorders, as well as the sociodemographic and clinical characteristics of this patient population.This cross-sectional study included 671 patients with psychiatric disorders who attended an outpatient private psychiatric clinic in Amman, Jordan, between January and May 2023. We compared the demographic and clinical characteristics of substance-using and non-substance-using patients. Bivariate and multiple binary logistic regression analyses were used to investigate factors associated with substance use.ResultsThe patients were aged 20–80 years, with a mean age of 32.45 ± 10.18 years. Most patients were men, more than half were single and unemployed, and mood disorders were the most prevalent psychiatric disorder. Male sex, a younger age, lower educational attainment, current unemployment, and having a family history of substance use were associated with substance use. Substance users exhibited a higher propensity for engaging in self-harming behaviours, having medical conditions, and being subjected to emotional trauma.ConclusionsThis study found that patients with psychiatric disorders are vulnerable to experiencing substance use. Clinicians should contemplate directing their attention towards patients as a strategy to proactively address the issue of emerging substance use and enhance overall treatment outcomes.

Development of a Symptom Validity Index for the Beck Anxiety Inventory

Objective: Anxiety disorders are the most prevalent psychiatric disorders experienced by individuals in the United States, and anxiety is often assessed with anxiety symptom inventories. At present, though, there are no anxiety symptom inventories that include symptom validity indices. The present study sought to develop a symptom validity index for the most commonly used anxiety symptom inventory in neuropsychological practice, the Beck Anxiety Inventory (BAI). Method: A sample of 244 veterans seeking outpatient neuropsychological assessments were included in the study. Participants were divided into valid and invalid groups based on external criterion symptom validity tests. The valid participants were then divided into clinical subgroups (Current Anxiety, Lifetime Anxiety, and No Anxiety). A validity index derived from the BAI total score was examined for the total sample and all subgroups. Results: A cutoff of ≥ 29 was identified when utilizing the Valid Full Sample, which resulted in a 0.91 specificity rate and 0.54 sensitivity rate. However, cutoffs had to be adjusted when applied to the clinical subgroups. The Valid Current Anxiety subgroup required the largest cutoff increase (i.e. ≥ 36), which resulted in a 0.91 specificity rate and a 0.42 sensitivity rate. Conclusions: This is the first published article to develop a symptom validity index for the BAI. To minimize false positive errors, a BAI total score of ≥ 36 is recommended.

Addressing treatment hurdles in adults with late-onset attention-deficit/hyperactivity disorder: a detailed case report

BackgroundAttention-deficit/hyperactivity disorder (ADHD) is the most prevalent psychiatric disorder in children, characterized by inattention, hyperactivity, and impulsivity. This neurobehavioral disorder often persists into adulthood, presenting significant challenges when undiagnosed and untreated, due to potential long-term implications and comorbidities, including anxiety, mood instability, and mixed symptoms along the bipolar spectrum.Case presentationA 49-year-old married male patient presented with anxiety and recurrent depressive episodes, initially diagnosed as major depressive disorder. His mood symptoms fluctuated between depressive lows, irritability, and impulsivity. His diagnosis was revised to ADHD with comorbid bipolar spectrum disorder. The patient exhibited lifelong ADHD symptoms affecting academic performance, relationships, and job responsibilities. Cognitive-behavioral therapy (CBT) was employed to manage symptoms and enhance coping strategies. Despite progress in controlling anger and impulsivity, challenges persisted in inhibitory control and negative triggers, causing impulsive decisions. The patient reported a restless mind, depressive mood, and a sense of inadequacy. Improvements were noted in anxiety regulation, concentration, and sleep quality, though deficits in cognitive and behavioral domains remained. The patient faced challenges in academic performance, information processing speed, attention, and executive functions.ConclusionThis case underscores the importance of accurately diagnosing ADHD and its comorbidities in adults to ensure effective treatment. Delayed diagnosis can have lasting impacts, emphasizing the need for further research and personalized therapeutic approaches. The insights from this case serve as a valuable resource for healthcare professionals enhancing their understanding of the diverse manifestations of ADHD, aiding in better diagnosis and management strategies.