Psychiatric Comorbidity In Patients Research Articles

Psychiatric comorbidities in patients with psychogenic nonepileptic seizures

BackgroundPsychogenic nonepileptic seizures (PNES) are major challenges for diagnosis and management. The heterogeneity of psychogenic seizures is attributed to diverse psychopathological comorbidities, and the causal relationship between PNES and underlying psychopathologies is still enigmatic. ObjectiveOur objective was to study psychiatric comorbidities and personality constructs in patients with PNES and compare them to a control group of patients with epilepsy. MethodWe randomly recruited 33 patients with PNES and 33 patients with epilepsy. All patients completed the Mini-International Neuropsychiatric Interview (MINI) to screen for psychiatric comorbidities, the Structured Clinical Interview for psychiatric disorders in Axis II (SCID II) to screen for personality disorders, and Goldberg’s International Personality Item Pool (IPIP) Big Five personality questionnaire to study the psychological constructs of extroversion–introversion, agreeableness, conscientiousness, emotional stability–neuroticism, and intellect. ResultMood and anxiety disorders were highly prevalent in patients with PNES (72.7% and 54.5%, respectively); however, the prevalence of only cluster B personality disorder was higher in patients with PNES (69.7%) compared to 33.3% among patients with epilepsy (p < 0.05). Screening for personality disorders using SCID II showed that the prevalence of borderline and depressive personality disorders was significantly higher in patients with PNES (p < 0.001). Patients with psychogenic seizures were more likely to be receiving polydrug therapy (75.8%) compared to patients with epileptic seizures (45.5%); this difference was statistically significant (p < 0.05). ConclusionPsychiatric comorbidities are highly prevalent among patients with PNES.

Genetic predictors of gene expression associated with psychiatric comorbidity in patients with inflammatory bowel disease – A pilot study

BackgroundInflammatory bowel disease (IBD) affects millions of people in North America, and patients with IBD have a high incidence of psychiatric comorbidities (PC). The genetic mechanisms underlying the link are, in general, poorly understood. Materials and methodsA transcriptome-wide association study (TWAS) was performed using genetically regulated gene expression profiles imputed from the genetic profiles of 240 IBD patients in the Manitoba IBD Cohort Study. The imputation was performed using the 44 non-diseased human tissue-specific reference models from the GTEx database. Linear modeling and gene set enrichment analysis were performed to identify genes and pathways that are significantly associated with IBD patients with PC compared to IBD alone in each of the 44 non-diseased human tissues. Finally, an enrichment map was generated to investigate networks of the enriched gene sets associated with IBD patients with PC. ResultsThe genes RBPMS in skeletal muscle (adjusted p = 0.05), KCNA5 in the cerebellar hemisphere of the brain (adjusted p = 0.09), GSR, SMIM34A, and LIPT2 in the frontal cortex of the brain (adjusted p = 0.09 for each) were the top genetically regulated genes with a suggestive association with IBD patients with PC. We identified three gene set networks, which include gene sets and pathways with a suggestive association with IBD patients with PC: one with 7 gene sets overlapping in apolipoprotein B mRNA editing subunit genes, one with 3 gene sets including pigmentation gene sets, and the other one with 3 gene sets including peptidyl tyrosine phosphorylation regulation related gene sets. ConclusionsOur TWAS analysis has identified genes and pathways with a suggestive association with IBD patients with PC. These findings can be potentially used for illustrating the mechanism of developing PC in the patients with IBD and developing diagnosis tool or drug targets for IBD patients with PC.

Toward evidence-based severity assessment in mouse models with repeated seizures: I. Electrical kindling

ObjectiveEthical decisions about an allowance for animal experiments need to be based on scientifically sound information about the burden and distress associated with the experimental procedure and models. Thereby, species differences need to be considered for recommendations regarding evidence-based severity assessment and refinement measures. MethodsA comprehensive analysis of behavioral patterns and corticosterone or its metabolites in serum and feces was completed in kindled mice. The impact of kindling via two different stimulation sites in the amygdala and hippocampus was determined. Data were compared to those from naive and electrode-implanted groups. ResultsAmygdala and hippocampus kindled mice exhibited comparable behavioral patterns with increased activity in the open field, reduced anxiety-associated behavior in the elevated-plus maze, and increased anhedonia-associated behavior in the saccharin preference test. In addition, repeated stimulation of the hippocampus caused a reduction in burrowing behavior and an increase in active social interaction. Levels of corticosterone and its metabolites were not altered in serum or feces, respectively. A comparison of mouse data with findings from amygdala kindled rats confirmed pronounced species differences in behavioral patterns associated with the kindling process. SignificanceTaken together the findings suggest a severity classification for the mouse kindling paradigms as moderate regardless of the stimulation site. The outcome of the species comparison provides valuable guidance for species selection for studies exploring behavioral comorbidities. In this context, it is emphasized that the mouse kindling paradigms seem to be well suited for studies exploring the link between ictal events and network alterations on the one hand, and hyperactivity and anhedonia-associated behavior on the other hand. Moreover, the underlying pathophysiological mechanisms and the impact of therapeutic interventions on these behavioral alterations can be studied in these paradigms providing guidance for the clinical management of respective psychiatric comorbidities in patients.

Psychiatric comorbidities in hidradenitis suppurativa/acne inversa

The findings of most studies suggest that depression and anxiety disorders are the most common psychiatric comorbidities in patients with hidradenitis suppurativa/acne inversa (HS/AI). In aprospective study, 51patients with HS/AI were further examined for psychiatric comorbidity using astandardized interview and questionnaires. In psychiatric examination, 29.4% of HS/AI patients had additional mental symptoms, mainly manifested as depressive disorder. The HS/AI patients were rather young and female, and they showed ahigh incidence of nicotine and alcohol use, and apositive family history of paternal alcohol dependence. In addition, HS/AI patients experienced more severe psychosocial impairments in the form of lack of partnership and lower school attainment. Acne inversa is asevere chronic inflammatory skin disease that, like other inflammatory dermatoses, is associated with mental comorbidity and psychosocial impairments. Since especially young patients are affected, apsychiatric-psychotherapeutic cotreatment should be considered already at an early stage.

Do Psychotropic Drugs Cause Epileptic Seizures? A Review of the Available Evidence.

Psychiatric comorbidities in patients with epilepsy are common. A bidirectional relationship has been well described where not only patients with epilepsy have a higher prevalence of psychiatric comorbidities but also patients with primary psychiatric disorders are at an increased risk of developing seizures. The aim of this review is to highlight the complex relationship between epilepsy and common psychiatric disorders and to answer the question whether psychotropic medications are proconvulsant by reviewing the preclinical and clinical literature. The evidence shows that the majority of psychotropic medications are not proconvulsant when used in therapeutic doses with the exception of a subset of medications, mainly bupropion IR and certain antipsychotic drugs such as clozapine. An effective treatment of psychiatric comorbidities in patients with epilepsy must consider not only the potential therapeutic effect of the drug, but also its potential iatrogenic effects on the seizure disorder.

Psychiatric comorbidity and quality of life in patients with dermatological diseases

ObjectiveThe aim of the study was to compare the psychiatric comorbidities in patients with vitiligo with control group considering the burden in their life quality.BackgroundSeveral studies reported high rates of depression and anxiety particularly for specific dermatological diseases such as vitiligo, affecting their life quality.Patients and methodsA total of 30 patients with vitiligo as well as 30 participants as a control group were included. The study was conducted in Neuropsychiatry Department, Menoufia University. Arabic version of the Structured Clinical Interview for psychiatric Disorders 1 based on the Diagnostic and Statistical Manual of Mental Health Disorders, fourth ed., was used for psychiatric diagnosis. Dermatology life quality index was used to assess life quality in patients with vitiligo. Arabic version of the Holmes and Rahe Stress Scale was used to determine stressful life events that might increase risk for illnesses.ResultsA statistically significant difference between the patients with vitiligo and controls was found regarding psychiatric comorbidities (P < 0.001). Only seven (23.3%) patients of vitiligo group were free of psychiatric disorders. Overall, 23 patients of vitiligo group had psychiatric comorbidities versus control group (76.7 vs. 16.7%). Quality of life (QOL) affection was at moderate effect in 16.7%, very large effect in 30%, and extreme large effect in 10%.ConclusionPatients with vitiligo disease were associated with high rates of psychiatric comorbidity. A significant disruption was found in QOL. Screening may be helpful for early diagnosis, improving their QOL.

A Clinicoepidemiological Study of Psychiatric Co-Morbidity in Hansen's Disease.

Introduction:Leprosy is a chronic disease caused by mycobacterium leprae. Chronicity of the disease leads to various psychiatric co-morbidities, which are often undiagnosed and untreated. The main objectives of this study were to evaluate the frequency and nature of psychiatric co-morbidity in patients of Hansen's disease.Materials and Methods:Seventy confirmed cases of Hansen's disease between the ages of 18 and 60 years attending the department of dermatology of Indira Gandhi Medical College and Hospital, Shimla were evaluated for various manifestations of Hansen's disease and screened for psychiatric co-morbidity using GHQ-12 and diagnosed using ICD-10 checklist. Severity of depression and anxiety was assessed with HAM-D and HAM-A scales, respectively.Results:The prevalence of psychiatric co-morbidity was found in 27.14% of enrolled patients. Depression was most prevalent in (20%) mental disorder; followed by anxiety disorder (7.14%). Moderate depressive episode was the commonest seen in 11.42% patients whereas 5.71% patients had mild depression. Generalized anxiety disorder was seen in 1.42% whereas 5.71% patients had mixed anxiety disorder. Patients with higher education status, positive family history of leprosy, lepromatous leprosy, and hand deformities were significantly associated with higher psychiatric co-morbidity.Conclusion:Patients suffering from Hansen's disease have significantly high prevalence of psychiatric co-morbidity complicating the Hansen's disease. High index of suspicion is required to diagnose and treat it.

THE BONE-BRAIN AXIS? BIOPSYCHOSOCIAL ASPECTS OF ORTHOPEDICS AND A MENTAL WELLBEING ACTION PLAN IN MUSCULOSKELETAL CARE

The aim: To review the biopsychosocial aspects of psychiatric comorbidity in patients with musculoskeletal conditions and recommend a relevant mental health action plan. Materials and methods: Keywords (orthopedics, psychiatry, mental health) were used to list down and analyze the literature in PubMed and Google Scholar. All types of articles, including original research, systematic reviews, and meta-analyses, along with gray literature dating back to 2000. We excluded studies reporting a significant conflict of interest and findings dispersed through popular media instead of peer-reviewed journals. Conclusions: The biopsychosocial aspects of the “bone – brain axis” need to be better addressed by means of a pragmatic approach involving all concerned parties and acknowledging the challenges and limitations along the way.

Psychiatric morbidity in patients with idiopathic Parkinson's disease: A cross-sectional study.

Objective:To evaluate the prevalence of psychiatric comorbidities in patients with idiopathic Parkinson's disease (IPD).Methodology:Two hundred and thirty-nine patients with IPD were evaluated on Mini-International Neuropsychiatric Interview PLUS (MINI-PLUS). In addition, patients found to have depression as per the MINI-PLUS were evaluated on Beck Depression Inventory.Results:One hundred and thirty-five (56.5%) patients had a current psychiatric diagnosis and 59.8% had a lifetime psychiatric diagnosis. As per MINI-PLUS, about two-fifth (39.7%) of patients had suicidality. In 18.8% of patients, suicidality was present in the absence of axis-I psychiatric diagnosis. Among the various psychiatric disorders, the most common disorders included depressive disorders (current: 17.5%; lifetime: 23.8%), anxiety disorders (current: 17.5%; lifetime: 17.5%), and psychotic disorders (current: 11.3%; lifetime: 11.7%).Conclusions:More than half of the patients with Parkinson's disease have psychiatric disorders. High prevalence of psychiatric morbidity calls for close liaison between the neurologist and the psychiatric disorders.

Psychiatric co-morbidities in patients of dhat syndrome: A cross-sectional study in a tertiary care centre

Dhat syndrome is a culture-bound syndrome characterised by inappropriate and excessive distress of losing semen from one’s body and thereby leading to multiple vague psychological and somatic symptoms. It is presumed that several of these symptoms could possibly be of other co-morbid psychiatric disorders. The aim of this study was to assess these co-morbidities with the help of a comprehensive diagnostic tool. Utilizing the purposive sampling technique, a total of 100 patients of Dhat syndrome who fulfilled the inclusion and exclusion criteria of this study were enrolled. They were administered Mini-International Neuropsychiatric Interview (MINI) to assess co-morbid psychiatric disorders. Overall, 37% of the patients had co-morbidity of at least one psychiatric disorder. Out of these 37 patients with psychiatric co-morbidity, major depression was the most common diagnosis (43.2%) followed by generalized anxiety disorder (16.2%), obsessive compulsive disorder (10.8%), panic disorder (5.4%), alcohol dependence (8.1%), alcohol abuse (5.4%), other substance abuse (5.4%), other substance dependence(2.7%), and social anxiety disorder (2.7%). We concluded that a co-morbidity of various psychiatric disorders is common in patients of Dhat syndrome and it is not only important to consider Dhat syndrome as a distinct psychiatric entity but also to address various psychiatric conditions co-morbid with it for the sake of overall better outcome. Keywords: Dhat syndrome, Co-morbidity, Psychiatric disorders.

English

BACKGROUND Skin diseases and psychiatric illnesses are frequently found in the same patient. Although the psychiatric comorbidity of patients with dermatological conditions have been frequently studied, the prevalence of skin diseases in patients with primary psychiatric illnesses in India has not yet been extensively analysed. We hope to shed some light on the topic through this study and to gain insights into the co-morbidity of skin disorders in primary psychiatric outpatients. METHODS We have utilised a cross-sectional descriptive design for estimating the prevalence of skin disorders in primary psychiatric outpatients attending the outpatient department of a tertiary medical college hospital in India during the period from October 2019 to January 2020. Patients over the age of 18 years had been recruited for the study. Informed consent was obtained from all the patients. RESULTS A total of 135 patients were recruited for the study. 70 were males and 65 were females. The mean age of the participants was 38.6 years. A total of 88 patients of whom 46 were females had a co-existing dermatological condition that amounts to a prevalence rate of 65.1 %. Around 94 cutaneous manifestations were found among the 88 patients who had a dermatological disorder. CONCLUSIONS Skin disorders were highly prevalent in patients attending the psychiatric outpatient department. This points to a need for an inquiry and examination into skin related ailments in all psychiatric patients. KEYWORDS Psychodermatology, Comorbidity in Psychiatry, Skin Diseases in Psychiatry

18714 Association of psychiatric comorbidities in patients with chronic itch

Chronic pruritus has been correlated with higher incidences of psychiatric disturbances. To better characterize the relationship between chronic itch and psychiatric diagnoses, chart review of 756 adult patients diagnosed with non-psychogenic chronic itch seen in our tertiary itch clinic from January 2017 through March 2019 was completed. Patients were divided based on the presence (n = 131) or absence (n = 625) of comorbid psychiatric conditions. Data regarding dermatologic diagnoses, validated itch questionnaire responses, and demographics was collected for both groups.

Psychiatric and psychosocial morbidity 1 year after epilepsy surgery.

There is a high rate of psychiatric comorbidity in patients with epilepsy. However, the impact of surgical treatment of refractory epilepsy on psychopathology remains under investigation. We aimed to examine the impact of epilepsy surgery on psychopathology and quality of life at 1-year post-surgery in a population of patients with epilepsy refractory to medication. This study initially assessed 48 patients with refractory epilepsy using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Hospital Anxiety and Depression Scale (HADS) and the Quality of Life in Epilepsy Inventory 89 (QOLIE-89) on admission to an Epilepsy Monitoring Unit (EMU) as part of their pre-surgical assessment. These patients were again assessed using the SCID-I, QOLIE-89 and HADS at 1-year follow-up post-surgery. There was a significant reduction in psychopathology, particularly psychosis, following surgery at 1-year follow-up (p < 0.021). There were no new cases of de novo psychosis and surgery was also associated with a significant improvement in the quality of life scores (p < 0.001). This study demonstrates the impact of epilepsy surgery on psychopathology and quality of life in a patient population with refractory surgery. The presence of a psychiatric illness should not be a barrier to access surgical treatment.

Increased Prevalence and Associated Costs of Psychiatric Comorbidities in Patients Undergoing Sports Medicine Operative Procedures

To evaluate the prevalence of preoperatively diagnosed psychiatric comorbidities and the impact of these comorbidities on the healthcare costs of ten common orthopaedic sports medicine procedures. Patients undergoing 10 common sports medicine procedures from 2007 to 2017q1 were identified using the Humana claims database. These procedures included anterior cruciate ligament reconstruction; posterior cruciate ligament reconstruction; medial collateral ligament repair/reconstruction; Achilles repair/reconstruction; Rotator cuff repair; meniscectomy/meniscus repair; hip arthroscopy; arthroscopic shoulder labral repair; patellofemoral instability procedures; and shoulder instability repair. Patients were stratified by preoperative diagnoses of depression, anxiety, bipolar disorder, or schizophrenia. Cohorts included patients with ≥1 psychiatric comorbidity (psychiatric) versus those without psychiatric comorbidities (no psychiatric). Differences in costs across groups were compared using Mann-Whitney U tests, with significance defined as P < .05. Linear regression analysis was used to assess rates of procedures per year from 2006 to2016. In total, 226,402 patients (57.7% male) from 2007 to 2017q1 were assessed. The prevalence of ≥1 psychiatric comorbidity within the entire database was 10.31% (reference) versus 21.21% in those patients undergoing the 10 investigated procedures. Patients with psychiatric comorbidity most frequently underwent rotator cuff repair (28%), hip labral repair (26.3%) and meniscectomy/meniscus repair (25.0%%) had ≥1 psychiatric comorbidity. Compared with the no psychiatric cohort, diagnosis of ≥1 psychiatric comorbidity was associated with increased health care costs for all 10 sports medicine procedures ($9678.81 vs $6436.20, P < .0001). The prevalence of preoperatively diagnosed psychiatric comorbidities among patients undergoing orthopaedic sports medicine procedures is high. The presence of psychiatric comorbidities preoperatively was associated with increased postoperative costsfollowing all investigated orthopaedic sports medicine procedures. Level III; retrospective comparative study.

The Relationship of Psychiatric Variables in Patients Undergoing Peripheral Nerve Surgery for Migraine Headache

BACKGROUND: Patients seeking peripheral nerve surgery for their headaches often have debilitating symptoms that can affect both their functional and psychological well-being. Although prior studies have shown strong associations between psychiatric variables and migraine headaches, their associations in patients undergoing peripheral nerve surgery have not been fully elucidated. This study aims to explore the relationship of psychiatric comorbidities in patients undergoing peripheral nerve surgery for their headaches. METHODS: One hundred twenty-nine patients were enrolled prospectively and completed the Patient Health Questionnaire-2 (PHQ-2) and Migraine Headache Index (MHI) surveys preoperatively and at 12 months postoperatively. Data on psychiatric comorbidities were collected both via survey and via retrospective chart review. RESULTS: Preoperatively, 38% of patients self-reported a diagnosis of depression, whereas 45% of patients met PHQ2 criteria for likely major depressive disorder (PHQ-2 score of 3 or greater). Twenty-seven percent of patients reported a diagnosis of generalized anxiety disorder. Patients with depressive symptoms and self-reported anxiety were more likely to report a higher severity of migraine symptoms. At 1-year postoperatively, patients reported a significant decrease in their PHQ-2 score (P = 0.02), with 22% of patients reporting depressive symptoms, as compared to 45% preoperatively. The preoperative presence of anxiety or depression did not affect postoperative outcomes. CONCLUSION: There is a high prevalence of psychiatric ailment in patients undergoing migraine surgery. Comorbid psychiatric conditions do not appear to affect postsurgical outcomes. However, surgery is associated with a significant decrease in depressive symptoms. Prior studies have shown that the surgical treatment of migraine headaches is associated with improved headache symptoms and functionality. This study demonstrates that surgery is also associated with improved psychiatric symptoms.

Lifetime Psychiatric Comorbidity and Diagnostic Trajectories in an Italian Psychiatric Sample.

ObjectiveComorbidity in psychiatric patients has been widely examined in the literature, enucleating the role in misinterpretation of symptom’s root in a multi-disease background, as well as the impact on the quality of life, outcome, and health-care effects. This research aimed to examine, in an Italian population of psychiatric patients, the diagnostic continuum in the context of lifetime psychiatric comorbidity, assessing possible differences related to the onset disorder.MethodA retrospective analysis of medical records of 458 subjects, in which various psychiatric diagnoses were represented and categorized in 16 nosographic classes, was conducted.ResultsResults showed that “Bipolar disorder” (22.06%) was the most frequent diagnosis, “Eating disorder” had the earliest age onset (Mean age years = 16 ± 1.41), and “Schizophrenia” showed the longest disease duration (Mean years = 24.20±12.76). Moreover, 54,4% of the final sample presented at least one psychiatric comorbidity in disease history, while “Other personality disorders” was the most comorbidity-associated diagnosis, representing 29% of all the cases with more than 3 past diagnoses. Heterotypic transition was observed in fairly all considered onset diagnoses, exception made for “Schizophrenia” with 75% of the subjects showing homotypic progression.ConclusionsOur results suggest a tendency to make multiple diagnoses over psychiatric patients' lifetime in the majority of cases, often escaping from the original onset nosographic domain. More generally, our findings agree with a broad consensus that describes psychiatric symptomatic dimensions rather overlapped and correlated with each other, leading to a more transdiagnostic clinical approach.

Psychiatric Comorbidity in Patients With Chronic Pancreatitis Associates With Pain and Reduced Quality of Life.

Abdominal pain, frequent in patients with chronic pancreatitis (CP), has a negative impact on quality of life (QOL). Psychiatric comorbidities including anxiety and depression are associated with pain, but their prevalence and effects on QOL in CP have not been quantified. We studied the prevalence of anxiety and depression in patients with CP and their associated patient and disease characteristics and impact on QOL. This was a cross-sectional, multicenter prospective study. Patients were screened with the Hospital Anxiety and Depression Scale questionnaire. A Hospital Anxiety and Depression Scale score >7 on the respective anxiety or depression subscales indicated the presence of anxiety or depression and was used as a surrogate for the diagnosis of psychiatric comorbidities. Patient demographics, disease characteristics, QOL (EORTC-QLQ-C30), and pain symptoms (Brief Pain Inventory Short Form) were compared between patients with and without psychiatric comorbidities. One hundred seventy-one patients with CP (mean age 53.8 ± 13.7 years, 60% men) were included. Anxiety and depression were present in 80 (46.8%) and 66 (38.6%) patients, with overlap in 50 (29%). Patients with anxiety or depression reported higher pain prevalence, pain severity, and pain interference scores (all P < 0.001). Psychiatric comorbidities also associated with reduced global health scores and functional subscales (all P < 0.001) and higher symptom burden (P ≤ 0.03). An independent association was noted between global health status and depression (P < 0.001). Psychiatric comorbidities are prevalent in patients with CP and associated with pain and QOL. Where the effect of anxiety on QOL may be mediated via pain, depression is independently related to QOL. These findings warrant consideration in the management of patients with CP.

Alexithymia and attention deficit and their relationship with disease severity in fibromyalgia syndrome

The aim of this study was to investigate the frequency of alexithymia and attention deficit and to evaluate their relationship with the severity of disease in patients with fibromyalgia syndrome (FMS). A total of 101 patients (6 males, 95 females; mean age 45.0 years; range, 33 to 56 years) who were admitted to Gaziantep University, Medical Faculty, Physical Medicine and Rehabilitation Department between January 2013 and December 2013 and were diagnosed with FMS and 40 healthy volunteers (4 males, 36 females; mean age 41.5 years; range, 31 to 51 years) were enrolled in this study. The Fibromyalgia Impact Questionnaire (FIQ), Hamilton Depression Scale (HAM-D), Toronto Alexithymia Scale-26 (TAS-26), and Jasper-Goldberg Attention Deficit Test (ADT) were applied. The rate of alexithymia and possible alexithymia was 56.4% and 20.8% in the patients with FMS and 2.5% and 5% in the control group, respectively. The mean TAS-26 score was 60.1±11.7 in the patients with FMS. According to the HAM-D, depressive symptoms were seen in 72.0% and 2.5% of the patients with FMS and healthy controls, respectively. Our study results confirm the presence of psychiatric comorbidities in patients with FMS and clearly suggest that depression, alexithymia, and attention deficit are high and mutually correlated in FMS patients. Therefore, all patients should be meticulously evaluated for these conditions at the treatment stage.

Psychiatric Disorders in Patients with Irritable Bowel Syndrome at a Tertiary Care Centre in Bangladesh

Background/Aims: Irritable bowel syndrome (IBS) is one of the common functional gastrointestinal disorder. Psychosomatic illness is a common association with IBS. Although studies in both western and Asian countries showed significant coexisting psychiatric illness in IBS patients, such studies are scarce in south-east Asian countries like Bangladesh. So, the aim of this study was to find out the association of psychiatric co-morbidities in patients with IBS in a tertiary care center. Methods: This was a cross-sectional study conducted from July 2017 to January 2019. Patients were selected from the dedicated IBS clinic of a tertiary care center in Bangladesh. IBS population were enrolled according to the Rome-IV diagnostic criteria. Relevant history, physical examination and investigations were done to exclude organic diseases. A psychiatric assessment of all the study subjects was done by a clinical psychiatrist using the General Health Questionnaire (GHQ)-12. Results: Ninety-six IBS patients were enrolled in this study. The mean age was 33.51±9.87 years. Male outnumbered female (85.4% vs 14.6%). IBS diarrhea (83.3%) was predominant in this study. Approximately 60.41% of IBS patients had different psychiatric illnesses. Major depressive disorder (27.1%) and generalized anxiety disorder (15.6%) were the most common psychiatric illness in this study. There was no significant difference in psychiatric comorbidities among various IBS types. Conclusions: A significant number of IBS patients have co-morbid psychiatric disorders. So, IBS patients should meticulously be screened for such co-morbidities for effective and integrated management.

Socio-Demographic, Clinical Profile, Life Stress Events and Psychiatric Comorbidities in Patients with First Attempt Suicide

Background: Contemporary literature focuses on various socio-demographic, clinical profile and psychiatric comorbitidies in patients with first attempt suicide. Aim: 1. To study the socio-demographic factors and the clinical profile of subjects with the first attempt suicide. 2. To assess the severity of depression and severity of stress due to various stressful events in patients with first attempt suicide. 3. To assess the severity of the suicide intent in patients with first attempt suicide. 4. To study the association between socio demographic profile of the patients with severity of depression, severity of suicide intent and severity of stress. Materials and Methods: Hundred fifteen patients were assessed using Hamilton rating scale for depression, becks suicide intent scale, Holmes-Rahe life stress inventory, MINI international neuropsychiatric interview. The data was analysed using the statistical software SPSS version 20. Results: The sample of 115 patients showed mean age to be 29 years, majority of them being males (58%). With most common mode of attempting suicide to be drug overdose and most of the patients had adjustment issues due to various domestic household issues and financial stressors. The severity of depression was mild and suicide intent were low (67%). In our study chi square finding association between various socio demographic variables and severity of depression found to be highly significant. It was strongest among gender at p value 0.009, occupation in which depression was found mostly among employed patients and housewives at p value 0.001. Results also found depression more common among participants with urban background at p value 0.03 and family type being nuclear at p value 0.05. Conclusion: Promoting healthy coping mechanism and reduction in stress is required to reduce self-harm. As is evident from the study, modifying the interpersonal relationship problems in the family might help in preventing many of suicide attempts/intentional self-harm and therefore important to address their various life events that might be stressful for them forcing them to take this step. In a country like India, where formal mental health resources are limited and are attached to a stigma, it is important to provide adequate information also among people hailing from lower economic status.