Psychiatric Help Research Articles

Individual-Specific Analysis for Psychoradiology.

In neuroimaging research, averaging data at the level of the group results in blurring of potentially meaningful individual differences. A more widespread use of an individual-specific approach is advocated for, which involves a more thorough investigation of each individual in a group, and characterization of idiosyncrasies at the level of behavior, cognition, and symptoms, as well as at the level of brain organization. It is hoped that such an approach, focused on individuals, will provide convergent findings that will help identify the underlying pathologic condition in various psychiatric disorders and help in the development of treatments individualized for each patient.

Demographic and clinical characteristics of children seeking psychiatric services in the Nile Delta region: an observational retrospective study

BackgroundEpidemiological studies, describing both community and clinical samples of youth in need for psychiatric help, are rare in the middle east. To our knowledge, this is the first study that aims to investigate the demographic and clinical characteristics of a sample of children suffering from emotional and behavioral problems seeking psychiatric services in the Nile Delta region and the largest clinical sample to date in Egypt.MethodsThe files of all new cases who presented for care in the outpatient service for children and adolescents between August 2016 and July 2018 were reviewed. Ninety-six files were excluded due to missing data while another 18 files were found to be for adults (ages > 18 years old), so the sample included 886 cases.ResultsThe ages of our sample (n = 886) ranged from 18 months to 18 years with an average of 7.5 (± 3.8) years. Most of our cases were male, school aged children, living within low-income households and predominantly coming from rural areas. The most common diagnoses were attention deficit hyperactivity disorder (ADHD) (22.6%), intellectual disability (ID) (13.7%), depressive disorders (13.3%), and disruptive behavior disorders (DBD) (12.3%). Strong protective effects were found for family integrity and stability. Corporal punishment and physical and sexual abuse were noted to be significant risk factors for internalizing and externalizing disorders in children and adolescents.ConclusionsExcept for males being a majority in our sample of children seeking psychiatric consultation, demographic patterns and prevalence of psychiatric disorders are comparable to other tertiary clinical samples in other parts of the world.

Positive screening rates for bipolar disorder in pregnant and postpartum women and associated risk factors

ObjectiveBipolar disorder affects 2–8% of pregnant and postpartum women; untreated illness is associated with poor outcomes. This study aimed to describe bipolar disorder screening rates in obstetric settings and associated characteristics. MethodWomen were recruited during pregnancy through three months postpartum from 14 obstetric clinics in Massachusetts. The Mood Disorder Questionnaire (MDQ) was used to screen for bipolar disorder; a subset previously diagnosed with bipolar was also examined. Differences in characteristics by screening outcome were tested using chi-square and t-tests. ResultsOf 574 participating women, 18.8% screened positive for bipolar disorder. Compared to those with negative, those with positive bipolar screens had 18.5-times the prevalence of positive substance use screens (11.1% vs. 0.6%, p < 0.001) and 3.4-times reported feeling they were not receiving adequate psychiatric help (24.0 vs. 7.0%, p < 0.001). Less than half of those with positive bipolar screens (42.0%) and 61.3% with pre-existing bipolar reported receiving current psychiatric care. ConclusionsAlmost one in five perinatal women screened positive for bipolar disorder. Positive screenings were associated with comorbid substance use and low treatment rates. This study highlights the importance of screening for bipolar disorder during the perinatal period and the need for systematic approaches to ensure adequate assessment and follow-up.Clinical trials registration: ClinicalTrials.gov identifier: NCT02760004

Mental Health Issues of Young Females in Mumbai: Case Studies

Youths of today particularly from urban areas are facing a highly demanding and challenging life than earlier generations, sandwiched between tradition and technology. There is a significant shift in terms of socio-economic development, life style, technological advancement and environmental patterns in everyone’s lives over the last few decades (Bohn & Short, 2009). Young adults (age group ranging from 18 to 25 years) today, face problems such as family/relationship conflicts, absence of emotional connect with family members, depression, addiction, low self-esteem/lack of confidence, etc. Many young adults get involved in an intimate relationship to fulfill their needs for belongingness (Maslow, 1943). The need for belongingness remains unfulfilled in young adults having insecure attachment with their parents (Ainsworth & Bell, 1970). With decrease in the family size (i.e. the number of children per married couple) over the years and rise in nuclear households (Bhasin, 2016), young girls in urban settings tend to lack coping mechanisms in stressful situations and become vulnerable to mental health related issues. This piece of research is an attempt to present four cases of young adult girls belonging to nuclear families who approached for psychological help. A common concern of each one of them was absence of emotional connect with their respective parents in spite of living under the same roof. Two of them suffered from severe depression and were referred for psychiatric help. Two of the four girls regularly indulged in deliberate self-harm while one was addicted to substance use. All four girls expressed dissatisfaction about their childhood as they felt neglected throughout. Findings suggest that the young adults need to be provided with proper care, attention and strong support at the family front to become confident, self-sufficient and self-reliant which would prevent them from getting into problems like depression, addiction, deliberate self-harm, etc.

The characteristics and risk factors for common psychiatric disorders in patients with cancer seeking help for mental health

BackgroundAlthough the adverse effects of cancer diagnoses and treatments on mental health are known, about less than 10% of patients are estimated to be referred to seek help. The primary purpose of this study was to obtain the baseline information on patients with cancer seeking help for mental health who presented for the first time to the psycho-oncology outpatient clinic, and to identify risk factors that may provide clues healthcare practitioners in recognizing those needing psychological help in oncology practice.MethodsWe reviewed the charts of 566 patients with cancer who were referred to the psycho-oncology outpatient clinic over a two-year period. The study includes the socio-demographic data, illness characteristics, psychiatric characteristics, psychiatric diagnoses, and treatment recommendations for these patients.ResultsThe incidence of diagnoses of psychiatric disorders was 97.5%. The distributions of psychiatric diagnoses were as follows: any kind of adjustment disorders, mood disorders, anxiety disorders, organic brain syndrome, personality disorders, delusional disorder, and insomnia. Recurrence of cancer, other chronic medical illnesses, a history of psychiatric disorders, poor social support, and low income comprised the common significant risk factors for adjustment disorders, mood disorders, and anxiety disorders. These risk factors were also seen to be significant in the regression analysis in terms of sex.ConclusionThis study identifies the distribution of psychiatric disorders, the risk factors for specific psychiatric disorders, and draws attention to the fact that there are serious delays in patients seeking psychiatric help and in the referrals of oncologists for psychological assessment. Identifying risk factors and raising oncologists’ awareness toward risk factors could help more patients gain access to mental health care much earlier.

An evaluation of proactive psychiatric consults on general medical units

ObjectiveRecent studies have shown an association between proactive psychiatric consultation on medical units and shorter length of stay. The aim of this study was to assess the impact of implementing a proactive psychiatric consult service on general medical units in an urban teaching hospital on length of stay and qualitative measurement of satisfaction of adequacy of psychiatric services. MethodsBivariate and multivariate analyses of demographic, clinical and outcome data were performed comparing patients seen by the proactive psychiatric consult team, patients seen contemporaneously on other general medical units by a traditional, reactive consult team and patients seen the prior year on the proactive intervention units by the reactive consult team. Length of stay was the primary outcome examined. Regression modeling was performed to assess further the relationship of length of stay with the three groups. Nursing and physician staff were queried before and after intervention regarding satisfaction with psychiatric resources on the intervention units. ResultsPatients seen by the proactive team had shorter length of stay than those seen by contemporaneous reactive consult team (p = 0.005) or the prior year by the reactive team on the intervention units (p = 0.005). There was no significant difference between the latter two groups. Time to consult was also shorter for patients seen through the proactive model than the reactive model on other units at the same time (0.01) or the preceding year (<0.001). Nursing and physician satisfaction with psychiatric help increased significantly in three of four measures. ConclusionsProactive psychiatric consultation in our study correlated with shorter time to consult, shorter length of stay, and improved staff satisfaction compared to a reactive consult model.

Somatization disorder and the issue of stigmatization among psychiatric patients

Background: The somatic accusations disorder represents those somatic complaints which affects deeply the mental state of the patient being accompanied by an affective allure which deteriorates the relationship between the physician, family and the patient, the source of these complaints being unable to be found after the numerous medical investigations the patient demands. Purpose and methods: The purpose of the presentation is to highlight the relationship between the multitude of investigations to which the patient is subjected and the evolution of the somatoform disorders and to describe the psycho-emotional implications in this type of pathology by describing a clinical case met in our clinic diagnosed as Somatoform Disorder according to ICD-10 and DSM-IV. Description of the case: D.O. is a 58 years-old woman which came for the first time in a psychiatry unit with the purpose of hospital admission. The first impression on this patient was made of the various somatic complaints with occipital and cervical pain, thorax lumbar pain and various accusations of paresthesia at the extremities of the inferior limbs accompanied by a melodramatic and profoundly affective expression of the poor general condition. For almost 17 years, numerous medical investigations with negative results and consultations with doctors from various specialties and from different cities in the country, as well as alternatives methods of treatment such as massage ,spa, alternative medicine and even local healers were used because of the fear of stigma the patient may felt searching for psychiatric help. Unsatisfied and constantly affected by his current state , the patient has finally recognized that it may be reasonable a psychiatric approach towards his condition and required specialized medical service. Following hospitalization which consisted of psychotherapy, psychotropic antidepressant, anxiolytic and brain neurotrophic treatment, the somatic complaints decreased in intensity to the patient`s tolerable threshold. Conclusions: Somatic complaints and the denial of a possible psychiatric etiology creates a psycho-familial picture difficult to accept and with its numerous investigations and presentations in various medical services and a purposeless and unintended journey in the identification of the somatic complaints while the material, moral and affective costs are up to date.

Knowledge and Awareness Regarding Mental Health and Barriers to Seeking Psychiatric Consultation in Saudi Arabia

The Middle Eastern region, in general and Saudi Arabia, in specific, suffers from a large burden of mental illness. People’s positive attitudes and correct perceptions towards mental illness and their willingness to seek help when needed can help in reducing such burden. To determine the knowledge, attitudes and perceptions of the Saudi population toward mental illness and health services and to understand the barriers that affect the people’s willingness to seek psychiatric help when needed. A convenient sample of Saudi population of either sex was included in the study. A structured questionnaire was used to assess knowledge, attitudes and perceptions on mental health and the willingness to seek psychiatric help through multi-approach methods. Logistic regression was used to determine factors that were associated with not willing to seek psychiatric help, adjusting for other factors in the model. A total of 5644 participants (49.5% males) participated. About 87% were unaware about psychiatric services available in the kingdom, 85% reported that social factors were responsible for mental illnesses, about a quarter of them reported that they wouldn’t seek psychiatric help when needed and about half felt ashamed about it. Male gender, >20 years age group, not knowing whether a relative is suffering from mental illness and not knowing about the services provided by psychiatric health services in the kingdom were significantly associated with not willing to seek psychiatrist consultation when needed. A number of gaps were identified in the people’s knowledge about mental illness. Anti-stigma campaigns and evidence-based mental health educational programs should be implemented to enable people to reduce stigma and seek early mental health care.

Sociodemographic Determinants of Personality Disorder In Patients of Obsessive-compulsive Disorder

Background &amp; objective: Obsessive Compulsive Disorder (OCD) is the 4th most prevalent psychiatric disorder in Epidemiological Catchment Area (ECA) Survey and most individuals with OCD have co-morbid personality disorders (PD). The present study was undertaken to find the prevalence of PD among patients with OCD and the sociodemographic determinants that influence the development PD in patients with OCD.&#x0D; Methods:The cross-sectional analytical study was conducted in OCD clinic of Bangabandhu Sheikh Mujib Medical University from January 2015 to September 2016. Respondents were recruited from the OCD patients diagnosed on the basis of DSM-IV criteria and face to face interview was conducted with the help of the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II questionnaire). The main outcome variable was PD in patients of OCD and the exposure variables (determinants) were selected sociodemographic characteristics.&#x0D; Result: The mean age of the OCD patients was (28 ± 8.7) years. Almost half (49%) of OCD patients belonged to the age group 20-30 years. Female respondents were 53.6%. Among the respondents, 62% had co-morbid PD. The mean age of the OCD patients with PD was observed to be significantly higher (29.1 ± 9.1 years) than those without PD (26.2 ± 7.8 years) (p = 0.047). Male OCD patients were 2.4 (95% CI of OR: 1.2 – 4.7) times more likely to have PD than their female counterparts (p = 0.012). Ethnic groups other than Muslims tend to be associated with PD more often and carry more than 8-fold (95% CI of OR: 8.4 – 37.2) higher risk of having the condition (p = 0.001). Likewise, other occupants were nearly 2(95% CI of OR: 0.98 – 3.74) times more prone to have PD than the students (p = 0.056).&#x0D; Conclusion: Personality Disorders are highly prevalent among people with OCD which remains underdiagnosed &amp; under-addressed. Male OCD patients, non-Muslims and occupants other than students are more prone to have PD. Persons with Personality Disorders are far more likely to refuse psychiatric help and deny their problems.&#x0D; Ibrahim Card Med J 2017; 7 (1&amp;2): 44-50

Comparison of obese and non-obese patients in terms of self-esteem, body perception, body weight perception and sociodemographic components

Objective: The aim of the study is to compare the randomly selected obese patients from the endocrinology outpa-tient clinic of a university hospital and the randomly selected non-obese patients from the general internal diseases outpatient clinic of the same hospital in the sense of self-esteem, body perception, body weight perception and some other sociodemographic features. Methods: The study included a total of 350 patients, of whom 175 were obese (147 female patients, 84%) and 175 were non-obese (115 female patients, 65.7%). The body mass indexes of the patients who were included in the study were measured. While the Rosenberg Self Esteem Scale was used to assess self-esteem, the body perception scale was used to assess the body perception of these patients. The consistency between the body mass index classifications and the self-body weight perceptions of the patients was also assessed. Results: The obese patients were found to have lower self-esteem and be less pleased about their bodies, and tend to perceive their body weights lower than their actual body weight when compared with the non-obese group. The non-obese patients in our study were found to be more pleased about their bodies whereas they showed higher levels of self-esteem and perceived their body weights more accurately. Discussion: In the light of these findings, obese patients should be evaluated in terms of psychiatry and get psychiatric help if needed. Eventually, obesity is an important issue which should be addressed multidisciplinary.

The Prevalence of Internet Addiction in Turkish Adolescents with Psychiatric Disorders.

The aim of this study is to determine the prevalence of Internet addiction (IA) in adolescents with psychiatric disorders. A total of 310 adolescents, aged from 12 to 18, participated in the study. The psychiatric sample group included 162 participants who had applied to the child psychiatry outpatients service. The psychiatric disorders among those in this group were assessed through clinical interviews based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision (DSM-IV-TR). The control group was chosen from adolescents of families who had never sought psychiatric help. The demographics of the participants and the features of their Internet usage habits were gathered through a questionnaire prepared by researchers. Young's Internet Addiction Test was used to assess internet addiction. The frequency of IA was found to be significantly higher in the psychiatric sample group than in the control group (24.1% vs. 8.8%, respectively). A total of 23.9% of the subjects had one, and 12.6% had two or more co-morbid psychiatric diagnoses. The frequencies of the diagnostic groups were as follows: attention deficit hyperactivity disorder 55.6%, anxiety disorder 29.0%, mood disorder 21.0%. IA was found to be significantly more common among adolescents in the child psychiatry outpatient department than among the adolescents who had no psychiatric history, even after confounding variables had been controlled. Further studies are needed to define IA more precisely and to improve prevention approaches.

SU76 - INCREASED FREQUENCY OF RARE GENETIC DISEASE VARIANTS IN LARGE SCHIZOPHRENIA, BIPOLAR, AND DEPRESSION POPULATIONS

Background Genetic diseases are individually rare but collectively common. Many genetic conditions can mimic mental health disorders, with psychiatric symptoms that are difficult to treat with regular medications. Treatment of the underlying genetic disease can cure the associated psychiatric symptoms or help regular medications work better. Discovery of rare genetic diseases in psychiatric patients would reveal specific treatment options, and give information about the chances of other family members being affected. In this study, we test the hypothesis that psychiatric populations are enriched for pathogenic variants associated with selected treatable genetic disorders. Methods Using targeted exome sequencing, we screened 2,046 schizophrenia, bipolar and major depressive disorder patients for variants in genes associated with Niemann-Pick disease type C (NPC), Wilson Disease (WD), Homocystinuria (HOM), and Acute Intermittent Porphyria (AIP). Results Our study is the first to explore the prevalence of NPC, WD, HOM and AIP gene variants in well-defined psychiatric populations. We found carrier rates of 0.88%, 0.88% and 0.20% for NPC, WD and HOM, respectively. Furthermore, an AIP affected rate of 0.20% was observed across the entire psychiatric cohort, a 200X enrichment in comparison to what is expected in the general population. Discussion Discovering genetic diseases in psychiatric patients will shift how health care is delivered to these vulnerable patients by addressing underlying conditions rather than masking symptoms with medications and will especially help patients who don't respond to regular medications. This will lead to significant cost savings to the health care system.

Psychiatric symptoms in migraine patients and their attitudes towards psychological support on stigmatization

ObjectiveAlthough migraine patients experience more psychological problems when compared to the general population, they are usually not treated. The reasons for non-treatment of these problems are not clear. The anxiety and concern of migraine patients about stigmatization may also prevent them to express psychological symptoms. The present study aimed to investigate the attitudes and behavior of migraine patients about receiving psychological help and their concerns about stigmatization. Material and methodThe study group included 50 18–49 years old patients diagnosed with migraine in the neurology clinic and the control group included 50 healthy individuals with similar age, gender socio demographic characteristics with the study group. Attitude Scale Towards Seeking Professional Help (ASPH-SF), Self-Stigma in Seeking Professional Help Scale (SSPHS), Intentions to Seek Psychological Help Scale (ISHP), Stigma Scale for Receiving Psychological Help (SSRPH) and Symptom Checklist (SCL-90-R) were applied to all participants. FindingsThe comparison of the patient and control groups based on SCL-90-R findings demonstrated that the patient group scores in somatization, anxiety (p = 0.000), depression (p = 0.003), anger (p = 0.02), interpersonal sensitivity (p = 0.006), phobia (p = 0.001), paranoid thoughts (p = 0.012), psychosis (p = 0.031) subscales and additional subscale (p = 0.014) and general symptom index (p = 0.001) scores were higher. Based on SCL 90, it was found that patients with higher levels of symptoms had higher social stigma scores when compared to patients with lower symptom levels (p = 0.007). Migraine patients with high symptom levels were found to have significantly lower rates of seeking psychiatric help (14% vs 33%) when compared to the control group. There was no difference between the patient and control groups based on ASPH-SF, SSPHS, ISPH and SSRPH scale scores. ConclusionAlthough migraine patients exhibit higher levels of psychiatric symptoms when compared to healthy individuals, it was determined that only a minority of these patients receive psychiatric treatment. Especially patients with high level of psychiatric symptoms could have sought less psychiatric help due to the concerns of stigmatization.

Stressors and coping strategies among physiotherapy students: Towards an integrated support structure.

BackgroundStress is a major problem among university and, specifically, health care students, as it may influence academic performance and psychological well-being negatively.AimsTo develop and implement a student support system based on the perceived stress, stressors and coping strategies of physiotherapy students.MethodsA cross-sectional, descriptive study was undertaken, using a literature-based, self-compiled questionnaire and the 28-item General Health Questionnaire (GHQ-28). Over a period of three years, 207 third- and fourth-year physiotherapy students at a South African university were included.ResultsPsychological distress was experienced by 61.8%–71.2% of participants. During the 3 months prior to the study, 6% of participants received psychological or psychiatric help and 9% of participants used some form of psychiatric medication. The main stressors identified during clinical training were the suffering and death of patients, academic pressure and tension during interaction with personnel. Participants indicated that they mainly coped with these stressors by talking to someone such as a family member or a friend.ConclusionsBased on the findings of this study, a framework to identify and support students in pre-clinical and clinical training years was developed and implemented over five years. This proposed framework might positively contribute to the psychological well-being of health care students.

Impact of oil recession on community mental health service utilization in an oil sands mining region in Canada.

This retrospective clinical audit compared changes in community mental health service utilization before and during an economic recession in an oil sands region in Canada which was characterized by a doubling of unemployment rates and poor economic outlook. Sociodemographic descriptors, psychiatric antecedents, clinical characteristics and follow-up care were compared before and during the recession for newly assessed patients in community mental health clinics located across a Northern Alberta oil mining region. Data were collected retrospectively as part of a clinical audit process and then analysed with descriptive statistics, cross-tabular univariate analyses with chi-square tests using SPSS version 20. A total of 1,465 patients were included. Sociodemographic factors disproportionately elevated during the recession included male sex, Caucasian ethnicity, own home ownership, higher levels of education and unemployment. More patients seeking mental health care were already taking psychotropic medications (e.g. antipsychotics, benzodiazepines and stimulants). At the same time, disproportionately fewer patients engaged in substance abuse or had a prior formal history of mental health problems. The referral reasons during recession were less likely to be associated with substance abuse or mood concerns and more likely for 'other' reasons. The patients seeking psychiatric help during a recession were disproportionately likely to be diagnosed with personality disorders and 'other' less common diagnostic categories and less likely to suffer from mood or trauma-related diagnoses. Referrals for counselling and social services were also disproportionately more common during the recession. This study provides a comprehensive description of longitudinal patterns of mental health service utilization before and during a recession. The findings provide important evidence for policy and planning decisions to encourage resource allocation to help promote accessibility of the most needed community mental health resources.

Prevalence and possible risk factor of social phobia among male secondary and intermediate school students in Al-Medinah, 2016

Background: When prevalence estimated was based on the examination of psychiatric clinic samples, social anxiety disorder was thought to be a relatively rare disorder. The opposite was instead true; social anxiety was common but may be were afraid to seek psychiatric help, leading to an underestimation of the problem. Objectives: To determine the prevalence and possible risk factors of social phobia among intermediate and secondary school male students in Almadinah city. Subjects and methods: A cross-sectional study was conducted included a random representative sample of male students enrolled in intermediate and secondary governmental schools in Al-Madinah city throughout the scholastic year 1436-1437 H (2014-2015).The social phobia Inventory (SPIN) scale was utilized to diagnose social phobia at a cut-off value of 19 whereas the Social Phobia Risk Factors Questionnaire (SPRFQ) was applied to assess risk factors for social phobia. Results: The study included 425 students; 258 were recruited from intermediate schools (60.7%) and the remaining 167 (39.3%) from secondary schools. Their age ranged between 12 and 22 years with a mean of 15.75 and standard deviation of ±1.94 years. Social phobia was identified among 29.5% of intermediate school students compared to 18.6% of secondary school students. The difference was statistically significant, p=0.011.Multivariate logistic regression analysis revealed that intermediate school students who had close friends with social phobia, those frequently experienced battering, bullying and humiliation, those experienced withdrawal and fear when facing new situation or people at least in the past 6 months. Students who have problems with their fathers and first born students were more significantly like to develop social phobia compared to their counterparts whereas secondary school students who frequently experienced battering, those experienced shyness when facing new situation or people at least in the past 6 months and first born students were more significantly like to develop social phobia compared to their counterparts. Conclusion: The prevalence of social anxiety disorder among the intermediate and secondary school students in Al-Madinah city is high. Important significant risk factors for social phobia have been identified.

An Overview of a Hospital-Based Child Advocacy Center’s Experience from Turkey

ABSTRACTThe purpose of the present study was to investigate sociodemographic variables, features of sexual abuse (SA), and first psychiatric evaluation results of abused children, and to analyze the relation of the psychiatric evaluation results to the children’s age and gender, type and duration of abuse, abuser–child relationship, and marital status of the children’s parents, at one of the most experienced Child Advocacy Centers (CACs) in Turkey. All data were obtained from reports prepared by child and adolescent psychiatrists. The sample of this study consists of 436 child sexual abuse (CSA) cases who admitted İzmir CAC between April 2014 and November 2015. The statistical analyses yielded significant relations between psychiatric symptoms and chronic abuse, the gender of the children, and type of abuse. Suicidal ideation and behaviors due to sexual abuse (SA) were also examined. According to our results, it is fair to say that children exposed to SA benefit from immediate psychiatric help because of their vulnerability for psychiatric disorders due to abuse. In this context, CACs are very important multidisciplinary establishments to determine children’s multiple needs to ease their trauma with collaborative teamwork. Psychiatric evaluation should be part of this multidisciplinary context.

F195. ENRICHMENT OF PATHOGENIC VARIANTS ASSOCIATED WITH TREATABLE GENETIC DISEASES IN LARGE SCHIZOPHRENIA, BIPOLAR AND DEPRESSION COHORTS

BackgroundGenetic diseases are individually rare but collectively common. Many genetic conditions can mimic mental health disorders, with psychiatric symptoms that are difficult to treat with regular medications. Treatment of the underlying genetic disease can cure the associated psychiatric symptoms or help regular medications work better. Discovery of rare genetic diseases in psychiatric patients would reveal specific treatment options, and give information about the chances of other family members being affected. In this study, we test the hypothesis that psychiatric populations are enriched for pathogenic variants associated with selected treatable inborn errors of metabolism (IEMs).MethodsUsing targeted next-generation sequencing, we screened schizophrenia (n=1132), bipolar (n=719) and major depressive disorder (n=195) patients for variants in genes associated with Niemann-Pick disease type C (NPC), Wilson disease (WD), homocystinuria (HOM) and acute intermittent porphyria (AIP), and compared the frequency of known and predicted pathogenic variants found to 123 136 samples from the gnomAD consortium.ResultsOur study is the first to explore the prevalence of NPC, WD, HOM and AIP gene variants in well-defined psychiatric cohorts. Among 2046 cases (male, n=1106; female, n=940), carrier rates of 0·93%, 0·98% and 0·20% for NPC, WD and HOM were seen, respectively. The carrier rate for NPC was marginally enriched in the SCZ cohort (1·15%) compared to general (95% CI, 0·007 – 0·021; p=0·084) and comparison (95% CI, 1·967 – 5·272; p=5·16e-05) populations. AIP affected rate of 0·29% was observed across the entire psychiatric cohort relative to the general (95% CI, 0·001 – 0·006; p=3·47e-13) and comparison (95% CI, 1·572 – 10·044; p=0·012) populations, an almost 300x enrichment in comparison to what is expected in the general population.DiscussionAn enrichment of known and predicted pathogenic variants associated with NPC and AIP was found in the psychiatric cohort, especially in SCZ patients. The results of this proof-of-principle study support that rare genetic disease variants, such as those associated with treatable IEMs, may contribute to the pathogenesis and treatment responsiveness of psychiatric disorders. Discovering genetic diseases in psychiatric patients will shift how health care is delivered to these vulnerable patients by addressing underlying conditions rather than masking symptoms with medications, and has the potential to especially help patients who don’t respond to regular psychotropic medications. Further studies screening large psychiatric cohorts for pathogenic variants in a large panel of treatable IEM genes will reveal the full impact of such disorders for psychiatric patients.

The Mental Health Status and Intellectual Ability of Unwed Mothers Dwelling in Korean Shelter Homes.

Although many unwed mothers have issues concerning mental health and intellectual ability, little research has focused on their mental and cognitive status. Due to the public stigma attached to unwed mothers in South Korea, they tend to conceal their status and are less likely to seek psychiatric and psychological help. In this context, this study aims to assess the current status of their mental health and intellectual characteristics. A total of 48 unwed mothers from two shelter homes in South Korea agreed to participate in the study. We compared the mental health status of these unwed mothers with that of the general female population. Unwed mothers were more likely than those of the general female population to have mood disorders, post traumatic stress disorder (PTSD), alcohol and nicotine use disorders, and attention-deficit hyperactivity disorder (ADHD). Among the 48 unwed mothers, 20 (41.7%) had an IQ of less than 70, and the mean IQ (78.31) was significantly lower than the normalized mean IQ of the general female population. This study confirmed that unwed mothers dwelling in Korean shelter homes are more likely than the general female population to have mental disorders.

Depersonalization and psychosensory disorders amongst young people who do not seek psychiatric help appeal for psychiatrysts (prevalence, clinical features and classification)

The importance of this study is justified by the high occurance frequency of this phenomenon amongst young people in the clinical structure of mental disorders and as well as in the framework of psychological defense mechanisms in psychiatrically healthy population. The question of the limits of depersonalization remains unresolved, as there is no single point of view regarding the syndromological affiliation, rendering it ambiguous to evaluate it as a productive or negative disorder.&#x0D; Aim. This study was aimed at verifying the prevalence and clinical structure of depersonalization symptoms amongst young people.&#x0D; Materials and Methods. A continuous sample consisting of 96 medical students – 68 (71%) female and 28 (29%) male, from 18 to 23 (19±1.2) years was studied using medico-social, clinico-psychopathological, psychometric and statistical methods.&#x0D; Results. Depersonalization symptoms were found amongst 94% of respondents. Different forms of autopsychic depersonalization were identified in the different psyche spheres – effector-volitional sphere, thinking and self-awareness (except the depersonalization in emotional sphere – «pathological insensitivity», which were previously identified). The validity of their separation was confirmed by cluster analysis. Along with depersonalization disorders, in more than half of the cases, a variety of psychosensory disorders were observed.&#x0D; Conclusions. Depersonalization phenomena along with various psychosensory disorders are widespread amongst adolescents without obvious mental disorders or gender preference. Therapy is useful if depersonalization obstructs social functioning and coupled with anxiety and depression.