Psychiatric Outpatient Department Research Articles

Adapting dialectical behavior therapy in Mandarin-speaking Chinese patients with borderline personality disorder: An open pilot trial in Taiwan.

Dialectical behavior therapy (DBT) is the most commonly used treatment for patients suffering from borderline personality disorder (BPD). However, data on its applications in Asian countries remain lacking. This pilot study aims to evaluate the feasibility and effectiveness of applying Mandarin-translated DBT among suicidal Chinese patients with BPD in Taiwan. An open-label trial design was implemented for the 1-year standard DBT model. Patients from a psychiatric outpatient department in a general hospital in Taiwan with a history of ≥2 episodes of suicidal behavior within the previous year and who scored >40 on the Borderline Symptom List were invited to participate in this trial. Outcomes of suicidal behaviors, severity of BPD and depression symptoms, suicidal ideation, hopelessness, and quality of life were assessed at the beginning of the treatment and every 3months until 12 months. Eighteen patients participated, three of whom (16.7%) dropped out. Significant improvements were found in the frequency and severity of suicidal behaviors and ideations, depressive symptoms, and BPD symptoms beginning as early as the third month after initiating DBT. This pilot study found that DBT may be an effective and feasible intervention for Mandarin-speaking individuals with a recent history of suicidal behaviors with BPD. Future randomized controlled trials with comparison groups are needed to further determine the efficacy of DBT on this population.

Assessment of the Level of Coping Strategies in Patients with Depression Attending Psychiatric Outpatient Department at Selected Teritary Care Hospitals Coimbatore

Depression is one of the four major diseases in the world. Patients with depression uses different coping stylesto cope up with their problems. The objective was to assess the coping strategies adopted by the patients withdepression and to find out the association between coping strategies and selected demographic variables. Thedescriptive study was undertaken among patients with depression and non-probability purposive samplingtechnique was used. The data was collected using structured questionnaire. In overall 60% of patients havemoderate level of coping strategies, 30% of patients have inadequate level of coping strategies and 10% ofpatients have adequate level coping strategies. There was significant association between the level of copingstrategies and the demographic variable like domicile. This study concluded that selected patients withdepression had moderate level of coping strategies.

Self-Information Module on Psychotropic Drug Management Among Mentally Ill Patients Attending Psychiatric OPD

Introduction: Psychiatric drugs, which are also used to treat mental problems, are given to a significant number of patients in today’s society. Many persons who have been diagnosed with psychiatric problems are now able to lead happy lives as a direct result of the use of psychiatric drugs. Aims: The purpose of this study was to evaluate the effectiveness of a self-information module on the management of psychotropic medicines for carers of mentally ill patients who were attending the psychiatric outpatient department at Krishna Hospital. evaluation of the knowledge of psychotropic drug use among caretakers of psychiatric patients is the purpose of this study, in order to determine the usefulness of the information module. to establish a connection between the findings and a range of relevant demographic data. Methodology: Consisted of using an evaluating strategy in conjunction with a one-group pre-test post-test pre experimental design. The mental outpatient department of Krishna Hospital in Karad served as the site of the study. The population of this study is comprised of all of the carers of psychiatric patients who visited the psychiatric outpatient department (OPD). The sample included sixty caretakers of patients who were being treated with antipsychotic medications. A technique known as non probability sampling is one in which the sample is collected by the use of a method that does not provide every individual in the population with an equal chance of being selected. The goals of the study served as the foundation for the development of the instrument. Result: The findings showed that 50 (83.33%) of the samples had an average level of expertise regarding the administration of psychotropic medicines. The results show that the 10 (16.66%) samples had inadequate understanding on the administration of psychiatric drugs. The table reveals that not a single sample achieved a perfect score of 0 (100%) on the pre-test. In the post-test, 54 (90%) of the samples have good knowledge regarding the management of psychotropic drugs, 5 (8.33%) of the samples have average knowledge regarding the management of psychotropic drugs, and only 1 (1.66%) of the samples have poor knowledge regarding the management of psychotropic drugs. The knowledge scores regarding the management of psychotropic medicines prior to and after undergoing the self-information module of 60 observations had a mean of 13.15 before the test and 23.45 after the test. Before the test, the standard deviation was 2.7558, and after the test, it was 2.9968. The null hypothesis is rejected since the computed result for the t-test statistical test is 57.592, and the p-value for the test is less than 0.05, hence the test rejects the null hypothesis. Conclusion: It has been demonstrated that the self-information module is an effective way for increasing the level of knowledge that carers have on the administration of psychiatric drugs.

Socioeconomic and demographic profile of autism spectrum disorder

Background: Autism spectrum disorder (ASD) is a multifactorial disorder resulting from genetic and nongenetic risk factors and their interaction. There is a paucity of data on the socioeconomic and demographic factors underlying ASD from India. Aim: The aim of this study was to evaluate the socioeconomic and demographic profile of ASD. Materials and Methods: Six hundred patients with behavioral complaints reporting to either psychiatric or pediatric outpatient departments were screened and validated as per Autism questionnaire (Childhood Autism Rating Scale [CARS]). Included patients were evaluated on socioeconomic and demographic scale the appropriate Child Behavior Checklist (CBCL). Results: Twenty-eight children out of 600 (4.66%) were found to have ASD. The average age at which parents first noticed symptoms was 16 months (range: 9–24 months). The mean age at first consultation for ASD symptoms was delayed for girls. A highly significant association between intelligence quotient (IQ) and a diagnosis of ASD was seen. The mean IQ of ASD patients (93.2 n = 28) was significantly lesser than either psychiatric diagnoses or no diagnosis. Even though all patients had an IQ >70, there were still 9/28 patients with a level 3 severity of ASD. A highly significant association between ASD diagnosis and CARS scores was seen. Out of the documented 26 presenting complaints, 17 were social impairment related and 9 related to repetitive patterns of behaviors. The clinical findings from the CBCL conform to a previously developed autism profile for CBCL. Conclusion: Children are taking longer than recommended for optimal outcome to receive a diagnosis. Girls were brought for consultation with the pediatrician later than the boys. Male preponderance in ASD with M: F ratio of 6:1 was highly significant. ASD was found higher in MSES and HSES families. Living in urban areas predicted higher severity. IQ was lesser than for other conditions in ASD.

Effect of COVID-19 and sociocultural milieu on the psychopathology of mental health disorders: A hospital-based study.

Background:Coronavirus disease (COVID-19) has posed a remarkable threat to mental health all around the world. This pandemic has increased the incidence of common as well as severe mental illness (SMI) all around the world.Materials and Methods:We report 10 cases presenting to the psychiatric outpatient department (OPD) of Institute of Medical Sciences, Banaras Hindu University, from August to October 2020. They were either referred by other departments (3 patients) or came primarily to psychiatric OPD (7).Results:Five out of these 10 cases presented with predominant psychotic features; 3 cases had predominant obsessive–compulsive features; and 1 case was of dissociative trance possession.Conclusion:COVID-19 can affect the psychopathology of both types of patients either with preexisting mental illness as well as new-onset SMI.

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

The Relationship of Relatives’ Illness Perception, Expressed Emotion and Their Burden in Caring for Patients with Schizophrenia

Background: The chronic burden of care to a patient with schizophrenia which produce negative emotions. As a result of de-institutionalization, caregivers have greater burden for the care of their mentally ill relatives. Objective of this study was to explore the relationship of relatives’ illness perception, expressed emotion and their burden in caring for patients with schizophrenia. Design: This study followed a correlation descriptive research design. Setting: This study conducted at inpatient and outpatient psychiatric department of Tanta University Hospital. Subject: The study subjects consist of 100 relatives of patient with schizophrenia. Tools: Tool 1 consisted of 2 parts: Part 1 Socio-demographic and general characteristics of studied participants, Part 2 Illness Perception Questionnaire-Schizophrenia Carers Version (IPQ-SCV), Tool 2 Family Questionnaire (FQ), Tool 3 Caregiver Burden Interview. Results: it was found that the studied participants had poor illness perception total score, it was found that the studied subjects (47%) had high emotional over- involvement level while it was observed that the two thirds of the studied relatives (61%) had high level of family criticism. majority of studied participants had moderate level of family burden. Conclusion: The results concluded that there was a significant positive correlation between family illness perception and family expressed emotion, also there was a significant positive correlation between family emotional expression and family burden level. Recommendations: this study recommended future studies to investigate distress and burden among caregivers with high emotion expression for intervention, reducing family stress and burden.

Η προσκόλληση και οι μηχανισμοί άμυνας σε άτομα διεγνωσμένα με οριακή διαταραχή προσωπικότητας

The interest with regard to the Borderline Personality Disorder (BPD) has increased in the past few years, because the number of people with the aforementioned diagnosis who use mental health services has risen. The study aimed at examining the defense mechanisms in people with BPD diagnosis in relation to the attachment type they adopt. Thesample consisted of 36 adult subjects diagnosed with BPD who attended psychiatric outpatient departments and 36 people who attended the ophthalmologic outpatient care at a general hospital. The adult attachment questionnaire CA-MIR and the Defense Style Questionnaire-40 were administered to the participants. In general, results are in accordance with the theoretical background, because it was demonstrated that diagnosed subjects scored higher in the insecure attachment types, that is, the ambivalent, the detached and the non-resolved, whereas the non-diagnosed scored higher in the autonomous attachment. Moreover, diagnosed subjects used more than the non-diagnosed participants the neurotic and the immature defenses,but they did not differ with respect to mature defenses. Finally, correlations between attachment and defenses were found with the exception of the mature that correlated with no attachment model. These findings may contribute to the identification of factors that participate in BPD and in the configuration of more efficient therapeutic interventions.

Characteristics of First Visit Pediatric Patients with Suicidal Ideation and Behavior: An 8-Year Retrospective Chart Review.

ObjectivesOur study aimed to analyze the demographic and clinical characteristics of children and adolescents during their first visit to psychiatric outpatient departments for the management of suicidal ideation and behavior, and to compare the changes before and in 2012 or later.MethodsThis multicenter study was conducted at five university hospitals in a metropolitan area in South Korea. Medical records of patients aged 6–18 years were retrospectively reviewed from January 2009 to December 2016. Patients were analyzed by classifying them into suicidal and non-suicidal groups based on their visit to the hospital for management of suicidal ideation or suicide attempt and other mental problems, respectively.ResultsThere were differences in the year of visit, diagnosis, education level, and referral sources between patients in the suicidal and non-suicidal groups. Multiple regression analysis was conducted based on the sex, education level, referral by school, and diagnosis of depression in patients in the suicidal group, which revealed significant association.ConclusionSuicide-related problems were significantly associated with the sex, education level, referral by school, and a diagnosis of depression in the patients. A well-connected referral system would be necessary for professional mental health management of high-risk children and adolescents.

A Study of Psychotropic Drugs Being Prescribed to the Patients Attending the Psychiatric Outpatient Department in a Tertiary Care Hospital

BACKGROUND & PURPOSE: Drug utilization research evaluates the appropriateness of the prescriptions which is important in clinical practice. Psychotropic polypharmacy is a major problem in psychiatric practice, which can lead to the development of adverse effects of those drugs in patients. Therefore, this study was carried out to evaluate the utilization of psychotropic drugs being prescribed for various psychiatric illnesses.
 MATERIALS & METHODS: A prospective, cross sectional, observational study was carried out in patients visiting the Psychiatric Out-Patient Department of B J Government Medical College and Sassoon General Hospital, Pune, INDIA; from December 2016 to May 2018. A total of 500 prescriptions were analysed using WHO Drug Use indicators and some other indicators.
 RESULTS: Average number of drugs per prescription was 3.14 ± 1.18; while average number of Psychotropic drugs per prescription was 2.27 ± 0.90. 84.35% of the total drugs prescribed by Generic name. 43.89% and 41.67% of the total drugs were prescribed from National List of Essential Medicines 2015 and WHO Model List of Essential Medicines 2017, respectively. Antipsychotics was the most commonly prescribed group of Psychotropic drugs, while Olanzapine was the most commonly prescribed Psychotropic drug. 64.25% of the total drugs were prescribed from the hospital drugstore.
 CONCLUSION: In the present study, drugs were prescribed rationally and judiciously. But there was a need to increase the prescription of drugs from essential drug lists. Apart from that, there was found a need to increase the availability of the commonly prescribed Psychotropic drugs in the hospital drugstore of the study institution.

Family planning awareness, utilization and associated factors among women of reproductive age attending psychiatric outpatient care, a cross- sectional study, Addis Ababa, Ethiopia.

BackgroundWomen with mental illness have a special need for family planning as they carry a high risk of unplanned pregnancy, sexual violence and, the poor obstetric outcomes due to their mental illness, as well as teratogenicity from exposure to psychotropic medications lower antenatal care utilization.ObjectiveTo assess knowledge, and utilization of family planning and associated factors among women attending psychiatric outpatient clinics in Addis Ababa.MethodsA cross-sectional study was conducted among 423 women attending the outpatient psychiatric clinics of three general and one specialized mental hospital in Addis Ababa, the capital city of Ethiopia. A structured and pretested questionnaire were administered by psychiatric nurses. Multiple logistic regression analysis was conducted to identify factors associated with utilization of family planning methods.ResultFour hundred twenty-two participants who had follow up at the psychiatric outpatient departments participated in the study. Almost 88% of participants had an unintended pregnancy. Only 68% of study participant had ever heard about Family planning. Just over one third (38.6%) reported current use of at least one method of Family planning. Of those not using family planning 73.3% had no intention to have children. And 38.8% did not have any intention to use Family Planning in the future. Fear of drug-interaction with psychiatric medication was the most common reason not to use contraceptives. Having one or two children was associated with higher utilization of family planning [adjusted odds ratio (95%, confidence interval) 2.05 (1.06, 3.99)].ConclusionsIn this study, the majority of women with mental illness were not using family planning methods. The Awareness of the Family planning methods is lower than the national average. Education and counselling about family planning for women attending psychiatric outpatient departments should be strengthened.

Profile of recipients of holistic health counselling in a psychiatric OPD in South India.

Persons with mental illness (PwMI) are prone to weight gain as a side effect of antipsychotics. Health counselling on diet, physical activity, medication adherence, expressed emotions and technology use, by health professionals, can help in managing these side-effects. The aim of this study was to identify the pre-counselling profile of the subjects such as body mass index (BMI), diet, physical activity, medication adherence, expressed emotions and technology use among PwMI; to attend the Holistic Health Clinic as part of follow-up services in the psychiatry Outpatient Department (OPD) as well as to find correlation and association between the study variables. The study involved a cross-sectional descriptive design based on convenience sampling. The sample consists of 56 patients who are receiving antipsychotics under symptom control (self-reported) and were overweight. Data were collected with a patient assessment proforma and analysed using SPSS-22. The patients referred to the holistic health counselling (HHC) had abnormal weight and BMI. The mean and SD of weight was 74.48 ± 14.07 and BMI 29.51 ± 5.15. All the participants received counselling on diet, 87.5% on physical activity, 62.5% on sleep hygiene, 55.4% on medication adherence, 8.9% on family emotional climate and only 5.4% on healthy use of technology. Weight has shown significant relation with gender (male = 80.84 ± 17.71, female = 71.09 ± 10.52, t = -2.52, p = .015) and near to significant relationship (χ2 = 7.685, p = .053) with educational status. Patients receiving second-generation antipsychotics (SGA) have lesser extra pyramidal side-effects; however, they are more prone to gain weight. Proper screening and counselling during the follow-up visit in the outpatient setting can help in identification, prevention and management of the obesity-related metabolic syndrome and cardiovascular disease (CVD), and motivate them to adopt healthy behaviours.

Effect of Social Skills Training Program on social functioning in patients with major depressive disorder in Outpatient Psychiatric Department, King Chulalongkorn Memorial Hospital (P. 335)

Effect of Social Skills Training Program on social functioning in patients with major depressive disorder in Outpatient Psychiatric Department, King Chulalongkorn Memorial Hospital (P. 335)

Psychiatrist experience of remote consultations by telephone in an outpatient psychiatric department during the COVID-19 pandemic.

In response to the COVID-19 pandemic, there has been a shift globally from face-to-face consultations to remote consultations. In our department, remote consultations have taken in the form of telephone consultations. In this paper, we set out to study a group of Irish psychiatrists' experience of these consultations. We identified recurrent themes in the existing literature on doctors' experience of telephone consultations with a view to determining the applicability of these themes to a group of Irish psychiatrists. A questionnaire was developed based on themes in the literature. This was sent to all psychiatrists working in a busy psychiatric service in Dublin. The questionnaire response rate was 72% (n = 26/35). Diagnostic challenges, the effect of phone consultation on the therapeutic alliance, challenges associated with the use of technology and ethical concerns were identified as issues. Flexibility in the working day and convenience were identified as possible benefits to telephone consultations. The group that participated in this research study identified a number of challenges to carrying out successful phone consultations. This study highlights the need at our clinical site for interventions to address the issues identified by staff. The findings also highlight the requirement for larger studies with stronger methodologies to determine the generalisability of our results.

Psychotropic drug utilization in psychiatric outpatient department of a tertiary care government hospital

Background: Mental disorders are associated with significant distress in social, occupational and other important activities. Of the ten health conditions contributing to the DALYs, four are psychiatric disorders. Psychiatric disorders form an important public health priority and major causes of morbidity. Psychotropic drugs had a remarkable impact in psychiatric practice. The utilization, clinical practice, effectiveness and safety in real life situation need continuous study.Methods: A cross-sectional study was carried out by analyzing prescriptions of patients who visited the OPD of the psychiatry department of VIMSAR, Burla for a period of 4 months. Patients of all ages and both sexes were included in this study with exclusion of patients suffering from epilepsy and cases with uncertain diagnosis. The prescribing pattern was analyzed using WHO basic drug indicators.Results: Average number of drugs per prescription was 3.17. Bipolar affective disorder (BPAD) was the most common psychiatric condition (44%) with a male predominance followed by schizophrenia. Olanzapine was the most common antipsychotic used. The most frequently used fixed dose combination was tri-hexiphenydyl and risperidone. Prescribing frequency of different psychotropic drugs (antipsychotics, antianxiety, selective serotonin reuptake inhibitors, tricyclic antidepressant, mood stabilizers) were compared.Conclusions: The study advocated a rational use of psychotropic drugs with fewer deviations due to socio-economic status of patients and prescription practices of healthcare providers.

Psychiatric Comorbidities in Patients with Migraine in a Tertiary Hospital.

Psychiatric disorders are common in the migraine patients and affect the quality of the life of the individual. The objective of the study was to study the different psychiatric comorbidities and its relationship in migraine patients. This was hospital based cross-sectional study. Seventy patients attending psychiatric outpatient department of Manipal Teaching Hospital, Pokhara with a diagnosis of migraine headache were included. The proforma was used to record socio-demographic variables. The patients were administered Mini International Neuropsychiatric Interview to find out the comorbid psychiatric disorder. The migraine was found more in the age group between 26 to 35 years, female gender and in the Brahmin caste. The migraine was also noticed to be higher in the homemakers, higher secondary educated and middle class patients and the patients living in the urban area. The comorbid psychiatric illness was found in 38 cases (54.3%) among which mild depressive disorder was the most common diagnosis (14.3%). The patients of migraine with aura had high risk of developing the psychiatric comorbidities as compared to the patients without aura (Odds Ratio = 1.22), although this relationship was insignificant (p value = 0.7688). Mild depressive episode was the most common comorbid psychiatric condition. Migraine with aura have high risk of developing psychiatric comorbidities.

Perceptions, clinical characteristics, and other factors associated with prolonged and high daily dose of benzodiazepine use among patients with anxiety or depressive disorders

BackgroundBenzodiazepines (BZDs) have been widely used to treat anxiety; however, the risk of adverse health effects caused by their long-term use is high. This study examined the factors associated with the duration and higher daily dose of BZDs use among a population with anxiety or depressive disorders. MethodsA cross-sectional study design was used. Patients from a psychiatric outpatient department who had been prescribed BZDs were recruited. Data were collected from 250 patients. ResultsNearly 94% of patients were long-term BZDs users. The mean duration of BZDs use was 5.5 years; and mean defined daily dose (DDD) of BZDs use, converted to diazepam milligram equivalent (DDD), was 1.53 DME-DDD. Patients who knew more about alternative treatments were less prone to use BZD longer. Patients aged 65 years or older and those with difficulty falling asleep were more prone to use BZDs longer. Patients who were currently taking BZDs at higher daily dose were those who felt more depressed, prescribed second generation antipsychotics, suffered from disrupted sleep, less aware of alternative treatments, had comorbid chronic physical illness, and were current smokers. LimitationsThe cross-sectional study design limited its ability to confirm causal relationships. ConclusionsLong-term and excessive daily dose of BZDs use in patients with depressive or anxiety disorders needs to be noted. Providing information or program of non-pharmacological treatment in reducing anxiety and improving specific sleep disturbance is suggested. Elderly, suffering from depressive mood, had comorbid chronic physical illness need to be targeted for further intervention.

Neurochemistry and subjunctivities of depression in Kerala, South India

The narrative of depression as a neurochemical imbalance in the brain or, more precisely, a deficiency of the neurotransmitters serotonin and norepinephrine – largely produced by commercial interests of the international and national pharmaceutical industry and spread globally by international diagnostic systems – has found its way into the offices of mainstream psychiatrists in Kerala. In the clinical encounters, social, economic and existential suffering is thus transformed into a medical condition, treatable with pharmacological means. On the one hand, the setting of a psychiatric outpatient department largely shapes the way depressive patients express their subjectivities. On the other hand, the diagnosis (and explanation) of depression as neurochemical imbalance and the prescription of drugs influences the way patients experience their suffering. Using two ethnographic examples, the aim of this paper is to analyze how subjectivities are construed and shaped in the process of negotiating depression in clinical encounters in mainstream psychiatric institutions in Kerala and how multiple framings and ontologies of affliction are assembled in them. Subjectivities of depression are, it will be argued, less coherent than ambigious and fractured, unstable and fragile. They engage, accentuate and sometimes merge different, often contradictory discourses. They should therefore better be referred to as ‘subjunctivities’. The idiom of depression often becomes a rhetorical device to emphasize affiliation to a scientific medical discourse or citizenship and is often a statement to emphasize ‘scientific temper’ and modernity and to demarcate oneself from backwardness and superstition.

Prevalence and Associated Factors of Metabolic Syndrome Among Patients with Severe Mental Illness at Hawassa, Southern-Ethiopia.

BackgroundPatients with severe mental disorders have a high risk of metabolic-related complications like metabolic syndrome (MetS), diabetes mellitus (DM), hypertension and lipid derangements, and these factors may predispose them to a high mortality rate. Data is very scarce regarding MetS among patients with severe mental illness in Ethiopia. Therefore, this study aimed to assess the prevalence of MetS and its associated factors among patients with severe mental illness.MethodsA cross-sectional study was conducted in Hawassa University Comprehensive Specialized Hospital from January to June 2019 among adult patients attending a psychiatric outpatient department, Southern Ethiopia. A systematic random sampling technique was used to select 245 study subjects. Socio-demographic and other data were collected using a structured questionnaire. Both the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) and International Diabetes Federation (IDF) guidelines were used to define MetS.ResultsThe prevalence of MetS was 24.5% and 26.9% by NCEP-ATP and IDF criteria respectively. In both definitions, females had significantly higher MetS when compared to males (31.4% vs 19.6%; p=0.03 by NCEP), and (34.3% vs 21.7%; p =0.03 by IDF), respectively. Duration >5 years with mental illness indicated higher MetS when compared to duration ≤ 5 years (42.9% vs 19.9%, p=0.001; and 46.9% vs 21.9%, p<0.0001) in NCEP and IDF, respectively. In addition, marital status [AOR (95% CI): 2.4 (1.1–5.3)], and BMI [AOR (95% CI): 8.4(4.0–17.6)], duration > 5 years with mental illness [AOR (95% CI): 2.8(1.2–6.5)], and age >40 years [AOR (95% CI): 2.7(1.2–6.1)] were significantly associated factors of MetS by NCEP. While BMI, age >40 years and duration > 5 years with mental illness were associated with MetS by IDF.ConclusionLong-time experience with severe mental illness and antipsychotic therapy might predispose patients to metabolic complications with significant risks of cardiovascular events. Therefore, intensive screening of patients for MetS/components is required during follow-up based on national non-communicable diseases guideline. Besides, the proper intervention of patients concerning lifestyle changes and averting risk full behaviors is mandatory.

Efficacy of cognitive behavioural therapy for internet gaming disorder.

Cognitive behavioural therapy (CBT) is considered to be an effective treatment for internet gaming disorder (IGD). This study examined the effectiveness of CBT in treating impulsivity, anxiety, avoidance, and family and environmental problems in patients. A total of 101 patients completed the CBT programme, and 104 completed the supportive therapy. The CBT programme consisted of fourteen 90-min sessions with one therapist and four to five patients, once or twice a week. The supportive therapy group visited a psychiatric outpatient department once or twice a week until they completed 14 visits. Outcomes were measured in terms of improvement in IGD, psychological symptoms, and social interaction. The CBT group (improvement: 67 [66.3%] versus non-improvement: 34 [33.7%]) showed more improvement in IGD compared with the supportive therapy group. The CBT group also showed a greater decrease in internet addiction, anxiety, impulsivity, and social avoidance. In the CBT group, among patients who improved, the greatest improvements were in internet addiction, attention, depression, anxiety, impulsivity, social avoidance, and family cohesion. Our CBT programme may be more effective than supportive therapy with regard to improvement in IGD symptoms by controlling anxiety, impulsivity, and social avoidance. In addition, CBT-related improvements in patients with IGD could be enhanced by controlling anxiety, social avoidance, and family cohesion.