Psychosocial Impairment Research Articles

First use of the Adolescent Depression Rating Scale (ADRS) in the management of young people with severe acne treated with isotretinoin: a pilot study of an active monitoring of depressive disorders by dermatologists.

During isotretinoin treatment, special attention is required to detect any symptom or change in the mental health of patients. The monitoring is complex for adolescents because of confounding factors such as mood changes associated with adolescence and puberty and the higher psychosocial impairment due to the acne itself. To determine the utility of the Adolescent Depression Rating Scale (ADRS) for monitoring symptoms in adolescents before and during isotretinoin treatment in dermatology real-life practice. This was a national, multicentre prospective study that enrolled a random sample of dermatologists treating adolescents. An algorithm including ADRS score and its changes between consecutive visits was used. At each visit, dermatologists rated their satisfaction with ADRS and its ease of use, while patients rated the acceptability of the ADRS. In total, 70 dermatologists used the algorithm for 1227 visits of 283 adolescents receiving isotretinoin. Of these 70 dermatologists, 80.8% were satisfied/very satisfied with the ADRS, 82.7% considered the use of the ADRS in clinical practice to be easy/very easy and 75% considered that the ADRS enabled them to discuss more easily the risk of depression with their patients. For the patients, acceptability of the ADRS was considered good by 93.8%. The implementation of the ADRS could be valuable in dermatology practice, optimizing the monitoring of patients and the good use of isotretinoin.

Impacts of Sexual Addiction on Intimate Female Partners—The State of the Art

here has been a surge of research articles in the last two decades about sexual addiction (SA) and compulsive sexual behavior (CSB). In the literature, SA/CSB is mostly presented as being comparable to other behavioral addictions and similarly involves a problematic consumption model: loss of control, psycho-social impairments, and risky sexual activities. Despite a recent rise in research interest in this area, only a small number of studies have focused on the partners’ lived experiences and wellbeing following the discovery or disclosure of compulsive sexual activities. This literature review addresses this knowledge gap by examining existing research on the female partners of those who have engaged in CSBs. The focus of this study is intentionally heteronormative, meaning that it expressly analyses the literature in relation to females who find themselves in a relationship with a male partner who experiences SA/CSBs. This research paper converges around the synthesis that female partners may endure a range of emotional, relational, physical, sexual, and/or spiritual effects following the discovery or disclosure of SA/CSB. In consequence, this review points to opportunities for future research whereby prospective studies may examine partner wellbeing through in-depth qualitative empirical research. This article charts pertinent perspectives and prospects.Supplemental data for this article is available online at https://doi.org/10.1080/26929953.2022.2050862 . HighlightsThe last two decades have seen a surge in research interest in sexual addiction (SA) and compulsive sexual behavior (CSB).Despite growing interest in this area, only a small number of studies have focused on the partners’ lived experiences and wellbeing following the discovery or disclosure of compulsive sexual activities.Applying a heteronormative analytical lens, this literary study addresses this knowledge gap by examining existing research on female partners of males experiencing SA/CSBs.The findings converge around the synthesis that female partners may endure a range of negative emotional, relational, physical, sexual, and/or spiritual effects following the discovery or disclosure of SA/CSB.The analysis points to opportunities for future studies to examine partner wellbeing through in-depth qualitative empirical research.

Chinese translation of the Clinical Impairment Assessment (CIA 3.0): Psychometric properties and measurement invariance across sex and age in adolescents, young adults, and adult men

The Clinical Impairment Assessment (CIA) is the most widely used instrument for assessing psychosocial impairment related to eating disorders (EDs). The CIA was translated into Chinese based on standard procedures. The psychometric properties of the Chinese CIA (C-CIA) were assessed among four adolescent and adult samples [i.e., 792 junior high school students (47.0% boys; Mage = 13.09 years), 1324 senior high school students (44.2% boys; Mage = 16.06 years), 812 undergraduate students (36.3% boys; Mage = 18.88 years), and 406 male adults from a general population (Mage = 28.53 years)]. The three-factor structure of the CIA was replicated. Excellent internal consistencies of the C-CIA were revealed, α = 0.93–0.98. The C-CIA showed moderate and good test-retest reliability in a six-month interval for junior high school students (ICC = 0.69) and senior high school students (ICC = 0.76), respectively. The C-CIA had good test-retest reliability in a two-week interval for undergraduate students (ICC = 0.78) and general adult men (ICC = 0.81). Our results supported good construct validity, known-group validity of the C-CIA, and measurement invariance across sex and age. These findings suggest that the C-CIA can be a useful tool assessing psychosocial impairment related to EDs for Chinese adolescents, young adults, and adult men.

Ketamine as a Novel Psychopharmacotherapy for Eating Disorders: Evidence and Future Directions

Eating disorders (EDs) are serious, life-threatening psychiatric conditions associated with physical and psychosocial impairment, as well as high morbidity and mortality. Given the chronic refractory nature of EDs and the paucity of evidence-based treatments, there is a pressing need to identify novel approaches for this population. The noncompetitive N-methyl-D-aspartate receptor (NMDAr) antagonist, ketamine, has recently been approved for treatment-resistant depression, exerting rapid and robust antidepressant effects. It is now being investigated for several new indications, including obsessive–compulsive, post-traumatic, and substance use disorder, and shows transdiagnostic potential for EDs, particularly among clinical nonresponders. Hence, the aim of this review is to examine contemporary findings on the treatment of EDs with ketamine, whether used as a primary, adjunctive, or combination psychopharmacotherapy. Avenues for future research are also discussed. Overall, results are encouraging and point to therapeutic value; however, are limited to case series and reports on anorexia nervosa. Further empirical research is thus needed to explore ketamine efficacy across ED subgroups, establish safety profiles and optimize dosing, and develop theory-driven, targeted treatment strategies at the individual patient level.

136. A trying time: Problematic Internet Use (PIU) and its Association With Depression and Anxiety During the COVID-19 Pandemic

Problematic Internet Use (PIU) is defined as uncontrollable internet use associated with psychosocial or functional impairment that is not due to a primary psychiatric diagnosis. PIU has been measured using different screening tools such as the Young Diagnostic Questionnaire (YDQ) for Internet Addiction or the Internet Addiction Tool (IAT) and the pre-pandemic prevalence has been variable at 0-26.3%. The prevalence using the Problematic and Risky Internet Use Screening Scale (PRIUSS) is estimated at 9-11.1% in American college-aged students.

Preventive putative mechanisms involved in the psychopathologies of mice passively coping with psychosocial defeat stress by quercetin

Derangements of neuroimmune, neurotrophic and neurochemical homeostasis have important implications in psychosocial stress-induced psychopathologies. Whether quercetin, a neuroactive compound, protects against psychosocial stress-induced psychiatric disturbances particularly via neurochemical mechanisms remain less well elucidated. Therefore, we further investigated the putative neurochemical as well as other cellular mechanisms of quercetin on social-defeat stress (SDS) model of psychosocial impairments. Saline (10 mL/kg,i.p.), quercetin (25, 50 and 100 mg/kg,i.p.) and ginseng (50 mg/kg,i.p.) were given to intruder mice for 14 days. From days 7–14, ten minutes of aggressive-resident-induced SDS (physical and psychological) were conducted thirty minutes after treatments. Subsequently, behavioral assessments: open-field, light/dark board, Y-maze, novel-object recognition, social-interaction and tail-suspension tests were conducted on day 14. Adrenal weight and glucose levels were measured. Monoamines, brain-derived neurotrophic factor (BDNF), corticosterone, inflammatory cytokines (TNF-α, IL-6) and executioner caspase-3 concentrations were determined in specific brain regions by ELISA. Oxidative/nitrergic stress and cholinergic markers were determined with UV-spectrophotometry. Psychosocial stress-induced anxiety, depression and cognitive defects were improved by quercetin. The decreased serotonin in the prefrontal-cortex and dopamine in the striatum, elevated levels of noradrenaline and acetylcholinesterase in the prefrontal-cortex and hippocampus with corresponding decrease in BDNF were reversed by quercetin. Quercetin reduced SDS-induced increased neuronal inflammation, caspase-3 activity, malondialdehyde, nitrite levels, but increased antioxidant activities in the three brain regions. Adrenal hypertrophy, increased serum glucose and corticosterone release were reduced by quercetin. Our findings showed that quercetin attenuates psychosocial stress-induced passive coping behavior via normalization of HPA-axis, modulation of neurochemical release, enhancement of BDNF, and inhibition of brain oxidative/nitrergic stress, neuroinflammation and apoptotic pathway.

Hyperhidrosis Comorbidities and Treatments: A Register-based Study among 511 Subjects.

Hyperhidrosis is a dermatological condition that causes psychosocial impairment and has a negative impact on patients’ quality of life. The epidemiology of hyperhidrosis is currently poorly understood. The aim of this study was to analyse comorbidities and treatments in 511 subjects with hyperhidrosis selected from the patient records of Oulu University Hospital. The mean age of patients with local hyperhidrosis was 27.9 years and the majority were female (62.7%). The most common anatomical site of symptoms in the youngest age group was the palms, whereas the axillae were a more common site in advanced age. Depression was a common comorbidity in both local (11.6%) and generalized hyperhidrosis (28.6%). Anxiety affected 12.7% of patients with generalized hyperhidrosis. In 36.8% of the patients with local hyperhidrosis there was a delay in diagnosis of more than 10 years. The most commonly used treatments included topical antiperspirants, iontophoresis and botulin toxin injections.

Eating Disorder Day Programs: Is There a Best Format?

The use of a Day Program (DP) format (i.e., intensive daily treatment with no overnight admission) has been shown to be an effective treatment for eating disorders (EDs). The disadvantages, however, include higher cost than outpatient treatment (including costs of meals and staff), greater disruption to patients’ lives, and the use of a highly structured and strict schedule that may interrupt the development of patients’ autonomy in taking responsibility for their recovery. This study investigated whether reducing costs of a DP and the disruption to patients’ lives, and increasing opportunity to develop autonomy, impacted clinical outcomes. Three sequential DP formats were compared in the current study: Format 1 was the most expensive (provision of supported dinners three times/week and extended staff hours); Format 2 included only one dinner/week and provision of a take-home meal. Both formats gave greater support to patients who were not progressing well (i.e., extended admission and extensive support from staff when experiencing feelings of suicidality or self-harm). Format 3 did not provide this greater support but established pre-determined admission lengths and required the patient to step out of the program temporarily when feeling suicidal. Fifty-six patients were included in the analyses: 45% were underweight (body mass index (BMI) < 18.5), 96.4% were female, 63% were given a primary diagnosis of anorexia nervosa (or atypical anorexia nervosa), and mean age was 25.57 years. Clinical outcomes were assessed using self-reported measures of disordered eating, psychosocial impairment, and negative mood, but BMI was recorded by staff. Over admission, 4- and 8-week post-admission, and discharge there were no significant differences between any of the clinical outcomes across the three formats. We can tentatively conclude that decreasing costs and increasing the opportunities for autonomy did not negatively impact patient outcomes, but future research should seek to replicate these results in other and larger populations that allow conclusions to be drawn for different eating disorder diagnostic groups.

Psychotherapeutic Intervention for Adults With Acquired Brain Injury: A Case Study Using BackUp.

A moderate-to-severe acquired brain injury (ABI) can have tremendous lifelong consequences for ABI-survivors and their families. Despite rehabilitation practice since the 1980s aspiring to a dynamic, coherent and holistic approach, the psychological dimension still seems to be a challenge and research has revealed persisting psychosocial impairments after ABI. Therefore, we developed BackUp©, a manual based short term psychological intervention for adults with ABI. This study explores the effect of the intervention though a small feasibility study, employing a single case design. One client received the intervention. Self-report measures were collected, and a semi structured interview was conducted. While results from pre, post and follow-up measures do not show clear positive results, the interview reveals positive experiences and the participant reported achieving his therapy goal. This case study provides support for a psychological intervention to support the psychological rehabilitation after an ABI.

Does assertive mental health care make a difference to children in out-of-home care? A pilot study

Background: Children in out-of-home care (OOHC) experience poor mental health. With the number of Australian children in OOHC rising, accessible and effective interventions are needed to address this escalating predicament. South Western Sydney Child &amp; Adolescent Mental Health Service (CAMHS) collaborated with the local statutory child protection agency, developing a specialized assertive mental health team supporting children in OOHC (OOHC MHT). This study outlines the characteristics of the first cohort of children referred to the OOHC MHT and the impact of intervention in improving outcomes, warranting ongoing provision of this service. Methodology: A two-part study was used to compare the psychosocial and emotional wellbeing of children referred to the OOHC MHT (OOHC group) against CAMHS-referred children who had not experienced OOHC (Control group). Evaluation of the OOHC MHT’s intervention was conducted by measuring Health of the Nation Outcome Scale-Child and Adolescent (HoNOSCA) and Child Global Assessment Scale (CGAS) scores over the first year of treatment. Results: The OOHC group demonstrated significantly higher levels of emotional, behavioural and social problems compared to the control group through their HoNOSCA score on admission (OOHC Group: M = 24.9; SD = 5.3, Control Group: M = 16.7; SD = 5.7; p = .001) and CGAS (OOHC Group: M = 40.5; SD = 7.9, Control Group: M = 50.3; SD = 7.9; p = .001). Significant improvements in the OOHC group’s HoNOSCA (T1 = 24.9, T3 = 17.0) and CGAS (T1 = 40.5, T3 = 52.8) measures were observed over the first year of treatment. Conclusion: Children in OOHC referred to CAMHS present with poorer mental health and psychosocial functioning than referred children who have not experienced OOHC. Assertive intervention was associated with improvement in social, emotional and behavioural problems and reduction in psychosocial impairment, suggesting the benefit of such an intervention both state-wide, and nationally.

Gender-specific differences concerning psychosocial aspects and functional impairments that influence quality of life in oral cancer treatment.

Patients with oral cancer have gender-specific differences with respect to health-related quality of life (HRQoL) and psychosocial variables (PV). The aim of the present study was to evaluate HRQoL and PV outcomes in patientstreated for oral squamous cell carcinoma. Data of 1234 patients were collected from a multicenter rehabilitation study of the German-Austrian-Swiss Cooperative Group on Tumours of the Maxillofacial Region (DÖSAK). Patient characteristics, oncological variables, post-treatment impairments, general quality of life (QoL), and PV (coping strategies, control beliefs, personal traits, perceived social support, depression, anxiety, and fear of tumor recurrence) were recorded. After treatment, HRQoL was similar between genders concerning general QoL, but men experienced significantly more treatment-related functional impairments influencing HRQoL. PV revealed gender-specific coping strategies, with women reporting significantly more "depressive coping," "religiosity," "fatalistic externality," and higher "social burden." Owing to their religious coping strategies, fatalistic attitude, and perceived higher social integration, women demonstrated superior disease acceptance, despite higher depression, anxiety, and lower psychosocial resilience. Conversely, men reported more introverted personal traits and lower social integration. Interventions during oral cancer treatment should address PV and have gender-specific elements to improve HRQoL after therapy.

Bicalutamide and the new perspectives for female pattern hair loss treatment: What dermatologists should know.

Female pattern hair loss (FPHL) is the most common form of alopecia in women. FPHL may compromise body image and strongly affect self-esteem, negatively impacting quality of life. Currently, the only Food and Drug Administration (FDA) approved drug for its treatment is topical minoxidil, with a variable response rate. Recently, a few studies in FPHL have pointed out bicalutamide as an emergent selective androgen receptor antagonist with a favorable safety and tolerability profile. This review aimed to summarize and discuss the key information on this new therapy for FPHL. Bicalutamide has no diuretic effect. It does not cross the blood-brain barrier, and it has little effect on serum luteinizing hormone. Additionally, bicalutamide was found to be effective on women presenting with other features of hyperandrogenism such as seborrhea, acne, and hirsutism with mild and well-tolerated adverse effects. Despite the high prevalence and psychosocial impairment, FPHL treatment remains challenging. Therefore, although future prospective, comparative, randomized clinical trials are essential to establish the ideal dose and efficacy of the drug, oral bicalutamide appears to be a promising option to expand the arsenal of FPHL treatment.

Role of occupational therapy in epilepsy patients after left temporal lobe surgery

There is a relevant risk of psychosocial as well as cognitive impairments in epilepsy patients with resective surgery in the left temporal lobe. Surgery in the speech-dominant hemisphere can be associated with deterioration of speech related functions including verbal memory. There are only limited studies addressing the impact of occupational therapy in postoperative rehabilitation of epilepsy patients.Method: In this study, a mixed-methods design based on the grounded theory concept was administered. Seven patients with left temporal lobe epilepsy and a risk profile for postoperative cognitive decline were investigated over various time points. Neuropsychological assessments occurred before surgery, 1 week, 3 months, and 6 months postoperatively. According to our rehabilitation concept, every patient started occupational therapy 1 month before surgery. Therapy lasted for at least 6 months after surgery. For all patients, extensive qualitative interviews with the occupational therapists and anamnestic data were analyzed.Results: In all patients, postoperative psychosocial difficulties emerged. Language and memory tests showed a decline after 6 months specifically for name retrieval. Occupational therapy was adapted to find individual solutions for the patients problems and to implement effective coping strategies.Conclusion: Cognitive training lead to consistent improvements over time. The results show that occupational therapy can be an efficient tool in the treatment of psychosocial and cognitive impairments after epilepsy surgery.

Pandemic-Related Experiences and Stress Among Children's Hospital Staff Predict Psychosocial Risk.

COVID-19 has imposed unique challenges for healthcare workers who have faced increased risk of exposure to the virus, heightened work demands, and disruptions in work-life balance. For some healthcare workers, these challenges may have contributed to increased stress, burnout, and psychosocial impairment, including symptoms of depression and anxiety. The current study addresses a knowledge gap of associations between pandemic-related experiences and psychosocial risk among medical and nonmedical pediatric healthcare staff. A sample of 369 staff (90% female) employed at an acute care, freestanding pediatric hospital in Connecticut completed an online survey. The survey assessed specific pandemic-related experiences and perceived impact with the Epidemic-Pandemic Impacts Inventory, and depression and anxiety risk with the 2-item Patient Health Questionnaire depression screen and 2-item Generalized Anxiety Disorder screen, respectively. Enrollment and survey completion occurred over a 6-week period during the pandemic (summer 2020). High rates of adverse pandemic-related experiences included workplace experiences (e.g., inadequate support, interpersonal difficulties), home life (e.g., childcare difficulties, partner conflict), and experiences reflecting social isolation and quarantine, child and adult mental health difficulties, increased alcohol or substance use, and unhealthy lifestyle behaviors. Medical relative to nonmedical staff reported significantly more adverse and fewer positive experiences, and a significantly higher perceived negative impact of workplace experiences. A positive screen for depression or anxiety was significantly predicted by cumulative adverse workplace experiences (OR = 1.15), changes in emotional/physical health (OR = 1.35), and perceived negative impact of workplace experiences (OR = 1.32). The present study joins recent reports of increased adverse experiences and psychosocial outcomes among healthcare workers during the COVID-19 pandemic. Findings underscore the need for pediatric hospitals to innovate ways to reduce burden and connect staff to mental health services during similar public health crises. Such services might include (1) assisting healthcare staff to navigate disruptions in their home and social lives as a result of new challenges faced at work, (2) adapting the hospital environment and culture to mitigate stress experienced by staff because of these challenges, and (3) bolstering mental health screening and services to address exacerbated or emerging mental health symptoms, such as depression and anxiety.

Hyperhidrosis Comorbidities and Treatments: A Register-based Study among 511 Subjects.

Hyperhidrosis is a dermatological condition that causes psychosocial impairment and has a negative impact on patients' quality of life. The epidemiology of hyperhidrosis is currently poorly understood. The aim of this study was to analyse comorbidities and treatments in 511 subjects with hyperhidrosis selected from the patient records of Oulu University Hospital. The mean age of patients with local hyperhidrosis was 27.9 years and the majority were female (62.7%). The most common anatomical site of symptoms in the youngest age group was the palms, whereas the axillae were a more common site in advanced age. Depression was a common comorbidity in both local (11.6%) and generalized hyperhidrosis (28.6%). Anxiety affected 12.7% of patients with generalized hyperhidrosis. In 36.8% of the patients with local hyperhidrosis there was a delay in diagnosis of more than 10 years. The most commonly used treatments included topical antiperspirants, iontophoresis and botulin toxin injections.

Supplemental Material for The Work and Social Adjustment Scale for Youth: Psychometric Properties of the Teacher Version and Evidence of Contextual Variability in Psychosocial Impairments

Supplemental Material for The Work and Social Adjustment Scale for Youth: Psychometric Properties of the Teacher Version and Evidence of Contextual Variability in Psychosocial Impairments

Prevalência de incontinência urinária, impacto na qualidade de vida e fatores associados em usuárias de Unidades de Atenção Primária à Saúde

Abstract Introduction: Urinary incontinence (UI) has a considerable negative impact on quality of life, resulting in psychosocial, emotional and health impairment, high costs to the health system and limited activities of daily living. Objective: To describe the proportion of women with UI and its impact on quality of life (QOL), and investigate the factors associated with this condition among users of Primary Health Care Units (PHCUs) in the municipality of Governador Valadares, Minas Gerais state (MG), Brazil. Methods: Cross-sectional study with female users of the municipal PHCUs. A questionnaire compiled by the researchers was used for data collection. Participants who reported urine leakage in any situation completed the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF). Results: A total of 201 women took part in the study, 36.32% of whom had UI and obtained a score of 7, indicating a moderate impact on their QOL. Urinary incontinence was associated with age, income, body mass index and parity. Conclusion: The proportion of women with UI corroborates the prevalence described by the International Continence Society (ICS), moderately impacting quality of life and indicating normalization of the problem. Urinary incontinence was also correlated with age, income, BMI and number of pregnancies. This demonstrates the need for health education strategies at PHCUs to prevent and treat UI in this group, as well as intersectoral activities to improve the income of the population in order to control modifiable risk factors.

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Background:Treatment resistant depression is a disabling disorder associated with relevant psychosocial impairment. Ketamine, an anesthetic agent as intravenous infusion proves to be an efficient antidepressant at subanesthetic doses of 0.5 mg/kg body weight. Suicide is a psychiatric emergency, and there are limited pharmacological options to treat acute risk. Rapidly acting agent such as Ketamine infusion can effectively manage such patients with treatment resistant depression and active suicidality.Aim:This study aims at assessing the sociodemographic profile of the depressive patients with treatment resistant depression and active suicidality, attending Ketamine clinic at Institute of Mental Health And Neurosciences (IMHANS) Kashmir.Method:Patients aged 18 years and above visiting the ketamine clinic from April 2020 to April 2021 for treatment resistant depression and suicidality were evaluated as per a preformed proforma and divided into various categories of socio-occupational status as per the modified Kuppuswamy scale. Clinical diagnosis of patients was established using DSM 5 system of classification.Results:A total of 21 patients were included in the study (M:F = 11:10). The mean age of the patients was 41.19 + 9.57 years. The majority of the patients belonged to upper lower class. MDD and BPAD was seen in 10 and 9 patients respectively. Thirteen patients were resistant to oral medication and two were actively suicidal, while both resistance to oral medication as well as active suicidality was seen in 6 patients. The difference between various reasons for ketamine infusion was statistically significant with a p-value of 0.012.Conclusion:Ketamine infusion can form an effective strategy in managing patients with treatment resistant depression. Ketamine shows its action within minutes to hours and thus reduces the acute risk of engaging in suicidal acts as well.

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BACKGROUNDBipolar disorder is an episodic psychiatric illness characterized by episodes of mania and hypomania. Presentation of bipolar disorder differs in women as compared to men, due to frequent occurrence of comorbidities like migraine, thyroid disorders, polycystic ovarian syndrome, etc. Migraine is one of the most disabling primary headaches and is more commonly seen in women with bipolar disorder. Women with migraine also tend to have more frequent mood episodes and greater psychosocial impairment. There are limited studies conducted on migraine and bipolar disorder in women in India.AIMS AND OBJECTIVESTo determine the co-occurrence of Migraine in women with Bipolar Affective DisorderMETHODOLOGYWomen with Bipolar Affective Disorder, who visited the Psychiatry Out Patient Department of a Tertiary Care Hospital in South India, were evaluated for the presence of migraine headache using the International Headache Society criteria for diagnosis.RESULTSOut of 80 subjects, 40% (N = 32) women with Bipolar Affective Disorder (BPAD) were also suffering from Migraine. 38.2% (N = 13) women with Type 1 BPAD had migraine; while 61.7% (N = 21) women with Type 2 BPAD had migraine.CONCLUSIONMigraine is a frequent complaint in women with bipolar disorder. It was more commonly seen in women with BPAD type 2. As the presence of migraine affects course and treatment response in women with bipolar disorder, it emphasizes on the importance of detailed evaluation and further research in the area.

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AIMTo assess and compare met and unmet needs of patients of schizophrenia and bipolar disorder and its association with their quality of life.METHODSOutpatients and inpatients ,male and female with a diagnosis of Bipolar Disorder (50) and schizophrenia (50) as per ICD-10 criteria ,had an insight score of at least 3/5. Demographic and clinical details were taken using semistructured intake proforma. The principal instrument employed to assess met and unmet needs was the Camberwell Assessment of Need Short Appraisal Schedule - Patients(CANSAS-P). Quality of life is assessed using the WHOQOL.RESULTSAn average of 6-7 needs were unmet by patients with schizophrenia and 5-6 needs were unmet by patients with Bipolar disorders .Most common unmet needs were in the areas of money and benefits needs, informational on condition and treatment , social needs, intimate relationships and sexual expression. According to the CANSAS-P, patients reported that more than 60% of the total needs were being met. Total, met and unmet needs were significantly higher for schizophrenia, but the most common types of needs were similar to BD. Significant associations were also obtained with greater the unmet needs and QOL of the patients.CONCLUSIONThe presence of unmet needs in patients was marker of the enduring psychosocial impairment.