Rates Of Major Depressive Disorder Research Articles

Rate of Major Depressive Disorder and Life Quality of Migrainous Patients Treated with Propranolol or Flunarizine

Rate of Major Depressive Disorder and Life Quality of Migrainous Patients Treated with Propranolol or Flunarizine

Is major depressive disorder specifically associated with mesial temporal sclerosis?

Whether a specific lesion such as mesial temporal sclerosis (MTS) increases the risk for a mood disorder in epilepsy remains subject to debate. Despite evidence of limbic system involvement in the genesis of emotional symptoms, recent studies fail to support an association between depression and MTS. We aimed to clarify this controversial issue by overcoming prior methodologic limitations, hypothesizing that rates of major depressive disorder (MDD) would be higher in patients with MTS. Three hundred eight patients with focal epilepsy (International League Against Epilepsy [ILAE] criteria), were classified into three groups on the basis of neuroimaging findings: MTS, a lesion different from MTS, or absence of lesion. Patients were assessed using the Structured Interview for DSM-IV axis I psychiatric disorders (SCID-I), by a psychiatrist blinded to epilepsy subtype. The Spanish version of the Hospital Anxiety and Depression Scale (HADS) was also administered. A complete logistic regression analysis was performed to investigate the association between MTS and MDD. MTS increased the likelihood of a lifetime MDD by nearly 2.5. No other current or "postseizure onset" lifetime Axis I DSM-IV psychiatric disorder was associated with MTS. Female gender, primary education, comorbid anxiety disorders, and antidepressant treatment were also associated with an increased risk of MDD. Marriage was found to be a protective factor for MDD. Our results support a specific association between MTS and lifetime "postseizure onset," MDD. The lack of association with current depression is in line with the hypothesis that the link between MTS and depression is more of a chronic than a state-dependent condition.

A Survey of Knowledge and Attitude of Non-Psychiatrists (Medical Specialists) Treating Major Depression

Background: Non-diagnosed depression might postpone the physical healing of patients and negatively affects prognosis. The rate of major depressive disorder among patients of general practitioners in the United States reaches 10 percent and among patients admitted to the inner wards reaches 15 percent. Patients and Methods: A cross sectional study on physician of two hospitals was performed. A questioner was designed to assess knowledge, attitude, and practice of non-psychiatrist physicians towards depression treatment. Results: Non-Physiatrist physicians’ score in knowledge and attitude was 6.7 and 103.75, respectively. Gender and the area of specialization of the physicians had no significant effect on their knowledge, attitude and medical treatment methods applied by them. Conclusions: The study highlights a low level of knowledge of physicians about depression. Further studies are paramount to assess the efficacy of interventions applied to improve current situation.

Comparison of depressive episodes in bipolar disorder and in major depressive disorder within bipolar disorder pedigrees

Although genetic epidemiological studies have confirmed increased rates of major depressive disorder among the relatives of people with bipolar affective disorder, no report has compared the clinical characteristics of depression between these two groups. To compare clinical features of depressive episodes across participants with major depressive disorder and bipolar disorder from within bipolar disorder pedigrees, and assess the utility of a recently proposed probabilistic approach to distinguishing bipolar from unipolar depression. A secondary aim was to identify subgroups within the relatives with major depression potentially indicative of 'genetic' and 'sporadic' subgroups. Patients with bipolar disorder types 1 and 2 (n = 246) and patients with major depressive disorder from bipolar pedigrees (n = 120) were assessed using the Diagnostic Interview for Genetic Studies. Logistic regression was used to identify distinguishing clinical features and assess the utility of the probabilistic approach. Hierarchical cluster analysis was used to identify subgroups within the major depressive disorder sample. Bipolar depression was characterised by significantly higher rates of psychomotor retardation, difficulty thinking, early morning awakening, morning worsening and psychotic features. Depending on the threshold employed, the probabilistic approach yielded a positive predictive value ranging from 74% to 82%. Two clusters within the major depressive disorder sample were found, one of which demonstrated features characteristic of bipolar depression, suggesting a possible 'genetic' subgroup. A number of previously identified clinical differences between unipolar and bipolar depression were confirmed among participants from within bipolar disorder pedigrees. Preliminary validation of the probabilistic approach in differentiating between unipolar and bipolar depression is consistent with dimensional distinctions between the two disorders and offers clinical utility in identifying patients who may warrant further assessment for bipolarity. The major depressive disorder clusters potentially reflect genetic and sporadic subgroups which, if replicated independently, might enable an improved phenotypic definition of underlying bipolarity in genetic analyses.

Persistence of Addictive Disorders in a First-Offender Driving While Impaired Population

We compared the prevalence of alcohol use and other psychiatric disorders in offenders 15 years after a first conviction for driving while impaired with a general population sample. To determine whether high rates of addictive and other psychiatric disorders previously demonstrated in this sample remain disproportionately higher compared with a matched general population sample. Point-in-time cohort study. Pacific Institute for Research and Evaluation, Albuquerque, New Mexico. We interviewed convicted first offenders using the Composite International Diagnostic Interview 15 years after referral to a screening program in Bernalillo County, New Mexico. We calculated rates of diagnoses for non-Hispanic white and Hispanic women (n=362) and men (n=220) adjusting for missing data using multiple imputation and compared psychiatric diagnoses with findings from the National Comorbidity Survey Replication by sex and Hispanic ethnicity. Eleven percent of non-Hispanic white women and 12.8% of Hispanic women in the driving while impaired sample reported 12-month alcohol abuse or dependence, compared with 1.0% and 1.8%, respectively, in the National Comorbidity Survey Replication (comparison) sample. Almost 12% of non-Hispanic white men and 17.5% of Hispanic men in the driving while impaired sample reported 12-month alcohol abuse or dependence, compared with to 2.0% and 1.8%, respectively, in the comparison sample. These differences were statistically significant. Rates of drug use disorders and nicotine dependence were also elevated compared with the general population sample, while rates of major depressive disorder and posttraumatic stress disorder were similar. In this sample, high rates of addictive disorders persisted over 10 years among first offenders and greatly exceeded those found in a general population sample.

Prevalence of psychiatric disorders in patients with chronic solvent induced encephalopathy (CSE)

IntroductionLong term occupational exposure to organic solvents may induce chronic solvent-induced encephalopathy (CSE), characterized by mild to severe cognitive impairment, generally seen as the key diagnostic feature. Psychiatric disorders are often diagnosed in subjects with CSE, but were never studied in more detail. This study was designed to establish the prevalence rates of DSM IV mood, anxiety, and alcohol and substance related disorders in patients with CSE. Materials and methodsIn CSE, n=203 (consecutively recruited between 2002 and 2005), defined according to the criteria of the World Health Organisation (WHO), one month prevalence rates of DSM IV mood, anxiety, and life time alcohol/substance related disorders were assessed using the Structured Clinical Interview for DSM IV disorders (SCID). These prevalences were compared with those from an age and gender matched community sample (n=3212) while controlling for insufficient neuropsychological test effort. ResultsIn CSE, prevalence rates for major depressive disorder (n=36, relative risk (RR)=7.4), dysthymia (n=15, RR=6.0), panic disorders (n=18, RR=7.1), agoraphobia (n=7, RR=5.5) and generalized anxiety disorder (n=19, RR=15.8) were increased. Reduced prevalence rates were found for alcohol related disorders (n=21, RR=0.3). Insufficient neuropsychological test effort was not associated with increased prevalence rates of DSM IV disorders in subjects suspected of CSE. Discussion and conclusionsIn conclusion, in this first large scale study in patients with CSE, prevalence rates of DSM IV mood and anxiety disorders were elevated as compared with those in the general community, while the prevalence rates of alcohol related disorders were reduced. Further study must determine whether CSE, and mood and anxiety disorders, share a same, solvent induced, neurobiological pathway, supporting the use of a more inclusive diagnostic approach. Additionally, randomised controlled trials are needed for the urgent issue of how to treat mood and anxiety disorders in CSE patients effectively.

Economic burden of depression in South Korea

A recent national survey in South Korea indicated that the 12-month prevalence rate of major depressive disorder was 2.5%. Depressive disorders may lead to disability, premature death, and severe suffering of patients and their families. This study estimates the economic burden of depression in Korea from a societal perspective. Annual direct healthcare costs associated with depression were calculated based on the National Health Insurance database. Annual direct non-healthcare costs were estimated for transport. Annual indirect costs were estimated for the following components of productivity loss due to illness such as morbidity (absenteeism and presenteeism) and premature mortality. Indirect costs were estimated using the large national psychiatric epidemiological surveys in Korea. The human capital approach was used to estimate indirect costs. The total cost of depression was estimated to be $4,049 million, of which $152.6million represents a direct healthcare cost. Total direct non-healthcare costs were estimated to be $15.9 million. Indirect costs were estimated at $3,880.5 million. The morbidity cost was $2,958.9 million and the mortality cost was $921.6 million. The morbidity cost was identified as the largest component of overall cost. Depression is a considerable burden on both society and the individual, especially in terms of incapacity to work. The Korean society should increase the public health effort to prevent and detect depression in order to ensure that appropriate treatment is provided. Such actions will lead to a significant reduction in the total burden resulting from depression.

A review of the epidemiology of depression in Korea

Depression is one of the most significant public health problems in Korea. The lifetime prevalence rates of major depressive disorder (MDD) in Korean adults have ranged from 3.3% to 5.6%, which are lower than those of western countries. Point prevalence rates of MDD in Korean elders from 4.6% to 7.5%, which are relatively higher than those of Western countries and other Eastern countries, have been reported. The prevalence rate of probable depression (depressive symptoms defined by the cutoff point of 16 on the Center for Epidemiologic Studies Depression Scale was lowest in the age group of 40 to 49 years at 7.6%, and highest in the age group of 15 to 18 years at 46.8%. The prevalence of probable depression in Korean elders increased with age and was highest in the group aged 80 years and over, at 35.4%. There is relatively consistent evidence that being female, having low income, no education, prior MDD, dementia and history of cerebrovascular attack increased the risk of depression. Although it is difficult to come to consistent conclusions on the epidemiology of depression in Korea due to methodological differences between studies, depression is already common and will become more common in Korea. Tremendous sociocultural, economic, and political changes along with rapid population aging have contributed and will contribute to the prevalence and impacts of depression in Korea.

Successful cognitive aging in persons living with HIV infection

The number of older adults living with human immunodeficiency virus (HIV) infection is growing and this subpopulation of the epidemic is at heightened risk for a variety of poor health outcomes including HIV-associated neurocognitive disorders. The current study sought to examine the factors associated with freedom from neurocognitive impairment in older HIV-infected adults. Participants included 74 middle-aged and older (mean age 51 years), HIV-infected individuals with a mean estimated duration of infection of 17 years who underwent comprehensive neuropsychological, psychiatric, and medical evaluations. Successful cognitive aging (SCA) was operationally defined as the absence of neurocognitive deficits as determined by a battery of well-validated cognitive tests and self-endorsed cognitive complaints. Thirty-two percent of the cohort met these criteria. Compared to the group that did not meet these criteria, successful cognitive agers had significantly lower lifetime rates of major depressive disorder and current affective distress (e.g., depression, anxiety). Moreover, the SCA group evidenced better everyday functioning outcomes, including medication adherence, lower self-reported rates of declines in activities of daily living, and superior abilities related to medication management and dealing with healthcare providers. SCA was not related to demographic composition, HIV disease or treatment factors, medical comorbidities, or histories of substance use disorders. Findings from this preliminary study suggest that approximately one-third of older persons with HIV were free of cognitive impairments, which is associated with more favorable emotional, psychosocial, and everyday functioning.

Psychiatric and Cognitive Functioning in Adolescent Inpatients with Histories of Dating Violence Victimization

The presence of dating violence victimization as well as its relation to psychiatric diagnosis and cognitive processes was examined in a sample of 155 adolescents hospitalized in a psychiatric facility. Participants and their parents completed semistructured diagnostic interviews. Participants also completed self-report measures of dating violence victimization and cognitive functioning. Seventy-seven percent of adolescents who had initiated dating reported psychological, physical, sexual abuse, or some combination by a dating partner over the past year. Victims of psychological abuse alone as well as physical or sexual violence endorsed higher rates of major depressive disorder compared to nonvictims. Physical and sexual dating violence victims also endorsed significantly higher rates of posttraumatic stress disorder and alcohol use disorders, more frequent cooccurrence of externalizing and internalizing disorders, and more frequent negative cognitive biases, relative to nonvictimized adolescents. Findings suggest that psychiatrically hospitalized adolescents with dating violence histories represent a subgroup of adolescent inpatients with a particularly serious clinical picture.

Examining the role of race and ethnicity in relapse rates of major depressive disorder

Objective We test the hypothesis that racial or ethnic differences exist in relapse rates to fluoxetine discontinuation in major depressive disorder (MDD). Method Data are from a prospective study examining the relapse rates secondary to fluoxetine discontinuation in MDD. Subjects in the discontinuation phase consisted of 255 adults aged 18 to 65: 214 subjects who self-identified as white, 22 as African American, 13 as Latino American, and 6 as Asian American. Results In both the fluoxetine and placebo groups, no statistically significant differences emerged when comparing time to relapse for minority groups as compared to the white population. Adjusting for statistically significant predictors of relapse (symptom severity, neurovegetative symptom pattern, sex) and for educational level did not change the outcome of the survival analyses. Conclusions Although the size of minority groups in this sample was modest, in a randomized, controlled trial setting, minority and white patients may have similar rates of relapse in MDD. This finding reinforces the importance of maintenance treatment in relapse for both minority as well as white patients with MDD. Given the self-selecting nature of clinical trials, future studies are needed to further examine the potential influence of underlying cultural factors on clinical outcomes in minority populations.

Rates of Major Depressive Disorder and Clinical Outcomes Following Traumatic Brain Injury

Uncertainties exist about the rates, predictors, and outcomes of major depressive disorder (MDD) among individuals with traumatic brain injury (TBI). To describe MDD-related rates, predictors, outcomes, and treatment during the first year after TBI. Cohort from June 2001 through March 2005 followed up by structured telephone interviews at months 1 through 6, 8, 10, and 12 (data collection ending February 2006). Harborview Medical Center, a level I trauma center in Seattle, Washington. Five hundred fifty-nine consecutively hospitalized adults with complicated mild to severe TBI. The Patient Health Questionnaire (PHQ) depression and anxiety modules were administered at each assessment and the European Quality of Life measure was given at 12 months. Two hundred ninety-seven of 559 patients (53.1%) met criteria for MDD at least once in the follow-up period. Point prevalences ranged between 31% at 1 month and 21% at 6 months. In a multivariate model, risk of MDD after TBI was associated with MDD at the time of injury (risk ratio [RR], 1.62; 95% confidence interval [CI], 1.37-1.91), history of MDD prior to injury (but not at the time of injury) (RR, 1.54; 95% CI, 1.31-1.82), age (RR, 0.61; 95% CI, 0.44-0.83 for > or = 60 years vs 18-29 years), and lifetime alcohol dependence (RR, 1.34; 95% CI, 1.14-1.57). Those with MDD were more likely to report comorbid anxiety disorders after TBI than those without MDD (60% vs 7%; RR, 8.77; 95% CI, 5.56-13.83). Only 44% of those with MDD received antidepressants or counseling. After adjusting for predictors of MDD, persons with MDD reported lower quality of life at 1 year compared with the nondepressed group. Among a cohort of patients hospitalized for TBI, 53.1% met criteria for MDD during the first year after TBI. Major depressive disorder was associated with history of MDD and was an independent predictor of poorer health-related quality of life.

Ethnicity in trauma and psychiatric disorders: findings from the collaborative longitudinal study of personality disorders

The study's aims are to explore ethnic differences in rates of adverse childhood experiences and lifetime traumatic events and in rates of psychiatric disorders for patients exposed to similar traumas. Rates of these events and rates of major depressive disorder, posttraumatic stress, substance use, and borderline personality disorders were compared among 506 non-Hispanic Whites (N-HW), 108 Latina(o)s, and 94 African Americans (AA) participating in the Collaborative Longitudinal Personality Disorder Study. We found that Whites reported higher rates of neglect than African Americans and Latina(o)s, higher rates of verbal/emotional abuse than African Americans, and higher rates of accidents and injuries/feared serious injury than Latina(o)s. African Americans had higher rates of seeing someone injured/killed than Whites. No significant interaction was observed between adverse events and ethnicity for mental disorders.

Comorbidity of pain and psychoaffective diseases — an update

ObjectivesTo give an update on current knowledge about the comorbidity of pain and psychoaffective diseases MethodsLiterature search (MEDLINE, PsycINFO, SCOPUS), summary of recent own data ResultsEpidemiological studies report a mean prevalence rate of major depressive disorder in patients with chronic pain assessed in pain clinics of 52%, and a mean prevalence of pain in depressed patients of 65%. Patients with the fibromyalgia syndrome are 4.3 times more likely than healthy control subjects to develop major depressive disorder and 4.7 times more likely to develop an anxiety disorder. The prevalence of anxiety disorders in patients with chronic arthritic pain is elevated relative to the general population (35 vs. 17%). Similar numbers have been reported for migraine and chronic back pain. Many biological factors overlap in patients with depression, chronic pain, and the fibromyalgia syndrome. For example, both patients with depression and patients with chronic pain often have cytokine profiles shifted toware the pro-inflammatory side. The downregulation of the neurotrophic factor brain-derived neurotrophic factor (BDNF) is another common finding in pain and depression. Common genetic determinants have been described. ConclusionsThere is a high comorbidity between pain, depression, and anxiety. The causative connection between these disorders remains to be elucidated. A common biological basis has been hypothesized.

Mental health in senior housing: Racial/ethnic patterns and correlates of major depressive disorder

Objectives: Mental health problems are associated with disability, overuse of medical care, higher rates of mortality and suicide as well as personal suffering for older adults. Residents of urban, low-income senior housing may face increased risk of a variety of mental health problems, including depression. This study identified the prevalence of multiple mental health problems in older residents of low-income senior housing and explored correlates of major depressive disorder for the two largest ethnic groups: black and Latino. Method: In-person diagnostic interviews identified rates of mental illness in a sample of 635 residents of 13 low-income senior housing buildings in a medium-sized northeastern city. Applying George's Social Antecedent Model of Depression, logistic regression analyses identified shared and unique correlates of depression for Latino and black participants. Results: This population had high rates of major depressive disorder (26%), generalized anxiety disorder (12%) and other mental health problems that varied significantly by ethnic and racial group. Separate multivariate models for Latino and black people showed that younger age, more chronic conditions and social distress were related to major depressive disorder for both ethnic groups. Perceived environmental stress, shorter tenure in the building, poorer perceived health, higher life stress and fewer leisure activities were associated with depression for Latinos only. Conclusion: Mental health screening and treatment services are needed in senior housing to address these high rates of mental illness. Unique constellations of correlates of depression for different ethnic groups underscore a need for culturally competent approaches to identification and treatment.

Psychiatric Diagnoses in Patients Previously Overdiagnozed With Bipolar Disorder

In a previous article from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we reported that bipolar disorder is often overdiagnosed in psychiatric outpatients. An important question not examined in that article was what diagnoses were given to the patients who had been overdiagnosed with bipolar disorder. In the present report from the MIDAS project, we examined whether there was a particular diagnostic profile associated with bipolar disorder overdiagnosis. Eighty-two psychiatric outpatients reported having been previously diagnosed with bipolar disorder that was not confirmed when they were interviewed with the Structured Clinical Interview for DSM-IV (SCID). Psychiatric diagnoses were compared in these 82 patients and in 528 patients who were not previously diagnosed with bipolar disorder. Patients were interviewed by a highly trained diagnostic rater who administered a modified version of the SCID for DSM-IV Axis I disorders and the Structured Interview for DSM-IV Personality for DSM-IV Axis II disorders. This study was conducted from May 2001 to March 2005. The most frequent lifetime diagnosis in the 82 patients previously diagnosed with bipolar disorder was major depressive disorder (82.9%, n = 68). The patients overdiagnosed with bipolar disorder were significantly more likely to be diagnosed with borderline personality disorder compared to patients who were not diagnosed with bipolar disorder (24.4% vs 6.1%; P < .001). A previous diagnosis of bipolar disorder was also associated with significantly higher lifetime rates of major depressive disorder (P < .01), posttraumatic stress disorder (P < .05), impulse control disorders (P < .05), and eating disorders (P < .05), although only the association with impulse control disorders remained significant after controlling for the presence of borderline personality disorder. Psychiatric outpatients overdiagnosed with bipolar disorder were characterized by more Axis I and Axis II diagnostic comorbidity in general, and borderline personality disorder in particular.

Major Depressive Disorder in Long-Term Cancer Survivors: Analysis of the National Comorbidity Survey Replication

Prior research is mixed as to whether long-term cancer survivors (LCSs) have higher rates of depression than the general population. This is the first study to compare the rates of major depressive disorder (MDD) between LCSs and people without cancer histories in a nationally representative cross-sectional multistage cluster survey sample, the National Comorbidity Survey-Replication (NCS-R). Between 2001 and 2003, face-to-face interviews were conducted for the NCS-R in a national sample of 9,282 people, of whom 5,692 were assessed for a history of cancer. Participants with cancer diagnoses at least 5 years before the interview were considered LCSs. Survivors of childhood cancers were excluded. Comparing LCSs to those without a cancer history, odds ratios for having a MDD episode in the last 12 months before interview were obtained using multiple logistic regression controlling for demographic and medical variables. Differences in characteristics of those MDD episodes were also compared between groups. Of participants age 23 years or older, 243 LCSs and 4,890 adults without a cancer history were identified in the sample. Adjusting for demographic variables and medical comorbidities, LCSs did not have increased odds of MDD in the last 12 months, with an odds ratio of (OR) 0.99 (95% CI, 0.55 to 1.79). LCSs reported higher mean levels of impairment from MDD in their home, social, and work life, but these differences were not significant. LCSs do not appear to have elevated rates of MDD. However, they may experience greater impairment from MDD compared to those without cancer. Longitudinal studies are needed to confirm these findings.

Association of depressive symptoms and metabolic syndrome in men

To explore the relationship between several indicators of depression and metabolic syndrome (MetS). A population-based sample with high (HMS group) or low (LMS group) levels of mental symptoms, including those of depression, in three follow-ups participated in a clinical examination in 2005 (n = 223). MetS was determined according to the NCEP criteria. The prevalence of MetS was 49% in men and 21% in women. Men with MetS had higher rates of major depressive disorder than other men. They also displayed higher Hamilton Rating Scale for Depression (HDRS) scores and more often signs of suicidality. In logistic regression analyses, higher HDRS scores (OR 1.31, 95% CI 1.04-1.64) and belonging to the HMS group (OR 10.1, 95% CI 1.98-51.3) were independent associates for MetS but only in men. The results highlight that there is an association between long-term depressive symptoms and the emergence of MetS, especially in men.

Major Depressive Disorder in Children and Adolescents After Renal Transplantation

This cross-sectional study evaluated the prevalence of major depressive disorder and depressive symptoms in children and adolescents after renal transplantation. A total of 71 patients who had undergone renal transplantation were interviewed in person using the Farsi (Persian) version of the Kiddie Schedule for Affective Disorders and Schizophrenia and Diagnostic and Statistical Manual of Mental Disorders diagnostic criteria. Major depressive disorder, depressive symptoms, and suicidal behaviors were assessed. The rate of major depressive disorder was 2.8%; two-thirds of the patients had irritability; and approximately 40% had recurrent thoughts of death and suicidal ideation. The rate of major depressive disorder was lower than in other chronic diseases such as thallasemia or hemophilia; however, the rate of suicidal behaviors was high.

Depression, anxiety and suicidal behaviour in children and adolescents with Haemophilia

It was aimed to study the prevalence of major depressive disorder, separation anxiety disorder and suicidal behaviour in the children and adolescents with haemophilia. A total of 83 children and adolescents with haemophilia A or B aged 5-19 years old were randomly selected using systematic random sampling method. They were interviewed using the Farsi (Persian) version of Kiddie Schedule for Affective Disorders and Schizophrenia by face-to-face interview with the subjects and their primary caregivers, according to the DSM-IV diagnostic criteria. Major depressive disorder, separation anxiety disorder and suicidal behaviour were surveyed. The rate of major depressive disorder was 6.0%. Approximately 2.4% of the patients were suffering from at least five symptoms of major depression, and 4.8% were suffering from more than five symptoms of major depressive disorder. One-third of the children and adolescents were suffering from irritability. Approximately 36% of the subjects wished to die at least once during the last 6 months. Also, 6% of the subjects had thought about suicidal attempt. Approximately 4.8% of them met the criteria of separation anxiety disorder. The incidences of major depressive disorder and separation anxiety disorder were comparable to that prevalent in the thalassaemic patients. The proportion of patients with death wish was very high. The proportion of patients with suicidal thought and attempt was much lower than that in the children and adolescents with thalassaemia. Therefore, psychiatric consultation needs to be included in the management of these children.