Risk Factors For Psychiatric Morbidity Research Articles

A 16-month longitudinal investigation of risk and protective factors for mental health outcomes throughout three national lockdowns and a mass vaccination campaign: Evidence from a weighted Israeli sample during COVID-19

BackgroundCOVID-19 is an ongoing global crisis, with a multitude of factors that affect mental health worldwide. We explored potential predictors for the emergence and maintenance of depression, anxiety, and posttraumatic stress symptoms (PTSS) in the general population in Israel. MethodsAcross the span of 16 months, 2478 people completed a repeated self-report survey which inquired psychiatric symptoms and pandemic related stress factors (PRSF). We applied mixed-effects models to assess how each stressor contributes to depression, anxiety and PTSS at each time point, and longitudinally assessed participants who completed at least two consecutive surveys (n = 400). We weighted our sample to increase representativeness of the population. ResultsFatigue was the strongest predictor for depression, anxiety and PTSS at all time points, and predicted deterioration overtime. Financial concerns associated with depression and anxiety at all time points, and with their deterioration overtime. Health related concerns were uniquely associated with anxiety and PTSS at all time points and their deterioration, but not with depression. Improvement in sense of protection overtime associated with decrease in depression and anxiety. Hesitancy towards vaccination was associated to higher financial concerns and lower sense of protection by the authorities. ConclusionsOur findings accentuate the multitude of risk factors for psychiatric morbidity during COVID-19, and the centrality of fatigue in determining mental health outcomes.

Living alone is associated with a higher prevalence of psychiatric morbidity in a population-based cross-sectional study.

Living alone has been linked to poor mental health, however large-scale epidemiological studies on the association between living alone and psychiatric morbidity including depression and anxiety are lacking. The aim of this study was to investigate this issue in a large Taiwanese cohort. In this cross-sectional study, we enrolled 121,601 volunteers from 29 community recruitment stations in Taiwan and divided them into two groups based on whether or not they lived alone. Psychiatric morbidity was defined as a Generalized Anxiety Disorder 2-item score ≥ 3, Patient Health Questionnaire 2-item score ≥ 3, or self-reported depression. Logistic regression was used to explore the associations between living alone and psychiatric morbidity. The participants who lived alone had a higher prevalence of psychiatric morbidity [odds ratio (OR) = 1.608, 95% confidence interval (CI) = 1.473 to 1.755] after adjusting for potential confounders. In a subgroup analysis, married subjects who lived alone and divorce/separation (OR = 2.013, 95% CI = 1.763 to 2.299) or widowing (OR = 1.750, 95% CI = 1.373 to 2.229) were more likely to have psychiatric morbidity than those who were married and not living alone. Our findings suggest that living alone is a risk factor for psychiatric morbidity, especially for married subjects who live alone in concordance with divorce, separation, or the death of a spouse.

Measuring and exploring mental health determinants: a closer look at co-residents’ effect using a multilevel structural equations model

ObjectivePrevious research has demonstrated that individual risk of mental illness is associated with individual, co-resident, and household risk factors. However, modelling the overall effect of these risk factors presents several methodological challenges. In this study we apply a multilevel structural equation model (MSEM) to address some of these challenges and the impact of the different determinants when measuring mental health risk.Study design and settingTwo thousand, one hundred forty-three individuals aged 16 and over from 888 households were analysed based on the Household Survey for England-2014 dataset. We applied MSEM to simultaneously measure and identify psychiatric morbidity determinants while accounting for the dependency among individuals within the same household and the measurement errors.ResultsYounger age, female gender, non-working status, headship of the household, having no close relationship with other people, having history of mental illness and obesity were all significant (p < 0.01) individual risk factors for psychiatric morbidity. A previous history of mental illness in the co-residents, living in a deprived household, and a lack of closeness in relationships among residents were also significant predictors. Model fit indices showed a very good model specification (CFI = 0.987, TLI = 0.980, RMSEA = 0.023, GFI = 0.992).ConclusionMeasuring and addressing mental health determinants should consider not only an individual’s characteristics but also the co-residents and the households in which they live.

Risk Factors for Psychiatric Morbidity and Demographic Characteristics Among Patients with Facial Injury

Risk Factors for Psychiatric Morbidity and Demographic Characteristics Among Patients with Facial Injury

Adolescent Pregnancy’s Ongoing Effects on the Depression and Anxiety Scores in Subsequent Pregnancy

Objective: Child/adolescent 'marriages' and following pregnancies have adverse effects both on the child and adolescent mother.The aim of this study is to detect whether the adult pregnant women who have previous adolescent pregnancy more susceptible to the depression and anxiety than current adolescent pregnants and the adult pregnant women who have no adolescent pregnancy history. Study Design: This cross sectional study evaluated a total of 163 pregnant women who attended to our antenatal clinic. Subjects aged between 16 and 43 years including both adolescent and adult pregnant women were divided into three groups. These groups are current adolescent pregnant women (Group I), adult pregnant women who have adolescent pregnancy history (Group II), adult pregnant women who have no adolescent pregnancy history (Group III). Three groups were compared in terms of the pregnancy status, socio-demographic variables and depression-anxiety scores.Result: In the current study the highest depression and anxiety scores were observed in Group II [depression scores’ median (IQR) values respectively 5 (8.5) points for Group I, 12.5 (8.5) for Group II, 9 (12) for Group III (p&lt;0.001 between Group I and Group II for BDI comparison). Anxiety scores’ median (IQR) values respectively 19.5 (15.5) for group II, 9 (15.5) for group I, 14 (15.25) for Group III (p=0.005 between Group I and Group II for BAI comparison). Conclusion: Marriage and pregnancy at an early age are considered as risk factors for psychiatric morbidity in the next pregnancy. Therefore, women with a history of teenage pregnancy should be carefully monitored for depression and anxiety symptoms.

Psychiatric Disorders among Suicidal Behavior Patients Attending Mental Health Facilities: A Descriptive Crosssectional Study

Background: Suicide is a leading cause of death worldwide. This is the first study in Bangladesh to find out the psychiatric morbidity profile and suicidal behavior. The study was aimed to delineate the types of suicidal behavior and the psychiatric morbidity profile, and sociodemographic status of patients.&#x0D; Methods: A descriptive cross-sectional study was done in Depatrment of Psychiatry, Cumilla Medical College, Cumilla from October 2015 to March 2017. A total 120 patient aged 9 to 40 years who fulfilled the enrolment criteria included in the study. The Composite International Diagnostic Interview (CIDI) module was used to assess the suicidal behavior. DSM-5 was used to diagnose the psychiatric disorders. Semi structural questionnaire were used for collecting information about the risk factors for psychiatric morbidity and sociodemographic information. Result: Of 120 suicidal behavior patients’ psychiatric disorders was 65%. Among suicidal behavior patients neurotic disorders was 19%, psychotic disorders was 15%, personality disorders was 39% and others disorder was 27%. Among 78 psychiatric patients borderline personality disorder was 25.64%, adjustment disorders were 15.38%, mood disorders were 11.53%, psychotic disorder was 7.69%, multiple personality disorder and oppositional defiant disorder were 6.42%, hystrionic personality disorder and substance use disorder were 3.84%, antisocial personality disorder, conduct disorder and anxiety disorder were 2.57%, and composite disorder was 11.53%. Among suicidal behavior in psychiatric patients suicidal ideation was 54, suicidal plan was 13, suicidal attempt was 45 , ideators only proceeded to plan was 17, ideation to attempt was 59. Among suicidal behavior in total 120 participants suicidal ideation was 84, suicidal plan was 19, suicidal attempt was 56, ideators only proceeded to plan was 26, ideation to attempt was 76, planned attempt was 14 and impulsive attempt was 62. Most of the suicidal behavior participants were female (77.5%) and age group of &lt;24 years (60%).&#x0D; Conclusions: Psychiatric disorders are important risk factors for the onset and persistence of suicidal behaviour, with this risk being the greatest in childhood, and early adult.&#x0D; J Bangladesh Coll Phys Surg 2019; 37(3): 130-134

Co-existing Non-communicable Diseases and Mental Illnesses Amongst the Elderly in Punjab, India.

Background: There is scant literature from India assessing the burden of mental disorders among elderly patients with non-communicable diseases (NCDs). This study aimed to determine the prevalence of depression and generalised anxiety disorder (GAD) among the elderly population with diabetes and/or hypertension and risk factors for psychiatric morbidity. Methodology: A cross-sectional study was conducted between September–December 2017 by using a semi-structured questionnaire amongst an elderly population (n=320), who were attending an NCD clinic in a rural district in the northern state of Punjab, India. The Geriatric Depression Scale (30-item) and GAD-7 scale were used to assess depression and GAD. Result: Depression was found in 58.1% (95% confidence interval [CI] 52.6–63.4%) of the study participants; of whom, 34.1% had severe depression. The proportion of GAD was found to be 38.7% (95% CI 33.6–44.2%), with 19.7% scoring in the severe range. Both GAD and depression was found in 37.8% (95% CI 32.7–43.2%). Female gender, nuclear family, being single/separated/divorced/widowed, low-income status and comorbid NCDs (especially hypertension) were found to be risk factors associated with depression and GAD. Conclusion: NCDs with co-morbid mental illness are a growing public health problem amongst the elderly population of the country. The NCD programme should make immediate efforts to provide mental-health care as part of a holistic care package to elderly with NCDs.

Psychiatric Illness in Indian Bone Marrow Transplant Patients.

Introduction: Bone marrow transplantation is the main stay treatment for various disorders. Psychosocial morbidity associated with Bone Marrow Transplant are due to the diagnosis of a deadly disease, curative option with its associated risk of death. Several psychosocial factors influence the long-term outcome in patients.Objective: To identify Psychiatric illnesses in Indian patients undergoing hematopoietic stem cell transplantation.Materials and Methods: This cross-sectional study was conducted during the period of July 2015 to March 2017 at Institute of Haematology and Bone Marrow Transplantation, MIOT INTERNATIONAL, Chennai, India. All consecutive patients, aged 15 years and above, who fulfilled inclusion and exclusion criteria and underwent transplantation, were enrolled in this study. Psychiatric assessment comprised of a semi-structured interview based on Present Status Examination (PSE).Results: Out of 72 enrolled patients, twenty-six (36.1%) patients met the psychiatric diagnostic criteria. Adjustment disorder (43%) was more frequently encountered among the affected individuals followed by depressive illnesses (24%).Discussion:We had 36% of patients with symptoms of psychiatric illnesses. Interestingly higher percentage (54% and 41%) of psychiatric morbidity was observed in studies carried out by Leigh et al. and Sasaki respectively. Regarding diagnostic breakup among transplant patients, adjustment disorders (with symptoms of anxiety and depression) was the most frequent diagnosis (43%) in our study, which is similar to research of Sasaki.While on the other hand study done by Jenkin et al.observed higher prevalence (40%) of depression, which was the second highest psychiatric morbidity in our research. Majority of patients appeared to be mentally prepared and tolerant during transplantation and very few patients observed psychological problems. So, any sort of psychological issues encountered during transplantation has no relation with the diagnosis or the therapy per se but rather is more intricately related to the personality and personal history of the patients.Post-transplantation period seems to be highly stressful mainly due to the isolation, high vigilance, expectations, apprehension of the future and reverse barrier nursing. Therefore, most of psychiatric symptoms were observed within first week after transplantation procedure in 69% (n=18) of patients in our study. Other studies by Illescas - Rico et al. and Sasaki also noted that psychiatric disorders mainly developed after transplantation in majority of cases (68.75%). 76%(n=20) required psychotropic medicines in addition to counselling and psychotherapy Psychiatric symptoms settled in 62% (n=16) of cases during their stay in BMT unit.In this study, patients of the age group 24-45 years, were mostly affected comprising of 54% of all the individuals having psychological problems. Another study carried out by Prieto et al.on 220 patients who had recieved stem cell transplantation had however observed that younger age is one of the risk factor associated with psychiatric disorder in BMT. This clearly reflects the more stress observed in younger population secondary to transplantation. Regarding gender, it is believed that psychiatric disorders are significantly more common in females than males. However in this study, the number of males (58%) were more than the number females amongst the affected patients.There are few limitations of our study like the relatively small sample size, single centre study and limited time period. A multi-centric study is mandated to establish the findings more strongly to bring about a comprehensive care for the patients.Conclusion: Significant psychiatric morbidity (>1/3 - 36%) associated with bone marrow transplantation was observed. This study indicates the importance of psychiatric intervention during the transplant procedure as well as pre-transplant psychiatric assessment and counselling regarding transplant procedure.Keywords: Psychiatric disorder, Adjustment disorder, Hematopoietic stem cell transplantation.ReferencesAndrykowski MA.Psychological factors in bone marrow transplantation: a review and recommendation. Bone Marrow Transplant 1994; 13: 357-375,PrietoJM, BlanchJ, AtalaJ, CarrerasE, RoviraM, CireraE, et.al. Stem cell transplantation: risk factors for psychiatric morbidity. Eur J Cancer 2006; 42:514-20. DisclosuresNo relevant conflicts of interest to declare.

Prevalence of Psychiatric Disorders among Elderly In-Patients in Non-Psychiatric Wards of a Teaching Hospital in Northern Nigeria

The population of the elderly is increasing globally with enormous challenges particularly in developing countries. Aging increases the risk for both physical and psychiatric disorders with psychiatric disorders often unrecognized in non-psychiatric settings. This presents huge costs to both patient and society. The study aimed at estimating the rate of psychiatric morbidity in non-psychiatric wards of a tertiary hospital in Northern Nigeria. One hundred and forty (140) subjects were recruited into this cross-sectional descriptive study. Participants were initially screened using the Self Reporting Questionnaire (SRQ) and the Modified Mini-Mental State Examination (MMSE) after administering the Socio-demographic questionnaire. Subjects scoring &gt;5 in the SRQ and or ≤13 in the Modified MMSE were then further interviewed using the Geriatric Mental State Schedule (GMS). Clinical Psychiatric diagnosis was also made based on ICD-10 diagnostic criteria from all information available and later compared with GMS diagnoses. Mean age of participants was 67.5, SD ±6.4. The rate of psychiatric morbidity using ICD-10 diagnosis was 47.9% with depression being the commonest disorder (18.6%) followed by delirium (17.1%) and dementia (10.7%). Depression and anxiety disorders were particularly under-recognized by non-psychiatric doctors. Identified risk factors for psychiatric morbidity included female gender, low socioeconomic status, low educational level and presence of multiple medical diagnoses. The rate of psychiatric morbidity among elderly in-patients in non-psychiatric settings has remained high in comparison to previous studies with huge gaps in recognition and treatment reflecting the need for more collaboration between medical teams.

Change in form of compulsive behavior after bariatric surgery is a phenomena best describe by deficiency of reward cycle in the brain

The prevalence of obesity related comorbidities has reached epidemic levels in the USA, 34.9% of people are obese. Surgical intervention is the most efficient management of morbid obesity. Between 2003 and 2010, 113,000 cases per year underwent bariatric surgery. Some studies suggest long-term total mortality rate is reduced after surgery, particularly deaths from heart disease, diabetes, and neoplasms. However, the rate of death from other causes was higher; suicide is the main contributing factor. Here we present a case of 41-year-old female with recurrent psychiatric hospitalizations due to Alcohol abuse and suicidal attempts after bariatric surgery. She was admitted to our service after she attempted to jump from the roof of her building while intoxicated with Alcohol. A month prior, she was hospitalized in another hospital for the same reason. She responded well to psychosocial support, psychoeducation, learning coping skills, and group supportive therapy. Her treatment regimen included the use of acamprosate, lithium, and risperidon. She reported a decrease in anxiety and anger, an improved sleep cycle, and improved judgment and impulse control. We use this case to illustrate the great need to identify the risk factors for psychiatric morbidity after bariatric surgery and encourage clinicians to be mindful of this potential development after bariatric surgery and ensure psychiatric follow up for these at risk patients.

Change in form of compulsive behavior after bariatric surgery is a phenomena best describe by deficiency of reward cycle in the brain

The prevalence of obesity related comorbidities has reached epidemic levels in the USA, 34.9% of people are obese. Surgical intervention is the most efficient management of morbid obesity. Between 2003 and 2010, 113,000 cases per year underwent bariatric surgery. Some studies suggest long-term total mortality rate is reduced after surgery, particularly deaths from heart disease, diabetes, and neoplasms. However, the rate of death from other causes was higher; suicide is the main contributing factor. Here we present a case of 41-year-old female with recurrent psychiatric hospitalizations due to Alcohol abuse and suicidal attempts after bariatric surgery. She was admitted to our service after she attempted to jump from the roof of her building while intoxicated with Alcohol. A month prior, she was hospitalized in another hospital for the same reason. She responded well to psychosocial support, psychoeducation, learning coping skills, and group supportive therapy. Her treatment regimen included the use of acamprosate, lithium, and risperidon. She reported a decrease in anxiety and anger, an improved sleep cycle, and improved judgment and impulse control. We use this case to illustrate the great need to identify the risk factors for psychiatric morbidity after bariatric surgery and encourage clinicians to be mindful of this potential development after bariatric surgery and ensure psychiatric follow up for these at risk patients.

Prisoners at ultra-high-risk for psychosis: a cross-sectional study.

The definition of ultra-high risk (UHR) for psychosis was derived from community-based help-seeking populations. Prisoners have high rates of psychosis and other severe mental health (MH) problems. They also have high rates of risk factors for psychiatric morbidity and yet they are among the populations who are less likely to seek help in the community. Despite a policy of equivalence of care for individuals in prison there are no early intervention services for psychosis in prisons in the UK. This was a study exploring feasibility of introducing such a service into a local London prison. This paper discusses the differences in MH profile of prisoners who met criteria for at-risk mental state compared with those who did not. A two-stage procedure was used. Participants in a local London prison were routinely screened in the first week of arrival in prison with the Prodrome Questionnaire - Brief Version (PQ-B; Loewy et al. 2011). Those that screened positive as well as a small sample of those who screened negative underwent a further semi-structured assessment to see whether they met criteria for UHR state. Data on self-harm and suicide attempt, family psychiatric history, and anxiety and depression was also collected. A total of 891 prisoners were screened, 44% of whom screened positive. A total of 354 underwent second stage assessment, 60 of whom had screened negative. Four groups were identified: those that had no MH problems, a group experiencing First Episode Psychosis, those at UHR of psychosis and a group with other MH problems. The UHR state and Psychotic groups had very similar MH profiles of symptoms and distress. Prisoners with no MH problems were at the other end of the spectrum with few symptoms and little distress. The Other group fell in between this group and the psychotic spectrum group in terms of symptomology and distress. This study is the first to examine risk for psychosis in an adult male prison population. We identified a broad spectrum of MH disorder for which there is little current service provision in prisons. Screening early in the custodial process has the potential to identify unmet MH need and has implications for keeping individuals safe in custody. A long-term strategic approach is required to address MH need in prisons.

Psychiatric morbidity and survival after surgery for esophageal cancer: a population-based cohort study.

To determine the cumulative incidence of and risk factors for psychiatric morbidity and establish the impact on survival among surgically treated patients with esophageal cancer. A nationwide Swedish cohort of 1,615 patients who underwent surgery for esophageal cancer between 1987 and 2010 with follow-up until 2012 was linked to national health registries for information on psychiatric morbidity (inferred from mental health care use). Multivariable logistic regressions were used to determine potential risk factors for postoperative psychiatric morbidity. A multivariable-adjusted Cox proportional hazard model was used to analyze overall survival. In patients without a history of psychiatric morbidity, the 2-year cumulative incidence for treatment in psychiatric in-patient care was 2.5%, for psychiatric out-patient care was 4.2%, and for treatment with psychotropic drugs was 32.3%. Married patients were less likely to be treated postoperatively in psychiatric in-patient care (odds ratio [OR], 0.42; 95% CI, 0.22 to 0.80) or out-patient care (OR, 0.41; 95% CI, 0.17 to 1.02), whereas patients with higher tumor stage were more likely to be treated in psychiatric out-patient care (OR, 4.99; 95% CI, 1.16 to 21.38) or with psychotropic drugs (OR, 2.78; 95% CI, 1.10 to 7.01). Bearing in mind possible residual confounding, new-onset psychiatric morbidity was associated with mortality (hazard ratio [HR], 1.65 [95% CI, 1.17 to 2.33] for treatment in psychiatric in-patient care; HR, 1.93 [95% CI, 1.18 to 3.16] for treatment in psychiatric out-patient care; and HR, 2.77 [95% CI, 1.72 to 4.44] for treatment with psychotropic drugs). These results highlight the importance of recognizing and addressing psychiatric morbidity in surgically treated patients with esophageal cancer.

The psychiatric sequelae of burn injury

ObjectiveTo examine factors predicting psychiatric morbidity, taking into account the full range of psychiatric disorders before and after burn injury. MethodsA cohort of 107 patients consecutively admitted to a Swedish national burn center was examined for lifetime psychiatric morbidity, as well as 94 patients at 1 year postinjury. Sixty-seven individuals, some from that same cohort, were interviewed at 2 to 7years postinjury. The predictive effects of psychiatric history, personality and other risk factors for psychiatric morbidity following burn were evaluated with multiple regression analyses. ResultsThe prevalence of having a psychiatric disorder preburn was 57%. One year postinjury 19% had minor or major depression and 23% had subsyndromal or full posttraumatic stress disorder. At 2 to 7years, 31% fulfilled the criteria for a psychiatric disorder. The strongest contributing factors were a history of psychiatric morbidity and neuroticism. ConclusionsTwo-thirds of the patients had a lifetime psychiatric disorder, and one-third had a psychiatric diagnosis 2 to 7years postburn. Mental health problems can have a major impact on daily life and functional abilities. Thus, identification and treatment of a range of psychiatric disorders, taking into account preburn psychiatric disorders and personality, is important for optimal adjustment after burn.

Persistent disability is a risk factor for late-onset mental disorder after serious injury.

Most of what we know about the psychiatric consequences of injury is limited to the first year. Determining the prevalence of and risk factors for psychiatric morbidity beyond one year will aid service development and facilitate timely diagnosis and treatment. The aim of this prognostic study was to determine the prevalence of mental disorders in the three years following serious injury and to identify risk factors for the onset of new disorders after 1 year. Of 272 patients assessed in hospital following serious injury, 196 (72.1%) were reassessed at 3 years. Assessment involved gold standard semi-structured interviews for psychiatric diagnoses, risk factors for mental disorder, injury measures and pain scores. More than a quarter of all patients were diagnosed with at least one mood or anxiety disorder at some stage during the three years following their injury. The most common diagnoses were major depression (20.0%), generalised anxiety disorder (6.7%) and panic disorder (6.7%). For a third of these patients, the disorder appeared after 12 months, for which persistent physical disability was an independent risk factor. Although there is a necessary focus on the early detection and treatment of mental disorders after injury, attention to later onset disorders is also required for those with persistent pain and physical disability.

A longitudinal investigation of posttraumatic stress and depressive symptoms over the course of the year following medical–surgical intensive care unit admission

ObjectiveThe objective was to identify risk factors for posttraumatic stress disorder (PTSD) and depressive symptoms after medical–surgical intensive care unit (ICU) admission. MethodThis longitudinal investigation included 150 medical–surgical ICU patients. We assessed acute stress and post-ICU PTSD symptoms with the PTSD Checklist-Civilian Version and post-ICU depressive symptoms with the Patient Health Questionnaire-9. Mixed-model linear regression ascertained associations between patient and clinical characteristics and repeated measures of post-ICU PTSD and depressive symptoms. ResultsThe prevalences of substantial PTSD and depressive symptoms were 16% and 31% at 3 months post-ICU and 15% and 17% at 12 months post-ICU, respectively. In-hospital substantial acute stress symptoms [beta: 16.9, 95% confidence Interval (CI): 11.4, 22.4] were independently associated with increased post-ICU PTSD symptoms. Lifetime history of major depression (beta: 2.2, 95% CI: 0.1, 4.2), greater prior trauma exposure (beta: 0.5, 95% CI: 0.2, 0.9) and in-hospital substantial acute stress symptoms (beta: 3.5, 95% CI: 0.8, 6.2) were independently associated with increased post-ICU depressive symptoms. ConclusionsIn-hospital acute stress symptoms may represent a modifiable risk factor for psychiatric morbidity in ICU survivors. Early interventions for at-risk ICU survivors may improve longer-term psychiatric outcomes.

Psychiatric disorders in children attending a Nigerian primary care unit: functional impairment and risk factors

BackgroundThere is dearth of data on the level of functional impairment and risk factors for psychiatric morbidity in children attending primary care services in developing countries like Nigeria. The risk factors for psychiatric morbidity and functional impairment in children attending the primary care unit of a teaching hospital in Ilorin, Nigeria was therefore investigated to obtain data that could be used in improving service provision by primary care physicians.MethodsA cross-sectional two-stage design was employed for the study. The first stage involved administration of the Child Behavior Questionnaire (CBQ) to 350 children while the children’s version of the schedule for affective disorders and schizophrenia was used for the second stage involving 157 children, all high scorers on CBQ (score of ≥ 7) and 30% of low scorers (score < 7). Diagnosis of psychiatric disorders was based on DSM-IV criteria.In addition, the Children Global Assessment Scale was used to assess the functional status of the children (score of ≤ 70 indicates functional impairment) while the mothers’ mental health status was assessed with the 12-item version of the General Health Questionnaire, a score of 3 or more on this instrument indicate presence of mental morbidity.ResultsIt was observed that 11.4% of the children had diagnosable psychiatric disorders and 7.1% were functionally impaired; and those with psychiatric disorders were more functionally impaired than those without. Thus, significant negative correlation was noted between CBQ scores and CGAS (r = 0.53; p < 0.001). Following logistic regression, younger age of children, frequent hospital attendance and maternal parenting distress independently predicted psychiatric morbidity while child psychopathology and maternal parenting distress predicted functional impairment.ConclusionsChild psychiatric disorders are prevalent in the primary care unit studied. Many of the risk factors identified in the study population are modifiable. Collaborative efforts between psychiatrists and primary care physicians could therefore help to reduce level of risk and functional impairment and psychiatric morbidity among children attending the primary care unit studied. It could also help improve referral rates of difficult cases to the child and adolescent psychiatric unit of the hospital.

Psychiatric long-term complications of intensive care unit survivors

Desai, Sanjay MD; Law, Tyler BHSc; Bienvenu, Joseph MD, PhD; Needham, Dale MD, PhD Author Information

Trauma, depression, and comorbid PTSD/depression in a community sample of Latina immigrants.

Trauma exposure is frequently overlooked as a risk factor for psychiatric morbidity among studies with Latinos. The purpose of this study was to examine the relationships among trauma history, immigration-related factors, and mental health status among Latina immigrants. The current study used baseline data from a randomized clinical trial for the treatment of depression (Miranda et al., 2006) of 64 women with comorbid PTSD and depression, 69 with depression-only, and 61 with no Axis I mental disorder. Sixty-four percent of the sample was Central American and 75% percent reported trauma exposure. Multinomial logit analysis suggested fewer years in the US was associated with worse mental health status. Having a non-married marital status was also associated with worse mental health. Reporting four or more types of traumatic events was associated with an increase in the probability of comorbidity. These findings have important implications for future research and clinical practice.

Psychiatric morbidity and functional impairments in survivors of burns, traumatic injuries, and ICU stays for other critical illnesses: A review of the literature

Severe burns, traumatic injuries and other critical illnesses are a substantial source of morbidity in the United States. As more patients survive these conditions, there has been increasing interest in psychiatric and functional outcomes of these individuals. In this article, we reviewed the literature on the prevalence of psychiatric conditions, with particular emphasis on posttraumatic stress disorder (PTSD) and depression, as well as functional impairments, in adult and pediatric survivors of burns, trauma and intensive care unit stays for other critical illnesses. We found that PTSD and depressive symptoms are quite prevalent in these patient groups. We also examined potential risk factors for psychiatric morbidity and impaired function in all three patient groups, and conclude that patient-specific and acute care factors, in addition to early post-acute care psychiatric symptoms, may convey risk for subsequent psychopathology and diminished function. Finally, we discussed limitations in the literature as well as possible directions for future research, particularly in clarifying risk factors for psychiatric disorders as well as potential preventative and treatment interventions that may improve outcomes.