Study Of Psychiatric Comorbidity Research Articles

A Study of Psychiatric Co-morbidities, Anxiety, Depression and Quality of Life in Patients of Chronic Obstructive Pulmonary Disease

ABSTRACT Aim: To study psychiatric co-morbidities, anxiety, depression, and quality of life in patients of chronic obstructive pulmonary disease (COPD). Materials and Methods: A cross-sectional, case-control study was conducted on 122 cases of COPD and equal number of age- and sex-matched controls in a tertiary care hospital. They were assessed with the Mini-International Neuropsychiatric Interview (MINI), depression, anxiety stress scale-42 (DASS-42), St. George Respiratory Questionnaire (SGRQ), and COPD Assessment Test (CAT). Results: COPD patients and control subjects were matched with respect to age, sex, education, employment, domicile, and socioeconomic status. Psychiatric disorders were diagnosed in 56% of cases and 14% of controls. Major depressive disorder, alcohol dependence, and anxiety disorders were the most common psychiatric diagnoses. There was significantly higher prevalence of smoking in cases with COPD compared to control subjects suicidality was present in two patients. The mean scores on depression, anxiety, and stress on DASS-42 of COPD patients were significantly higher than normal controls. On the CAT majority of the COPD patients belonged to the high-impact group followed by the very high-impact group. Mean scores on the SGRQ were in the range expected in COPD patients. A multiple regression analysis revealed that significant predictors of SGRQ scores were age, gender, economic status, domicile, alcohol habits, depression, anxiety, and stress. Conclusion: COPD patients have a significantly higher prevalence of psychiatric co-morbidities compared to healthy controls. Common psychiatric disorders were major depression, alcohol dependence, and anxiety disorders along with smoking.

A study of psychiatric comorbidities and quality of life in type 2 diabetes mellitus patients in a tertiary care hospital in Telangana

ABSTRACT Background: Diabetes affects physical and psychological and social health. Sufficient literature exists on management by self and psychosocial methods for diabetes, but there exists a paucity of literature on psychological response and unaddressed emotional distress on overall health. Many studies have shown that diabetes has a bad impact on quality of life (QOL). This study is done for estimating psychiatric morbidity prevalence and its influence on QOL in diabetic patients. Aim: We aimed to study psychiatric comorbidities and QOL in type 2 diabetes mellitus (T2DM) patients in a tertiary care hospital. Methodology: This was a study done cross-sectionally over a period of 18 months on a sample of 108 subjects at the Psychiatry Department and General Medicine Department, Government Medical College and General Hospital, Nizamabad. The Mini International Neuropsychiatric Interview PLUS 5.0 and World Health Organization QOL-BREF scales were the survey tools used. Data analysis was done using statistical methods. Results: The prevalence of psychiatric comorbidities among diabetic patients was found to be 58.3%, with Depression (17.6%) being the most common comorbidity, followed by Dysthymia (13.8%). QOL of patients with T2DM with psychiatric comorbidity was significantly poorer (P = 0.001) in physical health domain (P = 0.04) and psychological domain (P = 0.01), while it was relatively better in environment domain (P = 0.2) and social relationships domain (P = 0.5). Conclusion: This study concludes that psychiatric comorbidities are common comorbidities in persons with T2DM. Moreover, psychiatric comorbidities further reduce QOL in individuals having T2DM.

A study of psychiatric comorbidities in patients of bipolar disorder with and without attention deficit hyperactivity disorder during euthymic phase

A study of psychiatric comorbidities in patients of bipolar disorder with and without attention deficit hyperactivity disorder during euthymic phase

A Study of Psychiatric Comorbidity and Fear of Corona Virus in Patients with Obsessive Compulsive Disorder during Covid-19 Pandemic

Background and objective: The WHO declared the Chinese outbreak of COVID-19 to be health risk of National and International Concern from 30th January 2020. This has significant implications on mental health , especially for patients of OCD in various ways. This study was aimed to study Psychiatric comorbidity and Fear of Corona virus in patients with obsessive-compulsive disorder (OCD) during COVID-19 pandemic and compare socio-demographic & clinical variables between patients of OCD with or without psychiatric comorbidity during COVID-19 pandemic.Methods: In person interview including 96 old and new symptomatic patients of OCD diagnosed as per ICD 10-DCR, who had onset of illness prior to COVID-19 (march 2020), between the age of 18-60 years was conducted. The disease severity was recorded on D-YBOCS, HAM-A and HAM-D. The two groups of OCD, with comorbidity and without comorbidity were compared. Fear of COVID-19 Scale was used to analyse fear of corona virus.Results: Depression was the most common psychiatric comorbidity. The fear of coronavirus in 59.4% OCD patients was observed to be mild in severity and the mean FCV-19S score to be 14.42 ± 4.19. Positive correlation was found between FCV-19S score and the YBOCS obsession subtotal score, YBOCS compulsion subtotal score, YBOCS total score, HAM-D score and HAM-A score. FCV-19S score also had a statistically significant positive correlation with D-YBOCS severity score for contamination and cleaning, severity score for hoarding and collecting, severity score for symmetry and severity score for aggression. Among the OCD patients with comorbidity, a statistically significant higher YBOCS score, D-YBOCS severity score for Contamination and Cleaning and FCV-19S score were observed when compared to OCD patients without comorbidity.Conclusions: Fear of corona virus was seen in majority of the OCD patients and was associated with increased severity of disease. The OCD patients with comorbidity had significantly higher Y-BOCS score mainly for Contamination and Cleaning.

Cross-sectional study of psychiatric comorbidity in patients with atopic dermatitis

Cross-sectional study of psychiatric comorbidity in patients with atopic dermatitis

A study of psychiatric comorbidities among treatment seeking opioid injectors attending tertiary care teaching hospital, Imphal for a period of 2 years

Introduction: Psychiatric comorbidity among opioid injectors is the co-occurrence of other mental disorders among them besides being dependent on injecting opioid. Objectives: The purpose of this study is to find out the prevalence of psychiatric comorbidities among opioid injectors and to find out the association between drug use Profile with psychiatric comorbidities. Materials and Methods: All the consecutive opioid injectors who attended Drug De-addiction Centre, tertiary care teaching hospital, Imphal, from October 2013 till September 2015 were interviewed with General Health Questionnaire-12 to assess the mental health status, they were interviewed with Mini-International Neuropsychiatric Interview plus for the diagnosis of mental conditions. The data were analyzed statistically using Statistical Package for Social Sciences (SPSS21) software. Results: One hundred and five opioid injectors were enrolled in this study. The common psychiatric comorbidities were anti-social personality disorder 85.7% (n = 90) followed by depression 61.9% (n = 65), poly substance dependence 52.4% (n = 55), anxiety disorder 41% (n = 43), psychosis 23.8% (n = 25), suicide 11.4% (n = 12), panic disorder 4.8% (n = 5), and specific phobia 4.8% (n = 5). Conclusion: This study shows that the majority of dependent opioid injectors are vulnerable to many psychiatric comorbidities which should be screened and treated side by side while treating the dependency.

A study of psychiatric comorbidities in irritable bowel syndrome

Background Irretable bowel syndrome (IBS) is a functional syndrome characterized by chronic abdominal pain accompanied by altered bowel habits. Stress often worsens the symptoms of patients with IBS. Psychiatric disorders and IBS appear to have bidirectional comorbidities. Objectives The aim of this study was to assess the psychiatric comorbidities in patients with IBS. Patients and methods The study included a total number of 150 patients complaining of IBS symptoms with at least one episode of abdominal pain or flatulence per week in association with a change in bowel habit. All patients in the study were subjected to a detailed history taking and complete general and local abdominal examination. Moreover, International Classification of Diseases-10th revision internal medicine criteria for diagnosis, International Classification of Diseases-10th revision symptom checklist for mental disorders, and social readjustment rating scale were estimated. Results Patients of all age groups visit the clinics when they complain from IBS, mostly those of ages ranging from 31 to 40 years, who represented 38% of the studied group. Females complained more than males (66 and 34%). The most frequent psychiatric comorbidity with IBS was the neurotic and behavioral syndromes (53.3%) followed by psychotic and affective syndromes (32%), then the organic mental and psychoactive substance use syndrome (8%), and lastly, the personality disorders (4%). There was a significant association between IBS type and depression, generalized anxiety disorder (GAD), panic disorder, obsessive compulsive disorder (OCD), and somatization. Moreover, there was a significant correlation between IBS type and bipolar disorder, depression, GAD, panic disorder, OCD, somatization, and nonorganic sleep disorder. Conclusion Most patients with IBS have associated psychiatric or somatic comorbidities or overlapping other functional gastrointenstinal disorder (FGIDs). Patients with IBS have significantly higher levels of psychiatric comorbidities than healthy ones and are more susceptible to stress-related disorders.

A Study of Psychiatric Co-Morbidity in Patients Suffering from Thyroid Dysfunction

A Study of Psychiatric Co-Morbidity in Patients Suffering from Thyroid Dysfunction

A study of psychiatric comorbidity after traumatic limb amputation: A neglected entity.

Background:Amputation following trauma is emerging as a major health burden on the medical services and on the families and the society as well. Loss of limbs causes inability to support self and the family that further leads to various psychiatric disorders in many patients. Therefore, the present study is planned to explore psychiatric comorbidity in patients with amputation following trauma.Materials and Methods:Fifty-nine amputees were recruited by consecutive sampling within 6-month period from amputation clinic of a tertiary care hospital. All participants were interviewed on a semi-structured pro forma of sociodemographic and amputation-related parameters and assessed on psychiatric comorbidity using Mini-International Neuropsychiatric Interview scale.Results:Majority of the patients were male (88.1%) and belonged to younger age group of 16–30 years (71.2%). Approximately, 97% of patients had single-limb amputation (96.6), predominantly right limb (55.9%). Lower limb amputation was noted in 79.7% of participants. Motor vehicle accident was the most common mode of injury followed by railway track injury and others. The most common psychiatric comorbidities in our sample were major depressive disorder (71.2%), suicidality (30.5%), and posttraumatic stress disorder (PTSD) (20.3%). PTSD was positively correlated with phantom sensation (rs = 0.295, P = 0.05) and phantom pain (rs = 0.279, P < 0.05).Conclusion:A substantial proportion of amputees had alarming sign of depression, suicidal ideation, and PTSD. Thus, there is a need to form liaison between surgical treatment providers and psychiatrists and psychologists to manage psychiatric comorbidity in amputees.

Psychopathological phenotypes in childhood migraine.

Migraine headache represents a frequent reason for neurological evaluation in developmental age. Many studies in the last decades have been focused on the role of psychopathological profiles among migraineur children. On the other hand, conflicting results have been reported about the different psychopathological profiles among subjects affected by migraine. The role of psychopathological aspects on clinical findings among children may be relevant particularly for severity and frequency of attacks. A recent review showed the higher prevalence in migraine children of psychological symptoms, detected by using the Child Behavior Checklist (CBCL), than healthy controls[1]. Moreover, clinical and population-based studies suggest that children with migraine are more likely to have internalizing symptoms (i.e., particularly anxiety and depression traits), as well as psychological comorbidities[1]. Nevertheless it is still a matter of controversy whether children with migraine have specific psychological vulnerabilities or if they only cope differently with stressful situations. In 2015 Arruda et al reported that children with migraine are more likely to present emotional symptoms, conduct problems, hyperactivity, peer problems, and total difficulties in psychosocial adjustment stressing the role of psychological adjustment styles as predisposing factors for developing psychopathological troubles among migraine children[2]. In this perspective we could speculate that the psychopathological profile of migraine children could be influenced by environmental or familiar elements such as, by specific psychological vulnerabilities of migraine children[2]. In this light, some studies pinpointed the role of parenting styles effects on migraine severity and frequency in children, related to parental stress levels, while a preliminary study indicated the potential value of maternal personality assessment for better comprehension and clinical management of children affected by migraine[3, 4]. According to the analysis of specific psychopathological vulnerabilities in migraine children, a higher prevalence among migraineur children of the avoidant attachment style (type A) and the significantly lower prevalence of the secure style attachment (type B) than controls was found[5]. Moreover, also significant differences among temperamental characteristics in MwA children respect to the comparisons[6], suggesting that the study of psychiatric comorbidities in pediatric headache may be enriched by these new aspects.

Study of psychiatric comorbidity in patients with headache using a short structured clinical interview in a rural neurology clinic in Western India.

Background:Psychiatric disorders are common in patients attending neurology clinics with headache. Evaluation of psychiatric comorbidity in patients with headache is often missed in the busy neurology clinics.Aims:To assess the prevalence of Axis-I DSM-IV psychiatric disorders in patients with primary headache disorders in a rural-based tertiary neurology clinic in Western India.Settings and Design: A cross-sectional observation survey was conducting assessing all patients with migraine, tension-type headache and chronic daily headache attending the Neurology Clinic of Shree Krishna Hospital, a rural medical teaching hospital in Karamsad, in Gujarat in Western India.Materials and Methods:A total of 101 consecutive consenting adults with headache were interviewed using Mini International Neuropsychiatric Interview (M.I.N.I.), a structured diagnostic clinical interview to assess prevalence of Axis-I DSM-IV psychiatric disorders.Statistical Analysis:Descriptive statistics were calculated using SPSS software version 16 and a binomial regression model was used to study the relationship of psychiatric co-morbidity with patient-related factors.Results:49 out of 101 (48.5%) patients with headache suffered from depressive disorders (dysthymia or depression or suicidality), 18 out of 101 patients with headache (17.90%) suffered from anxiety related disorders (generalized anxiety disorder or agoraphobia or social phobia or panic disorder).Conclusions:Axis-I psychiatric disorders are a significant comorbidity among patients with headache disorders. M.I.N.I. can be used as a short, less time consuming instrument to assess all patients with headache disorders.

Study of psychiatric comorbidities in epilepsy by using the Mini International Neuropsychiatric Interview

BackgroundEpilepsy is a neurological condition affecting men and women of all age groups and is associated with psychiatric comorbid conditions. There is a paucity of published data available regarding psychiatric comorbid conditions in patients with epilepsy (PWEs) from developing countries. MethodsWe compared the psychiatric comorbid conditions in 80 PWEs, 80 patients with asthma (asthma control (AC) subjects), and 80 healthy controls (normal control (NC) subjects) using the Mini International Neuropsychiatric Interview (MINI) for the diagnosis of Axis I psychiatric disorders. ResultsPsychiatric comorbid conditions are more common in PWEs (32.50%) as compared with the AC (17.5%) and NC (7.5%) subjects. Longer duration of seizures, increased frequency of seizures, recent recurrence of seizures, anticonvulsant polypharmacy, poor compliance with medications, and family history of seizures were associated with increased psychiatric comorbidity. ConclusionPatients with epilepsy are more likely to have psychiatric comorbid disorders compared with the other patients with chronic illness or with the healthy controls. It is of immense clinical importance to identify the comorbid psychiatric disorders in PWEs as the treatment of these disorders apart from a good seizure control may significantly improve their quality of life.

EPA-0253 – The study of psychiatric disorders comorbidity in patient with pemphigus vulgaris

Introduction The relationship between skin, neuron system and mental status is complicated. Pemphigus is severe and painful autoimmune skin disorder that occurs in 0.5–1 person in 100000 (Mooler & Stanley, 1990). Objective & Aim Regarding the critical role of mental status in autoimmune diseases such as pemphigus, the aim of this research is to study of psychiatric comorbidity in patient with Pemphigus. Materials & Methods The society of this research included the patients with Pemphigus inferred to Razi Hospital of skin diseases in Tehran. Participants were 200 persons who were selected through available sampling. Finally 198 persons filled out the demographic questionnaire and SCL-90. Result This research showed that the prevalence of psychiatric disorders in this sample was 62.62%. 28.78% of patients were male and 33.84% were female. In both genders the symptoms of paranoia were the most prevalent disorders (45% in female and 60% in male) and phobia was the least prevalent in our sample. The upper grade in education, the less prevalent disorders. 81.45% of participants with mental disorders were married and 18.55% of them were single. Of patients only 26.32% had visited the psychiatrist or psychologist and 95.15% of them had used medications. Conclusions The results showed that psychiatric disorders in patients with Pemphigus is high compared to general population. Thus dermatologists must recognize and manage these comorbidities to treat patients effectively and to improve the quality of life in patients with autoimmune diseases such as Pemphigus.

Study of Psychiatric Comorbidity in the Survivors of Deliberate Self Harm ina Rural Setting

Background: Deliberate self-harm (DSH) is one of the most common causes of morbidity and mortality throughout the world, psychiatric comorbidity in such patients further worsens the picture. Scanty data are available from India, much less on the correlation between the psychiatric morbidity and the intent of the act. Aims And Objectives: To categorize the survivors of the DSH on the degree of intentionality of the act. To study the correlation of the characteristics of the suicidal act and the psychiatric comorbidity with the intentionality of the act. Methodology: In this cross-sectional study, 90 patients referred for consultation-liaison psychiatric services with the history of deliberate self-harm over the study period of 1 year were assessed using Beck’s Suicidal Intent Scale and ICD 10 Mental and Behavioural Disorders. Results were analyzed using SPSS version 16 and Pearson’s Chi-Square test. Results: 95.5% of the low and 66.7% moderate intent patients had impulsive attempt whereas 80% of the high intent patients had planned attempt. Interpersonal problem with the person other than the spouse acted as precipitant in 52.5% of low and 33.5% of moderate intent patients, in 40% of the patients with high intent psychopathology itself was precipitant. Only 1.5% of low and 16.7% of moderate intent patients wanted to die, whereas 40% of high intent patients expected death as an outcome. No psychiatric diagnosis (n=26; 38.8%) followed by adjustment disorder (n=19; 28.4%) substance dependence (n=11; 16.4%) were found to be more among the low intent patients, moderate depressive disorder without somatic syndrome (n=7; 38.9%) followed by adjustment disorder (n=5; 27.8%) schizophrenia and other psychosis (n=3; 16.7%) were more among moderate intent patients, obsessive compulsive disorder with predominantly obsessions (n=2; 40%) severe depression without psychotic symptoms (n=2; 40%) were found more among high intent patients. Conclusion: Characteristics of the suicidal act in terms of preparation behind the act, precipitant, motive behind the act and the psychiatric comorbidity vary significantly with the degree of intentionality of the act.

A Hospital Based Study of Psychiatric Co-Morbidity in Cases of Dengue in West U.P. Rural Hospital

Introduction: Dengue fever is caused by dengue virus and transmitted by Aedes mosquito, is an acute febrile condition. Psychiatric manifestation is seen in large number of patients. Aim: This study was targeted to establish psychological disturbances seen in acute and Follow up cases of dengue fever. It can be helpful in managing such cases efficiently. Material&Methods: 60 consecutive dengue patients who were admitted in sarawathi Institute of Medical Sciences, Hapur from June 2012- October 2012 was studied for the psychological disturbance. It also assessed the progression of symptoms with the progression of disease. Results: out of 60 patients, approximately 85% presented fear of death, 75% patients presented with anxiety and needed mild anxiolytic medicines. Depression and panic reaction was very common. Conclusion: Phobic and anxiety symptoms are very common initial presentation. But gradually subsides. By the end of 4week, maximum symptoms subsides and patient gets relief.Depression can continue for longer period.

Attachment styles in children affected by migraine without aura

BackgroundIn recent years, great attention has been given to the presence of psychological problems and psychiatric comorbidity that are also present in children affected by primary headaches. The relationship between pain and attachment has been identified, and it may be that pain perception may change in relation with specific attachment styles. The aim of the present study was to assess the prevalent attachment style and verify its putative relationship and correlation with the main characteristics of migraine attacks, in school-aged children affected by migraine without aura (MoA).Materials and methodsThe study population consisted of 219 children (103 males, 116 females) aged between 6 and 11 years (mean 8.96 ± 2.14 years), consecutively referred for MoA compared with 381 healthy controls (174 males, 207 females; mean age 9.01 ± 1.75 years) randomly selected from schools. All the children were classified according to the attachment typologies of the Italian modified version of the Separation Anxiety Test; monthly headache frequency and mean headache duration were assessed from daily headache diaries kept by all the children. Headache intensity was assessed on a visual analog scale. The chi-square test and t-test, where appropriate, were applied, and the Spearman rank correlation test was applied to explore the relationship between the types of attachment style and clinical aspects of MoA.ResultsThe MoA group showed a significantly higher prevalence of type A (avoidant) attachment (P<0.001) and a significantly lower prevalence of type B (secure) attachment (P<0.001) compared with the control group. Moreover, the Spearman rank correlation analysis showed a significant relationship between MoA characteristics and the attachment style of MoA children.ConclusionThe main findings of the present study were the higher prevalence among MoA children of the avoidant attachment style (type A) and the significantly lower prevalence of the secure style attachment (type B) compared with the normal controls, suggesting that the study of psychiatric comorbidity in pediatric headache may be enriched by this new aspect of analysis.

DSM-IV Axis-I comorbidity among illicit drug users seeking treatment for substance use disorders: results from the Multi-centre Study of Psychiatric Comorbidity in Drug Addicts (MUPCDA)

Background: To contribute to the discussion on Integrated Dual Disorders Treatment in persons seeking treatment for substance use disorders and carrying a substance dependence diagnosis. Aims: To capture current (4 weeks) DSM-IV Axis-I comorbidity in a sample of German in-treatment substance use disorders patients. Method: A clinical sample of n = 301 patients (75% male, 25% female; mean age 31 years, range 15–55 years) were interviewed face-to-face by 40 raters, using the Mini-DIPS (German version of the Anxiety Disorders Interview Schedule). In this multi-centre study, 19 German treatment centres participated. Results: Diagnoses for opioid dependence were given to 86% and for polydrug dependence to 75% of the patients. Socio-demographic data revealed high unemployment, indebtedness and crime rates. Most frequent diagnoses of comorbidity were: generalized anxiety disorder (28%) and dysthymia (26%). Women were more likely to be dually diagnosed and to report lifetime substance-induced visual hallucination...

A prospective study of psychiatric comorbidity of DSM-IV bipolar I and II disorders

A prospective study of psychiatric comorbidity of DSM-IV bipolar I and II disorders

Obesity and psychopathology. A study of psychiatric comorbidity among patients attending a specialist obesity unit

The study aims to evaluate the frequency of association between Axis I and II disorders according to DSMIVTR criteria and obesity, and use of mental health services in a clinical sample of patients attending a centre for the diagnosis and treatment of Obesity. 150 consecutive patients (32 Males, 118 females, mean age 44.6 +/- 14.3 yrs; mean BMI 35.4 +/- 6.2) were interviewed by means of SCID I and SCID II. Lifetime Prevalence of Axis I disorders was 58% (males 50%; females 61%); the highest prevalence rate was found for Anxiety Disorders (approx 35%), whilst 30% of subjects were affected by Mood disorders, chiefly Major Depression (20%), and 18% by Eating Disorders. 28% of obese patients presented a Personality Disorder, 23% of patients being affected both by an Axis I and Axis II disorder. Mood Disorders, in particular Major Depression, were significantly prevalent among female obese. 50% of females and approx 37% males included in the sample had contacted mental health units for treatment. Data obtained in the present study confirm the high prevalence rates of mental disorders in obese patients seeking treatment. Specialist units should therefore include thorough psychiatric evaluation of patients as a routine practice.

Lifetime Prevalence and Pseudocomorbidity in Psychiatric Research

Comorbidity is the rule rather than the exception with psychiatric disorders and is consequently of great interest to both researchers and clinicians. However, many studies of psychiatric comorbidity have been based on lifetime prevalence with mixed-age samples, a practice that (1) biases the assessment of epidemiologic comorbidity and (2) creates the appearance of comorbidity even when disorders are randomly associated. This bias is what we refer to as pseudocomorbidity. To clarify the source of the problem and to discuss strategies that might be adopted to deal hereafter with lifetime prevalence data. A simulated example is presented to show that even when there is only random association between disorders, there will appear to be nonrandom comorbidity when lifetime prevalence is used with mixed-age samples. An actual example relating psychosis to phobia is presented to show the bias that can result and to illustrate one way of dealing with lifetime prevalence data. Use of lifetime prevalence with mixed-age samples, used almost exclusively in psychiatric research, generates problematic results, especially when used for assessment of comorbidity, and should be viewed with some skepticism. Hereafter, we recommend that any future use of lifetime prevalence should require determination of the age of onset, even if only by retrospective report. Comorbidity then should be reported by age.