Total Psychiatric Morbidity Research Articles

Psychiatric morbidity in family members of alcohol dependence patients.

There is a paucity of Indian studies assessing psychiatric morbidity among family members of subjects with alcohol use disorder. To study psychiatric morbidity in wives/life partners and children of alcohol-dependent patients. Fifty consecutive index patients diagnosed to be alcohol dependent according to the International Classification of Diseases-10 classification of mental and behavioral disorders diagnostic criterion for research reporting to psychiatry department were taken. The study was conducted on family members of alcohol-dependent patients who were enrolled in the study as subjects. These included both their children and spouses and they were evaluated for any psychopathology using M. I. N. I. AND M. I. N. I.-KID scales. Out of 50 spouses and 67 children enrolled in the study group. Sixty-eight percent had psychiatric morbidity in spouses which include 34% had major depressive episodes. Spouses living in the nuclear family and illiterate had more psychiatric morbidity. Total psychiatric morbidity in children above 18 years was 56.25%, maximum being in alcohol and substance dependence. Total psychiatric morbidity in children between 6 years and 18 years was 31.37%, maximum being in generalized anxiety disorder (11.76%). Spouses of subjects with alcohol dependence have a high prevalence of psychiatric morbidity. Spouses living in the nuclear family had a more major depressive episode and generalized anxiety disorder. Psychiatric morbidity was more in illiterate spouses. Psychiatric morbidity was also high in children. Female children between 6 years and 18 years had more generalized anxiety disorder than males.

Prevalence of psychiatric morbidity among parents of children with intellectual disability.

Background:Intellectual disability is a permanent disabling condition, and caregivers are more vulnerable to develop mental illness. There is little data in developing countries, such as India, concerning about psychological issues in caregivers of intellectually disabled children.Objective:The objective of this study was to find the prevalence of psychiatric morbidity and correlation between sociodemographic factors and psychiatric morbidity in parents of children with intellectual disability.Materials and Methods:This study was carried out among 60 parents of children with intellectual disability at the outpatient Department of Psychiatry, Tertiary Care Centre, India. Parents, who fulfill the inclusion and exclusion criteria of the study, were interviewed by using semi-structured pro forma, International Disease Classification-10 criteria for mental illness, Beck Depression Inventory and Hamilton Anxiety Rating Scale, Brief Psychiatric Rating Scale, and Alcohol Use Disorder Identification Test.Results:The prevalence of depressive disorder was 28.33%, anxiety disorder was 18.33%, and other psychiatric disorders was 8.33% (psychotic disorder 3.33%, insomnia 1.66%, and alcohol use disorder 3.33%) and total psychiatric morbidity was about 55% in parents of children with intellectual disability.Conclusion:The study shows high psychiatric morbidity in parents of children with intellectual disability, and psychiatric screening should be considered among parents of children with intellectual disability.

Prevalence of psychiatric morbidity among urban elderlies: Lucknow elderly study.

Background:Paucity of systematic studies in elderly mental health in an aging population is an urgent need, which is required to address services and planning issues for health.Aim:The present study aims to investigate the distribution of physical, neuropsychiatric, and cognitive disorders of a community sample of elderlies with certain socioeconomic data.Materials and Methods:A door-to-door household survey was conducted to identify houses with elderlies (≥55 years) in two urban localities of Lucknow. Mini mental state examination (MMSE), Survey Psychiatric Assessment Schedule (SPAS)/Mood Disorder Questionnaire (MDQ) and physical and neurological examination were used for screening all consenting elderlies. MMSE positive participants were assessed on Cambridge Mental Disorders of the Elderly Examination-Revised for diagnosis of cognitive disorders; SPAS/MDQ positives were assessed on Schedule for Clinical Assessment in Neuropsychiatry based clinical interview for diagnosis of neuropsychiatric disorders other than cognitive disorders (using ICD-10 criteria). Routine and indicated laboratory/radiological investigations on all and on MMSE/SPAS (organic section) positive/physically ill participants respectively were done to confirm organic and/or physical illness. Only percentages were calculated to find the distribution of morbidity.Results:The sample had proportionate age structure as that of the surveyed population and had balanced gender representation in each age deciles. Prevalence of neuropsychiatric disorders (with/without comorbidities) was 11.8% in the elderlies (60 years and above) highest being in the 60-69 years age group. Being women and of lower socioeconomic status was more commonly associated with a neuropsychiatric diagnosis. 7.6% of the elderlies had cognitive impairment. Overall findings suggest a prevalence rate of 17.34% of total psychiatric morbidity among elderlies. A significant number had comorbid physical illness diagnoses.Conclusion:More than half the elderlies had some diagnosable physical or mental ailment. The study familiarizes us to the significant amount of physical and psychiatric comorbidity in the particular age group. About one-fifth was found to suffer from psychiatric morbidity, which any health services for the elderly should be oriented towards.

Psychiatric morbidity in asymptomatic human immunodeficiency virus patients

Background:Psychiatric morbidity in human immunodeficiency virus (HIV) patients is being studied all over the world. There is paucity of Indian literature particularly in asymptomatic HIV individuals.Aim:The aim of the following study is to establish the prevalence and the determinants of psychiatric morbidity in asymptomatic HIV patients.Materials and Methods:A cross-sectional study was undertaken to assess psychiatric morbidity as per ICD-10 dacryocystorhinostomy criteria in 100 consecutive asymptomatic seropositive HIV patients and an equal number of age, sex, education, economic and marital status matched HIV seronegative control. All subjects were assessed with the general health questionnaire (GHQ), mini mental status examination, hospital anxiety and depression scale (HADS) and sensation seeking scale (SSS) and the scores were analyzed statistically.Results:Asymptomatic HIV positive patients had significantly higher GHQ caseness and depression but not anxiety on HADS as compared to HIV seronegative controls. On SSS asymptomatic HIV seropositive subjects showed significant higher scores in thrill and adventure seeking, experience seeking and boredom susceptibility as compared to controls. HIV seropositive patients had significantly higher incidence of total psychiatric morbidity. Among the individual disorders, alcohol dependence syndrome, sexual dysfunction and adjustment disorder were significantly increased compared with HIV seronegative controls.Conclusion:Psychiatric morbidity is higher in asymptomatic HIV patients when compared to HIV seronegative controls. Among the individual disorders, alcohol dependence syndrome, sexual dysfunction and adjustment disorder were significantly increased compared with HIV seronegative controls. High sensation seeking and substance abuse found in HIV seropositive patients may play a vital role in engaging in high-risk behavior resulting in this dreaded illness.

Official psychiatric morbidity and the incidence of schizophrenia 1881–1994

We assess claims that the documented rise in psychiatric morbidity during the nineteenth and twentieth centuries was associated with an increasing incidence of schizophrenia. Cross-sectional epidemiological comparison of the incidence of schizophrenia in one urban, industrialized community at three points over more than 100 years using new data from 1881-1902 and two pre-existing datasets, 1978-1980 and 1992-1994. For 1881-1902, 34 cases of schizophrenia were obtained through retrospective diagnosis, using Research Diagnostic Criteria, of a random 14.5% sample of first admissions to Nottingham Asylum (n = 330). Inter-rater reliability and leakage analyses were performed. The administrative incidence for all three studies was directly standardized against 1991 census data. Local statistics on total psychiatric morbidity in Nottingham were taken from the asylum superintendent's register and recent data from the Office of National Statistics. Official local and national rates of total psychiatric morbidity increased exponentially. There was no significant change in the incidence of schizophrenia over the 114-year period 1881-1994. The rise in both local and national official statistics of psychiatric morbidity 1881-1994 was not associated with a significant increase in the incidence of schizophrenia. Stability in the epidemiology of schizophrenia at a geographical level is found despite important demographic changes.

Job strain and psychiatric morbidity.

This study examined the association between job strain and psychiatric morbidity using interview-based assessments of mental health. We assessed the prevalence of neurotic disorder in high job strain (high demand, low control) and low job strain (low demand, high control) school teachers, and compared these rates with data from individuals with similar educational qualifications from the National Psychiatric Morbidity Survey of Great Britain. One hundred and sixty primary and secondary school teachers were selected from a larger survey on the basis of high or low job strain, and were assessed for psychiatric morbidity using the Revised Clinical Interview Schedule (CIS-R). The prevalence of neurotic symptoms and a total psychiatric morbidity score were calculated. After adjusting for age, gender and occupational grade, the prevalence of psychiatric morbidity was greater in high job strain than low job strain individuals. The prevalence of severe anxiety, worry and fatigue symptoms was significantly greater in the high job strain teachers. In comparison with the British psychiatric morbidity survey, the prevalence of neurotic disorders was greater in the high job strain, but not in low job strain teachers. Individuals in the low job strain group were more likely to report severe anxiety, irritability and fatigue in the week prior to interview, than comparably educated individuals in the national survey. Job strain is associated with psychiatric morbidity. The high levels of neurotic psychopathology among teachers is consistent with previous research that has found teaching to be a highly stressful occupation.

Prevalence of mental disorders in an urban sample examined at 70, 75 and 79 years of age.

The prevalence of mental disorders in a representative sample of old people in Gothenburg, Sweden, was studied at 70, 75 and 79. The study comprised 392 subjects at 70, 302 subjects at 75 and 203 at 79. A case was defined by cut-off points on symptom and sign rating scales, and diagnoses were defined operationally as closely as possible to the ICD-classification. The total psychiatric morbidity was 21.9, 24.2 and 31.0% in the three age groups. The prevalence of schizophrenic and paranoid syndromes was 0.5, 1.7 and 2.5% and of affective disorders 1.0, 2.3 and 0.5%. The prevalence of dementias of psychotic degree was 1.3, 2.3 and 6.9% and of asthenic neuroses corresponding to dementias of mild-moderate degree 2.3, 4.0 and 9.4%. The prevalence of anxiety, depressive and obsessive-compulsive neuroses of moderate-severe degree was 6.6, 4.6 and 3.9% and of mild degree 7.9, 6.0 and 5.9%. The prevalence of active alcoholism in men was 4.2, 3.4 and 3.0% and in women 0.0% in all age groups. Current treatment was reported by 67-85% of subjects with psychoses, about one half of them in psychiatric services, and by 35-65% of subjects with neuroses, about one fifth of them in psychiatric services.

Epidemiology of psychosomatic disorders in Iran.

Psychiatric-epidemiological surveys executed from 1963 to 1976 in Iran with the help of the WHO sampled all three principal components (rural, urban, tribal) of the population greater than or equal to 6 years. The surveys employed questionnaires and tests in a first screening phase and individual psychiatric examinations of all suspects in a second. They were based partly on census studies, partly on random samples. Prevalencies per 1,000 for all psychiatric cases were: rural 149, urban 166, tribal 21; for all psychoreactive cases (included in the foregoing) rural 87, urban 98, tribal 12; for all psychosomatic cases (included in the psychoreactive) rural 17, urban 23, tribal 9. All tribal rates were significantly lower. Reactive cases thus accounted for 59% of the total psychiatric morbidity, psychosomatic cases for 14% of it. Significant sex differences were found only in the poorer strata. The distribution of types of psychosomatic disorder differed from what Cremerius has reported for Munich, with more psychosomatic headache and less pulmonary/cardiovascular and gastrointestinal disturbance.

Prevalence of mental disorders in a 70-year-old urban population.

The prevelance of mental diseases and abnormalities in a representative, systematic sample of 70-year-olds in Gothenburg, Sweden, is presented. Out of 460 selected subjects, 392 (85.2%) took part and the responders and non-responders were similar in several respects. A case was defined by cut-off points on symptom and/or sign rating scales and diagnoses were defined operationally but as closely as possible to the ICD-classification. The total psychiatric morbidity, excluding personality deviations, was 16.9% in men and 26.1% in women, and excluding also mild neuroses 12.7% in men and 15.5% in women. The prevalence of psychoses was 3.0% in men and 3.5% in women, of neuroses of moderate-severe degree 6.6% in men and 11.5% in women, of neuroses of mild degree 4.2% in men and 10.6% in women, of alcoholism 3.0% in men and 0.0% in women and of oligophrenia 0.0% in men and 0.4% in women. The prevalence of demential syndromes of a psychotic degree was 2.4% in men and 1.3% in women, of a neurotic degree 4.2% in men and 1.8% in women and the total prevalence of demential syndromes was thus 6.6% in men and 3.1% in women. Indications of previous alcohol problems and no or a low current consumption of alcohol were noted among 18.1% of the men.

Prevalence of mental illness among 70-year-olds domiciled in nine Copenhagen suburbs.

The results of a study on the prevalence of mental diseases and abnormalities among a geographically well-defined group of 70-year-olds, all living in nine suburbs of Copenhagen, are submitted and discussed. The total psychiatric morbidity was found to be 15.5%; 6.4% suffered from psychoses, males preponderating, and 7.4% classified as "neuroses + personality disorders", females preponderating. Only 15% of the pschotic group were institutionalised. Of the entire material, 5% were demented, and this included 1.l% patients who were severley demented. There was a definite preponderance of males. Of the population, 2.6% were living in their homes with senile or arteriosclerotic dementia. About 1% of the population were looked after in their homes despite severe dementia of varying geneses. Hidden morbidity, meaning that the proband had neither been institutionalised nor had consulted a doctor for mental illness within the past 5 years, made up of 15% of the psychotic group and 19.2% of the group "neuroses + personality disorders + alcoholisms". The total hidden morbidity constituted 2.6% of the population or 16.5% of the demonstrated psychiatric morbidity. The prevalence findings are on the whole on a level with those reported from other studies, most of which have been concerned with population groups over 65 years of age.

Psychiatric morbidity in an out-of-hours deputizing service.

A survey undertaken on a consecutive series of 500 patients, visited by a doctor who was employed by a deputizing service providing out-of-hours medical attention, revealed a psychiatric morbidity of 8%. The distinction between the total psychiatric morbidity and the conspicuous psychiatric morbidity of a population is discussed, and reasons are suggested why the determined conspicuous psychiatric morbidity of 8% is low. The psychiatric conditions encountered in such a practice are described. The incidence of psychosis and of psychiatric problems in children was low. Alcoholic disorders were common and diverse in their clinical manifestations, and presented difficulties in diagnosis. Case studies of the alcoholic patients are included to illustrate these findings. Problems presented by drug-dependent patients are described. A descriptive impression is given of the type of patients with a psychiatric problem who seek the attention of a deputizing service.