Mini International Neuropsychiatric Interview Version Research Articles

Prevalence and pattern of mental disorders in the state of West Bengal: Findings from the National Mental Health Survey of India 2016.

West Bengal, situated in eastern India, comprising 19 districts as of 2016 and consisting of 9.13 crore population, had been one of the participating states in the National Mental Health Survey, 2015-16. To estimate the prevalence and pattern of mental disorders in a representative population in West Bengal. Based upon a multi-stage stratified random cluster sampling with probability proportionate to each stage, 2646 eligible individuals were interviewed. Standard validated instruments in Bengali like socio-demographic profiles and Mini International Neuropsychiatric Interview (MINI) version 6 were used by trained data collectors with quality monitoring as per a standardized protocol. The current prevalence of mental illness in the state of West Bengal is 13.07% (12.9-13.24 95% CI), which is more than the current national average of 10.56% (10.51-10.61 95% CI). The prevalence of severe mental illness of 2.32% and suicide risk of 1.75% (1.68-1.81 95% CI) is higher than the national average. The common mental illness prevalence is 11.29 (11.13-11.45 95% CI), which is similar to the national weighted average. In West Bengal, severe mental illness is more concentrated in the rural areas in contrast to the national trend. Also, the prevalence of alcohol use disorder is 3.04 (2.96-3.13 95% CI) and epilepsy is 0.03 (0.27-0.29 95% CI), which is less than the national average. The prevalence of mental disorders in the state of West Bengal is higher than the national average, and for severe mental illness, the prevalence is the highest as compared to the national average.

Impact of JME on quality of life: Does a well-controlled epilepsy also hamper the psychological wellbeing?

PurposeEpilepsy is a stigmatizing disorder and its diagnosis can have important psychosocial consequences on individuals, severely impacting their quality of life(QOL). There are numerous studies which have seen an adverse impact on the psychosocial aspects of life in patients with intractable epilepsy. The aim of this study was to assess the QOL in adult and adolescent patients with JME, which is largely a well-controlled form of epilepsy. MethodologyThis was a hospital based cross-sectional observational study comprising of 50 JME patients. QOLIE-31-P and QOLIE–AD-48 questionnaires were used to assess QOL in adults & adolescents(11–17 years) respectively. The Mini international neuropsychiatric interview-version 7.0.2 and Brief psychiatric rating scale were used for screening of underlying psychopathology and if, the screening tests were positive then they were further evaluated and classified using DSM V and ICD 10. ResultsThe mean QOLIE-31-P score was 64.65 ± 15.74. Majority of the adult patients had fair QOL (poor, fair and good QOL scores in 18 %, 54 % and 28 % respectively). Subscale scores in poor category were for the medication effects and pertaining to seizure worry.Among adolescent patients, the mean QOLIE 48 AD score was 69.15 ± 13.13. 50 % had fair QOL. Amongst those with poor QOL, majority of poor scores were for the attitude towards epilepsy. The QOL scores were significantly poorer in patients with uncontrolled seizures. 78 % of the patients had comorbid anxiety and depression, however syndromic psychiatric diagnosis was seen in 10.25 % and 2.56 % for anxiety and depression respectively. Presence of psychiatric symptoms did not influence QOL scores. ConclusionQOL, in well controlled JME, is fair in majority of patients. QOL might improve if seizure worry is addressed and patients are educated about medication effects at the time of initial diagnosis. Vast majority of patients may experience minor psychiatric issues, which do need addressal for formulating a holistic and individualized treatment plan.

Prevalence of Psychiatric Disorders in Chhattisgarh: Findings from National Mental Health Survey.

Psychiatric disorders are among the leading contributors to disability in India and worldwide. The pattern, prevalence, and distribution of psychiatric disorders in the country and its regions need to be assessed to facilitate early diagnosis and treatment. No study on the epidemiology of psychiatric disorders has been conducted in the Chhattisgarh state. This paper, as part of the National Mental Health Survey (NMHS), discusses the prevalence and pattern of psychiatric disorders in Chhattisgarh state. A stratified random cluster sampling technique and random selection based on probability proportional to size (PPS) at each stage were adopted. Participants were from three selected districts of Chhattisgarh, such as Janjgir-Champa, Kabirdham, and Raipur. Adults (aged ≥18 years) residing in selected households were interviewed using Mini International Neuropsychiatric Interview (version 6.0), the Fagerstrom test for nicotine dependence, the WHO-SEARO screening questionnaire for generalized tonic-clonic seizures, and screening tools for intellectual disability and autism spectrum disorders. A total of 2841 individuals were interviewed. The state's lifetime and current prevalence of psychiatric disorders for adults were 14.06% [95% confidence interval (CI) = 13.83-14.29] and 11.66% (95% CI = 11.45-11.87), respectively. Prevalence of substance use disorders, tobacco use disorders, schizophrenia and related disorders, and mood disorders was 32.4% (95% CI = 32.09-32.71), 29.86% (95% CI = 29.56-30.16), 0.8% (95% CI = 0.75-0.86), and 4.44% (95% CI = 4.31-4.58), respectively. High risk for suicide was detected in 0.28% (95% CI = 0.25-0.31). Psychiatric disorders were twice more common in males than in females. The study gives authentic data on the prevalence of psychiatric disorders in Chhattisgarh. This shall pave the way for policymakers and planners to design state-specific plans for dealing with mental disorders and related issues.

Relations between clinical characteristics and cognitive deficits among adult patients diagnosed with major depressive disorder

Objective The present study examined the relations between clinical characteristics and cognitive deficits in adult patients with major depressive disorder (MDD) from a local outpatient psychiatric clinic in Malaysia. Methods The present sample included 110 participants aged 20–60 years old. Participants were invited to provide their information on sociodemographic variables (age, gender, and educational level) and clinical characteristics (age at onset of depression and duration of illness) and to complete a series of cognitive performance measures including the Trail Making Tests A (psychomotor speed) and B (executive function), the Digit Symbol Substitution Test (attention), and the Auditory Verbal Learning Test (immediate free recall, acquisition phase, and delayed recall). The Mini International Neuropsychiatric Interview Version 6.0 was used to confirm the diagnosis of MDD and the Montgomery–Åsberg Depression Rating Scale was used to assess illness severity. Results At the bivariate level, relations of age and educational level to all cognitive deficit domains were significant. At the multivariate level, only educational level and illness severity consistently and significantly predicted all cognitive deficits domains. Conclusions Therapeutic modalities should be individualised whilst considering the impacts of cognitive deficits in an attempt to prevent further deterioration in psychosocial functioning of MDD patients. KEY POINTS Cognitive deficits are an elemental component of Major Depressive Disorder (MDD) persisting during a current major depressive episode or during remission, altering individuals’ ability to process information and changes the way they perceive and interact with the environment. Cognitive deficits in MDD are evident among the upper-middle income groups in South-Eastern Asian countries warranting more local research as such deficits could lead to functional decline and work performance such as absenteeism and presenteeism. Therapeutic modalities should be individualised by taking the impacts of cognitive deficits into consideration to promote psychosocial functioning of MDD patients.

Study of Internet addiction among medical students

Background Internet addiction is a serious and growing problem. There is an emerging public health concern over the increase in Internet usage, particularly among adolescents. Aim The purpose of this study was to assess the pattern of Internet use among university students and to evaluate the personality and the associated psychiatric disorders with students of Internet addiction. Participants and methods A total of 300 medical students were subjected to the Internet Addiction Test (IAT) developed by Young in 1998. Personality evaluation by Eysenck Personality Questionnaire and psychiatric interview by Arabic version of Mini-International Neuropsychiatric Interview were done for Internet addicts to assess any associated personality or psychiatric disorders. Results Students were divided into four Internet user groups according to their IAT total scores: normal Internet users (n=117, 39.0%), mild Internet addicts (n=116, 38.7%), moderate Internet addicts (n=64, 21.3%), and severe Internet addicts (n=3, 1.0%). Males were more prone than females to develop severe forms of Internet addiction. Family environment had a major effect on developing Internet addiction. Neurotics and introverts were more susceptible to develop Internet addiction than others. Depression and anxiety were significantly associated with Internet addiction. Conclusions This study suggests that students who use the Internet excessively exhibit significantly more psychiatric symptoms than students who use the Internet less frequently. In addition, pathological Internet addicts appear to have a distinctive personality and social profile when compared with nonpathological users.

Factor structure and item response of psychosis symptoms among Kenyan adults

BackgroundThe aim of this study was to evaluate the construct validity of the psychosis module of the Mini International Neuropsychiatric Interview version 7.0.2 (MINI-7). MethodWe utilized data collected from 2738 participants with a primary psychotic or bipolar disorder. Participants were drawn from two Kenyan sites of a large multi-center neuropsychiatric genetic study. The factor structure of the MINI-7 psychosis items were explored using confirmatory factor analyses (CFA) and Item Response Theory approach, for the full sample and by gender. ResultsThe CFA revealed that a 1-factor model provided adequate fit for the MINI-7 psychosis items for the full sample (x2 = 397.92, df = 35, p < .0001; RMSEA = 0.06; CFI = 0.92; TLI = 0.90) as well as for the female (x2 = 185.16.92, df = 35, p < .0001; RMSEA = 0.06; CFI = 0.93; TLI = 0.91) and male groups (x2 = 242.09, df = 35, p < .0001; RMSEA = 0.06; CFI = 0.92; TLI = 0.89). Item thresholds for the full sample, and female and male groups were highest for ‘odd beliefs’ (−1.42, −1.33, and −1.51 respectively) and lowest for ‘visual hallucinations’ (−0.03, −0.04, and −0.01 respectively). LimitationsOur study used a hospital-based population, which may have excluded patients with milder psychotic symptoms. Findings may therefore not be generalizable to the community setting. ConclusionsOur findings indicate good construct validity of the MINI-7 psychosis module, and provides support for use of the tool in diagnosing psychotic disorders in clinical settings in Kenya.

Physical and psychiatric comorbidities among patients with severe mental illness as seen in Uganda.

While psychiatric and physical comorbidities in severe mental illness (SMI) have been associated with increased mortality and poor clinical outcomes, problem has received little attention in low- and middle-income countries (LMICs). This study established the prevalence of psychiatric (schizophrenia, bipolar affective disorder, and recurrent major depressive disorder) and physical (HIV/AIDS, syphilis, hypertension and obesity) comorbidities and associated factors among 1201 out-patients with SMI (schizophrenia, depression and bipolar affective disorder) attending care at two hospitals in Uganda. Participants completed an assessment battery including structured, standardised and locally translated instruments. SMIs were established using the MINI International Neuropsychiatric Interview version 7.2. We used logistic regression to determine the association between physical and psychiatric comorbidities and potential risk factors. Bipolar affective disorder was the most prevalent (66.4%) psychiatric diagnoses followed by schizophrenia (26.6%) and recurrent major depressive disorder (7.0%). Prevalence of psychiatric comorbidity was 9.1%, while physical disorder comorbidity was 42.6%. Specific comorbid physical disorders were hypertension (27.1%), obesity (13.8%), HIV/AIDS (8.2%) and syphilis (4.8%). Potentially modifiable factors independently significantly associated with psychiatric and physical comorbidities were: use of alcohol for both syphilis and hypertension comorbidities; and use of a mood stabilisers and khat in comorbidity with obesity. Only psychiatric comorbidity was positively associated with the negative outcomes of suicidality and risky sexual behaviour. The healthcare models for psychiatric care in LMICs such as Uganda should be optimised to address the high burden of psychiatric and physical comorbidities.

Persian Translation and Cultural Adaptation of Mini International Neuropsychiatric Interview and its Psychometric Properties.

The main objectives of this study were the translation, cultural adaptation, and assessment of the psychometric properties of the Persian version of Mini International Neuropsychiatric Interview (MINI). All processes of linguistic methodology were conducted according to the published guidelines. A total of 180 patients with psychiatric problems were interviewed using MINI and Structured Clinical Interview for DSM-5(R) - Clinician Version (SCID-5-CV) by different interviewers. Another 30 patients were selected for examining the test-retest reliability. The study sample was recruited from a psychiatric hospital and a general hospital in Tehran, Iran. Face validity, feasibility, time of the interview, test-retest reliability, and concurrent validity were evaluated. Mean interview time was 19.76±10.30 minutes, indicating satisfactory feasibility. The test-retest reliability was very good (phi=2, Cramer's V=0.89, P<0.0001). The kappa values showed good or excellent agreement between MINI and SCID-5-CV for psychotic disorders (0.88), substance-related disorders (0.86), bipolar disorder (0.85), major depressive disorder (0.84), obsessive-compulsive disorder (0.74), and mental disorder due to other medical disorders (0.7). However, the kappa values were found to be lower for generalized anxiety disorder (0.44) and posttraumatic stress disorder (0.32) diagnoses. The Persian version of MINI is a feasible, reliable, and valid instrument for diagnosing some mental disorders. Further research is needed to evaluate the validity of this instrument in other categories of psychiatric diagnoses in the general population.

Prevalence and Factors Associated with Risky Sexual Behaviors among Patients with Severe Mental Illness in Uganda: A Descriptive Cross Sectional Study

Background: Persons living with severe mental illness (SMI) which includes schizophrenia, bipolar affective disorder and recurrent major depressive disorder are predisposed to risky sexual behavior (RSB). There is a paucity of data on this problem in sub-Saharan Africa and where research has been undertaken, only a limited range of risk factors have been considered and most of it was undertaken before antiretroviral therapy was universally available, hence the need for this study. The objective of this study was to determine the prevalence and factors associated with risky sexual behavior among individuals with SMI attending care in central and south western Uganda. Methods: A cross sectional study was conducted among 393 persons with SMI attending two psychiatric out-patient facilities in Uganda. Psychiatric disorder was confirmed using MINI International Neuropsychiatric Interview version 7.2. RSB was defined as engaging in at least one of four risky sexual behaviours that have been associated with HIV infection in the Ugandan psychosocial environment in the last three months using an 8 item RSB questionnaire used for assessment of RSB. Prevalence of RSB and associated correlates were determined using multiple logistic regression. Results: The Prevalence of RSB in last 3 months’ periods was 24.2% (95% CI: 20.2% - 28.7%). The factors that were independently significantly associated with RSB were: trauma related (history of childhood trauma, past and current sexual abuse, past and current physical abuse) current psychosocial challenges (mental health stigma) and psychiatric illness factors (history of a past manic episode, current psychotic episode, severity of depressive symptoms and severity of manic symptoms). Conclusions: One quarter of clinic attending respondents with severe mental illness in Uganda practice risky sexual behaviour. Factors associated with risky sexual behaviour fall under the domains of past and present trauma, current psychosocial challenges and psychiatric illness factors. This calls for a multi-sectoral approach that includes community awareness about the nature of SMI and the rights of persons with SMI and measures to improve Psychiatric symptom management.

Prevalence of Depression and Associated Factors among Medical Students in a Southern Nigerian University

INTRODUCTION: Medical students may be vulnerable to depression and other psychiatric morbidity. This study sought to assess the prevalence of depression and associated factors among medical students in Niger Delta University, Bayelsa State, Nigeria.&#x0D; &#x0D; METHODS: Using a self-administered, author-developed questionnaire with adaptations from the Patient-rated version of Mini-International Neuropsychiatric Interview (MINI-PR) and the Depression Anxiety Stress Scale (DASS), data including socio-demographic characteristics, alcohol use/abuse, cigarette smoking, features of depression and anxiety were collected from 243 medical students in this descriptive cross-sectional study over a period of 4months. &#x0D; &#x0D; RESULTS: Of the 243 participants, 52.7% were male, mostly aged 18 to 24 years (67.1%). The incidence of depression, suicidal ideation, alcohol use, and psychoactive substance use as defined by the MINI questionnaire was 30.5%, 14.8%, 14.8%, and 9.9%, respectively. As defined by DASS 21, almost a third suffered different levels of anxiety (29.6%), and less than one-fifth reported different levels of stress (17.7%). Female gender and year of study showed a significant association with the diagnosis of depression (X2=15.75;p&amp;ndash;0.008). Living arrangement (X2=11.43;p&amp;ndash;0.022), perception of accommodation condition (X2=16.35;p&amp;ndash;0.001), academic performance (X2=18.02;p&amp;ndash;0.001), and experience of academic failure (X2=5.13;p&amp;ndash;0.023) all had a significant relationship with depression among the study population.&#x0D; &#x0D; CONCLUSION: Prevalence of depression among medical students is high; its diagnosis showed a significant association with female gender, year of study, and perception of social and academic factors. Several comorbid psychiatric conditions may coexist with depression among medical students; therefore, the approach to their mental health should be holistic with attention paid to associated factors and psychiatric comorbidities.

Psychiatric and Substance Use Comorbidities among People who Inject Drugs in India

Background: People who Inject Drugs (PWID) show higher rates of comorbid psychiatric illnesses than the general population. We aimed to assess the rates of different psychiatric disorders and substance dependence among PWID in the state of Delhi, India. Methods: We conducted a community-based, cross-sectional study interviewing 104 adult male participants receiving various harm reduction and HIV prevention services. A semi-structured questionnaire assessed socio-demographics, drug use and injecting patterns, and opioid overdose experience. Mini-International Neuropsychiatric Interview Version 7.0.2 (for screening and diagnosing major psychiatric disorders), World Health Organization-Alcohol, Smoking, and Substance Involvement Screening Test for the pattern of other psychoactive substance use were used. Results: The mean age of participants was 27.9 years. The predominant opioid injected in the last 1 year was heroin. About 52% of participants had at least one psychiatric illness during their lifetime. Antisocial personality disorder (25%) was the most common psychiatric illness followed by suicidality (23.1%). About 23.1% had more than one psychiatric comorbidity other than substance use disorder. Being unskilled (χ 2 = 11.39; P = 0.03), having early mean age of tobacco onset (t = −2.416; P = 0.02), longer duration of tobacco (t = 2.033; P = 0.04), alcohol (t = 2.204; P = 0.03) use, less abstinent attempts for opioid use (χ 2 = 5.003; P = 0.03), longer duration of injecting drug use (t-test = 2.437; P = 0.02), higher vein-related complications (χ 2 = 9.27; P = 0.02), high HIV positivity rate (χ 2 = 8.54; P = 0.01), and high rates of nonfatal opioid overdose over lifetime (χ 2 = 4.87; P = 0.03) were significantly associated with having lifetime psychiatric illness. Conclusion: Our study found high rates of psychiatric illnesses and the use of other psychoactive substances among PWID from India. There is an urgent need to incorporate mental health services into the existing HIV prevention services directed at PWID in India.

A Cross-sectional Study to Determine the Factors Affecting the Quality of Life in Patients with Grand Mal Epilepsy

Introduction: Epilepsy is a chronic neurological condition that affects various domains of life apart from causing physical dysfunction. It is associated with various cognitive and psycho- social complications that can adversely affect the Quality of Life (QoL). Aim: To study the socio-demographic and clinical factors affecting QoL in Patients With Epilepsy (PWE). Materials and Methods: This cross-sectional study was conducted at a tertiary care centre in northern India on patients with Grand Mal Epilepsy. Total 60 PWE were assessed for psychiatric co-morbidity using Mini International Neuropsychiatric Interview version 6.0 and were divided into two groups, Group I and Group II, based on absence and presence of psychiatric co-morbidity, respectively. Self-administered QoL in Epilepsy-31 Scale was then used in both the groups to assess QoL in the study subjects and statistical analysis was done. Normally, distributed quantitative data was analysed using independent t-test for two groups and Analysis of Variance (ANOVA) test for three or more groups. Results: The mean age of the study population was 27.68±9.51 years. A 55% of the study population were males and 45% of total study population were females. The mean total duration of epilepsy was 7.42±6.98 years. There was significant main effect due to socio-economic status for domains of emotional well-being (F=7.513, p=0.010), energy/fatigue (F=5.625, p=0.021), cognitive functions (F=7.708, p=0.007) and overall score (F=6.876, p=0.011) on QOLIE-31 scale. There was a significant main effect due to total duration of seizure disorder for domains of energy/fatigue (F=2.724, p=0.03) and cognitive functions (F=2.852, p=0.03). The mean scores of PWE with psychiatric co-morbidity were lower than PWE without psychiatric co-morbidity in all the domains of QoL in epilepsy scale and the differences in two groups were statistically significant (p=0.01). Conclusion: The present study showed that QoL in PWE is associated with various socio-demographic and clinical factors beyond seizure control.

Alcohol and drug use disorders in adult attention-deficit/hyperactivity disorder: Prevalence and associations with attention-deficit/hyperactivity disorder symptom severity and emotional dysregulation.

BACKGROUNDHigh risk of alcohol and drug use disorders in people with attention-deficit/hyperactivity disorder (ADHD) calls for exploratory research of relationships with clinical features of ADHD.AIMTo estimate prevalence of alcohol/drug use disorders and associations with ADHD symptom severity and emotional dysregulation, in adults with ADHD.METHODSThis observational cross-sectional clinical study consisted of patients admitted to a private psychiatric outpatient clinic in Oslo, Norway (2014-2018). Five-hundred and fifty-eight eligible patients diagnosed with ADHD (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria) agreed to participate. Alcohol and drug use disorders were diagnosed using the Mini International Neuropsychiatric Interview (MINI). Dependence and abuse were merged into “use” disorder as in MINI version 7.0/DSM-5. Questions were related both to lifetime and the past 12-mo. ADHD severity was assessed by the Adult ADHD Self Report Scale (ASRS). Subdivisions of the ASRS questionnaire as inattentive items and hyperactive/impulsivity items were recorded separately. Emotional dysregulation was assessed by the eight-item version of Barkley’s Current Behavior Scale - Self Report.RESULTSThe 12-mo prevalence was 5.3% for alcohol use disorder and 13.7% for drug use disorder. The lifetime prevalence was 12.0% for alcohol use disorder and 27.7% for drug use disorder. Men had higher rates of both alcohol use disorder and drug use disorder compared to women. The prevalence of drug use disorder was more than twice that of alcohol use disorder for both sexes. The drugs most participants reported having used were (in descending order): Amphetamine (19.1%), cannabis (17.1%), cocaine or ecstasy (7.4%), benzodiazepines (7.4%), and heroin or other opioids (2.9%). Lifetime drug use disorder was significantly associated with both hyperactivity-impulsivity symptoms and emotional dysregulation symptom severity. Lifetime alcohol use disorder, on the other hand, was not significantly associated with ADHD symptoms or emotional dysregulation when adjusted for gender and age.CONCLUSIONPatients with ADHD have a high lifetime prevalence of drug use disorder, which is associated with higher levels of hyperactivity-impulsivity symptoms and emotional dysregulation.

Neurocognitive functioning in MDR-TB patients with and without HIV in KwaZulu-Natal, South Africa.

Optimising medication adherence is one of the essential factors in reversing the tide of a TB-HIV syndemic in sub-Saharan Africa, especially South Africa. Impairment in key neurocognitive domains may impair patients' ability to maintain adherence to treatment, but the level of cognition and its relationship to HIV status has not been examined in individuals with drug-resistant TB. We therefore investigated performance on several key neurocognitive domains in relationship to HIV status in a multidrug-resistant tuberculosis patients (MDR-TB) sample. We enrolled microbiologically confirmed MDR-TB inpatients at a TB-specialist referral hospital in KwaZulu-Natal province, South Africa. We collected cross-sectional data on sociodemographic, clinical and neurocognitive function (e.g. attention, memory, executive functioning, language fluency, visual-spatial, eye-hand coordination). For the primary analysis, we excluded participants with major depressive episode/substance use disorder (MDE/SUD). We fitted adjusted Poisson regression models to explore the association between HIV and neurocognitive function. We enrolled 200 people with MDR-TB; 33 had MDE/SUD, and data of 167 were analysed (151 HIV+, 16 HIV-). The mean age of participants was 34.2years; the majority were female (83%), and 53% had not completed secondary school. There was evidence of impaired neurocognitive functioning across all domains in both HIV+/- study participants. Based on the regression analyses, individuals with co-infection (MDR-TB/HIV+), as well as those who had longer duration of hospital stays experienced significantly lower cognitive performance in several domains. Poor cognitive performance was significantly related to older age and lower educational attainment. The presence of major depression or substance use disorders did not influence the significance of the findings. Adults with MDR-TB have significant neurocognitive impairment, especially if HIV positive. An integrated approach is necessary in the management of MDR-TB as cognitive health influences the ability to adhere to chronic treatment, clinical outcomes and functionality.

Effect of Osteopathic Manipulative Therapy on Generalized Anxiety Disorder.

Traditional management options for generalized anxiety disorder (GAD) have produced low remission rates. As a result, the medical community has turned to complementary and alternative medicine for adjunctive treatment. To investigate the efficacy of adjunctive osteopathic manipulative therapy (OMTh; manipulative care provided by foreign-trained osteopaths) in individuals with GAD. This open-label, nonrandomized, black-box study took place at a tertiary care mental health clinic in Toronto, Canada. Adult outpatient participants aged 18 to 65 years with a primary diagnosis of moderate-severe GAD (HAM-A score of ≥20) with or without comorbidities were enrolled in the study between June 2014 and January 2015. Patients who qualified and completed the study received 5 individually tailored OMTh sessions over the course of 8 to 9 weeks. A diagnostic psychiatric assessment (Mini International Neuropsychiatric Interview version 6.0.0) was conducted to confirm diagnoses, along with physician-administered and self-reported measures of anxiety, including the Hamilton Anxiety Scale (HAM-A), the Beck Anxiety Inventory, and the Intolerance for Uncertainty Scale. Significant reductions in total HAM-A scores after OMTh were observed (P<.0001). Significant reductions in total Intolerance for Uncertainty Scale scores were also observed (P<.0001). Beck Anxiety Inventory scores were not found to change significantly with OMTh. Response (defined as 50% reduction of symptoms) and remission (defined as HAM-A score of ≤7) rates were found to be 62% and 26.9%, respectively. Osteopathic manipulative therapy may be a valuable adjunct to conventional therapy in patients with GAD, thus warranting further investigation using double-blind procedures.

The pregnancy as protection for suicidal behavior: a population-based study in south Brazil

Objective: To describe the incidence of suicidal attempts and the prevalence of suicidal ideation in pregnancy; verifying the factors associated with suicidal ideation in pregnant women. Methods: This analysis is a section from a population-based cohort study with pregnant women between the first and second gestational trimester, identified at their homes in the urban area from a southern Brazilian. The Mini International Neuropsychiatric Interview version Plus (MINI PLUS) was used to assess suicidal ideation and behavior. Variables with a p&lt;0.20 value in the bivariate analysis were retained in the logistic regression-adjusted analysis using SPSS (Statistical Package for the Social Sciences) Statistics software. This study was approved by the Research Ethics Committee of the Catholic University of Pelotas. Results: In the baseline, 974 pregnancy women completed the diagnostic interview for evaluation of psychiatric symptoms, totaling 9.5% (n=93) woman had current suicidal ideation. In addition, 1.3% (n=13) of pregnant women reported a suicide attempt in the last month, and 11 of them had a history of suicidal behavior throughout their lives. Conclusion: Despite the presence of suicidal ideas in pregnancy, suicidal behavior is not very common at this time.

Psychiatric Morbidity, Cultural Factors, and Health-Seeking Behaviour in Perinatal Women: A Cross-Sectional Study from a Tertiary Care Centre of North India.

Background:Poor mental health of the mother affects her physical health and the neonate's health and development. Studies from Southern India place different estimates of perinatal mental ill-health. Cultural variables affect health-seeking behaviour and are thus important to study in perinatal women with psychiatric morbidity.Methods:A total of 281 perinatal women were screened on Edinburgh Postnatal Depression Scale (EPDS), Perinatal Anxiety Screening Scale (PASS) and Mini International Neuropsychiatric Interview version 6.0 (MINI), assisted with a clinical interview to identify psychiatric illnesses. The cultural formulation interview (CFI) of DSM-5 was applied on perinatal women having psychiatric illnesses and their caregivers.Results:A psychiatric diagnosis was present in 10.3% of perinatal women. Depression and anxiety disorders were seen in 7.12% and 1.41%, respectively. Marital discord (P < 0.0001), psychosocial stressors (P < 0.0001), and past history of psychiatric disorder (P < 0.001) were significantly higher in perinatal women with a current psychiatric diagnosis. On CFI work-related stress, the gender of the infant, low education and conflict across generations were identified as the negative aspects of the culture associated with psychiatric illness during and after pregnancy. Religion and social support were the major coping strategies, while stigma and financial problems were the major barriers to help-seeking.Conclusion:The high prevalence of psychiatric disorders and the strikingly low help-seeking are noteworthy. These findings can help in planning treatment and prevention programs for timely detection and intervention for perinatal psychiatric disorders.

Undiagnosed depression among adults with diabetes mellitus in Jos.

Diabetes mellitus (DM) and depression are common chronic disease states of public health importance with huge burden and the potential to impact many aspects of life. They are said to be related though this relationship is not fully understood. The presence of depression among patients with DM is associated with poor glycemic control, complications, and poor self-care. This was a descriptive cross-sectional study conducted at the Diabetes Clinic of the Jos University Teaching Hospital. Three hundred and ten (310) patients with diabetes mellitus were recruited consecutively. The depression module of the Mini International Neuropsychiatric Interview (M.I.N.I.) version 5.0 was used to ascertain depression among these patients. Other demographic data were obtained using a questionnaire. Blood pressure, weight, and height were also measured and the body mass index (BMI) calculated. One hundred and eighty four (59.35%) of the study population were females and the mean age (SD) of the study population was 54 ± 12 years. The mean age (SD) of the females was 53 ± 11 years and that of the males was 54 ± 12 years with no significant statistical difference (P = 0.35). Two hundred and forty nine (80.32%) of the study population were urban dwellers with 140 (45.16%) earning less than N500, 000 (794 USD) yearly. Current major depression was found in 35 (11.3%) patients, among whom 7 (2.3%) had recurrent depression. The presence of DM complications (OR: 3.50, 95% CI 1.16-10.61) and a positive family history of depression (OR: 4.03, 95% CI 1.32-12.29) were found to be correlates of current major depression. The prevalence of current major depression among patients with diabetes mellitus in this study is high. We recommend that all patients with DM should be screened for depression and treated appropriately to reduce its consequences.

Perception of Weight changes among People with Depression SymptoCities in Indonesia

Background: Obesity is a growing problem so obesity is a threat to health, especially in a developing country like Indonesia. Obesity is a caused for death and burden of disease-causingvariousdiseases.Thisstudylookedatthecorrelationbetweenmental disorders associated with eating disorders or perceptions of changes in respondents’ weight toward depressive disorders. The perception to the body weight is one of the factors that are often found in symptoms of mental disorders.&#x0D; Objectives: This research aim to understand the individuals’ obesity condition picture of patients based on their characteristics.&#x0D; Methods: In this study individuals with depressive symptoms were established using MINI instruments through interviews using the ICD-10 Mini International Neuropsychiatric Interview Version mental health instrument conducted in October–November 2017 by nursing diploma enumerators who were trained by psychiatrists. The perception of the state of body weight obtained from sampling was carried out by stratified random sampling. This study is a further analysis of data on mentalhealthresearchconductedin3districts/citiesinIndonesia,namelyinthecityof Bogor,JombangandTojouna-Unadistrictsusingcrosssectionalmethod.Theresearch samplesanalyzedwereindividualswhoexperiencedsymptomsofdepression&#x0D; Results: From the 262 respondents who experienced a history of symptoms of depressive disorders, appetite disorders/changes in body weight experienced by majority of the respondents,amountingto66.0%.Asignificantrelationbetweengenderandownership economy level with the appetite disorder/body weight changes. Where women on lower economy level suffered from depression were highly probable risking appetite disorder/body weight changes experience.&#x0D; Conclusion: A majority of people with the depression symptoms history has the symptom of lack of appetite or the feel of the weight change. The symptom of lack of appetite/weight change happened to woman with depression and low income respondents.

Depression and psychosis related to the absence of visitors and consumption of drugs in male prisoners in Ecuador: a cross sectional study

BackgroundMajor mental disorders in prison populations have been recognised as a long-term problem with an important impact on public health. Despite this, screening activities in prisons are still weak in Latin America. We proposed to estimate the prevalence of depression and psychosis and associated factors in the largest Ecuadorian prison for male inmates.MethodsCross-sectional study with 309 prisoners chosen at random between January and February 2017, who were administered two structured questionnaires. The first examined socio-demographic and occupational characteristics prior to incarceration and presence of social support networks; the second was the Mini International Neuropsychiatric Interview version in Spanish 5.0.0. We used maximum likelihood tests and multiple logistic regression to assess associations between depression, psychosis and study factors.ResultsThe prevalence of depression and psychosis were 50.2% (95% CI 44.6–55.8) and 25.9% (95% CI 21.0–30.8), respectively. The two conditions occurred together in 22.0% of the cases (95% CI 14.8–29.2), and depression or psychosis (D/P) was found in 54.0% (95% CI 48.4–59.6). Consuming drugs while in prison was found in 41.4% (95% CI 35.9–46.9). When age was considered among those consuming drugs, the prevalence of D/P were 72.2, 88.0, and 92.3%, respectively for the age-groups 18–29, 30–39 and 40 years or over (p-value < 0.001). Using a multivariate model, we found that not receiving visits (AOR 3.15 95%CI 1.42–6.96) and consuming drugs while in prison (AOR 5.85 95%CI 3.06–11.16) were associated with D/P, while the age effect disappears. Inmates who stopped drug consumption in prison or who had never consumed did not present any significant differences.ConclusionsDepression and psychosis in prisoners are strongly affected by the absence of visitors and by consumption of drugs in prison. Greater presence of social support networks and preventive actions targeting drug abuse would contribute to improving the mental health of prison inmates.