Psychiatric morbidity in acromegaly

Previous reports on psychiatric morbidity in acromegaly have been unsystematic. This study examined 51 acromegalic patients for psychiatric morbidity using the General Health Questionnaire and a standard psychiatric interview, the Present State Examination. Although psychiatric morbidity was higher in the female than the male acromegalics, the study showed no increase in psychiatric morbidity in general, nor an increased incidence of depression, in comparison with general population and patient samples. No relationship was found between growth hormone levels and psychiatric morbidity. The results raise the question whether acromegalic patients show lower psychiatric morbidity than expected from patients with such an illness. The data suggest that previous reports of depression in acromegalic patients examplify the simple coincidence of a likely and an unlikely condition.     

Psychiatric morbidity and physical illness in health centres

This study examined, in health care attenders, the effect of different sociodemographic variables and physical illness on the probability of suffering from mental disorders. In health centres, the prevalence of mental disorders was 19.3% (12.4% for males and 23.8% for females). Logistic modelling was used to investigate the joint effect on psychiatric morbidity of 6 sociodemographic variables and physical illness. It was found that sex, age, and physical illness exerted independent but not interactive effects on the probability of psychiatric morbidity.     

The Nordic comparative study on sectorised psychiatry: repeated emergency admissions to inpatient care during a 1-year follow-up

The emergency admissions to hospital care in six psychiatric services in four Nordic countries were explored as a part of a Nordic comparative study on sectorised psychiatry. One year treated incidence cohorts were used, with the total cohort comprising 2,454 patients. Of the 803 patients who were admitted to inpatient care during a 1-year follow-up, 82% had at least one emergency admission and 23% repeated emergency admissions. The definition for the repeated emergency admissions was at least two admissions during the follow-up. The mean length of stay in emergency inpatient care per treatment episode for this patient subgroup was 28 days. Their emergency inpatient episodes constituted 30% of all inpatient days during the follow-up. However, the variations between the services and diagnostic subgroups were large. The results of a logistic regression analysis indicated that the following variables predicted repeated emergency admissions: inpatient care at index contact, emergency outpatient contacts or no planned hospital admissions during the follow-up, psychiatric service, age under 45 years, and a diagnosis of psychosis, personality disorder or dependency. The repeated emergency admissions were related to the existence of a special service unit for abusers but not to the rates of outpatient staff or acute beds in the services, to geographical distances, referral practice or existence of emergency services.     

Psychiatric morbidity among people aged 85+ in 1987. A follow-up study at two and a half years: Associations with changes in psychiatric morbidity

This article reports findings from a longitudinal survey of very elderly people living at home in London. The research aimed to identify social, psychological and physical characteristics associated with positive ageing and successful survival in the community in later life and its converse—negative ageing—as well as the associated policy implications. Associations with psychiatric morbidity, measured using the General Health Questionnaire, among sample members without cognitive impairment between the baseline interviews in 1987 and at follow-up, two and a half years later in 1990, are reported. Twenty-five per cent of survivors scored over the threshold of the GHQ in 1987 and 30% scored over the threshold in 1990. Half of those with a score over the threshold in 1990 also scored over the threshold in 1987. Hierarchical regression (using residualized change analysis) was used to estimate the effects of the independent variables on changes in psychiatric morbidity. The most significant predictor of psychiatric morbidity (GHQ score) in 1990 was baseline GHQ score, followed by health and functional status scores. Health and functional status were also the strongest predictors of baseline (1987) GHQ scores. The uniqueness of the study lies in the collection of follow-up data on a sample of very elderly people, given that most surveys are corss-sectional and contain too few people aged 85+ to merit separate analysis. It contributes to the small body of literature on outcome of depression. The lack of consistent associations with recovery from psychiatric morbidity in the literature enhances the importance of studies aiming to identify factors associated with different outcomes.     

Correlations between standard auditory evoked potentials and symptomatology in a group of 50 schizophrenic patients

Standard auditory evoked potentials (AEP) were recorded in 50 schizophrenic patients and 47 normal controls. All patients were rated on the Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment of Negative Symptoms (SANS), the Scale for the Assessment of Positive Symptoms (SAPS), and the Positive and Negative Syndrome Scale (PANSS), and were classified in three groups (positive-type [n = 10], negative-type [n = 23]and mixed-type [n = 17]patients) according to the normative criteria suggested by Kay. The mean latencies of AEP components (N1, P2, N2) and mean peak-to-peak amplitudes (N1P2, P2N2) did not correlate with age, duration of illness, length of hospitalisation or neuroleptic dosage. The evoked response did not differ between the three groups of patients (positive, negative and mixed). There was only a trend (P = 0.075) to a longer N1 latency in the negative-type group and a shorter one in the positive-type group than in the mixed-type and the control groups. The latency of N1 component correlated significantly with negative symptoms of schizophrenia (SANS scores). This correlation was related to the severity of a depressive dimension of the disorder reflected by the “depressive factor” of BPRS or “affective flattening” and “avolition” subscales of SANS.     

Psychiatric morbidity in primary public health care: a multicentre investigation. Part II. Hidden morbidity and choice of treatment

A total of 1281 patients were examined during consultation with their GP in a Nordic multicentre study focusing on the prevalence of psychiatric illness, hidden psychiatric morbidity, treatment and pathways to specialized care. The methodology and prevalence were reported in an accompanying paper. The present paper presents results concerning the variables hidden psychiatric morbidity, treatment and pathways to specialized care. The GPs detected 44% of the psychiatric cases compared with the result of a diagnostic interview (PSE). The distinction between psychosis and non-psychosis did not influence the GPs' ability to detect a mental illness. According to the GPs' assessment the majority of patients suffering from a mental disorder consulted their GP about physical complaints. The GPs treated the patients themselves, and only a limited number of cases were referred to psychiatrists or psychologists.     

Psychotic symptoms in mood disorders: Evaluation of 159 inpatients

The authors investigated the historical and clinical variables of 159 inpatients affected by mood disorders in order to identify variables which might differentiate psychotic from non-psychotic forms. The results showed that 32% of the patients had psychotic symptoms. Although no significant difference was detected with regard to the severity of depression, psychotic depressives were younger and had a lower age at onset, as well as a shorter episode length. These features suggest that depression may express itself with or without psychotic symptoms, according to the different individual and, perhaps, biological substrate. Taken together, our findings seem to indicate that psychotic depression should not be considered a separate clinical entity, but a subtype of mood disorders.     

Heart rate changes during sleep in normal two-month-old infants

Thirty-five normal two-month-old infants had nighttime followed by daytime polygraphic recordings. Heart rates were calculated every minute in active and quiet sleep states. A difference in mean heart rates was found between the two states and between the two recordings. Rates were lower at night than during the day (P < 0.0001), regardless of the sleep state. During nighttime or daytime recordings as a function of sleep cycles or during sustained sleep episodes, heart rates were minimal in the middle of recordings, but differences were statistically significant for only a few results (mainly in QS). Intrasleep awakening led to a marked increase in heart rate after sleep was resumed, although differences were only statistically significant when the awakened infant was fed. Infants with episodes of periodic breathing had lower mean heart rates throughout the recordings, but differences were not statistically significant. Respiratory and heart rates showed similar changes during the recordings, and a statistically significant correlation was found between the two measurements.     

Psychiatric morbidity among children in North Aceh district (Indonesia) exposed to the 26 December 2004 tsunami

Introduction: The aim of the study was to ascertain, using available data from the Bio‐psychosocial Program for children, psychiatric morbidity and specific diagnoses among youths in North Aceh in the year after the tsunami disaster. Methods: All youths (n=2,135) who participated in the program were included in the study and screened in two phases. They were first administered the Strengths and Difficulties Questionnaire (SDQ); those with positive scores were then clinically interviewed by a psychiatrist, who then provided a diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders (fourth edition) (DSM‐IV). Results: Subjects ranged in age from 4 to 18 years. Female‐to‐male ratio was 1:1.5. 98.1% of subjects were directly exposed to the trauma. There were significantly higher percentages (P<0.05) of abnormal total SDQ scores among trauma‐exposed youths (52.3% among 4 to 10‐year‐olds and 46.5% among 11 to 18‐year‐olds, compared with youths in the non‐trauma‐exposed group (8% among 4 to 10‐year‐old children and 12% among 11 to 18‐year‐old adolescents. Clinical interviews revealed that 8.94% of the trauma‐exposed youths met criteria for any mental disorder. Among youths with DSM‐IV diagnoses, the most common diagnoses were post‐traumatic stress disorder (PTSD; 24.6% of total diagnoses among 4 to 10‐year‐olds and 35.6% among 11 to 18‐year‐olds), followed by depressive disorders. Discussion: Consistent with our hypotheses, youths directly exposed to the trauma demonstrated more psychiatric difficulties and higher rates of psychiatric diagnoses, most notably PTSD. Also, compared to younger children, adolescents and older children exposed to the trauma appeared to have higher rates of psychiatric disorders. In the face of disasters – natural or otherwise – further research is needed on optimal prevention of child and adolescent psychiatric morbidity.     

Psychiatric morbidity in primary public health care: a Nordic multicentre investigation. Part I: method and prevalence of psychiatric morbidity

The prevalence of mental illness in five different Scandinavian primary care populations was investigated in this study. Patients consecutively consulting their general practitioner a particular week-day were included in the study. Initially the SCL-25 was applied and next the high scores and a sample of the low scores were interviewed by the PSE. In the analysis the screening procedure was first validated. The internal validity of the SCL was tested by means of Rasch latent structure analysis and the external validity tested by ROC/QROC analysis. Based on this, a short 8–item version of the SCL was developed. The prevalence of mental illness in all centres was 0.26 with a minimum of 0.14 in Nacka and a maximum of 0.34 in Turku.