Relationships of psychiatric disorders with sleep duration in an adult general population sample

The objective was to explore psychiatric disorders as potential predictors of sleep duration. A cross-sectional survey study with a probability sample of residents of a northern German area was carried out. There were 4075 study participants, aged 18–64 years, with a participation rate of 70.2%. Face-to-face in-home computer-aided interviews (Composite International Diagnostic Interview) provided diagnoses of nicotine and alcohol dependence, alcohol abuse, depressive, anxiety and somatoform disorders according to the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-IV), and included questions about sleep duration. Results show that subjects with a short sleep duration of 5 h or less had significantly increased odds ratios (OR) for current nicotine dependence (OR 1.9,; confidence interval, CI, 1.2–2.9), alcohol dependence (OR 2.6, CI 1.2–5.6), depressive disorder (OR 3.0, CI 1.7–5.4) or anxiety disorder (OR 2.1, CI 1.3–3.4) compared to individuals who never had the respective psychiatric disorder after adjustment for sex, age, and school education in a multinomial regression analysis. The conclusion is drawn that current nicotine or alcohol dependence, depressive, and anxiety disorders may add to short sleep duration in this random adult general population sample.     

Peptic ulcer disease and mental illnesses

Objective

We evaluated the association between self-reported doctor-diagnosed peptic ulcer disease (PUD) and mental disorders in a representative cross-sectional study conducted in 2010 in Singapore.

Method

The sample comprised 6616 community-dwelling individuals. Participants were asked about a previous history of doctor-diagnosed PUD. Assessment of mental disorders was performed using the World Mental Health Composite International Diagnostic Interview version 3.0. Quality of life was assessed using the EuroQoL 5D.

Results

The weighted prevalence of PUD was 1.58% (95% CI=1.13–2.02). In adjusted analyses, PUD was more common among people with anxiety disorders [obsessive compulsive disorders (OR 4.22, 95% CI 1.59–11.21), Generalized Anxiety Disorders (OR 9.25, 95% CI 2.43-35.17), any anxiety disorders (OR 4.41, 95% CI 1.82-10.61)] and with any mood disorders (OR 2.66, 95% CI 1.08-6.53). PUD was associated with alcohol abuse and alcohol dependence, but not with smoking or nicotine dependence. Adjustment for nicotine and alcohol use attenuated the association of mood disorders with PUD, but not that of anxiety disorders. PUD was associated with reduced quality of life as measured on EuroQoL 5D, with further reduction in those with concomitant mental disorders.

Conclusion

PUD was associated with anxiety disorders, and this association is not attenuated with adjustment for nicotine dependence or alcohol use disorder.     

Post-traumatic stress disorder

BACKGROUND: The study is aimed at investigating the influence of trauma type, pre-existing psychiatric disorders with an onset before trauma, and gender on post-traumatic stress disorder (PTSD). METHODS: Traumas, PTSD and psychiatric disorders were assessed in a representative sample of 4075 adults aged 18-64 years using the Composite International Diagnostic Interview. Pre-existing DSM-IV diagnoses of anxiety disorders, depressive disorders, somatoform disorders, alcohol abuse and dependence, nicotine dependence, gender, and the type of trauma were analysed with logistic regressions to estimate the influence of these factors on the risk for developing PTSD. RESULTS: The lifetime prevalence of exposure to any trauma did not vary by gender. The conditional probability of PTSD after exposure to trauma was higher in women (11.1% SE = 1.58) than men (2.9% SE = 0.83). Univariate analyses showed that pre-existing anxiety disorders, somatoform disorders and depressive disorders significantly increase the risk of PTSD. Multivariate analyses revealed that specific types of trauma, especially rape and sexual abuse, pre-existing anxiety disorders and somatoform disorders are predictors of an increased risk of PTSD, while gender and depressive disorder were not found to be independent risk factors. CONCLUSION: Women do not have a higher vulnerability for PTSD in general. However, especially sexually motivated violence and pre-existing anxiety disorders are the main reasons for higher prevalences of PTSD in women.     

Is sexual orientation related to mental health problems and suicidality in young people?

BACKGROUND: This study examines the extent to which gay, lesbian, and bisexual young people are at increased risk of psychiatric disorder and suicidal behaviors using data gathered on a New Zealand birth cohort studied to age 21 years. METHODS: Data were gathered during the course of the Christchurch Health and Development Study, a 21-year longitudinal study of a birth cohort of 1265 children born in Christchurch, New Zealand. At 21 years of age, 1007 sample members were questioned about their sexual orientation and relationships with same-sex partners since the age of 16 years. Twenty-eight subjects (2.8%) were classified as being of gay, lesbian, or bisexual sexual orientation. Over the period from age 14 to 21 years, data were gathered on a range of psychiatric disorders that included major depression, generalized anxiety disorder, conduct disorder, and substance use disorders. Data were also gathered on suicidal ideation and suicide attempts. RESULTS: Gay, lesbian, and bisexual young people were at increased risks of major depression (odds ratio [OR], 4.0; 95% confidence interval [CI], 1.8-9.3), generalized anxiety disorder (OR, 2.8; 95% CI, 1.2-6.5), conduct disorder (OR, 3.8; 95% CI, 1.7-8.7), nicotine dependence (OR, 5.0; 95%, CI, 2.3-10.9), other substance abuse and/or dependence (OR, 1.9; 95% CI, 0.9-4.2), multiple disorders (OR, 5.9; 95% CI, 2.4-14.8), suicidal ideation (OR, 5.4; 95% CI, 2.4-12.2), and suicide attempts (OR, 6.2; 95% CI, 2.7-14.3). CONCLUSIONS: Findings support recent evidence suggesting that gay, lesbian, and bisexual young people are at increased risk of mental health problems, with these associations being particularly evident for measures of suicidal behavior and multiple disorder.     

Clinical and prognostic characteristics associated with addictive comorbidity in hospitalized psychiatric patients

The aims of this study were to estimate: 1) the prevalence of substance use disorder, 2) the social and clinical characteristics associated to such a comorbid disorder in patients hospitalised in psychiatry. METHOD: Patients consecutively hospitalised for a non-addictive disorder were included in the present survey. A standardised method was used to collect information on clinical and social characteristics. DSM IV diagnoses, including those of substance use, were made using a structured diagnostic interview and all available clinical and historical informations collected during the hospital stay. RESULTS: We have included 127 patients fulfilling the diagnostic criteria for affective disorders (n = 61), non-affective psychotic disorder (schizophrenia, schizoaffective disorder, delusional disorder, other psychotic disorders, n = 50) and personality disorder (n = 16). Among these patients, 11.8% presented with a current abuse/dependence to alcohol (lifetime prevalence: 25.2%), 11% to cannabis (lifetime prevalence: 22.8%). The lifetime prevalence for any other substance disorder was 2.4%. The subjects presenting with an abuse/dependence to alcohol had a higher rate of psychiatric hospitalisation (OR = 2.9; 95% CI 1.0-8.1; p = 0.04) and had more frequently a history of attempted suicide (OR = 2.6; 95% CI 1.0-6.5; p = 0.04). The cannabis misuse was associated with medication noncompliance (OR = 3.1; 95% CI 1.1-9.1; p = 0.04) and more frequent penal problems (OR = 15.0; 95% CI 2.9-78.7; p = 0.001). CONCLUSION: Cannabis and alcohol misuse have a negative, but different, impact on social adaptation and clinical outcome in subjects with psychiatric disorder. These results confirm the necessity to systematically assess this type of comorbid disorder and to distinguish the different substances.     

Psychiatric comorbidity in binge-eating disorder as a function of smoking history

OBJECTIVE: To examine the comorbidity of psychiatric disorders in obese women with binge-eating disorder (BED) as a function of smoking history. METHOD: A consecutive series of 103 obese treatment-seeking women with current DSM-IV diagnoses of BED were administered structured diagnostic interviews to assess all DSM-IV Axis I psychiatric disorders. Participants were classified as "never" or "daily" smokers, and lifetime rates of comorbid psychopathology were compared across smoking groups using logistic regression. The study was conducted from February 2003 to March 2005. RESULTS: Smokers were significantly more likely to meet criteria for co-occurring diagnoses of major depressive disorder (p = .03), panic disorder (p = .01), posttraumatic stress disorder (p < .05), and substance abuse or dependence (p = .01). Even after excluding participants with substance use disorders, significant differences remained, with lifetime smokers having significantly higher rates of co-occurring anxiety disorders. CONCLUSIONS: It is possible that for some obese women with BED, binge eating and cigarette smoking share common functions, i.e., both behaviors may serve to modulate negative affect and/or anxiety. Although the current findings are consistent with a view of a common diathesis for the development of impulsive eating, cigarette or other substance use, and additional Axis I psychopathology, prospective longitudinal studies are needed to elucidate the nature of potential pathways.     

Anxiety disorders moderate the association between externalizing problems and substance use disorders: Data from the National Comorbidity Survey-Revised

Anxiety disorders and externalizing problems are both associated with substance use disorders. However, the nature of this relationship remains unclear. To examine whether presence of an anxiety disorder changes the association between externalizing problems (conduct disorder, oppositional defiant disorder, and attention deficit hyperactivity disorder) and substance use disorders, we analyzed data from the National Comorbidity Survey-Replication, which is based on a nationally representative sample of 9282 English-speaking adults. Presence of externalizing problems was associated with an increased odds for alcohol abuse (OR: 6.7, CI: 5.6–8.1), alcohol dependence (OR: 7.6, CI: 5.9–9.6), substance abuse (OR: 9.9, CI: 8.1–12.2), and substance dependence (OR: 13.1, CI: 9.6–17.8). Similarly, anxiety disorders were associated with increased odds for substance use disorders. The highest association was found between post-traumatic stress disorder and substance use disorder (OR: 9.2, CI: 5.4–15.5). Individuals who met diagnostic criteria for an anxiety disorder and externalizing problems showed consistently and significantly lower odds for substance use problems than subjects with externalizing problems without a comorbid anxiety disorder. The results suggest that presence of any anxiety disorder reduces the association between externalizing problems and substance use disorders, possibly because the fear of bodily symptoms prevents individuals with externalizing problems from engaging in drug-seeking behaviors.     

Cigarette smoking and psychiatric comorbidity in children and adolescents

OBJECTIVE: To review the current state of knowledge of psychiatric comorbidity in adolescent cigarette smokers. METHOD: assisted literature search was conducted and seminal articles were cross-referenced for comprehensiveness of the search. For each disorder, a synopsis of knowledge in adults is provided and compared with the knowledge in adolescents. RESULTS: Psychiatric comorbidity is common in adolescent cigarette smokers, especially disruptive behavior disorders (such as oppositional defiant disorder, conduct disorder, and attention-deficit/hyperactivity disorder), major depressive disorders, and drug and alcohol use disorders. Anxiety disorders are modestly associated with cigarette smoking. Both early onset (<13 years) cigarette smoking and conduct problems seem to be robust markers of increased psychopathology, including substance abuse, later in life. In spite of the high comorbidity, very few adolescents have nicotine dependence diagnosed or receive smoking cessation treatment in child and adolescent psychiatric treatment settings. CONCLUSIONS: There is increasing evidence for high rates of psychiatric comorbidity in adolescent cigarette smokers. Cigarette smoking in adolescence appears to be a strong marker of future psychopathology. Child and adolescent psychiatry treatment programs may be a good setting for prevention efforts and treatment, which should focus on both nicotine dependence and psychiatric disorders.     

Smoking increases the risk of panic: findings from a prospective community study

BACKGROUND: We examined prospectively determined bidirectional associations between smoking and panic and other anxiety disorders and their temporal ordering of onset in a representative community sample of adolescents and young adults. METHODS: Baseline and 4-year follow-up data were used from the Early Developmental Stages of Psychopathology Study, a prospective longitudinal study of adolescents and young adults in Munich, Germany. We assessed smoking (occasional and regular), nicotine dependence, panic attacks, panic disorder, other anxiety disorders, and other mental disorders using the Munich-Composite International Diagnostic Interview. RESULTS: At baseline, panic attacks and panic disorder were strongly associated with occasional and regular smoking and nicotine dependence (odds ratio [OR] range, 3.0-28.0). In the prospective analyses, we found increased risk for new onset of panic attacks with prior regular smoking (OR, 2.9; 95% confidence interval [CI], 1.0-8.4) and nicotine dependence (OR, 3.6; 95% CI, 1.2-10.5). Prior nicotine dependence increased also the risk for onset of panic disorder (OR, 3.3; 95% CI, 1.0-10.5), whereas preexisting panic was not associated with subsequent smoking or nicotine dependence. When using Cox regression with time-dependent covariates, prior nicotine dependence was confirmed to be related to subsequent panic attacks (hazard ratio, 2.7; 95% CI, 1.7-4.2), but not panic disorder (hazard ratio, 1.7; 95% CI, 0.7-3.9). Rather, we found indications that prior panic attacks/disorder might also have an effect on secondary development of nicotine dependence. CONCLUSIONS: In young adults, prospective analyses revealed a fairly unique and specific, unidirectional relationship between prior smoking and increased risk for subsequent panic attacks/disorder. However, we could not exclude the existence of a second, less frequent, reverse pathway of prior panic and secondary nicotine dependence.     

Psychiatric and alcohol disorders as risk factors for drug abuse

This study tested the hypothesis that a history of psychiatric and alcohol disorders would affect the risk of developing drug abuse or dependence later in life. This case-control study selected cases and controls using the snowball technique in order to obtain cases from this hidden population and to match sex, age and friendship. Information was gathered using the Composite International Diagnostic Interview (CIDI), and computer diagnoses were generated according to the DSM-III-R criteria. The study included 370 subjects. Results of the conditional logistic regression analysis showed that having a history of alcohol dependence was independently associated with an increased risk of drug abuse/dependence (OR=2.6, 95% CI 1.1–6.0) and that this risk was even higher for those whose alcohol dependence occurred in combination with another psychiatric disorder (OR=4.6, 95% CI 2.1–10.0). An increased risk of drug abuse/dependence was also found for those who were aged 12 years or under when their first psychiatric disorder was manifested (OR=2.2, 95% CI 1.3–3.7) and among those with two or more psychiatric disorders (OR=2.5, 95% CI 1.5–4.1). These findings suggest that programmes directed towards the treatment and prevention of drug abuse must be prepared to address psychiatric and alcohol disorders in childhood and adolescence.This research received financial support from CAPES/Brazilian Government and from the Institute of Psychiatry, University of London     

Self-rated general health and psychiatric disorders in a general population sample

The purpose of this study was to explore the relationships between nicotine and alcohol dependence, depressive, anxiety and somatoform disorders with self-rated general health (GH). A cohort study of a random sample of the non-institutionalised general population aged 18–64 with a participation rate of 70.2% was carried out in a German area (n = 4075 at baseline). A follow-up of tobacco smokers or heavy drinkers (n = 1083, 79.4% of those who had given consent to be followed-up) was conducted 30 months after baseline measurement. The assessments included self-ratings of GH and Diagnostic and Statistical Manual (DSM-IV) diagnoses based on the Composite International Diagnostic Interview. The results show that nicotine dependence, anxiety disorders and somatoform disorders moderately predicted self-rated GH at follow-up (general linear model, R² = 0.12). We conclude that psychiatric disorders may contribute to the prediction of a low self-rated GH.     

Sociodemographic and psychopathologic predictors of first incidence of DSM-IV substance use, mood and anxiety disorders: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions

The objective of this study was to present nationally representative findings on sociodemographic and psychopathologic predictors of first incidence of Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM-IV) substance, mood and anxiety disorders using the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. One-year incidence rates of DSM-IV substance, mood and anxiety disorders were highest for alcohol abuse (1.02), alcohol dependence (1.70), major depressive disorder (MDD; 1.51) and generalized anxiety disorder (GAD; 1.12). Incidence rates were significantly greater (P<0.01) among men for substance use disorders and greater among women for mood and anxiety disorders except bipolar disorders and social phobia. Age was inversely related to all disorders. Black individuals were at decreased risk of incident alcohol abuse and Hispanic individuals were at decreased risk of GAD. Anxiety disorders at baseline more often predicted incidence of other anxiety disorders than mood disorders. Reciprocal temporal relationships were found between alcohol abuse and dependence, MDD and GAD, and GAD and panic disorder. Borderline and schizotypal personality disorders predicted most incident disorders. Incidence rates of substance, mood and anxiety disorders were comparable to or greater than rates of lung cancer, stroke and cardiovascular disease. The greater incidence of all disorders in the youngest cohort underscores the need for increased vigilance in identifying and treating these disorders among young adults. Strong common factors and unique factors appear to underlie associations between alcohol abuse and dependence, MDD and GAD, and GAD and panic disorder. The major results of this study are discussed with regard to prevention and treatment implications.     

Pharmacological treatment of psychiatric comorbidity in bipolar disorder: a review of controlled trials

OBJECTIVE: Little is known about the treatment of psychiatric comorbidities in bipolar disorder. The aim of this review was to summarize the literature on controlled pharmacological trials that have been conducted in psychiatric conditions that commonly co-occur in bipolar disorder. METHODS: A Medline search (1980-October 2005) using the terms bipolar disorder and randomized controlled trials, comorbidity, anxiety disorders, alcohol abuse or dependence, substance abuse or dependence, eating disorder, impulse control disorders, attention-deficit disorder, lithium, anticonvulsants, atypical antipsychotic drugs, antidepressants, stimulants was used. RESULTS: The literature establishes a strong association between bipolar disorder and substance abuse/dependence, anxiety disorders, impulse control disorders, eating disorders and attention-deficit hyperactivity disorder. Comorbidity often complicates the diagnosis and the treatment of bipolar disorder and worsens its course of illness and prognosis. Few controlled pharmacological studies have examined the treatment of comorbid conditions in patients with bipolar disorder. CONCLUSIONS: Treatment of psychiatric comorbidities in bipolar disorder is not based on controlled data but is largely empirically based. Controlled trials in patients with bipolar disorder and comorbidity are urgently needed.     

Prevalence of major depressive disorder in Nigerian college students with alcohol-related problems

OBJECTIVES: The study aimed to estimate the prevalence of major depressive disorder (MDD) among Nigerian college students with alcohol-related problems (ARP) and compare the estimated prevalence with their counterparts without ARP. METHOD: A cross-sectional survey of a representative sample of students (n=2658) in six colleges in Osun state, Western Nigeria. The students were independently assessed for ARP and MDD with the Mini International Neuropsychiatric Interview (MINI). RESULTS: The current (2 weeks) prevalence of MDD in college students with alcohol dependence is 23.8%; alcohol abuse 17.2% and hazardous use 12.4%. Compared with total abstainers, major depressive disorder is significantly more likely to be associated with diagnosis of alcohol dependence (OR 3.14, 95% CI 1.42-6.96), alcohol abuse (OR 2.27, 95% CI 1.38-3.72) and hazardous use (OR 1.64, 95% CI 1.12-2.38), but less associated with alcohol users without ARP (OR 0.93, 95% CI 0.69-1.25). CONCLUSION: Nigerian college students with ARP are significantly more at risk of depressive disorders than those without ARP. Early recognition and treatment of depression are important considerations when planning preventive strategies for alcohol-related problems in college students.     

Psychopathology and comorbidity of psychiatric disorders in patients with kleptomania

OBJECTIVE: This study compared patients with kleptomania, patients with alcohol abuse or dependence, and psychiatric patients without impulse-control disorders or substance-related disorders on several key psychopathological dimensions. In addition, the comorbidity of kleptomania with other psychiatric disorders was examined. METHOD: Eleven patients with kleptomania recruited over a cumulative 2-year period and 60 patients with alcohol abuse or dependence and 29 psychiatric comparison patients recruited over a consecutive 6-month period participated in structured clinical interviews to determine the presence of impulse-control and substance-related disorders and of other psychiatric disorders that were comorbid with kleptomania. Psychopathological dimensions were measured with the Barratt Impulsiveness Scale, the Sensation Seeking Scale, the Montgomery-Asberg Depression Rating Scale, and the anxiety and depression subscales of the Hospital Anxiety and Depression Scale. RESULTS: Significant group effects were found for the Barratt Impulsiveness Scale total and cognitive impulsivity scores, with the patients with kleptomania having higher impulsivity scores than the other groups. Significant group differences were found on the Sensation Seeking Scale total and disinhibition scores. No significant group effects were found for the mood and anxiety measures. Patients with kleptomania had high rates of comorbid psychiatric disorders, particularly mood disorders, other impulse-control disorders, and substance abuse or dependence (mainly nicotine dependence). CONCLUSIONS: Kleptomania presented a specific psychopathological profile that distinguished patients with this disorder from patients with alcohol abuse or dependence and other psychiatric comparison patients. Impulsivity was the major psychopathological feature of kleptomania. A link between kleptomania and affective disorder was supported by the high rate of comorbid affective disorders in patients with kleptomania and a specific pattern of variation in the two conditions over time. Further prospective studies are needed to confirm this pattern. Because kleptomania is characterized by a low rate of comorbid substance-related disorders other than nicotine dependence and by severe psychopathology, it could be an appropriate disorder in which to study the information processes and psychobiology underlying impulsivity.     

Nicotine dependence, major depression, and anxiety in young adults.

To determine whether nicotine dependence, classified by level of severity, was associated with other substance dependence, major depression, and anxiety disorders, we studied a random sample of 1007 young adults in the Detroit (Mich) area using the National Institute of Mental Health Diagnostic Interview Schedule, revised according to DSM-III-R. The systematic coverage of DSM-III-R criteria of nicotine dependence provides an unprecedented opportunity to separate persons with nicotine dependence from the larger class of persons with a history of smoking and to examine the prevalence of psychiatric disorders among persons with nicotine dependence and among nondependent smokers. The lifetime prevalence of nicotine dependence was 20%. Nicotine dependence was associated with alcohol, cannabis, and cocaine dependence. Controlling for the effects of other substance dependencies, persons with nicotine dependence had higher rates of major depression and anxiety disorders. The strength of these associations varied by level of severity of nicotine dependence. Nondependent smokers had higher rates of other substance dependencies, but not of major depression or anxiety disorders.     

Mental disorders among adults with asthma: results from the World Mental Health Survey

OBJECTIVE: Our objectives were (a) to determine which common mental disorders are associated with asthma in the general population after controlling for age and sex, and (b) to assess whether the associations of mental disorders with asthma are consistent across diverse countries. METHOD: Eighteen population surveys of household-residing adults were carried out in 17 countries (N=85,088). Mental disorders were assessed with the Composite International Diagnostic Interview 3.0, a fully structured diagnostic interview. The disorders considered here are 12-month anxiety disorders (generalized anxiety disorder, panic disorder/agoraphobia, posttraumatic stress disorder and social phobia), depressive disorders (dysthymia and major depressive disorder) and alcohol use disorders (abuse and dependence). Asthma was ascertained by self-reports of lifetime diagnosis among a subsample (n=42,697). RESULTS: Pooled estimates of age-adjusted and sex-adjusted odds of mental disorders among persons with asthma relative to those without asthma were 1.6 [95% confidence interval (95% CI)=1.4, 1.8] for depressive disorders, 1.5 (95% CI=1.4, 1.7) for anxiety disorders and 1.7 (95% CI=1.4, 2.1) for alcohol use disorders. CONCLUSION: This first cross-national study of the relationship between asthma and mental disorders confirms that a range of common mental disorders occurs with greater frequency among persons with asthma. These results attest to the importance of clinicians in diverse settings being alert to the co-occurrence of these conditions.     

Psychotic-Like Experiences in Major Depression and Anxiety Disorders: A Population-Based Survey in Young Adults

Objective: Population-based surveys have confirmed that psychotic-like experiences are prevalent in the community. However, it is unclear if these experiences are associated with common mental disorders. The aim of this study was to examine the prevalence of psychotic-like experiences in those with affective and anxiety disorders. Methods: Subjects were drawn from the Mater-University of Queensland Study of Pregnancy. Delusion-like experiences were assessed with the Peters Delusional Inventory (PDI). The Composite International Diagnostic Interview (CIDI) was used to identify individuals with Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) lifetime diagnoses of major depression, anxiety disorder, substance use/dependence, and psychotic disorders. The influence of affective and anxiety disorders on PDI and CIDI psychosis-related items’ scores were assessed with logistic regression, with adjustments for age, sex, and the presence of the other comorbid psychiatric diagnoses. Results: Having either a lifetime diagnosis of major depressive disorder or an anxiety disorder was associated with significantly higher PDI total scores (highest vs lowest quartile adjusted odds ratios [ORs] and 95% confidence intervals [CIs] = 4.43, 3.09–6.36; 3.08, 2.26–4.20, respectively). The odds of endorsing any CIDI hallucination or delusion item was increased in those with a major depressive or anxiety disorder. The presence of current anxiety disorder symptoms was significantly associated with PDI score (OR = 5.81, 95% CI = 3.68–9.16). Conclusion: While psychotic-like experiences are usually associated with psychotic disorders, individuals with depression and anxiety are also more likely to report these symptoms compared with well individuals. Psychotic-like experiences are associated with a range of common mental disorders.     

Comorbidity of fibromyalgia and psychiatric disorders

OBJECTIVE: To assess the co-occurrence of fibromyalgia with psychiatric disorders in participants of a fibromyalgia family study. METHOD: Patients (probands) with fibromyalgia, control probands with rheumatoid arthritis, and first-degree relatives of both groups completed a structured clinical interview and tender point examination. The co-occurrence odds ratio (OR) (the odds of a lifetime comorbid DSM-IV disorder in an individual with fibromyalgia divided by the odds of a lifetime comorbid disorder in an individual without fibromyalgia, adjusted for age and sex) was calculated; observations were weighted by the inverse probability of selection, based on the fibromyalgia status of the pro-band; and standard errors were adjusted for the correlation of observations within families. The study was conducted from September 1999 to April 2002. RESULTS: We evaluated 78 fibromyalgia pro-bands and 146 of their relatives, and 40 rheumatoid arthritis probands and 72 of their relatives. Among the relatives of both proband groups, we identified 30 cases of fibromyalgia, bringing the total number of individuals with fibromyalgia to 108, compared with 228 without fibromyalgia. The co-occurrence ORs for specific disorders in individuals with versus those without fibromyalgia were as follows: bipolar disorder: 153 (95% CI = 26 to 902, p < .001); major depressive disorder: 2.7 (95% CI = 1.2 to 6.0, p = .013); any anxiety disorder: 6.7 (95% CI = 2.3 to 20, p < .001); any eating disorder: 2.4 (95% CI = 0.36 to 17, p = .36); and any substance use disorder: 3.3 (95% CI = 1.1 to 10, p = .040). CONCLUSIONS: There is substantial lifetime psychiatric comorbidity in individuals with fibromyalgia. These results have important clinical and theoretical implications, including the possibility that fibromyalgia might share underlying pathophysiologic links with some psychiatric disorders.     

Lifetime and 12-month prevalence of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition disorders among older African Americans: findings from the National Survey of American Life.

OBJECTIVE: The purpose of this study was to estimate lifetime and 12-month prevalence of 13 psychiatric disorders for older African Americans. METHODS: Data are from the older African American subsample of the National Survey of American Life. Selected measures of lifetime and 12-month Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) psychiatric disorders were examined (i.e., panic disorder, agoraphobia, social phobia, generalized anxiety disorder, obsessive compulsive disorder, posttraumatic stress disorder (PTSD), major depressive disorder, dysthymia, bipolar I and II disorders, alcohol abuse/dependence, and drug abuse/dependence). RESULTS: Twenty-three percent of older African Americans reported at least one lifetime disorder and 8.54% reported at least one 12-month disorder. Alcohol abuse, PTSD, and major depression were the most prevalent lifetime disorders. The most prevalent 12-month disorders were PTSD, major depression, and social phobia. Age, sex, education, and region were significantly associated with the odds of having a lifetime disorder. CONCLUSION: This is the first study of prevalence rates of serious mental disorders for older African Americans based on a national sample. Demographic correlates of the prevalence of disorders are discussed with an emphasis on age and regional differences.