A psychiatric epidemiological study of postpartum Chinese women

OBJECTIVE: Epidemiological studies in the 1980s have suggested that depression is rare in the Chinese population and there is no postpartum depression among Chinese women. However, subsequent small-scale studies of postpartum depression in China have yielded contradictory and inconsistent findings. Furthermore, after two decades of profound socioeconomic transformation, depression may no longer be rare in the contemporary population. The authors conducted a psychiatric epidemiological study among postpartum Chinese women using rigorous methodology and a representative sample. METHOD: A total of 959 consecutive women were recruited at the antenatal clinic of a university hospital in Hong Kong. At 3 months postpartum, the prevalence and incidence rates of depression were measured with a two-phase design. The participants were first stratified by means of the 12-item General Health Questionnaire. Subsequently, all high scorers and 10% of low scorers were assessed with the nonpatient version of the Structured Clinical Interview for DSM-III-R. The 1-month and 3-month prevalence and incidence rates were estimated by using reverse weighting. RESULTS: The 1-month prevalence rates for major and minor depression were 5.5% and 4.7%, respectively. At 3 months, the corresponding prevalence rates were 6.1% and 5.1%. Together, 13.5% of the participants suffered from one or more forms of psychiatric disorder in the first 3 months postpartum. CONCLUSIONS: Postpartum depression is common among contemporary Chinese women. A universal postpartum depression-screening program would be useful for early detection. Our data suggest that depression may no longer be rare in the Chinese population.     

Interpersonal problems among 988 Norwegian psychiatric outpatients. A study of pretreatment self-reports

Objective

No studies, to our knowledge, have examined what specific kinds of interpersonal problems characterize a general psychiatric outpatient population. Do they differ from the normal population in any specific way, apart from the expected “more of everything”? The aim of this study was to map and categorize a large psychiatric outpatient sample with regard to self-reported interpersonal problems.

Method

First-admission psychiatric patients completed the 64-item version of the Inventory of Interpersonal Problems (Horowitz et al, Inventory of Interpersonal Problems Manual. San Antonio, TX: The Psychological Corporation 2000) before treatment. Scores were compared with Norwegian reference data. Profile characteristics of 8 subgroups (octant groups), corresponding to 8 different forms of predominant interpersonal problem, were calculated according to the structural summary method (Gurtman and Balakrishnan, Circular measurement redux: the analysis and interpretation of interpersonal circle profiles. Clin Psychol Sci Pract. 1998;5[3]:344-360).

Results

The clinical sample had considerably more interpersonal problems than the normal reference sample. Among the 8 octant groups with different predominant interpersonal problems, the 3 most prevalent in the sample, characterized by a low degree of assertiveness (low agency), were also the most distressed with regard to interpersonal problems.

Conclusions

Psychiatric outpatients seem to have the most severe interpersonal problems along the agency dimension; that is, they have problems being assertive. Patients within different octant groups of the 64-item version of the Inventory of Interpersonal Problems system, corresponding to different kinds of specific, predominant interpersonal problems, have characteristic ways of relating to others, which ought to be identified and addressed in therapy.     

Adverse drug reactions. An epidemiological study at psychiatric hospitals

A drug monitoring system has been established at psychiatric university hospitals in Berlin, Goettingen, and Munich since 1979 in order to investigate adverse reactions to psychotropic drugs. This report describes the system and presents results obtained over 3 years. 504 randomly selected patients were observed by Intensive Drug Monitoring; 75% of them had an adverse drug reaction (ADR) during hospitalization that was assessed as possible, probable, or definite including all grades (I-III) of severity. 5,096 other patients were monitored by Organized Spontaneous Reporting during treatment with psychotropic drugs: ADRs were responsible for drug withdrawal (severity grade III) in about 10% of them. Parkinsonism, psychomotor disturbance, akathisia, delirium, oversedation and increased transaminases were the most frequent ADRs of this kind. The relative frequency of ADRs was calculated, and ADR-profiles established for drugs most frequently withdrawn. The impact of ADRs on ongoing therapy of patients was assessed. Reliable data obtained by drug monitoring systems can be expected to aid in therapeutic decisions in patients with special risks of side effects to psychotropic drugs.     

An epidemiological study of minor psychiatric disturbances

Summary A representative epidemiological field study of minor mental disturbances among 19- to 20-year-old persons in Zurich (Switzerland) is reported. Respondents had completed two selfreport inventories; SCL-90R by Derogatis and a Syndrome List concerning psychosomatic and neurotic syndromes. There is a high prevalence rate of such disturbances. Usually, however, they do not lead to treatment-seeking behaviour. Females show higher prevalence figures on nearly all scales and syndromes. The syndromes of anxiety and depression are most prominent among females. Unexpectedly, there are few differences in prevalence rates between different socio-demographic groups. There are, however, three high-risk groups: (1) persons without occupational training; (2) persons without religious affiliation and (3) persons whose parents or siblings had psychiatric problems. Reasons for the lack of clearcut associations between social status and psychiatric syndromes are discussed.This research is supported by the Swiss National Science Foundation, grant no. 3.804-0.76.     

Poor sleep and psychiatric symptoms at school: an epidemiological study

The objective of this study was to evaluate associations between sleep problems and psychiatric symptoms at school. A random sample consisting of 5813 eight- to nine-year-old children was selected from ordinary schools. Both parents' and children's reports of sleep problems were taken into account. The psychiatric symptoms were addressed according to the teachers' reports (the Rutter Scale B). Children with severe sleep problems were more likely to have a psychiatric disturbance according to the Rutter B Scale (OR 2.45, 95 % CI 1.85–3.25). Logistic regression models showed that severe sleep problems were highly associated with emotional problems (OR 2.74, 95 % CI 1.84–4.13), school attendance problems (OR 2.53, 95 % OR 1.45–4.41), behavioural problems (OR 2.44, 95 % CI 1.59–3.75) and hyperactivity (OR 2.02, 95 % CI 1.30–3.13). Over 95 % of severe sleep problems were reported only by the children themselves. In conclusion, children with severe sleep problems have substantially more teacher-reported psychiatric symptoms than those with no or mild sleep complaints. In diagnosing sleep disorders, it is important to include children as informants because relevant information may be overlooked when only parents are questioned. Accepted: 20 August 2001     

Polydipsia and water intoxication in 353 psychiatric inpatients: an epidemiological and psychopathological study.

INTRODUCTION: According to several authors, water intoxication can lead to irreversible brain damage and could be the cause of nearly a fifth of the deaths of schizophrenic patients below the age of 53 years. The aim of our study was first to determine the prevalence of polydipsia and water intoxication in a population of psychiatric inpatients of a well-defined French geographic area (the Somme), and secondly to determine the clinical and socio-demographic factors associated with this disorder. METHOD: A cross-sectional survey was done on the 450 psychiatric beds whose catchment area had a total population of 559,429 inhabitants. Using staff reports and patients' charts, the drinking habits of 353 psychiatric inpatients hospitalised during the survey in the 450 psychiatric beds of this area were examined. RESULTS: Thirty-eight patients (10.76%; 95% confidence interval: 7.53-13.99%) among the 353 inpatients were polydipsic. About one-third of these patients were at risk of water intoxication. Polydipsia appeared to be significantly associated with male gender, smoking, celibacy and chronicity. The polydipsic patients presented also a high prevalence of schizophrenia, mental retardation, pervasive developmental disorders and high frequency of somatic disorders.     

On spatio-temporality. A psychiatric and interdisciplinary study

There is no scientific knowledge without a method, no method without a minimum of theory and no theory without a general frame of reference. The concepts of space and time constitute undoubtedly the most comprehensive frame of reference; it is relevant both to the interior, experienced world of man and to the universe in which he lives. The concepts of space and time, which have emerged from various disciplines such as philosophy, cosmology, physics, biology, neurophysiology, ethology and psychiatry show a certain number of mutual relations and even connections. Characteristically, these concepts fit in with the levels, integrations, communications and self-regulations, all the structural properties, which are emphasized by the model of mental disturbances, created by application of a special systems approach, the "systemal method", to the psychiatric clinic. This structural isomorphism between the mental disturbances and the cognitive concepts of space-time reinforce by feed-back the validity of the systemal method. It also indicates the relevance of the basic sciences to the further development of psychiatry.     

Design and subjects of a Finnish epidemiological study on psychiatric disorders in childhood

In an epidemiological multi-centre study, parents filled in the Rutter Parent Questionnaire (RA2) and teachers filled in the Rutter Teacher Questionnaire (RB2) for almost 6000 children. The children filled in the Children's Depression Inventory (CDI). The subjects well represented the entire population of 8-9-year-old children in Finland. The material and design of the study as well as the basic demographic characteristics are presented.     

A cytogenetic study of children with psychiatric disorders.

The development of techniques permitting the visualization of chromosomal cross-bands has greatly enhanced the field of human cytogenetics. It has led to the exact identification of chromosomes and the detection of subtle chromosomal changes characterizing new clinical syndromes.^1–4The G (Giemsa) and Q (Quinacrine mustard) banding techniques are the most widely used. As a relatively simple and replicable procedure, G banding is the method of choice for clinical application. It is attained by staining the chromosome preparation with Giemsa-like stains. The resulting thick dark staining cross-bands that alternate with lighter ones confer distinctive features to each chromosomal pair.By using elongated chromosomes from late prophase or early metaphase instead of the customary late metaphases, the visual resolution is greatly increased, making it feasible to detect chromosomal changes on different groups of patients. The major psychiatric illnesses are important to study with the new techniques because (1) they have a strong genetic component and (2) an association between chromosomal changes and psychiatric disorders has been proposed.A population of children affected with psychiatric disorders was chosen for the present study since extraneous factors such as drugs, chronic physical illness, and institutionalization are less likely to play a role in the nature-nurture interaction.     

Juvenile delinquency,adult criminality,and adult psychiatric treatment: An epidemiological study

This report explores some associations among juvenile delinquency, subsequent criminality, and subsequent psychiatric treatment. A sample of 255 males known to the juvenile court 25 years prior to the study is examined in terms of subsequent documented psychiatric treatment and/or criminal activity. Of the 255 former delinquents, 6% were known later to both criminal justice and psychiatric systems, 6% to psychiatric systems only, 28% to the criminal justice system only, and 60% to neither. Delinquents with later psychiatric histories were twice as likely to be known to the criminal justice system than were those without psychiatric histories. Those with adult psychiatric histories were also significantly younger at the time of their first delinquent offense and committed more juvenile offenses than the nonpsychiatric group. Only 2 of the 16 individuals later known to both systems were diagnosed sociopathic. The findings are discussed.