Lifetime comorbidity of obsessive-compulsive disorder with psychiatric disorders in a community sample

Epidemiological research indicates that obsessive-compulsive disorder (OCD) still constitutes a major public health problem. To study the comorbidity of psychiatric disorders in OCD subjects in a non-Western community sample, 25,180 individuals were interviewed face-to-face at home according to DSM-IV for diagnosis of psychiatric disorders by 250 trained clinical psychologists. The subjects were predetermined with a randomized cluster sampling method among all families residing in Iran. From 444 individuals diagnosed as OCD, 157 (35.4%) developed at least one of the psychiatric disorders. The most common comorbid psychiatric disorders were major depressive disorder and simple phobia. Comorbidity of two or more additional psychiatric disorders in OCD individuals was rare. There was no difference between genders in the comorbidity of psychiatric disorders with OCD. Low comorbidity of psychiatric disorders with OCD shows that OCD tends to occur in isolated rather than as cluster problems in a clinical sample.     

Cognitive performance of male adolescents is lower than controls across psychiatric disorders: a population-based study

OBJECTIVE: Psychiatric patients, as well as humans or experimental animals with brain lesions, often concurrently manifest behavioral deviations and subtle cognitive impairments. This study tested the hypothesis that as a group, adolescents suffering from psychiatric disorders score worse on cognitive tests compared with controls. METHOD: As part of the assessment for eligibility to serve in the military, the entire, unselected population of 16-17-year old male Israelis undergo cognitive testing and screening for psychopathology by the Draft Board. We retrieved the cognitive test scores of 19 075 adolescents who were assigned any psychiatric diagnosis, and compared them with the scores of 243 507 adolescents without psychiatric diagnoses. RESULTS: Mean test scores of cases were significantly poorer then controls for all diagnostic groups, except for eating disorders. Effect sizes ranged from 0.3 to 1.6. CONCLUSION: As group, adolescent males with psychiatric disorders manifest at least subtle impairments in cognitive functioning.     

Child and adolescent psychiatric disorders in a public service over seventy years

The entire sample of N=45554 patients attending the child and adolescent psychiatric service of the Canton of Zurich, Switzerland between 1921 and 1990 was analyzed with regard to age, sex, and diagnoses. Data were based on annual reports of the institution for the period between 1921 and 1978. From 1979 onwards, electronically stored data on each patient were available. ICD-9 diagnoses were applied between 1979 and 1987. The ICD-10 system was introduced in 1988. The total administrative prevalence rate varied between 0.15 and 0.40 percent with an increasing trend over time. On the average, boys outnumbered girls by a sex ratio of 2:1. The age distribution showed peaks at 8 to 9 years and during adolescence. The distributions of the most common diagnoses showed remarkable differences over time. It is assumed that changes in diagnostic categories rather than changes in true prevalence rates play a major role in the latter trend.     

Regional differences in psychiatric disorders in Chile

Background Psychiatric epidemiological surveys in developing countries are rare and are frequently conducted in regions that are not necessarily representative of the entire country. In addition, in large countries with dispersed populations national rates may have low value for estimating the need for mental health services and programs. Methods The Chile Psychiatric Prevalence Study using the Composite International Diagnostic Interview was conducted in four distinct regions of the country on a stratified random sample of 2,978 people. Lifetime and 12-month prevalence and service utilization rates were estimated. Results Significant differences in the rates of major depressive disorder, substance abuse disorders, non-affective psychosis, and service utilization were found across the regions. The differential prevalence rates could not be accounted by socio-demographic differences between sites. Conclusions Regional differences across countries may exist that have both implications for prevalence rates and service utilization. Planning mental health services for population centers that span wide geographical areas based on studies conducted in a single region may be misleading, and may result in areas with high need being underserved.     

Gender differences in the associations between past-year gambling problems and psychiatric disorders

Background Psychiatric disorders frequently co-occur with pathological gambling. The extent to which co-occurence extends to subsyndromal levels of gambling or differs between women and men is incompletely understood. Aim To examine whether the association between psychiatric disorders and past-year gambling problems is stronger in women than men. Methods Data from the national epidemiological survey of alcoholism and related disorders (NESARC) (n = 43,093) were analyzed. Results Increasing severity of past-year gambling problems was associated with increasing odds of most past-year Axis I and lifetime Axis II disorders, regardless of gender. Associations between gambling problems and major depression, dysthymia, panic disorder, and nicotine dependence were statistically stronger in women than in men. Conclusions A severity-related association exists between past-year gambling problems and psychiatric disorders. The stronger associations in women suggest that gambling research, prevention and treatment efforts consider gender differences.     

Prevalence of DSM-III-R and ICD-10 psychiatric disorders in a Spanish population of 18-year-olds

The aim of this study was to estimate the current prevalence of DSM-III-R and ICD-10 psychiatric disorders in Spanish 18-year-old members of the general population. Subjects were assessed using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Nearly 30% of the study subjects reported at least one current disorder according to ICD-10 criteria, and almost 21% reported at least one current disorder according to DSM-III-R criteria. Women had a significantly higher probability of suffering from any psychiatric disorder than men. The most common disorders were insomnia, dysthymia, major depression and simple phobia. Nearly 40% of the diagnosed subjects had one or more comorbid disorders. Comorbidity was found to be higher among female subjects. Consistent with previous risk factor research, it was found that women had higher rates of mood, anxiety and sleep disorders than men. Good communication between parents and their offspring was found to be a protecting factor for all disorders.     

Comorbid psychiatric disorders in Arab children with Autism spectrum disorders

The objective of our study is to estimate the prevalence of comorbid psychiatric disorders in a sample of children with autism spectrum disorders (ASD) recruited from three Arab countries. We also examine the relationship between comorbidity and children's cognitive functioning and gender. Children who received a diagnosis of ASD (n = 60) from a child psychiatric outpatient clinic in Mansoura (Egypt), Al-Ahsa (Saudi Arabia) and Amman (Jordan) were included in this study. Comorbid diagnoses were established with a clinical interview and a semi-structured clinical interview for children and adolescents (SCICA). In addition, for all patients the cognitive evaluation was measured given the range in age and level of ability. Sixty-three percent of the children were diagnosed with at least one comorbid disorder. The most commonly reported comorbid disorders were anxiety disorders (58.3%), ADHD (31.6%), conduct disorders (23.3%), and major depressive disorder (13.3%). Out of the total sample, Obsessive compulsive disorder was the most prevalent anxiety disorder (55%). Elimination disorders were also diagnosed in 40% of patients. These findings emphasize a wide variety of psychiatric comorbidity afflicting youth with ASD and may be important targets for intervention.     

Health care utilization in children and adolescents with psychiatric disorders

Objective

Mental illness is increasing among young people and likewise the request for health care services. At the same time, somatic comorbidity is common in children and adolescents with psychiatric disorders. There is a lack of studies on health care use in children and adolescents, and the hypothesis was that children and adolescents with psychiatric disorders use more primary-, and specialized somatic health care compared to children without psychiatric disorders.

Methods

In this retrospective population-based register study, all individuals aged 3–17 years living in Västra Götaland region in Sweden in 2017 were included (n = 298,877). Linear and Poisson regression were used to compare health care use during 2016–2018 between children with and without psychiatric diagnoses, controlling for age and gender. The results were reported as unstandardised beta coefficient (ß) and adjusted prevalence ratio (aPR) respectively.

Results

Having a psychiatric diagnosis was associated with more primary care visits (ß 2.35, 95% CI 2.30–2.40). This applied to most diagnoses investigated. Girls had more primary care visits than boys. Likewise, individuals with psychiatric diagnoses had more specialized somatic outpatient care (ß 1.70, 95% CI 1.67–1.73), both planned and unplanned (ß 1.23, 95% CI 1.21–1.25; ß 0.18, 95% CI 0.17–0.19). Somatic inpatient care was more common in those having a psychiatric diagnosis (aPR 1.65, 95% CI 1.58–1.72), with the diagnoses of psychosis and substance use exerting the greatest risk.

Conclusions

Psychiatric diagnoses were associated with increased primary-, somatic outpatient- as well as somatic inpatient care. Increased awareness of comorbidity and easy access to relevant health care could be beneficial for patients and caregivers. The results call for a review of current health care systems with distinct division between medical disciplines and levels of health care.     

Associations of obesity with psychiatric disorders and suicidal behaviors in a nationally representative sample

Objective

To determine whether obesity is associated with a variety of psychiatric outcomes after taking into account physical health conditions.

Methods

Data came from the public use dataset of the Canadian Community Health Survey Cycle 1.2 (age 15 years and older, N=36,984). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition psychiatric diagnoses of major depressive disorder, mania, panic attacks, panic disorder, social phobia, agoraphobia, alcohol dependence, and drug dependence were examined, as was suicidal behavior (ideation or attempts). Multiple logistic regression was utilized to examine the association between obesity (defined as body mass index ≥30) and mental health outcomes. Covariates in the regressions included sociodemographic factors and a measure of physical illness burden (the Charlson Comorbidity Index).

Results

In adjusted models, obesity was positively related to several lifetime psychiatric disorders (depression, mania, panic attacks, social phobia, agoraphobia without panic disorder), any lifetime mood or anxiety disorder, suicidal ideation, and suicide attempts [adjusted odds ratio (AOR) range: 1.22-1.58]. Obesity was similarly positively associated with past-year depression, mania, panic attacks, social phobia, any anxiety disorder, and suicidal ideation (AOR range: 1.24-1.52), and negatively associated with past-year drug dependence (AOR=0.53, 95% CI 0.31-0.89). Most of these associations were found to be specific to women, while some were also present in men.

Conclusion

Independent of physical health conditions, obesity was associated with psychiatric disorders and suicidal behavior in the Canadian population. Possible mechanisms and clinical implications of these findings are considered.     

Predictors of first incidence of DSM-III-R psychiatric disorders in the general population: findings from the Netherlands Mental Health Survey and Incidence Study

OBJECTIVE: To investigate determinants of 12-month first incidence of DSM-III-R mood disorder (MD), anxiety disorder (AD) and substance use disorder (SUD) in the general population. METHOD: Data are from the Netherlands Mental Health Survey and Incidence Study (NEMESIS), a prospective epidemiologic study in which a representative sample of 7076 adults aged 18-64 years were interviewed with the Composite International Diagnostic Interview. New cases diagnosed 12 months after baseline were compared with never diagnosed controls on sociodemographic and psychosocial variables. RESULTS: Multivariate, the only demographic variable associated with incidence of MD was female gender. The strongest predictors were negative life events and ongoing difficulties. High level of neuroticism was also associated. Incidence of AD was likewise predicted by female gender. Negative life events and ongoing difficulties were also significant predictors, though weaker than for MD. Incidence of SUD was more common among males, young adults, people not living with a partner and those experiencing positive life events. CONCLUSION: Incident MD and AD were predicted more strongly by life events, and SUD more strongly by demographic factors.     

Viral infection and psychiatric disorders.

A psychiatric population of 94 inpatients and 12 outpatients was investigated on referral to a psychiatric unit in a general hospital for serum antibody titres to several viruses by a complement fixation technique. Of the total population studied, only eight were considered to have antibody titres of possible significance. This result would appear to indicate that viral infection does not play a major part in the causation or precipitation of psychiatric disorders.     

Labour market conditions,labour force activity and prevalence of psychiatric disorders

Background  At a population level, the extent that labour market conditions influence labour force activity among people with psychiatric disorders, remains equivocal. Similarly equivocal is the hypothesised relationship between economic conditions and the reported prevalence of specific psychiatric disorders. We investigated these issues by examining the extent that labour market conditions were associated with change in labour force activity among people with anxiety disorders, affective disorders, and schizophrenia, in comparison to healthy working age adults. Methods  Data files were provided by the Australian Bureau of Statistics (ABS) from a population survey conducted in 1998 and replicated in 2003. Multi-stage probability samples were obtained in 1998 (N ₁ = 37,580) and 2003 (N ₂ = 36,088). Adults with schizophrenia, depression, and anxiety disorders were compared to healthy working age adults. Results  Greater labour demand in 2003 was positively associated with increased labour force participation among healthy adults. The proportions actively looking for work declined among healthy adults and among those with anxiety disorders. Full-time employment significantly increased among healthy working age residents. The proportions employed part-time significantly increased in all groups except among people with schizophrenia. Conclusion  These results support policies which remove disincentives and increase access to the more intensive evidence-based employment programs even when labour market conditions are improving.     

Prevalence of psychiatric disorders in children and adolescents with and without intellectual disability

Background There have been very few population‐based studies of the prevalence of psychiatric disorders among children and adolescents with and without intellectual disability (ID). Methods Secondary analysis of the 1999 Office for National Statistics survey of the Mental Health of Children and Adolescents in Great Britain was performed. This survey collected information on a multistage, stratified, random sample of 10 438 children between 5 and 15 years of age across 475 postcode sectors in England, Scotland and Wales. Results The prevalence of any diagnosed ICD‐10 disorder, conduct disorder, anxiety disorder, hyperkinesis and pervasive developmental disorders were significantly greater among children with ID than among their non‐ID peers. There were no statistically significant differences between children with and without ID with regard to the prevalence of depressive disorders, eating disorders or psychosis. Factors associated with an increased risk of psychopathology among children and adolescents with ID included age, gender, social deprivation, family composition, number of potentially stressful life events, the mental health of the child's primary carer, family functioning and child management practices. Conclusions Children and adolescents with ID are at significantly increased risk of certain forms of psychiatric disorder. Careful consideration of the social and economic adversity facing such families will be necessary to ensure that support services are responsive to both the needs of child as well as the needs of the family in which they are living.     

Hospital vs. outreach treatment of patients with mental retardation and psychiatric disorders: a controlled study

The aim of this study was to investigate the effectiveness of specialized hospital treatment vs. outreach treatment of patients with mental retardation and serious mental illness. A total of 50 patients were randomly assigned to either the hospital treatment (n=25) or the outreach treatment group (n=25). The outcome measures included psychiatric symptoms, family burden, costs and hospital admissions. At most observation points (up to 28 weeks) and at all endpoints the two groups were equivalent with regard to psychiatric symptoms. The burden on carers did not increase significantly during the outreach treatment. Treatment costs were lower for the outreach treatment. Of the 25 patients who received outreach treatment, four had to be admitted to the specialized hospital. Aggressive behaviour, social competence and number of previous psychiatric hospitalizations were found to be predictors of treatment outcome. It is concluded that outreach treatment represents an effective and efficient alternative to hospital treatment for patients with mental retardation and psychiatric disorders.     

Sleep disturbances associated with minor psychiatric disorders in medical students

We performed a cross-sectional study with 342 medical students (age range, 18–35 years) to identify, among a group of sleep disturbances, those which are related to minor psychiatric disorders in this population. The instruments employed for data collection were the self-reporting questionnaire (SRQ-20), the morningness/eveningness questionnaire, the Epworth sleepiness scale, and a general questionnaire regarding demographic characteristics, use of drugs, history of psychopathology, usual fall-asleep time, usual wake-up time, amount of sleep, arousal during the night, and insomnia. We used a logistic regression model to determine independent factors associated with minor psychiatry disorders. Daytime sleepiness [odds ratio (OR), 2.12; 95% CI, 1.21–3.71], arousal [OR, 4.54; 95% CI, 1.97–10.47], insomnia [OR 2.45; 95% CI, 1.32–4.56], and sleeping less than 7 hours per night [OR, 2.02; 95% CI, 1.11–3.67] were associated with minor psychiatric disorders. This group of variables determined a cumulative risk ratio of 5.47 [95% CI, 2.87–10.41] for the main outcome. Received: 11 September 2001 / Accepted in revised form: 26 February 2002