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1.
Mohamad Jafar Modabernia Hossein Shodjai Tehrani Mahnaz Fallahi Maryam Shirazi Amir Hossein Modabbernia 《Clin Pract Epidemiol Ment Health》2008,4(1):20
Introduction
Depression is a well known health problem worldwide. Prevalence of depressive disorders varies in different societies.Aim
to determine the prevalence of depressive disorders and some associated factors in Rasht City (Northern part of Iran).Materials and methods
4020 subjects were selected among 394925 residents of Rasht aged between 18–70 during 2003 – 2004. In the first phase, subjects were screened by Beck's Depression Inventory. In the second phase, those who scored more than 15 were assessed through semi-structured psychiatric interview (DSMIV-TR). Socio-demographic characteristics including age, gender, marital status, educational level, and socio-economic class were recorded as well.Results
9.5% of samples (63% female and 37% male) were diagnosed by depressive disorders. The prevalence of minor depressive disorder, dysthymia and major depressive disorder was 5%, 2/5%, and 1% respectively. Socio-economic class was significantly associated with both depressive symptoms based on BDI score (p < 0.001) and depressive disorders based on clinical interview (p < 0.001).Conclusion
Comparing to other studies, this study revealed that prevalence of dysthymic and minor depressive disorder were more than major depressive disorder, and low socio-economic class was the most significant risk factor associated with depression. Regarding our study limitations, researchers and policy makers should not consider our findings as conclusive results. Findings of this study could be applied by researchers using analytical methodology to assess relationship between depressive disorders and associated factors.2.
Objectives
1) to assess the prevalence of hepatitis C virus (HCV) infection in a population of acute psychiatric in-patients; 2) to find out relationships between HCV comorbidity and clinical features of psychiatric patients.Methods
Prospective observational study in a 6-year period.Results
2396 cases (1492 patients) were admitted in the considered period. Forty-two patients (2.8%) were affected by HCV infection. HCV infection was more frequent in patients with less years of education, lower social class, lower last year best Global Assessment of Functioning score, more hostile or violent behavior in hospital, with a lifetime history of previous suicide attempt, and with substance-related disorders.Conclusion
HCV infection in psychiatric patients constitutes a major threat to the health of psychiatric patients and is related with unfavorable social background, worse global functioning, hostile or violent behavior, substance-related disorders. It appears also to be a significant risk of suicidal behavior.3.
Background
Owing to a rise of psychosomatic comorbidities, the treatment of psychological disorders, which may negatively impact prognosis and therapy, is increasingly becoming a focus of attention for pain outpatient clinics.Aim
This study investigates and discusses the advantages of liaison psychiatric care in a university pain clinic.Methods
In this retrospective study, we investigated all patients who presented to an anaesthesiologically led pain clinic between January and June 2014. The psychiatric history was taken by the liaison psychiatrist of the pain clinic.Results
In the period investigated, 485 patients were treated as outpatients. A psychiatric diagnosis was present 351 patients (72.4%). The distribution of the diagnoses was comparable with that of a consultation service. Adaptation and affective disorders dominated. The patients were preferentially treated with new generation antidepressants.Conclusion
The constant presence of a liaison psychiatrist allows for timely, specialised care of pain patients in terms of a multimodal therapeutic approach.4.
Background
Personality disorders affect a substantial proportion of the population. It is unclear, however, whether the burden of personality disorders on modern mental health services has been increasing. To fill this gap, we analyzed trends in admissions for personality disorders in Italy from 1988 to 1998.Methods
We used the yearly data from the Italian Central Institute of Statistics to analyse trends in the total number of admissions for personality disorders and in the total number of first admissions for personality disorders.Results
The absolute number of admissions for personality disorders almost trebled from 1988 to 1998, as well as the proportion of all psychiatric admissions that were for personality disorders. Whilst there has been a marked increase in the absolute number of first admissions, the proportion of all first psychiatric admissions that were for personality disorders showed a steady but modest increase, from 5.7% to 7.6%.Conclusion
In Italy, the burden of personality disorders on modern mental health services has been increasing. In terms of public health, these findings highlight the urgent need of developing policies to tackle the increasing demand of care of this difficult-to-treat patient population.5.
Background
Aim was to determine the predictive factors for polypharmacy among inpatient children and adolescents with psychiatric disorders.Methods
Blinded, case-note review of children and adolescents with ICD 10 diagnosis of psychiatric disorders on psychotropic medication was conducted. Data on demography, illness, and treatment was analyzed with univariate and multivariate techniques.Results
Proscribing non-pharmacological interventions (OR = 4.7) and pro re nata medication (OR = 3.3), increased the risk of polypharmacy. Prescribing physical restraint reduced the risk of receiving multiple medications (OR = 0.3).Conclusion
Proscribing non-pharmacological interventions, pro re nata medication and physical restraints increased polypharmacy.6.
T. Rumpold S. Schur M. Amering K. Kirchheiner E. K. Masel H. Watzke B. Schrank 《Supportive care in cancer》2016,24(5):1975-1982
Purpose
Informal caregivers of advanced cancer patients are known to suffer from high distress due to their caregiving responsibilities. Nevertheless, a comprehensive evaluation of psychiatric morbidity is often missing in clinical practice due to time resources, and mental health problems may be unnoticed in this population. A feasible approach is needed to identify caregivers at risk for psychiatric disorders to offer targeted interventions and enhance their well-being.Methods
This cross-sectional, multi-institutional study screened 345 caregivers of advanced cancer patients for psychiatric disorders (i.e., depression, anxiety, posttraumatic stress disorder, and alcohol abuse/dependence) and assessed factors potentially associated with mental health diagnoses (including socio-demographic factors, burden, hope, caring-related quality of life, and coping preferences).Results
Overall, almost 52 % of participants had one or more suspected psychiatric disorders, with anxiety being the most prevalent. Perceived hope, higher burden, and more emotion-oriented coping were associated with psychiatric morbidity in this sample. Spouses and parents showed significantly more symptoms of psychiatric disorders than other relatives.Conclusions
This study confirms the high risk of informal caregivers of advanced cancer patients to develop psychiatric disorders and suggests a practically feasible approach to identify at risk caregivers to offer support.7.
Background
Information on mental health sequel in adolescents following natural disasters from developing countries is scant.Method
Around one year after a super-cyclone, proportion of adolescents exhibiting post-traumatic psychiatric symptoms, prevalence of post-traumatic stress disorder (PTSD), major depression and generalized anxiety disorder, comorbidity and impairment of performance in school were studied in Orissa, India. Mini International Neuropsychiatric Interview for children and adolescents was used for evaluation and diagnosis. The criteria for diagnoses were based on Diagnostic and Statistical Manual of Mental Disorders – IV.Results
Post-disaster psychiatric presentation in adolescents was a conglomeration of PTSD, depression and anxiety symptoms. The prevalences of PTSD, major depressive disorder and generalised anxiety disorder were 26.9%, 17.6% and 12.0% respectively. Proportion of adolescents with any diagnosis was 37.9%. Comorbidity was found in 39.0% of adolescents with a psychiatric diagnosis. Adolescents from middle socioeconomic status were more affected. There were gender differences in the presentation of the symptoms rather than on the prevalence of diagnoses. Prolonged periods of helplessness and lack of adequate post-disaster psychological support were perceived as probable influencing factors, as well as the severity of the disaster.Conclusion
The findings of the study highlight the continuing need for identification and intervention for post-disaster psychiatric morbidities in adolescent victims in developing countries.8.
Marco Di Nicola Sergio De Filippis Giovanni Martinotti Luisa De Risio Mauro Pettorruso Simone De Persis Angelo Giovanni Icro Maremmani Icro Maremmani Massimo di Giannantonio Luigi Janiri 《Advances in therapy》2017,34(7):1636-1649
Introduction
Nalmefene is the first drug to be approved for reducing alcohol consumption in alcohol use disorder (AUD) patients at high drinking risk. In real-world settings, there is a high prevalence of concurrent psychiatric disorders in AUD subjects, with associated increased morbidity and worse prognosis. This study evaluated the use of nalmefene in AUD patients with stabilized psychiatric comorbidity previously treated unsuccessfully for alcohol dependence, and assessed craving reduction and safety.Methods
Sixty-five AUD outpatients treated with as-needed 18 mg nalmefene for 24 weeks were included. Primary outcome measures were: changes in heavy drinking days (HDDs) and total alcohol consumption (TAC, g/day). Secondary outcome measures were: changes in drinking risk level and craving (obsessive–compulsive drinking scale and visual analogue scale for craving).Results
Forty-two AUD subjects (64.6%) had one or more stabilized psychiatric comorbidity. There was a significant reduction in HDDs, TAC and craving measures (p < 0.001), with no differences between subjects with and without psychiatric comorbidity. Nalmefene was safe and well tolerated in all patients.Conclusion
As-needed nalmefene reduced drinking and craving in AUD subjects with and without psychiatric comorbidity. These findings suggest that nalmefene is a valid therapeutic option in real-world clinical settings, where comorbid conditions are common, and has the potential to engage AUD patients who may otherwise not have sought help.Funding
Lundbeck Italia S.P.A.9.
Objective
To estimate 12-month prevalence and co-occurrence of symptoms of specific mental problems among US adolescents (12–17 years) by age, sex and racial/ethnic subgroups.Method
Data from the 2000 National Household Survey of Drug Abuse (NHSDA) adolescent sample are used to estimate prevalence and co-occurrence rates using the DISC predictive scales. Multiple logistic regressions were used to derive significant correlates of each domain of DPS-derived symptom cluster indicators of psychiatric problems and of severe comorbidity, with control of demographics and environmental factors.Setting
The National Household Survey on Drug Abuse (NHSDA), a national household probability sample, includes a nationally representative sample of 12–17 year-old adolescents (N = 19,430), through in-home surveys.Results
Three out of five adolescents screened positive for at least one DPS symptom cluster with estimates for specific symptom cluster ranging over 9.7% (substance use disorder), 13.4% (affective), 36.3% (disruptive-behavior), and 40.1% (anxiety). Co-occurrence was high with almost one-third of any DPS symptom cluster reporting multiple positive screens of four or more clusters. Blacks and younger females were most likely to report mental health problems and co-occurrence.Conclusion
Mental health problems among U.S. youth may be far more common than previously believed, although these symptoms have not yet reached the point of clinical impairment. The data speak to important patterns of age, gender and racial/ethnic differences in mental health problems deserving of further study.10.
Background and objective
Asperger's Syndrome (AS) is a pervasive developmental disorder that is sometimes unrecognized, especially in the adult psychiatric setting. On the other hand, in patients with an AS diagnosis, comorbid psychiatric disorders may be unrecognized in the juvenile setting. The aim of the paper is to show and discuss some troublesome and complex problems of the management of patients with AS and comorbid Bipolar Disorder (BD).Methods
The paper describes three patients affected by AS and bipolar spectrum disorders.Results and conclusion
Mood stabilizers and 2nd generation antipsychotics were effective in the treatment of these AS patients with comorbid BD, while the use of antidepressants was associated with worsening of the mood disorder.It is of importance to recognize both the psychiatric diagnoses in order to arrange an exhaustive therapeutic program and to define specific and realistic goals of treatment.11.
Aiste Pranckeviciene Sarunas Tamasauskas Vytenis Pranas Deltuva Robertas Bunevicius Arimantas Tamasauskas Adomas Bunevicius 《Supportive care in cancer》2016,24(7):2963-2970
Purpose
Suicidal ideation (SI) is an important complication in cancer patients that should be promptly recognized and adequately managed. We investigated the prevalence rate and correlates of pre-operative SI in brain tumor (BT) patients admitted for elective BT surgery.Methods
Two hundred and eleven consecutive patients (70 % women; mean age 55.9 ± 15.4 years) scheduled for BT surgery were evaluated for SI (“suicidal thought” item from the Beck Depression Inventory-II), depressive/anxiety symptom severity (Hospital Anxiety and Depression scale (HADS)), health-related quality of life (SF-36 scale), functional status (Barthel Index), and psychiatric histories and treatments. The majority of patients were diagnosed with meningioma (39 %) and high-grade glioma (17 %).Results
SI was self-reported by 12 (6 %) patients. Patients expressing SI were most commonly diagnosed with meningioma (50 %). Patients with SI were more likely to have a past history of psychiatric disorders, scored higher on the HADS anxiety subscale, and reported worse health-related quality of life across physical and mental health domains. In multivariate regression analyses, worse perceived mental health was associated with increased risk for SI independently from clinical, sociodemographic, and other patient-oriented variables considered in the study.Conclusions
SI was self-reported by 6 % of BT patients before surgical intervention and was associated with a past history of psychiatric disorders and worse perceived health status. Poor mental health was an independent correlate of SI. The perception of health status by a patient should be considered as an important determinant of poor mental health in BT patients.12.
Objective
The aim of the present study was to find out the extent of hostility and violence and the factors that are associated with such hostility and violence in a psychiatric intensive care unit.Methods
Retrospective analysis of data prospectively collected in a 6-year period.Results
No hostility was observed in 56.1%, hostility in 40.9%, and violence in 3.0% of the admitted cases. Seclusion was never used. Six cases (2,5‰) required physical restraint. Risk factors associated with violence were younger age, suicidal risk, and diagnosis of schizophrenia. Risk factors associated with hostile and violent behavior were younger age at the onset of the disorder, being single, having no children, lower GAF scores, higher BPRS hostility, SAPS, and CGI scores, lower BPRS anxiety-depression score, higher doses of psychoactive drugs, more frequent use of neuroleptics, diagnosis of mania, personality disorder, substance and alcohol related disorders, no diagnosis of depression.Conclusion
The study confirms the low rate of violence among Italian psychiatric in-patients, the major relevance of clinical rather than socio-demographic factors in respect of aggressive behavior, the possibility of a no seclusion-no physical restraint policy, not associated either with higher rates of hostility or violence or with more severe drug side effects.14.
Maria Carolina Hardoy Mariangela Cadeddu Andrea Murru Bernardo Dell'Osso Bernardo Carpiniello Pier Luigi Morosini Joseph R Calabrese Mauro Giovanni Carta 《Clin Pract Epidemiol Ment Health》2005,1(1):8
The study measured the accuracy of the Italian version of the Mood Disorder Questionnaire (MDQ) as a screening instrument for bipolar disorders in a psychiatric setting. 相似文献
Methods
154 consecutive subjects attending the Division of Psychiatry of the University of Cagliari (Italy), were screened for bipolar disorders using the Italian translation of the MDQ, and diagnostically interviewed with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) by physicians.Results
On the basis of the SCID: 51 (33.1%) received a diagnosis of bipolar or schizoaffective bipolar type disorders, 63 (40.9%) were diagnosed as having at least one psychiatric disorder in Axis I (other than bipolar or schizoaffective bipolar type disorders), whilst 40 (25.9%) were unaffected by any type of psychiatric disorder. MDQ showed a good accuracy for bipolar or schizoaffective bipolar type disorders: the cut-off 4 had sensitivity 0.90 and specificity 0.58; the cut-off 5 had sensitivity 0.84 and specificity 0.70; and the cut-off 6 had sensitivity 0.76 and specificity 0.86. The accuracy for bipolar II disorders was sufficient but not excellent: the cut-off 4 had sensitivity 0.80 and specificity 0.45; the cut-off 5 had sensitivity 0.70 and specificity 0.55; and the cut-off 6 had sensitivity 0.55 and specificity 0.65.Conclusion
Our results seem to indicate a good accuracy of MDQ, and confirm the results of recent surveys conducted in the USA. Moreover the instrument needs to be validated in other settings (e.g. in general practice).15.
Camilla Bock Jens Drachmann Bukh Maj Vinberg Ulrik Gether Lars Vedel Kessing 《Clin Pract Epidemiol Ment Health》2009,5(1):4
Objective
To validate the ICD-10 diagnosis of a single depressive episode as used in daily clinical psychiatric practice and as recorded in the Danish Psychiatric Central Research Register.Methods
Patients discharged with a diagnosis of a single depressive episode were consecutively sampled from the register and diagnosed according to an interview using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN).Results
A total of 75.4% of 399 patients with a register diagnosis of a single depressive episode also got this diagnosis according to the SCAN interview (82.8% for severe type of a single depression, 76.0% for moderate type of a single depression and 65.2% for mild type of a single depression).Conclusion
The ICD-10 diagnosis of a single depressive episode can be used in daily clinical practice with sufficient precision. The validity of the diagnosis is highest for severe and moderate type of depression and decreases for mild depression.16.
Alessandra Benedetti Pietro Scarpellini Francesco Casamassima Lorenzo Lattanzi Maria Liberti Laura Musetti Giovanni Battista Cassano 《Clin Pract Epidemiol Ment Health》2008,4(1):22
Background
Although manic episodes in older adults are not rare, little published data exist on late-life manic episodes. Resistance to treatment and concomitant neurological lesions are frequent correlates of elderly mania. The aim of this study was to investigate the prevalence of hospitalizations due to mania in patients older than 64 years through a period of 5 years in an Italian public psychiatric ward. Moreover, we aimed at describing clinical presentation of elderly manic episodes.Methods
A retrospective chart review was conducted in order to describe clinical presentation of 20 elderly patients hospitalized for manic episode; moreover, we compared age at onset, the presence of family history for mood disorders, psychosis and irritability between the elderly group and a matched group of 20 younger manic inpatients.Results
Seven percent of the whole inpatient elderly people suffered from mania. Half of those patients had a mood disorder age at onset after 50 years and 5 patients were at their first manic episode. Geriatric- and adulthood mania showed similar clinical presentation but younger people had more frequently a mood disorders family history.Conclusion
Half of our older manic inpatients consisted of "classic" bipolar patients with an extension of clinical manifestations into later life; the other half of our sample was heterogeneous, even though it was not possible to identify clearly which patients may have had vascular lesions related to the onset of mania.17.
Dana Bichescu Maggie Schauer Evangelia Saleptsi Adrian Neculau Thomas Elbert Frank Neuner 《Clin Pract Epidemiol Ment Health》2005,1(1):17
Background
Research has suggested that organized violence and torture have long-term psychological effects that persist throughout the lifespan. The present survey aimed at examining the prevalence of posttraumatic stress disorder (PTSD), and other disorders and symptoms, all present in old age, as long-term consequences of politically motivated violence in a comparison design.Methods
A group of former political detainees (N = 59, mean age 73.5 years) who had been arrested by the Romanian communist regime were compared to an age- and gender-matched control group (N = 39). PTSD was assessed using a structured clinical interview (CIDI). The investigation of the clinical profile was further accomplished by self-rating measures for anxiety, depression, and health-related functioning, as well as by clinician-administrated interviews for substance abuse, dissociation, and somatization symptoms.Results
Lifetime prevalence of PTSD was 54%. In the case of participants left untreated, PTSD persisted, often over four decades, such that current PTSD was diagnosed still in a third of the survivors. Other clinical conditions such as somatization, substance abuse, dissociative disorders, and major depression were also common among the former political detainees and often associated with current PTSD.Conclusion
Our findings suggest that political detention may have long-term psychological consequences that outlast the changes in the political system.18.
Tilman Steinert Frank Eisele Ulla Goeser Stefan Tschoeke Carmen Uhlmann Peter Schmid 《Clin Pract Epidemiol Ment Health》2008,4(1):27
Background
Self-directed and other violence as well as subsequent coercive interventions occur in a substantial proportion of patients with personality disorders during in-patient treatment. Different strategies may be required to reduce coercive interventions for patients of different diagnostic groups.Methods
We specialised one of our acute admission wards in the treatment of personality disorders and adjustment disorders (ICD-10 F4 and F6). Patients are not transferred to other acute wards in case of suicidal or violent behaviour. Violent behaviour and coercive interventions such as seclusion or restraint were recorded in the same way as in the rest of the hospital. We recorded the percentage of subjects affected by diagnostic group and average length of an intervention in the year before and after the change in organisational structure.Results
The total number of coercive interventions decreased by 85% both among patients with an F4 and those with an F6 primary diagnosis. Violent behaviours decreased by about 50%, the proportion of involuntary committed patients decreased by 70%.Conclusion
The organisational change turned out to be highly effective without any additional cost of personnel or other resources.19.
Background
Pain, restriction of mobility and cognitive impairment are often present in old age and intensify each other.Objectives
Is there a relationship between mobility, pain, cognitive capacity, diagnoses and number of prescribed medication for residents of nursing homes?Methods
Subgroup analysis of the baseline data from an intervention study for optimization of the medication safety of 120 nursing home residents.Results
Pain was presumed in 77.8% of the residents. Persons with cognitive impairment were more frequently affected. The results of the observational and self-reported pain assessment in cognitively impaired patients did not agree for two-thirds of the cases. A correlation between prevalence of pain, pain intensity and mobility could only be shown for persons without cognitive impairment. Half of the persons were unable to walk; 80% of the residents with analgesics as a permanent medication were more restricted in their mobility.Conclusions
Cognitive impairment is associated with pain and reduced mobility, whereby self-rated pain did not concur with the observational pain assessment for two-thirds of the residents with cognitive impairment. This illustrates the difficulty of observational pain assessment.20.
Stefan Kropp Christoph Andreis Bert te Wildt Udo Reulbach Martin Ohlmeier Irina Auffarth Marc Ziegenbein 《Clin Pract Epidemiol Ment Health》2005,1(1):27