Pharmacological treatment for schizoaffective disorder : A comparison with schizophrenia and bipolar disorder.

PubMed

Assion, H-J; Schweppe, A; Reinbold, H; Frommberger, U

2018-03-21

Bipolar disorder and schizophrenia are severe mental illnesses, each with a prevalence of approximately 1-2% in the general population. There is considerable controversy about differentiating schizophrenia from schizoaffective or bipolar disorder owing to many similarities in psychopathology, progression, and biological factors. The aim of this study was to identify similarities and differences in the pharmacological treatment of these disorders by comparing the prescription patterns. In this retrospective, explorative study we analyzed the prescribed medication of 300 patients with bipolar, schizophrenic, or schizoaffective disorders from data obtained from ten German adult psychiatric clinics of the LWL ("Landschaftsverband Westfalen-Lippe") psychiatric network. Only 21.8% of patients analyzed were consistently compliant in taking their medication before hospitalization. Polypharmacy was applied in 75.6% of cases, whereby 2.27 psychopharmacological agents were prescribed at discharge. Briefly, we observed greater similarity between prescription patterns associated with bipolar and schizoaffective disorders than with schizophrenia prescription patterns. Polypharmacy tends to be more the rule than the exception, especially when patients present with affective psychotic features. Bipolar and schizoaffective disorders cannot be differentiated according to their prescription patterns.

["Nervous breakdown": a diagnostic characterization study].

PubMed

Salmán, E; Carrasco, J L; Liebowitz, M; Díaz Marsá, M; Prieto, R; Jusino, C; Cárdenas, D; Klein, D

1997-01-01

An evaluation was made of the influence of different psychiatric co-morbidities on the symptoms of the disorder popularly known as "ataque de nervios" (nervous breakdown) among the US Hispanic population. Using a self-completed instrument designed specially for both traditional nervous breakdown and for panic symptoms, and structured or semi-structured psychiatric interviews for Axis I disorders, and evaluation was made of Hispanic subjects who sought treatment for anxiety in a clinic (n = 156). This study centered on 102 subjects who presented symptoms of "nervous breakdown" and comorbidity with panic disorder, other anxiety disorders, or affective disorder. Variations in co-morbidity with "nervous breakdown" enabled the identification of different patterns of "nervous breakdown" presenting symptoms. Individuals with "nervous breakdown" and panic disorder characteristically expressed a greater sense of asphyxiation, fear of dying, and growing fear (panic-like) during their breakdowns. Subjects with "nervous breakdown" and affective disorder had a greater sensation of anger and more tendency toward screaming and aggressive behavior such as breaking things during the breakdown (emotional anger). Finally, subjects with "nervous breakdown" and co-morbidity with another anxiety disorder had fewer "paniclike" or "emotional anger" symptoms. These findings suggest that: a) the widely used term "nervous breakdown" is a popular label for different patterns of loss of emotional control; b) the type of loss of emotional control is influenced by the associated psychiatric disorder; and c) the symptoms characteristics of the "nervous breakdown" can be useful clinical markers for associated psychiatric disorders. Future research is needed to determine whether the known Hispanic entity "ataque de nervios" is simply a popular description for different aspects of well-known psychiatric disorders, or if it reflects specific demographic, environmental, personality and/or clinical characteristics of the population.

Impact of Gender, Age at Onset, and Lifetime Tic Disorders on the Clinical Presentation and Comorbidity Pattern of Obsessive-Compulsive Disorder in Children and Adolescents

PubMed Central

Adaletli, Hilal; Gunes, Hatice; Kilicoglu, Ali Guven; Mutlu, Caner; Bahali, Mustafa Kayhan; Aytemiz, Tugce; Uneri, Ozden Sukran

2015-01-01

Abstract Background: Obsessive–compulsive disorder (OCD) is a heterogeneous disorder; therefore, there is a need for identifying more homogeneous subtypes. This study aimed to examine the clinical characteristics and comorbidity pattern of a large sample of pediatric OCD subjects, and to examine the impact of gender, age at onset, and lifetime tic disorders on the clinical presentation and comorbidity pattern. Methods: A total of 110 children and adolescents diagnosed with OCD were assessed using the Kiddle Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL) for psychiatric comorbidity, and a clinical data form was filled out. The cutoff for differentiating prepubertal from adolescent onset was 11 years of age. Results: A total of 83.6% of the subjects had at least one comorbid psychiatric disorder. Oppositional defiant disorder and contamination/somatic obsessions were significantly higher in males (p=0.036 and p=0.03, respectively) than in females. Depressive disorders and religious obsessions were significantly higher in the adolescent-onset group (p=0.02, p=0.05, respectively) whereas disruptive behavior disorders were higher in the prepubertal-onset group (p=0.037). Disruptive behavior disorders were significantly more frequent in the tic (+) group than in tic (-) group (p=0.021). Conclusions: There were differences in the comorbidity pattern and clinical expression between genders and between prepubertal and adolescent-onset cases. Findings of this study supported the introduction of tic-related OCD as a specifier in Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5), and the necessity of a detailed assessment of other psychiatric disorders in youth with OCD. PMID:26091196

Psychiatric comorbidities of adults with early- and late-onset attention-deficit/hyperactivity disorder.

PubMed

Lin, Yu-Ju; Yang, Li-Kuang; Gau, Susan Shur-Fen

2016-06-01

We evaluated the psychiatric comorbidities in adults who were diagnosed with Diagnostic and Statistical Manual of Mental disorders, 5th edition attention-deficit/hyperactivity disorder as a function of recalled symptom onset before and after the age of 7 years and whether the childhood attention-deficit/hyperactivity disorder symptoms were associated with psychiatric comorbidities. In all, 214 adults who were diagnosed with Diagnostic and Statistical Manual of Mental disorders, 5th edition attention-deficit/hyperactivity disorder and 174 non-attention-deficit/hyperactivity disorder controls (aged 17-40 years) received psychiatric interviews to confirm their previous and current attention-deficit/hyperactivity disorder status and other psychiatric diagnoses. Demographics and risks of lifetime psychiatric disorders were compared among three groups: (1) attention-deficit/hyperactivity disorder, onset <7 years (early-onset); (2) attention-deficit/hyperactivity disorder, onset between 7 and 12 years (late-onset) and (3) non-attention-deficit/hyperactivity disorder controls. We also tested the effects of attention-deficit/hyperactivity disorder symptoms on the risk of later psychiatric comorbidities by Cox regression analyses. Regardless of the age of onset, attention-deficit/hyperactivity disorder was significantly associated with a wide range of psychiatric comorbidities. There were similar comorbid patterns between early- and late-onset attention-deficit/hyperactivity disorder. Regardless of attention-deficit/hyperactivity disorder diagnosis, increased severity of attention-deficit/hyperactivity disorder symptoms was associated with higher risks of oppositional defiant disorder, conduct disorder, dysthymia and sleep disorder but not major depression, which was associated with the attention-deficit/hyperactivity disorder diagnosis. Our findings suggest that elevating the threshold of age of onset to 12 years in Diagnostic and Statistical Manual of Mental disorders, 5th edition would not over-diagnose attention-deficit/hyperactivity disorder in the adult population. Recalled childhood attention-deficit/hyperactivity disorder symptom severity was correlated with conduct disorder, oppositional defiant disorder, dysthymia and sleep disorders. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Pattern of psychiatric morbidity among theft offenders remanded or referred for psychiatric evaluation and factors associated with reoffence.

PubMed

Chan, Lai Gwen; Bharat, Saluja; Dani, Dhaval Kirti

2013-06-01

In Singapore, theft and related crimes constitute more than 50% of all reported crime, and are the most common offences committed by accused persons remanded to the Institute of Mental Health (IMH), Singapore. There is a need for better understanding of the forensic psychiatric aspects of such offenders. This study aimed to determine the prevalence of psychiatric disorders among theft offenders remanded or referred for forensic assessment in 2010, compare the differences between first-time and repeat theft offenders, and identify the factors associated with reoffence. Forensic evaluations of inpatient and outpatient theft offenders that were conducted at IMH in the year 2010 were retrieved and reviewed. The sociodemographic and clinical data of first-time and repeat theft offenders were collected and compared using Student's t-test and chi-square test for continuous and categorical variables, respectively. Multivariate regression was used to identify the factors that were predictive of repeat offence. Overall, 10% of offenders had no mental illness. Substance use disorders, mood disorders and psychotic disorders were the most common diagnoses. Psychotic disorders were significantly less common in repeat offenders. Repeat offenders also tended to have a history of conduct problems in childhood. Noncompliance with psychiatric treatment was positively associated with repeat offence, while psychotic disorders were negatively associated. The pattern of psychiatric morbidity among theft offenders in Singapore has changed over the last ten years. Kleptomania remains rare. Significant differences between first-time and repeat offenders have implications on the treatment, follow-up and rehabilitation of theft offenders in Singapore.

Psychiatric Comorbidity and Physical Correlates in Alcohol-dependent Patients.

PubMed

Gauba, Deepak; Thomas, Pramod; Balhara, Yatan P S; Deshpande, Smita N

2016-01-01

To examine the prevalence and pattern of comorbidity in alcohol dependence and its relationship with physical and laboratory findings. Eighty males with alcohol dependence were examined using the Hindi version of Diagnostic Interview for Genetic Studies, the International Classification of Disease-10 th Edition Personality Disorder Examination, Alcohol Use Disorder Identification Test for alcohol use, global assessment of functioning, blood sampling electrocardiogram, and ultrasonogram. Eighty-seven percent had a comorbid Axis I or an Axis II psychiatric disorder, over 78% had nicotine dependence, and 56% had comorbid Axis II disorder, antisocial personality being the most common. Gamma glutamyl transpeptidase levels were significantly associated with comorbidity. High comorbidity of Axis I psychiatric disorders was found among persons with alcohol dependence. Axis II disorders were also present.

A good time to panic? Premorbid and postmorbid panic disorder in heart failure affects cardiac and psychiatric cause admissions.

PubMed

Tully, Phillip J

2015-04-01

The authors sought to identify characteristics associated with premorbid and postmorbid panic disorder onset in relation to heart failure (HF) onset, and examine the effect on unplanned hospital admissions. In a two-stage screening process, 404 HF patients admitted to three hospitals in South Australia were referred for structured psychiatric interview when any of the following four criteria were met: (a) Patient Health Questionnaire≥10; (b) Generalized Anxiety Disorder Questionnaire≥7); (c) positive response to one-item panic attack screener; (d) or evidence of suicidality. A total of 73 referred HF patients (age 60.6±13.4, 47.9% female) were classified into three groups: premorbid panic disorder (27.4%), postmorbid panic disorder (24.7%), and no panic disorder (47.9%). Postmorbid panic disorder was associated with more psychiatric admissions and longer hospital stay in the 6 months prior to the index psychiatric assessment, and also in the 6 months after the index psychiatric assessment (all p<.05 unadjusted). In sensitivity analysis, years since panic disorder onset were associated with longer cardiac length of stay (β=.34, p=.03). Panic disorder onset in relation to HF diagnosis was associated with discrete patterns of hospital admissions for cardiac and psychiatric causes. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Psychiatric Disorders and Personality Profiles of Middle-Aged Suicide Attempters with No Evidence of Specific Psychopathological Profiles Referred to an Emergency Department

PubMed Central

Brand, Serge; Nejat, Mehri; Haghighi, Mohammad; Rahimi, Alireza; Jahangard, Leila; Sadeghi Bahmani, Dena; Bajoghli, Hafez; Holsboer-Trachsler, Edith; Ahmadpanah, Mohammad

2017-01-01

Objective: The present study aimed at assessing the sociodemographic and psychiatric characteristics of 40 to 65 year- old suicide attempters, who were referred to an emergency department within 4 hours of the attempt. Method: A total of 93 suicide attempters (Mean age=46.59 years) who were referred to an emergency department, were assessed in this study. Patients completed questionnaires covering sociodemographic data, personality traits, mood, and impulsivity. Psychiatric status of the patients was rated by experts. Results: Experts rated 85 (92.4%) of the suicide attempters as having a psychiatric disorder. Based on self-ratings and compared to normative data, 42 (46.6%) patients were psychopathologically ill. It was found that suicide attempts were not related to impulsive personality traits, mood disorders, sociodemographic patterns, or gender (gender-ratio: 1:1.58; f: m). Conclusion: The pattern of results suggests that further unknown factors were involved in pushing people to attempt suicide. PMID:29472951

Psychiatric Disorders and Personality Profiles of Middle-Aged Suicide Attempters with No Evidence of Specific Psychopathological Profiles Referred to an Emergency Department.

PubMed

Brand, Serge; Nejat, Mehri; Haghighi, Mohammad; Rahimi, Alireza; Jahangard, Leila; Sadeghi Bahmani, Dena; Bajoghli, Hafez; Holsboer-Trachsler, Edith; Ahmadpanah, Mohammad

2017-10-01

Objective: The present study aimed at assessing the sociodemographic and psychiatric characteristics of 40 to 65 year- old suicide attempters, who were referred to an emergency department within 4 hours of the attempt. Method: A total of 93 suicide attempters (Mean age=46.59 years) who were referred to an emergency department, were assessed in this study. Patients completed questionnaires covering sociodemographic data, personality traits, mood, and impulsivity. Psychiatric status of the patients was rated by experts. Results: Experts rated 85 (92.4%) of the suicide attempters as having a psychiatric disorder. Based on self-ratings and compared to normative data, 42 (46.6%) patients were psychopathologically ill. It was found that suicide attempts were not related to impulsive personality traits, mood disorders, sociodemographic patterns, or gender (gender-ratio: 1:1.58; f: m). Conclusion: The pattern of results suggests that further unknown factors were involved in pushing people to attempt suicide.

Diagnostic profiles of adult psychiatric outpatients with and without attention deficit hyperactivity disorder.

PubMed

Gorlin, Eugenia I; Dalrymple, Kristy; Chelminski, Iwona; Zimmerman, Mark

2016-10-01

Despite growing recognition that attention deficit/hyperactivity disorder (ADHD) is a highly prevalent, impairing, and comorbid disorder that persists into adulthood, reports on the nature and extent of its psychiatric comorbidities have been mixed to date. This study compared the prevalence rates of all major Axis I disorders as well as borderline personality disorder in an unselected sample of adult psychiatric outpatients with and without ADHD. As part of the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we administered a DSM-IV-based semi-structured diagnostic interview assessing ADHD and other psychiatric disorders to 1134 patients presenting for initial evaluation at an outpatient psychiatric practice. Logistic regression analyses were used to compare the rates of each disorder in patients with versus without an ADHD diagnosis (both overall and by Combined and Inattentive type). Patients with (versus without) any ADHD diagnosis had significantly higher rates of bipolar disorder, social phobia, impulse control disorders, eating disorders, and BPD, and significantly lower rates of major depressive disorder and adjustment disorder (all p<.05). Patients with (versus without) ADHD-Inattentive type had significantly higher rates of social phobia and eating disorders, whereas those with (versus without) the ADHD-Combined type had significantly higher rates of bipolar disorder, alcohol dependence, and BPD (all p<.05). In this novel investigation of the psychiatric profiles of an unselected sample of treatment-seeking adult outpatients with versus without ADHD, a distinct pattern of comorbidities emerged across subtypes, with implications for the accurate assessment and treatment of patients presenting for psychiatric care. Copyright © 2016 Elsevier Inc. All rights reserved.

Course and outcome of somatoform disorders in non-referred adolescents.

PubMed

Essau, Cecilia A

2007-01-01

The author examined the course of somatoform disorders in non-referred adolescents. Somatoform disorders were coded from DSM-IV criteria, using the computerized Munich (Germany) version of the Composite International Diagnostic Interview. About 35.9% of the adolescents with somatoform disorders at the index investigation continued to have the same disorders at the follow-up investigation: 26.7% had anxiety, 17.1% had depression, 22% had substance-use disorders, and 53.7% had no psychiatric disorders. Factors related to the chronicity of somatoform disorders included gender, comorbid depressive disorders, parental psychiatric disorders, and negative life events. Somatoform disorders showed a heterogeneous pattern of course.

Characterizing psychiatric comorbidity in children with autism spectrum disorder receiving publicly funded mental health services.

PubMed

Brookman-Frazee, Lauren; Stadnick, Nicole; Chlebowski, Colby; Baker-Ericzén, Mary; Ganger, William

2017-09-01

Publicly funded mental health programs play a significant role in serving children with autism spectrum disorder. Understanding patterns of psychiatric comorbidity for this population within mental health settings is important to implement appropriately tailored interventions. This study (1) describes patterns of psychiatric comorbidity in children with autism spectrum disorder who present to mental health services with challenging behaviors and (2) identifies child characteristics associated with comorbid conditions. Data are drawn from baseline assessments from 201 children with autism spectrum disorder who participated in a community effectiveness trial across 29 publicly funded mental health programs. Non-autism spectrum disorder diagnoses were assessed using an adapted Mini-International Neuropsychiatric Interview, parent version. Approximately 92% of children met criteria for at least one non-autism spectrum disorder diagnosis (78% attention deficit hyperactivity disorder, 58% oppositional defiant disorder, 56% anxiety, 30% mood). Logistic regression indicated that child gender and clinical characteristics were differentially associated with meeting criteria for attention deficit hyperactivity disorder, oppositional defiant disorder, an anxiety, or a mood disorder. Exploratory analyses supported a link between challenging behaviors and mood disorder symptoms and revealed high prevalence of these symptoms in this autism spectrum disorder population. Findings provide direction for tailoring intervention to address a broad range of clinical issues for youth with autism spectrum disorder served in mental health settings.

The Relationship of Hypochondriasis to Anxiety, Depressive, and Somatoform Disorders

PubMed Central

Scarella, Timothy M.; Laferton, Johannes A. C.; Ahern, David K.; Fallon, Brian A.; Barsky, Arthur

2015-01-01

Background Though the phenotype of anxiety about medical illness has long been recognized, there continues to be debate as to whether it is a distinct psychiatric disorder and, if so, to which diagnostic category it belongs. Our objective was to investigate the pattern of psychiatric co-morbidity in hypochondriasis and to assess the relationship of health anxiety to anxiety, depressive, and somatoform disorders. Methods Data were collected as part of a clinical trial on treatment methods for hypochondriasis. 194 participants meeting criteria for DSM-IV hypochondriasis were assessed by sociodemographic variables, results of structured diagnostic interviews, and validated instruments for assessing various symptom dimensions of psychopathology. Results The majority of individuals with hypochondriasis had co-morbid psychiatric illness; the mean number of co-morbid diagnoses was 1.4, and 35.1% had hypochondriasis as their only diagnosis. Participants were more likely to have only co-morbid anxiety disorders than only co-morbid depressive or somatoform disorders. Multiple regression analysis of continuous measures of symptoms revealed the strongest correlation of health anxiety with anxiety symptoms, and a weaker correlation with somatoform symptoms; in multiple regression analysis, there was no correlation between health anxiety and depressive symptoms. Conclusion Our findings suggest that the entity of health anxiety (Hypochondriasis in DSM-IV, Illness Anxiety Disorder in DSM-5) is a clinical syndrome distinct from other psychiatric disorders. Analysis of co-morbidity patterns and continuous measures of symptoms suggest its appropriate classification is with anxiety rather than somatoform or mood disorders. PMID:26785798

Psychiatric disorders in preschoolers: the structure of DSM-IV symptoms and profiles of comorbidity.

PubMed

Wichstrøm, Lars; Berg-Nielsen, Turid Suzanne

2014-07-01

Psychiatric disorders have been increasingly recognized in preschool children; at present, however, we know comparatively less about how well current diagnostic manuals capture the symptoms described in this age group and how comorbidity is patterned. Therefore, this study aimed to investigate whether the symptoms defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) load on their respective disorders, examine whether individual symptoms exist that load particularly high or low on the disorder they allegedly define, and analyze how comorbidity clusters in individual children. Parents of a community sample of Norwegian 4-year-olds (N = 995) were interviewed using the Preschool Age Psychiatric Assessment. A confirmatory factor analysis (CFA) and a latent profile analysis (LPA) were performed on the symptoms of seven DSM disorders: attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder, conduct disorder, major depressive disorder (MDD), generalized anxiety disorder (GAD), social phobia, and separation anxiety disorder. The results showed that the CFA solution that closely resembled the disorders delineated in the DSM-IV fitted the data best. However, vegetative symptoms did not define preschool depression. The LPA identified nine symptom profiles among preschoolers, of which four showed evidence of psychopathology: comorbid MDD/GAD ? ADHD combined type, comorbid MDD/GAD ? ADHD hyperactive/impulsive type, separation anxiety only, and social phobia only. In conclusion, the symptoms observed in preschoolers fit the DSM-IV well, and comorbidity followed specific patterns.

Patterns of Performance on the Stroop Color and Word Test in Children with Learning, Attentional, and Psychiatric Disabilities.

ERIC Educational Resources Information Center

Golden, Zarabeth L.; Golden, Charles J.

2002-01-01

Investigates the performance of children with learning, psychiatric, and attentional disabilities on the Stroop Color and Word Test. Results indicated clear differences between groups, with the learning disabled (LD) and the psychiatric/attention deficit/hyperactivity disorder (ADHD) groups generating unique profiles. Children with LD showed…

Schizophrenia, depression, and sleep disorders: their traditional Oriental medicine equivalents.

PubMed

Bosch, Peggy; de Rover, Peter; Staudte, Heike; Lim, Sabina; van den Noort, Maurits

2015-02-01

Psychiatric disorders can be described and treated from both a Western (allopathic) and an Eastern perspective, which should be taken into account when conducting research. Patients with schizophrenia or depression are likely to be undergoing Western treatment when they are referred to an acupuncturist for (add-on) treatment, and knowledge of both types of treatments is necessary to integrate them successfully. In this study, the different Traditional Oriental Medicine (TOM) diagnostic patterns in patients with a Western diagnosis of schizophrenia, depression, or sleep disorders are described from a literature and a clinical perspective. The data on 30 depression and 30 schizophrenia patients from a German study are presented. Our results show that if a psychiatric group, sorted in accordance to Western diagnostic principles, is diagnosed on the basis of TOM diagnostic patterns, it can be categorized into different groups of patients with psychiatric disorders; this finding has far-reaching consequences in scientific research on acupuncture. Moreover, we found a high prevalence of sleep disorders in patients with both schizophrenia and depression, which could be explained from the perspective of a TOM diagnostic pattern. Finally, we discuss sleep quality as a treatment objective that may play a crucial role in mediating acupuncture-induced treatment effects in patients with schizophrenia and depression. Copyright © 2015. Published by Elsevier B.V.

Lifetime risk and persistence of psychiatric disorders across ethnic groups in the United States

PubMed Central

BRESLAU, JOSHUA; KENDLER, KENNETH S.; SU, MAXWELL; GAXIOLA-AGUILAR, SERGIO; KESSLER, RONALD C.

2009-01-01

Background Recent research in the United States has demonstrated striking health disparities across ethnic groups. Despite a longstanding interest in ethnic disadvantage in psychiatric epidemiology, patterns of psychiatric morbidity across ethnic groups have never been examined in a nationally representative sample. Method Ethnic differences in psychiatric morbidity are analyzed using data from the National Comorbidity Survey (NCS). The three largest ethnic groups in the United States – Hispanics, Non-Hispanic Blacks and Non-Hispanic Whites – were compared with respect to lifetime risk and persistence of three categories of psychiatric disorder: mood disorder, anxiety disorder, and substance use disorder. Results Where differences across ethnic groups were found in lifetime risk, socially disadvantaged groups had lower risk. Relative to Non-Hispanic Whites, Hispanics had lower lifetime risk of substance use disorder and Non-Hispanic Blacks had lower lifetime risk of mood, anxiety and substance use disorders. Where differences were found in persistence of disorders, disadvantaged groups had higher risk. Hispanics with mood disorders were more likely to be persistently ill as were Non-Hispanic Blacks with respect to both mood disorders and anxiety disorders. Closer examination found these differences to be generally consistent across population subgroups. Conclusions Members of disadvantaged ethnic groups in the United States do not have an increased risk for psychiatric disorders. Members of these groups, however, do tend to have more persistent disorders. Future research should focus on explanations for these findings, including the possibility that these comparisons are biased, and on potential means of reducing the disparity in persistence of disorders across ethnic groups. PMID:15841868

Dissociative disorders in a psychiatric institute in India--a selected review and patterns over a decade.

PubMed

Chaturvedi, Santosh K; Desai, Geetha; Shaligram, Deepika

2010-09-01

The prevalence--and type--of dissociative disorders is considered to vary across cultures and over time. The aim of the study was to examine patterns of dissociative disorders among subjects attending psychiatric services over a period of 10 years. The sample consisted of both inpatients and outpatients attending a psychiatric hospital between 1999 and 2008. Information of those subjects diagnosed to have dissociative disorders was reviewed. A semi-structured proforma was used to collect information about demographic details and diagnosis. A total of 893 patients had been diagnosed with dissociative disorder over the past decade: 591 (66%) were outpatients and 302 (34%) were inpatients. The proportion of patients diagnosed with dissociative disorders ranged between 1.5 and 15.0 per 1,000 for outpatients and between 1.5 and 11.6 per 1,000 for inpatients. The majority of patients were diagnosed with dissociative motor disorder (43.3% outpatients, 37.7% inpatients), followed by dissociative convulsions (23% outpatients, 27.8% inpatients). Female preponderance was seen across all sub-types of dissociative disorder except dissociative fugue. Dissociative disorders are still commonly diagnosed in both inpatient and outpatient settings. Dissociative motor disorders and dissociative convulsions are the most common disorders. Unlike in the West, dissociative identity disorders were rarely diagnosed; instead, possession states were commonly seen in the Indian population, indicating cross-cultural disparity.

Preschoolers’ Observed Temperament and Psychiatric Disorders Assessed with a Parent Diagnostic Interview

PubMed Central

Dougherty, Lea R.; Bufferd, Sara J.; Carlson, Gabrielle A.; Dyson, Margaret; Olino, Thomas M.; Durbin, C. Emily; Klein, Daniel N.

2011-01-01

Evidence supports the role of temperament in the origins of psychiatric disorders. However, there are few data on associations between temperament and psychiatric disorders in early childhood. A community sample of 541 three-year old preschoolers participated in a laboratory temperament assessment, and caregivers were administered a structured diagnostic interview on preschool psychopathology. In bivariate analyses, temperamental dysphoria and low exuberance were associated with depression; fear, low exuberance, and low sociability were associated with anxiety disorders; and disinhibition and dysphoria were associated with oppositional defiant disorder. Although there were no bivariate associations between temperament and attention-deficit/hyperactivity disorder, disinhibition emerged as a unique predictor in multivariate analyses. Findings indicate that the pattern of relations between temperament and psychopathology in older youth and adults is evident as early as age 3. PMID:21391025

The Relationship of Hypochondriasis to Anxiety, Depressive, and Somatoform Disorders.

PubMed

Scarella, Timothy M; Laferton, Johannes A C; Ahern, David K; Fallon, Brian A; Barsky, Arthur

2016-01-01

Though the phenotype of anxiety about medical illness has long been recognized, there continues to be debate as to whether it is a distinct psychiatric disorder and, if so, to which diagnostic category it belongs. Our objective was to investigate the pattern of psychiatric comorbidity in hypochondriasis (HC) and to assess the relationship of health anxiety to anxiety, depressive, and somatoform disorders. Data were collected as part of a clinical trial on treatment methods for HC. In all, 194 participants meeting criteria for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) HC were assessed by sociodemographic variables, results of structured diagnostic interviews, and validated instruments for assessing various symptom dimensions of psychopathology. Most of the individuals with HC had comorbid psychiatric illness; the mean number of comorbid diagnoses was 1.4, and 35.1% had HC as their only diagnosis. Participants were more likely to have only comorbid anxiety disorders than only comorbid depressive or somatoform disorders. Multiple regression analysis of continuous measures of symptoms revealed the strongest correlation of health anxiety with anxiety symptoms, and a weaker correlation with somatoform symptoms; in multiple regression analysis, there was no correlation between health anxiety and depressive symptoms. Our findings suggest that the entity of health anxiety (HC in DSM-IV and illness anxiety disorder in DSM-5) is a clinical syndrome distinct from other psychiatric disorders. Analysis of comorbidity patterns and continuous measures of symptoms suggest that its appropriate classification is with anxiety rather than somatoform or mood disorders. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

The Association between Mental Health and Violence among a Nationally Representative Sample of College Students from the United States.

PubMed

Schwartz, Joseph A; Beaver, Kevin M; Barnes, J C

2015-01-01

Recent violent attacks on college campuses in the United States have sparked discussions regarding the prevalence of psychiatric disorders and the perpetration of violence among college students. While previous studies have examined the potential association between mental health problems and violent behavior, the overall pattern of findings flowing from this literature remain mixed and no previous studies have examined such associations among college students. The current study makes use of a nationally representative sample of 3,929 college students from the National Epidemiologic Study on Alcohol and Related Conditions (NESARC) to examine the prevalence of seven violent behaviors and 19 psychiatric disorder diagnoses tapping mood, anxiety, personality, and substance use disorders. Associations between individual and composite psychiatric disorder diagnoses and violent behaviors were also examined. Additional analyses were adjusted for the comorbidity of multiple psychiatric diagnoses. The results revealed that college students were less likely to have engaged in violent behavior relative to the non-student sample, but a substantial portion of college students had engaged in violent behavior. Age- and sex-standardized prevalence rates indicated that more than 21% of college students reported at least one violent act. In addition, more than 36% of college students had at least one diagnosable psychiatric disorder. Finally, the prevalence of one or more psychiatric disorders significantly increased the odds of violent behavior within the college student sample. These findings indicate that violence and psychiatric disorders are prevalent on college campuses in the United States, though perhaps less so than in the general population. In addition, college students who have diagnosable psychiatric disorders are significantly more likely to engage in various forms of violent behavior.

The Association between Mental Health and Violence among a Nationally Representative Sample of College Students from the United States

PubMed Central

Schwartz, Joseph A.; Beaver, Kevin M.; Barnes, J. C.

2015-01-01

Objectives Recent violent attacks on college campuses in the United States have sparked discussions regarding the prevalence of psychiatric disorders and the perpetration of violence among college students. While previous studies have examined the potential association between mental health problems and violent behavior, the overall pattern of findings flowing from this literature remain mixed and no previous studies have examined such associations among college students. Methods The current study makes use of a nationally representative sample of 3,929 college students from the National Epidemiologic Study on Alcohol and Related Conditions (NESARC) to examine the prevalence of seven violent behaviors and 19 psychiatric disorder diagnoses tapping mood, anxiety, personality, and substance use disorders. Associations between individual and composite psychiatric disorder diagnoses and violent behaviors were also examined. Additional analyses were adjusted for the comorbidity of multiple psychiatric diagnoses. Results The results revealed that college students were less likely to have engaged in violent behavior relative to the non-student sample, but a substantial portion of college students had engaged in violent behavior. Age- and sex-standardized prevalence rates indicated that more than 21% of college students reported at least one violent act. In addition, more than 36% of college students had at least one diagnosable psychiatric disorder. Finally, the prevalence of one or more psychiatric disorders significantly increased the odds of violent behavior within the college student sample. Conclusions These findings indicate that violence and psychiatric disorders are prevalent on college campuses in the United States, though perhaps less so than in the general population. In addition, college students who have diagnosable psychiatric disorders are significantly more likely to engage in various forms of violent behavior. PMID:26445360

Associations Between Early-Adolescent Substance Use and Subsequent Young-Adult Substance Use Disorders and Psychiatric Disorders Among a Multiethnic Male Sample in South Florida

PubMed Central

Gil, Andres G.; Wagner, Eric F.; Tubman, Jonathan G.

2004-01-01

Objectives. We examined the associations among early-adolescent substance use, subsequent young-adult substance use disorders, and psychiatric disorders among a community sample of males. Methods. Early-adolescent data were collected in classroom surveys (1990–1993), and young-adult data were collected in face-to-face interviews (1998–2000). Results. We found strong associations between early-adolescent substance use and young-adult substance use disorders and psychiatric disorders. The magnitudes of these associations varied by racial/ethnic group and were strongest among African Americans and foreign-born Hispanics, who reported the lowest early-adolescent substance use. Conclusions. Early-adolescent substance use is most strongly associated with a later pattern of dysfunction among the racial/ethnic groups that reported the lowest levels of early use. The implications of our findings in the context of primary and secondary prevention are discussed. PMID:15333322

Same-sex sexuality and psychiatric disorders in the second Netherlands Mental Health Survey and Incidence Study (NEMESIS-2).

PubMed

Sandfort, Theo G M; de Graaf, Ron; Ten Have, Margreet; Ransome, Yusuf; Schnabel, Paul

2014-12-01

Sexual orientation has been shown to be a risk factor for psychiatric disorders. This study compared whether sexual orientation-related disparities in the prevalence of psychiatric disorders are similar based on homosexual behavior versus attraction and tested whether, with increased acceptance of homosexuality, these disparities have diminished over time. The Composite International Diagnostic Interview 3.0 was administered with a total of 6,646 Dutch persons, aged 18 to 64 years. Between 2.0% and 2.5% of the participants reported same-sex sexual behavior in the preceding year or same-sex attraction. Homosexually active persons and persons with same-sex attraction reported a higher prevalence of disorders than heterosexual persons. There were more disparities in the prevalence of disorders based on sexual attraction than based on sexual behavior. Comparing these results with a previous study, showed that no significant changes over time have occurred in the pattern of health disparities. Sexual orientation continues to be a risk factor for psychiatric disorders, stressing the need for understanding the origins of these disparities.

High psychiatric comorbidity in adolescents with dissociative disorders.

PubMed

Bozkurt, Hasan; Duzman Mutluer, Tuba; Kose, Cigdem; Zoroglu, Salih

2015-06-01

The aim of this study was to evaluate psychiatric comorbidity rates and patterns in a sample of clinically referred adolescents diagnosed with dissociative disorders (DD) by using a structured interview. All participants completed a comprehensive test battery, which consisted of a questionnaire for sociodemographic data and clinical history, Child Posttraumatic Stress Reaction Index, Childhood Abuse and Neglect Questionnaire and the Adolescent Dissociative Experiences Scale. Diagnosis was made by the Structured Clinical Interview for DSM-IV Dissociative Disorders. Psychiatric comorbidity was assessed using the Schedule for Affective Disorders and Schizophrenia for School Age Children - Present and Lifetime Version. A total of 25 adolescent subjects aged 12-18 years participated in the study. Ten adolescents were diagnosed as having dissociative identity disorder and 15 of them were diagnosed as having dissociative disorder-not otherwise specified based on the Structured Clinical Interview for DSM-IV Dissociative Disorders findings. Adolescents with dissociative identity disorder were found to have higher scores on the Adolescent Dissociative Experiences Scale and Child Posttraumatic Stress Reaction Index than the dissociative disorder-not otherwise specified group. Sexual and physical abuses were also found to be among the main traumatic events. Incest was reported in six cases of the study sample. All subjects had at least one comorbid psychiatric disorder. The most common psychiatric diagnoses were major depressive disorder (n = 25; 100%) and post-traumatic stress disorder (n = 22; 88%). High psychiatric comorbidity rates were found in adolescents diagnosed with DD. A prevalent history of abuse and traumatic events was represented. Clinicians should be aware of the impacts of DD on adolescents' mental health. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

Euthanasia requests, procedures and outcomes for 100 Belgian patients suffering from psychiatric disorders: a retrospective, descriptive study

PubMed Central

Thienpont, Lieve; Verhofstadt, Monica; Van Loon, Tony; Distelmans, Wim; Audenaert, Kurt; De Deyn, Peter P

2015-01-01

Objectives To identify patterns in euthanasia requests and practices relating to psychiatric patients; to generate recommendations for future research. Design Retrospective analysis of data obtained through medical file review. Setting Outpatient psychiatric clinical setting in the Dutch-speaking region of Belgium, between October 2007 and December 2011; follow-up at the end of December 2012. Participants 100 consecutive psychiatric patients requesting euthanasia based on psychological suffering associated with psychiatric disorders (77 women, 23 men; mean age 47 years; age range 21–80 years). Main outcome measures Patient sociodemographic characteristics; diagnoses; decisions on euthanasia requests; circumstances of euthanasia procedures; patient outcomes at follow-up. Results Most patients had been referred for psychiatric counselling by their physician (n=55) or by LEIF (Life End Information Forum) (n=36). 90 patients had >1 disorder; the most frequent diagnoses were depression (n=58) and personality disorder (n=50). 38 patients required further testing and/or treatment, including 13 specifically tested for autism spectrum disorder (ASD); 12 received an ASD diagnosis (all Asperger syndrome). In total, 48 of the euthanasia requests were accepted and 35 were carried out. Of the 13 remaining patients whose requests were accepted, 8 postponed or cancelled the procedure, because simply having this option gave them enough peace of mind to continue living. In December 2012, 43 patients had died, including 35 by euthanasia; others died by suicide (6), palliative sedation (1) and anorexia nervosa (1). Conclusions Depression and personality disorders are the most common diagnoses in psychiatric patients requesting euthanasia, with Asperger syndrome representing a neglected disease burden. Further research is needed, especially prospective quantitative and qualitative studies, to obtain a better understanding of patients with psychiatric disorders who request euthanasia due to unbearable psychological suffering. PMID:26216150

Reading problems and major mental disorders - co-occurrences and familial overlaps in a Swedish nationwide cohort.

PubMed

Cederlöf, Martin; Maughan, Barbara; Larsson, Henrik; D'Onofrio, Brian M; Plomin, Robert

2017-08-01

Reading problems often co-occur with ADHD and conduct disorder. However, the patterns of co-occurrence and familial overlap between reading problems and other psychiatric disorders have not been systematically explored. We conducted a register-based cohort study including 8719 individuals with reading problems and their siblings, along with matched comparison individuals. Conditional logistic regressions estimated risks for ADHD, autism, obsessive-compulsive disorder, anorexia nervosa, schizophrenia, bipolar disorder, depression, substance use disorder, and violent/non-violent criminality in individuals with reading problems and their siblings. Diagnoses of psychiatric disorders were physician-assigned and ascertained from the Swedish National Patient Register, and crime convictions from the Swedish National Crime Register. We found that individuals with reading problems had excess risks for all psychiatric disorders (except anorexia nervosa) and criminality, with risk ratios between 1.34 and 4.91. Siblings of individuals with reading problems showed excess risks for ADHD, autism, schizophrenia, bipolar disorder, depression, substance use disorder, and non-violent criminality, with risk ratios between 1.14 and 1.70. In summary, individuals with reading problems had increased risks of virtually all psychiatric disorders, and criminality. The origin of most of these overlaps was familial, in that siblings of individuals with reading problems also had elevated risks of ADHD, autism, schizophrenia, bipolar disorder, depression, substance use disorder, and non-violent criminality. These findings have implications for gene-searching efforts, and suggest that health care practitioners should be alert for signs of psychiatric disorders in families where reading problems exist. Copyright © 2017 Elsevier Ltd. All rights reserved.

A multiple-risk interaction model: effects of temperament and divorce on psychiatric disorders in children.

PubMed

Kasen, S; Cohen, P; Brook, J S; Hartmark, C

1996-04-01

Effects of family status on the trajectory of problematic temperament-adjustment at 1 and 10 years of age and associated psychiatric disturbance 8 years later were examined in an epidemiological sample of 648 children. After adjusting for predivorce temperament-adjustment and background factors, logistic regression yielded independent effects of single custodial mother (SCM) family status for increased risk of disruptive and anxiety disorders, and of stepfamily status for increased risk of disruptive disorders. Increased risk of psychiatric disorders was more pervasive for SCM family boys versus intact family boys than for SCM family girls versus intact family girls, however only significantly more so for depression. No significant sex interaction was observed for stepfamily status. When girls and boys were treated independently, patterns of family status and outcomes of internalizing disorders varied. In stepfamilies, an elevated risk of depression and anxiety disorders was observed in girls but not boys, whereas in SCM families an elevated risk of depression was observed in boys but not girls. Within each family status group there was support for an altered risk of later psychiatric disorders given specific problematic predivorce temperament-adjustment characteristics. Implications for future research and treatment are discussed.

Psychiatric manifestations of 22q11.2 deletion syndrome: a literature review.

PubMed

Bertrán, M; Tagle, F P; Irarrázaval, M

2018-03-01

The 22q11.2 deletion syndrome is a genetic disorder with variable clinical manifestations. It affects one out of 5950 neonates and has an autosomal dominant inheritance pattern. The aim of this article is to review its psychiatric manifestations and any underlying genetic alterations. We reviewed the scientific literature available as of October 2014 in the LILACS and Medline databases. Sixty per cent of these patients fulfilled diagnostic criteria for a mental disorder at some point in their lives, referring to psychotic disorders, attention deficit hyperactivity disorder, mood disorders, anxiety disorders, and autism spectrum disorders. Specific genes, such as COMT and PRODH, have been linked to these psychiatric manifestations. It is necessary to raise awareness among all health care professionals so that they understand the relevance of these manifestations, are able to anticipate them, and can provide appropriate information to patients and family members. Copyright © 2015 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Depression in Child Psychiatric Inpatients: Cognitive and Attributional Patterns.

ERIC Educational Resources Information Center

Asarnow, Joan Rosenbaum; Bates, Susan

1988-01-01

In a study of 53 psychiatric inpatients (ages 6-13), depressed children reported significantly more hopelessness, more negative self-perceptions, negative self-perceptions across a wider variety of domains, and more dysfunctional attributional styles than nondepressed controls. Additional results suggested that childhood depressive disorders may…

The Relationship between Child Abuse and Negative Outcomes among Substance Users: Psychopathology, Health, and Comorbidities

PubMed Central

Banducci, Anne N.; Hoffman, Elana; Lejuez, C.W.; Koenen, Karestan C.

2014-01-01

Background Adults with substance use disorders (SUDs) report higher rates of child abuse than adults without SUDs. Prior work suggests this abuse is associated with higher rates of psychosis, posttraumatic stress disorder, physical health problems, alcohol dependence, and cannabis dependence among substance users. Little is known about other problems associated with child abuse experienced by substance users. We hypothesized among adults with SUDs, child abuse would be associated with elevated rates of all Diagnostic and Statistical Manual (DSM-IV-TR) psychiatric disorders, substance dependencies, and comorbidities assessed. Method We assessed 280 inpatients in substance use treatment with the Structured Clinical Interview for the DSM-IV-TR, the Diagnostic Instrument for Personality Disorders, and Childhood Trauma Questionnaire (CTQ). We used chi-square and regression analyses to establish whether rates of psychiatric disorders, substance dependencies, and comorbidities differed as a function of child abuse. Results Consistent with our hypotheses, higher scores on the CTQ were associated with elevated rates of psychiatric disorders (mood disorders, anxiety disorders, psychotic symptoms, and personality disorders) and substance dependencies (alcohol dependence and cocaine dependence). Moreover, higher rates of all comorbidity patterns (e.g. comorbid alcohol dependence and anxiety) were observed among individuals who reported experiencing child abuse. Across all substance dependencies examined, individuals who had been abused had significantly higher rates of all psychiatric disorders assessed. Conclusions Individuals with substance use disorders who have been abused have particularly elevated rates of psychiatric and substance use disorders as a function of their abuse experiences. These findings have important treatment implications for individuals in residential substance use treatment settings. PMID:24976457

Psychiatric diagnosis - is it universal or relative to culture?

PubMed

Canino, Glorisa; Alegría, Margarita

2008-03-01

There is little consensus on the extent to which psychiatric disorders or syndromes are universal or the extent to which they differ on their core definitions and constellation of symptoms as a result of cultural or contextual factors. This controversy continues due to the lack of biological markers, imprecise measurement and the lack of a gold standard for validating most psychiatric conditions. Empirical studies were used to present evidence in favor of or against a universalist or relativistic view of child psychiatric disorders using a model developed by Robins and Guze to determine the validity of psychiatric disorders. The prevalence of some of the most common specific disorders and syndromes as well as its risk and protective factors vary across cultures, yet comorbid patterns and response to treatments vary little across cultures. Cross-cultural longitudinal data on outcomes is equivocal. The cross-cultural validity of child disorders may vary drastically depending on the disorder, but empirical evidence that attests for the cross-cultural validity of diagnostic criteria for each child disorder is lacking. There is a need for studies that investigate the extent to which gene-environment interactions are related to specific disorders across cultures. Clinicians are urged to consider culture and context in determining the way in which children's psychopathology may be manifested independent of their views. Recommendations for the upcoming classificatory system are provided so that practical or theoretical considerations are addressed about how culture and ethnic issues affect the assessment or treatment of specific disorders in children.

Saccadic eye movement applications for psychiatric disorders

PubMed Central

Bittencourt, Juliana; Velasques, Bruna; Teixeira, Silmar; Basile, Luis F; Salles, José Inácio; Nardi, Antonio Egídio; Budde, Henning; Cagy, Mauricio; Piedade, Roberto; Ribeiro, Pedro

2013-01-01

Objective The study presented here analyzed the patterns of relationship between oculomotor performance and psychopathology, focusing on depression, bipolar disorder, schizophrenia, attention-deficit hyperactivity disorder, and anxiety disorder. Methods Scientific articles published from 1967 to 2013 in the PubMed/Medline, ISI Web of Knowledge, Cochrane, and SciELO databases were reviewed. Results Saccadic eye movement appears to be heavily involved in psychiatric diseases covered in this review via a direct mechanism. The changes seen in the execution of eye movement tasks in patients with psychopathologies of various studies confirm that eye movement is associated with the cognitive and motor system. Conclusion Saccadic eye movement changes appear to be heavily involved in the psychiatric disorders covered in this review and may be considered a possible marker of some disorders. The few existing studies that approach the topic demonstrate a need to improve the experimental paradigms, as well as the methods of analysis. Most of them report behavioral variables (latency/reaction time), though electrophysiological measures are absent. PMID:24072973

Psychiatric disorders in cases of completed suicide in a hospital area in Spain between 2007 and 2010.

PubMed

Gómez-Durán, Esperanza L; Forti-Buratti, M Azul; Gutiérrez-López, Beatriz; Belmonte-Ibáñez, Anna; Martin-Fumadó, Carles

2016-01-01

Suicide is an important Public Health problem. One of the most relevant known risk factors for suicide is suffering from a mental health disorder, identified in up to 90-95% of completed suicides, with this risk being increased if comorbidity is present. Findings from international research on the most common psychiatric disorders are dichotomous, divided into mood disorders and psychotic disorders. In Spain, data of this kind are scarce. This study describes the psychiatric and forensic characteristics of completed suicide cases (n=79) ocurred in a psychiatric hospital healthcare area (in Spain), between 2007 and 2010. The forensic data were obtained from the Institute of Legal Medicine of Catalonia and the clinical data by reviewing the clinical records. Most of the subjects in this sample were males (78.5%, 95% CI; 68.4%-87.3%). Almost half of the sample (45.4%, 95% CI; 33.8%-57.1%, 35/77) had records in the Mental Health Services Network (including substance misuse services). Two of the 79 were under 18, so we were not able to access the records. More than half (54.3%, 95% CI; 37.1%-71.4%) of those with psychiatric history suffered from a mood disorder; 37.1% (95% CI; 22.9%-51.4% from a depressive disorder; 14.3% (95% CI; 2.9%-25.7%) from a bipolar disorder, and 17.1% (95% CI; 5.7%-31.4%) suffered from a psychotic disorder. With regard to substance misuse, 42.9% (95% CI; 25.7%-60.0%) presented substance misuse, and 48.6% did not. Psychiatric and forensic characteristics of completed suicide in this Spanish sample confirm previous findings from international studies: there is a high rate of psychiatric disorders in those who complete suicide, and there is a specific pattern as regards the method used to complete it. Copyright © 2013 SEP y SEPB. Published by Elsevier España. All rights reserved.

Cross-Cultural Studies of Personality Traits and their Relevance to Psychiatry

PubMed Central

Terracciano, Antonio; McCrae, Robert R.

2009-01-01

Aims This article provides a brief review of recent cross-cultural research on personality traits at both individual and culture levels, highlighting the relevance of recent findings for psychiatry. Method In most cultures around the world, personality traits can be clearly summarized by the five broad dimensions of the Five-Factor Model (FFM), which makes it feasible to compare cultures on personality and psychopathology. Results Maturational patterns and sex differences in personality traits generally show cultural invariance, which generates the hypothesis that age of onset, clinical evolution, and sex differences in the prevalence of psychiatric disorders might follow similar universal patterns. The average personality profiles from 51 cultures show meaningful geographical distributions and associations with culture-level variables, but are clearly unrelated to national character stereotypes. Conclusions Aggregate personality scores can potentially be related to epidemiological data on psychiatric disorders, and dimensional personality models have implications for psychiatric diagnosis and treatment around the world. PMID:17128620

Anorexia nervosa in males: excess mortality and psychiatric co-morbidity in 609 Swedish in-patients.

PubMed

Kask, J; Ramklint, M; Kolia, N; Panagiotakos, D; Ekbom, A; Ekselius, L; Papadopoulos, F C

2017-06-01

Anorexia nervosa (AN) is a psychiatric disorder with high mortality. A retrospective register study of 609 males who received hospitalized care for AN in Sweden between 1973 and 2010 was performed. The standardized mortality ratios (SMRs) and Cox regression-derived hazard ratios (HRs) were calculated as measures of mortality. The incidence rate ratios (IRRs) were calculated to compare the mortality rates in patients with AN and controls both with and without psychiatric diagnoses. The SMR for all causes of death was 4.1 [95% confidence interval (CI) 3.1-5.3]. For those patients with psychiatric co-morbidities, the SMR for all causes of death was 9.1 (95% CI 6.6-12.2), and for those without psychiatric co-morbidity, the SMR was 1.6 (95% CI 0.9-2.7). For the group of patients with alcohol use disorder, the SMR for natural causes of death was 11.5 (95% CI 5.0-22.7), and that for unnatural causes was 35.5 (95% CI 17.7-63.5). The HRs confirmed the increased mortality for AN patients with psychiatric co-morbidities, even after adjusting for confounders. The IRRs revealed no significant difference in mortality patterns between the AN patients with psychiatric co-morbidity and the controls with psychiatric diagnoses, with the exceptions of alcohol use disorder and neurotic, stress-related and somatoform disorders, which seemed to confer a negative synergistic effect on mortality. Mortality in male AN patients was significantly elevated compared with the general population among only the patients with psychiatric co-morbidities. Specifically, the presence of alcohol and other substance use disorders was associated with more profound excess mortality.

Attention Deficit Hyperactivity Disorder in Childhood: Healthcare Use in a Danish Birth Cohort during the First 12 Years of Life.

PubMed

Laugesen, Britt; Mohr-Jensen, Christina; Boldsen, Søren Kjærgaard; Jørgensen, Rikke; Sørensen, Erik Elgaard; Grønkjær, Mette; Rasmussen, Philippa; Lauritsen, Marlene Briciet

2018-06-01

To compare the mean number of medical and psychiatric hospital-based services in children with and without attention deficit hyperactivity disorder (ADHD) and to assess the effect of ADHD on hospital-based service use, including child-, parental-, and socioeconomic-related risk factors. A Danish birth cohort was followed through 12 years, and children with ADHD were identified using Danish nationwide registries. Poisson regression analyses were used to assess the association of ADHD with service use and to adjust for a comprehensive set of explanatory variables. Children diagnosed with ADHD used more medical and psychiatric hospital-based healthcare than those without ADHD. In children with ADHD, intellectual disability and parental psychiatric disorder were associated with increased medical and psychiatric service use. Low birth weight and low gestational age were associated with increased medical service use. Psychiatric comorbidity and having a divorced or single parent were associated with increased psychiatric service use. ADHD independently affected medical and psychiatric hospital-based service use even when adjusting for a comprehensive set of explanatory variables. However, the pattern of medical and psychiatric hospital-based service use is complex and cannot exclusively be explained by the child-, parental-, and socioeconomic-related variables examined in this study. Copyright © 2018 Elsevier Inc. All rights reserved.

Substance use disorders and comorbid Axis I and II psychiatric disorders among young psychiatric patients: findings from a large electronic health records database.

PubMed

Wu, Li-Tzy; Gersing, Ken; Burchett, Bruce; Woody, George E; Blazer, Dan G

2011-11-01

This study examined the prevalence of substance use disorders (SUDs) among psychiatric patients aged 2-17 years in an electronic health records database (N=11,457) and determined patterns of comorbid diagnoses among patients with a SUD to inform emerging comparative effectiveness research (CER) efforts. DSM-IV diagnoses of all inpatients and outpatients at a large university-based hospital and its associated psychiatric clinics were systematically captured between 2000 and 2010: SUD, anxiety (AD), mood (MD), conduct (CD), attention deficit/hyperactivity (ADHD), personality (PD), adjustment, eating, impulse-control, psychotic, learning, mental retardation, and relational disorders. The prevalence of SUD in the 2-12-year age group (n=6210) was 1.6% and increased to 25% in the 13-17-year age group (n=5247). Cannabis diagnosis was the most prevalent SUD, accounting for more than 80% of all SUD cases. Among patients with a SUD (n=1423), children aged 2-12 years (95%) and females (75-100%) showed high rates of comorbidities; blacks were more likely than whites to be diagnosed with CD, impulse-control, and psychotic diagnoses, while whites had elevated odds of having AD, ADHD, MD, PD, relational, and eating diagnoses. Patients with a SUD used more inpatient treatment than patients without a SUD (43% vs. 21%); children, females, and blacks had elevated odds of inpatient psychiatric treatment. Collectively, results add clinical evidence on treatment needs and diagnostic patterns for understudied diagnoses. Copyright © 2011 Elsevier Ltd. All rights reserved.

Refinements in the hierarchical structure of externalizing psychiatric disorders: Patterns of lifetime liability from mid-adolescence through early adulthood.

PubMed

Farmer, Richard F; Seeley, John R; Kosty, Derek B; Lewinsohn, Peter M

2009-11-01

Research on hierarchical modeling of psychopathology has frequently identified 2 higher order latent factors, internalizing and externalizing. When based on the comorbidity of psychiatric diagnoses, the externalizing domain has usually been modeled as a single latent factor. Multivariate studies of externalizing symptom features, however, suggest multidimensionality. To address this apparent contradiction, confirmatory factor analytic methods and information-theoretic criteria were used to evaluate 4 theoretically plausible measurement models based on lifetime comorbidity patterns of 7 putative externalizing disorders. Diagnostic information was collected at 4 assessment waves from an age-based cohort of 816 persons between the ages of 14 and 33. A 2-factor model that distinguished oppositional behavior disorders (attention-deficit/hyperactivity disorder, oppositional defiant disorder) from social norm violation disorders (conduct disorder, adult antisocial behavior, alcohol use disorder, cannabis use disorder, hard drug use disorder) demonstrated consistently good fit and superior approximating abilities. Analyses of psychosocial outcomes measured at the last assessment wave supported the validity of this 2-factor model. Implications of this research for the theoretical understanding of domain-related disorders and the organization of classification systems are discussed. PsycINFO Database Record 2009 APA, all rights reserved.

Sparse network-based models for patient classification using fMRI

PubMed Central

Rosa, Maria J.; Portugal, Liana; Hahn, Tim; Fallgatter, Andreas J.; Garrido, Marta I.; Shawe-Taylor, John; Mourao-Miranda, Janaina

2015-01-01

Pattern recognition applied to whole-brain neuroimaging data, such as functional Magnetic Resonance Imaging (fMRI), has proved successful at discriminating psychiatric patients from healthy participants. However, predictive patterns obtained from whole-brain voxel-based features are difficult to interpret in terms of the underlying neurobiology. Many psychiatric disorders, such as depression and schizophrenia, are thought to be brain connectivity disorders. Therefore, pattern recognition based on network models might provide deeper insights and potentially more powerful predictions than whole-brain voxel-based approaches. Here, we build a novel sparse network-based discriminative modeling framework, based on Gaussian graphical models and L1-norm regularized linear Support Vector Machines (SVM). In addition, the proposed framework is optimized in terms of both predictive power and reproducibility/stability of the patterns. Our approach aims to provide better pattern interpretation than voxel-based whole-brain approaches by yielding stable brain connectivity patterns that underlie discriminative changes in brain function between the groups. We illustrate our technique by classifying patients with major depressive disorder (MDD) and healthy participants, in two (event- and block-related) fMRI datasets acquired while participants performed a gender discrimination and emotional task, respectively, during the visualization of emotional valent faces. PMID:25463459

Patterns of co-occurring addictions, posttraumatic stress disorder, and major depressive disorder in detoxification treatment seekers: Implications for improving detoxification treatment outcomes.

PubMed

Anderson, RaeAnn E; Hruska, Bryce; Boros, Alec P; Richardson, Christopher J; Delahanty, Douglas L

2018-03-01

Poly-substance use and psychiatric comorbidity are common among individuals receiving substance detoxification services. Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) are the most common co-occurring psychiatric disorders with substance use disorder (SUD). Current treatment favors a one-size-fits-all approach to treating addiction focusing on one substance or one comorbidity. Research examining patterns of substance use and comorbidities can inform efforts to effectively identify and differentially treat individuals with co-occurring conditions. Using latent class analysis, the current study identified four patterns of PTSD, MDD, and substance use among 375 addiction treatment seekers receiving medically supervised detoxification. The four identified classes were: 1) a PTSD-MDD-Poly SUD class characterized by PTSD and MDD occurring in the context of opioid, cannabis, and tobacco use disorders; 2) an MDD-Poly SUD class characterized by MDD and alcohol, opioid, tobacco, and cannabis use disorders; 3) an alcohol-tobacco class characterized by alcohol and tobacco use disorders; and 4) an opioid-tobacco use disorder class characterized by opioid and tobacco use disorders. The observed classes differed on gender and clinical characteristics including addiction severity, trauma history, and PTSD/MDD symptom severity. The observed classes likely require differing treatment approaches. For example, people in the PTSD-MDD-Poly SUD class would likely benefit from treatment approaches targeting anxiety sensitivity and distress tolerance, while the opioid-tobacco class would benefit from treatments that incorporate motivational interviewing. Appropriate matching of treatment to class could optimize treatment outcomes for polysubstance and comorbid psychiatric treatment seekers. These findings also underscore the importance of well-developed referral networks to optimize outpatient psychotherapy for detoxification treatment-seekers to enhance long-term recovery, particularly those that include transdiagnostic treatment components. Copyright © 2017. Published by Elsevier Inc.

Psychiatric Morbidity Pattern in a Child Guidance Clinic.

PubMed

Chaudhury, S; Prasad, P L; Zacharias, R; Madhusudan, T; Saini, R

2007-04-01

There is a paucity of Indian studies on psychiatric morbidity in children. Present work was undertaken in a child guidance clinic in armed forces. Retrospective analysis of 213 patients who attended a child guidance clinic was done. Majority (n=138) were boys. 55.9% were referred from paediatric outpatient department while medical officers in periphery referred 38.5%. The diagnoses was mental retardation in 30.97%, behavioral and emotional disorders in 23.06% and neurotic, stress related and somatoform disorders in 15.98% cases.

Electronic media use and addiction among youth in psychiatric clinic versus school populations.

PubMed

Baer, Susan; Saran, Kelly; Green, David A; Hong, Irene

2012-12-01

Electronic media use is highly prevalent among today's youth, and its overuse in the general population has been consistently associated with the presence of psychiatric symptoms. In contrast, little information exists about electronic media use among youth with psychiatric disorders. Our study aims to compare patterns of television and computer and gaming station use among youth in psychiatric clinic and community-based school populations. Surveys were completed by 210 youth and parents, from school (n = 110) and psychiatric clinic (n = 100) populations. Duration and frequency of television, video gaming, and nongaming computer activities were ascertained, along with addictive features of use. Descriptive and comparative analyses were conducted, with a statistical threshold of P < 0.05. Quantitative and qualitative differences were identified between the patterns of use reported by the 2 groups. The mean reported daily duration of exposure to electronic media use was 6.6 hours (SD 4.1) for the clinic sample and 4.6 hours (SD 2.6) for the school sample (P < 0.01). Self-reported rates of addictive patterns related to computer and gaming station use were similar between the 2 populations. However, the clinically based sample favoured more violent games, with 29% reporting playing mature-rated games, compared with 13% reported by the school-based sample (P = 0.02). Youth with externalizing disorders expended greater time video gaming, compared with youth with internalizing disorders (P = 0.01). Clinically based samples of youth with mental illnesses spend more time engaged in electronic media activities and are more likely to play violent video games, compared with youth in the general population. Further research is needed to determine the long-term implications of these differences.

Psychopathology in a Swedish Population of School Children with Tic Disorders

ERIC Educational Resources Information Center

Khalifa, Najah; Von Knorring, Anne-Liis

2006-01-01

Objective: To examine patterns of psychiatric comorbid disorders and associated problems in a school population of children with tic disorders. Method: From a total population of 4,479 children, 25 with Tourette's disorder (TD), 34 with chronic motor tics (CMT), 24 with chronic vocal tics (CVT), and 214 with transient tics (TT) during the past…

The relationship between child abuse and negative outcomes among substance users: psychopathology, health, and comorbidities.

PubMed

Banducci, Anne N; Hoffman, Elana; Lejuez, C W; Koenen, Karestan C

2014-10-01

Adults with substance use disorders (SUDs) report higher rates of child abuse than adults without SUDs. Prior work suggests that this abuse is associated with higher rates of psychosis, posttraumatic stress disorder, physical health problems, alcohol dependence, and cannabis dependence among substance users. Little is known about other problems associated with child abuse experienced by substance users. We hypothesized that among adults with SUDs, child abuse would be associated with elevated rates of all Diagnostic and Statistical Manual (DSM-IV-TR) psychiatric disorders, substance dependencies, and comorbidities assessed. We assessed 280 inpatients in substance use treatment with the Structured Clinical Interview for the DSM-IV-TR, the Diagnostic Instrument for Personality Disorders, and Childhood Trauma Questionnaire (CTQ). We used chi-square and regression analyses to establish whether rates of psychiatric disorders, substance dependencies, and comorbidities differed as a function of child abuse. Consistent with our hypotheses, higher scores on the CTQ were associated with elevated rates of psychiatric disorders (mood disorders, anxiety disorders, psychotic symptoms, and personality disorders) and substance dependencies (alcohol dependence and cocaine dependence). Moreover, higher rates of all comorbidity patterns (e.g. comorbid alcohol dependence and anxiety) were observed among individuals who reported experiencing child abuse. Across all substance dependencies examined, individuals who had been abused had significantly higher rates of all psychiatric disorders assessed. Individuals with substance use disorders who have been abused have particularly elevated rates of psychiatric and substance use disorders as a function of their abuse experiences. These findings have important treatment implications for individuals in residential substance use treatment settings. Copyright © 2014 Elsevier Ltd. All rights reserved.

Psychiatric diagnosis – is it universal or relative to culture?

PubMed Central

Canino, Glorisa; Alegría, Margarita

2009-01-01

Background There is little consensus on the extent to which psychiatric disorders or syndromes are universal or the extent to which they differ on their core definitions and constellation of symptoms as a result of cultural or contextual factors. This controversy continues due to the lack of biological markers, imprecise measurement and the lack of a gold standard for validating most psychiatric conditions. Method Empirical studies were used to present evidence in favor of or against a universalist or relativistic view of child psychiatric disorders using a model developed by Robins and Guze to determine the validity of psychiatric disorders. Results The prevalence of some of the most common specific disorders and syndromes as well as its risk and protective factors vary across cultures, yet comorbid patterns and response to treatments vary little across cultures. Cross-cultural longitudinal data on outcomes is equivocal. Conclusions The cross-cultural validity of child disorders may vary drastically depending on the disorder, but empirical evidence that attests for the cross-cultural validity of diagnostic criteria for each child disorder is lacking. There is a need for studies that investigate the extent to which gene–environment interactions are related to specific disorders across cultures. Clinicians are urged to consider culture and context in determining the way in which children’s psychopathology may be manifested independent of their views. Recommendations for the upcoming classificatory system are provided so that practical or theoretical considerations are addressed about how culture and ethnic issues affect the assessment or treatment of specific disorders in children. PMID:18333929

Euthanasia requests, procedures and outcomes for 100 Belgian patients suffering from psychiatric disorders: a retrospective, descriptive study.

PubMed

Thienpont, Lieve; Verhofstadt, Monica; Van Loon, Tony; Distelmans, Wim; Audenaert, Kurt; De Deyn, Peter P

2015-07-27

To identify patterns in euthanasia requests and practices relating to psychiatric patients; to generate recommendations for future research. Retrospective analysis of data obtained through medical file review. Outpatient psychiatric clinical setting in the Dutch-speaking region of Belgium, between October 2007 and December 2011; follow-up at the end of December 2012. 100 consecutive psychiatric patients requesting euthanasia based on psychological suffering associated with psychiatric disorders (77 women, 23 men; mean age 47 years; age range 21-80 years). Patient sociodemographic characteristics; diagnoses; decisions on euthanasia requests; circumstances of euthanasia procedures; patient outcomes at follow-up. Most patients had been referred for psychiatric counselling by their physician (n=55) or by LEIF (Life End Information Forum) (n=36). 90 patients had >1 disorder; the most frequent diagnoses were depression (n=58) and personality disorder (n=50). 38 patients required further testing and/or treatment, including 13 specifically tested for autism spectrum disorder (ASD); 12 received an ASD diagnosis (all Asperger syndrome). In total, 48 of the euthanasia requests were accepted and 35 were carried out. Of the 13 remaining patients whose requests were accepted, 8 postponed or cancelled the procedure, because simply having this option gave them enough peace of mind to continue living. In December 2012, 43 patients had died, including 35 by euthanasia; others died by suicide (6), palliative sedation (1) and anorexia nervosa (1). Depression and personality disorders are the most common diagnoses in psychiatric patients requesting euthanasia, with Asperger syndrome representing a neglected disease burden. Further research is needed, especially prospective quantitative and qualitative studies, to obtain a better understanding of patients with psychiatric disorders who request euthanasia due to unbearable psychological suffering. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Delayed Maturation in Brain Electrical Activity Partially Explains the Association Between Early Environmental Deprivation and Symptoms of Attention-Deficit/Hyperactivity Disorder

PubMed Central

McLaughlin, Katie A.; Fox, Nathan A.; Zeanah, Charles H.; Sheridan, Margaret A.; Marshall, Peter; Nelson, Charles A.

2010-01-01

Background Children raised in institutional settings are exposed to social and environmental circumstances that may deprive them of expected environmental inputs during sensitive periods of brain development that are necessary to foster healthy development. This deprivation is thought to underlie the abnormalities in neurodevelopment that have been found in previously institutionalized children. It is unknown whether deviations in neurodevelopment explain the high rates of developmental problems evident in previously institutionalized children, including psychiatric disorders. Methods We present data from a sample of children raised in institutions in Bucharest, Romania (n = 117) and an age- and sex-matched sample of community control subjects (n = 49). Electroencephalogram data were acquired following entry into the study at age 6 to 30 months, and a structured diagnostic interview of psychiatric disorders was completed at age 54 months. Results Children reared in institutions evidenced greater symptoms of attention-deficit/hyperactivity disorder, anxiety, depression, and disruptive behavior disorders than community controls. Electroencephalogram revealed significant reductions in alpha relative power and increases in theta relative power among children reared in institutions in frontal, temporal, and occipital regions, suggesting a delay in cortical maturation. This pattern of brain activity predicted symptoms of hyperactivity and impulsivity at age 54 months, and significantly mediated the association between institutionalization and attention-deficit/hyperactivity disorder symptoms. Electroencephalogram power was unrelated to depression, anxiety, or disruptive behaviors. Conclusions These findings document a potential neurodevelopmental mechanism underlying the association between institutionalization and psychiatric morbidity. Deprivation in social and environmental conditions may perturb early patterns of neurodevelopment and manifest as psychiatric problems later in life. PMID:20497899

What Did We Learn from Research on Comorbidity In Psychiatry? Advantages and Limitations in the Forthcoming DSM-V Era.

PubMed

Dell'osso, Liliana; Pini, Stefano

2012-01-01

Despite the large amount of research conducted in this area over the last two decades, comorbidity of psychiatric disorders remains a topic of major practical and theoretical significance.Official diagnostic and therapeutic guidelines of psychiatric disorders still do not provide clinicians and researchers with any treatment-specific indications for those cases presenting with psychiatric comorbidity. We will discuss the diagnostic improvement brought about, in clinical practice, by the punctual and refined recognition of threshold and subthreshold comorbidity. From such a perspective, diagnostic procedures and forthcoming systems of classification of mental disorders should attempt to combine descriptive, categorical and dimensional approaches, addressing more attention to the cross-sectional and longitudinal analysis of nuclear, subclinical, and atypical symptoms that may represent a pattern of either full-blown or partially expressed psychiatric comorbidity. This should certainly be regarded as a positive development. Parallel, continuous critical challenge seems to be vital in this area, in order to prevent dangerous trivializations and misunderstandings.

Examining the Impact of Psychiatric Diagnosis and Comorbidity on the Medical Lethality of Adolescent "Suicide Attempts"

ERIC Educational Resources Information Center

Mc Manama O'Brien, Kimberly H.; Berzin, Stephanie C.

2012-01-01

Specific psychiatric diagnoses and comorbidity patterns were examined to determine if they were related to the medical lethality of "suicide attempts" among adolescents presenting to an urban general hospital (N = 375). Bivariate analysis showed that attempters with substance abuse disorders had higher levels of lethality than attempters without…

Psychiatric Manifestations of Learning Disorders.

ERIC Educational Resources Information Center

Gever, Benson E.

1991-01-01

This article examines the descriptive influences of reading and learning disorders on personality development. It discusses the effects of biologic vulnerabilities and environmental interaction, the variant patterns of defense and symptom development at various life stages, and evidence that early development failures are key elements in later…

Meal Plan in the Treatment of Anorexia Nervosa: A Way of Feeding the Disorder and Starving the Patient

PubMed Central

Padrão, Maria João; Barbosa, Maria Raquel; Coimbra, Joaquim Luís

2013-01-01

For the mainstream Psychology/Psychiatry, anorexia nervosa is considered an eating disorder characterized by the low body weight and by the restrictive eating pattern. The traditional psychiatric treatment consists in the establishment of a meal plan that must be scrupulously followed and, most frequently, in pharmacological treatment. We propose an alternative conceptualization of anorexia nervosa that envisages this disorder as pertaining to the control domain. In this sense, we formulate psychiatric intervention as a “pact with anorexia”, once it follows the very same logic, prohibitions and self-impositions of the disorder. Specifically, we envisage the meal plan as a way of maintaining anorexia, instead of suppressing it. As we could observe in our four year research project, in which we’ve followed several anorectic female patients, those who were more committed to their psychiatric treatment were precisely those who had more difficulty in recovering from anorexia – i.e., from renouncing the control from which the disorder lives. Finally, we suggest some fundamental underpinnings to an effective therapeutic approach, based in our conceptualization and understanding of the disorder. PMID:23283043

Female impulsive aggression: a sleep research perspective.

PubMed

Lindberg, Nina; Tani, Pekka; Putkonen, Hanna; Sailas, Eila; Takala, Pirjo; Eronen, Markku; Virkkunen, Matti

2009-01-01

The rate of violent crimes among girls and women appears to be increasing. One in every five female prisoners has been reported to have antisocial personality disorder. However, it has been quite unclear whether the impulsive, aggressive behaviour among women is affected by the same biological mechanisms as among men. Psychiatric sleep research has attempted to identify diagnostically sensitive and specific sleep patterns associated with particular disorders. Most psychiatric disorders are typically characterized by a severe sleep disturbance associated with decreased amounts of slow wave sleep (SWS), the physiologically significant, refreshing part of sleep. Among men with antisocial behaviour with severe aggression, on the contrary, increased SWS has been reported, reflecting either specific brain pathology or a delay in the normal development of human sleep patterns. In our preliminary study among medication-free, detoxified female homicidal offenders with antisocial personality disorder, the same profound abnormality in sleep architecture was found. From the perspective of sleep research, the biological correlates of severe impulsive aggression seem to share similar features in both sexes.

Clinical findings of the second 1000 UK Gulf War veterans who attended the Ministry of Defence's Medical Assessment Programme.

PubMed

Lee, H A; Gabriel, R; Bale, A J; Bolton, P; Blatchley, N F

2001-06-01

To review the diagnoses made in the second 1000 veterans of the Gulf conflict 1990-91 seen in the Ministry of Defence's Gulf Veterans' Medical Assessment Programme and to determine the main conditions related to Gulf service. Case series of 1000 consecutive Gulf veterans who presented to the programme between 25 February 1997 and 19 February 1998. Gulf War veterans. Assessment of the patient's health status. Diagnosis of medical and psychiatric conditions using ICD-10. 204 patients were unwell. 309 patients had organic disease, of whom 248 were well, 252 had psychiatric conditions which remained active in 173. The remaining 79, now well, had had psychiatric disorders following Gulf service. The principal psychiatric diagnosis was post traumatic stress disorder and the majority arose as a result of Gulf service. 796 (80%) veterans were well. There were 309 (31%) patients with organic disease. 252 (25%) veterans had psychiatric conditions of which 173 (69%) had an active diagnosed disorder and post traumatic stress disorder was the predominant condition. The pattern of disease is similar to that seen in NHS practice. We found, like others, no evidence to support a unique Gulf War syndrome. Post conflict illnesses have many common features.

Specificity of Putative Psychosocial Risk Factors for Psychiatric Disorders in Children and Adolescents

ERIC Educational Resources Information Center

Shanahan, Lilly; Copeland, William; Costello, E. Jane; Angold, Adrian

2008-01-01

Background: Most psychosocial risk factors appear to have general rather than specific patterns of association with common childhood and adolescence disorders. However, previous research has typically failed to 1) control for comorbidity among disorders, 2) include a wide range of risk factors, and 3) examine sex by developmental stage effects on…

Neuroimaging Studies of Normal Brain Development and Their Relevance for Understanding Childhood Neuropsychiatric Disorders

ERIC Educational Resources Information Center

Marsh, Rachel; Gerber, Andrew J.; Peterson, Bradley S.

2008-01-01

Neuroimaging findings which identify normal brain development trajectories are presented. Results show that early brain development begins with the neural tube formation and ends with myelintation. How disturbances in brain development patterns are related to childhood psychiatric disorders is examined.

Mischievous responding in Internet Gaming Disorder research

PubMed Central

2016-01-01

The most recent update to the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5) included Internet Gaming Disorder as a new potential psychiatric condition that merited further scientific study. The present research was conducted in response to the APA Substance-Related Disorders Working Group’s research call to estimate the extent to which mischievous responding—a known problematic pattern of participant self-report responding in questionnaires—is relevant to Internet Gaming Disorder research. In line with a registered sampling and analysis plan, findings from two studies (ntot = 11,908) provide clear evidence that mischievous responding is positively associated with the number of Internet Gaming Disorder indicators participants report. Results are discussed in the context of ongoing problem gaming research and the discussion provides recommendations for improving the quality of scientific practice in this area. PMID:27672496

Mischievous responding in Internet Gaming Disorder research.

PubMed

Przybylski, Andrew K

2016-01-01

The most recent update to the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5) included Internet Gaming Disorder as a new potential psychiatric condition that merited further scientific study. The present research was conducted in response to the APA Substance-Related Disorders Working Group's research call to estimate the extent to which mischievous responding-a known problematic pattern of participant self-report responding in questionnaires-is relevant to Internet Gaming Disorder research. In line with a registered sampling and analysis plan, findings from two studies (n tot = 11,908) provide clear evidence that mischievous responding is positively associated with the number of Internet Gaming Disorder indicators participants report. Results are discussed in the context of ongoing problem gaming research and the discussion provides recommendations for improving the quality of scientific practice in this area.

Clinical Use of Mood Stabilizers With Antidepressants in Asia: Report From the Research on Asian Psychotropic Prescription Patterns for Antidepressants (REAP-AD) Projects in 2004 and 2013.

PubMed

Rajaratnam, Kamini; Xiang, Yu-Tao; Tripathi, Adarsh; Chiu, Helen F K; Si, Tian-Mei; Chee, Kok-Yoon; Avasthi, Ajit; Grover, Sandeep; Chong, Mian-Yoon; Kuga, Hironori; Kanba, Shigenobu; He, Yan-Ling; Lee, Min-Soo; Yang, Shu-Yu; Udomratn, Pichet; Kallivayalil, Roy A; Tanra, Andi J; Maramis, Margarita M; Shen, Winston W; Sartorius, Norman; Kua, Ee-Heok; Tan, Chay-Hoon; Mahendran, Rathi; Shinfuku, Naotaka; Sum, Min Yi; Baldessarini, Ross J; Sim, Kang

2017-04-01

As most reports concerning treatment with combinations of mood stabilizer (MS) with antidepressant (AD) drugs are based in the West, we surveyed characteristics of such cotreatment in 42 sites caring for the mentally ill in 10 Asian countries. This cross-sectional, pharmacoepidemiologic study used 2004 and 2013 data from the REAP-AD (Research Study on Asian Psychotropic Prescription Patterns for Antidepressants) to evaluate the rates and doses of MSs given with ADs and associated factors in 4164 psychiatric patients, using standard bivariate methods followed by multivariable logistic regression modeling. Use of MS + AD increased by 104% (5.5% to 11.2%) between 2004 and 2013 and was much more associated with diagnosis of bipolar disorder than major depression or anxiety disorder, as well as with hospitalization > outpatient care, psychiatric > general-medical programs, and young age (all P < 0.001), but not with country, sex, or AD dose. The findings provide a broad picture of contemporary use of MSs with ADs in Asia, support predictions that such treatment increased in recent years, and was associated with diagnosis of bipolar disorder, treatment in inpatient and psychiatric settings, and younger age.

Development of schizotypal symptoms following psychiatric disorders in childhood or adolescence.

PubMed

Fagel, Selene S A A; Swaab, Hanna; De Sonneville, Leo M J; Van Rijn, Sophie; Pieterse, Jolijn K; Scheepers, Floor; Van Engeland, Herman

2013-11-01

It was examined how juvenile psychiatric disorders and adult schizotypal symptoms are associated. 731 patients of the Department of Child and Adolescent Psychiatry of the University Medical Centre Utrecht, the Netherlands, with mean age of 12.1 years (SD = 4.0) were reassessed at the mean age of 27.9 years (SD = 5.7) for adult schizotypal symptoms using the Schizotypal Personality Questionnaire-Revised (Vollema, Schizophr Bull 26(3):565-575, 2000). Differences between 13 juvenile DSM categories and normal controls (n = 80) on adult schizotypal total and factor scores were analyzed, using (M)ANCOVA. Pervasive developmental disorders (PDD), attention deficit hyperactivity disorders (ADHD), deferred diagnosis, sexual and gender identity disorders and depressive disorders had higher SPQ total scores when compared to normal controls (p < 0.001). Higher levels of disorganized schizotypal symptoms were found for PDD, ADHD, and deferred diagnosis (p < 0.001). The same diagnostic groups showed higher level of negative schizotypal symptoms, which was likewise true for sexual and gender identity disorders, depressive disorders, disruptive disorders, and the category of 'Other conditions that may be a focus of clinical attention' (p < 0.001). No differences with normal controls were found for adult positive schizotypal symptoms (p < 0.110). The current findings are suggestive of the idea that psychiatric disorders in childhood or adolescence are a more general expression of a liability to schizophrenia spectrum pathology in future life. In addition, specific patterns of adult schizotypal symptomatology are associated with different types of juvenile psychiatric disorder.

Prevalence and correlates of comorbid depression in a nonclinical online sample with DSM-5 internet gaming disorder.

PubMed

Wang, Hee Ryung; Cho, Hyun; Kim, Dai-Jin

2018-01-15

We investigated the prevalence and correlates of comorbid depression among patients with internet gaming disorder using the Internet Gaming Disorder scale (IGD-9) and the Patient Health Questionnaire-9 (PHQ-9) among nonclinical online survey respondents. Korean adolescents and adults from 14 to 39 years of age were selected. We compared internet gaming use patterns and sociodemographic and clinical variables between patients with internet gaming disorder who had depression and those without depression. In 2016, 7200 people participated in an online survey. Respondents with internet gaming disorder that was comorbid with depression were older, more often female, had greater Internet Addiction Test total scores, Alcohol Use Disorder Identification Test total scores, Generalized Anxiety Disorder Scale-7 total scores, Fagerstrom Test for Nicotine Dependence total scores, and higher Dickman Dysfunctional Impulsivity Instrument dysfunctional subscale scores than those without depression. The binary logistic regression analysis revealed that female gender, problematic alcohol use, anxiety, and a past history of psychiatric counseling or treatment due to internet gaming use were significant predictors for comorbid depression among participants with internet gaming disorder. Depression was a common comorbidity of internet gaming disorder. Internet gaming disorder with comorbid depression was related to more serious psychiatric phenomenology and a greater psychiatric burden. Copyright © 2017. Published by Elsevier B.V.

Neurocognitive Allied Phenotypes for Schizophrenia and Bipolar Disorder

PubMed Central

Hill, S. Kristian; Harris, Margret S. H.; Herbener, Ellen S.; Pavuluri, Mani; Sweeney, John A.

2008-01-01

Psychiatric disorders are genetically complex and represent the end product of multiple biological and social factors. Links between genes and disorder-related abnormalities can be effectively captured via assessment of phenotypes that are both associated with genetic effects and potentially contributory to behavioral abnormalities. Identifying intermediate or allied phenotypes as a strategy for clarifying genetic contributions to disorders has been successful in other areas of medicine and is a promising strategy for identifying susceptibility genes in complex psychiatric disorders. There is growing evidence that schizophrenia and bipolar disorder, rather than being wholly distinct disorders, share genetic risk at several loci. Further, there is growing evidence of similarity in the pattern of cognitive and neurobiological deficits in these groups, which may be the result of the effects of these common genetic factors. This review was undertaken to identify patterns of performance on neurocognitive and affective tasks across probands with schizophrenia and bipolar disorder as well as unaffected family members, which warrant further investigation as potential intermediate trait markers. Available evidence indicates that measures of attention regulation, working memory, episodic memory, and emotion processing offer potential for identifying shared and illness-specific allied neurocognitive phenotypes for schizophrenia and bipolar disorder. However, very few studies have evaluated neurocognitive dimensions in bipolar probands or their unaffected relatives, and much work in this area is needed. PMID:18448479

Prevalence of psychiatric and physical morbidity in an urban geriatric population.

PubMed

Seby, K; Chaudhury, Suprakash; Chakraborty, Rudraprosad

2011-04-01

With a rapidly increasing population of older aged people, epidemiological data regarding the prevalence of mental and physical illnesses are urgently required for proper health planning. However, there is a scarcity of such data from India. To study the frequency and pattern of psychiatric morbidity present and the association of physical illness with psychiatric morbidity in an elderly urban population. Cross-sectional, epidemiological study. All the consenting elderly persons in a municipal ward division (n=202) were enrolled after surveying a total adult population of 7239 people. A door to door survey was undertaken where the participants were interviewed and physically examined. General Health Questionnaire-12, Mini Mental State Examination, CAGE Questionnaire and Geriatric Depression Scale were used in the interview apart from consulting the available documents. Other family members were also interviewed to verify the information. Chi-square test with Yates correction. Psychiatric illnesses were detected in 26.7% while physical illnesses were present in 69.8% of the population surveyed. Predominant psychiatric diagnoses were depressive disorders, dementia, generalized anxiety disorder, alcohol dependence and bipolar disorder. The most common physical illness was visual impairment, followed by cardiovascular disease, rheumatic illnesses, pulmonary illnesses, hearing impairment, genitourinary diseases and neurological disorders. Presence of dementia was associated with increased age, single/widowed/separated status, nuclear family, economic dependence, low education, cardiovascular disorders, rheumatic disorders and neurological disorders. Depression was associated with female sex, single/widowed/separated status, staying in nuclear families, economic dependence on others and co-morbid physical illnesses, specifically cardiovascular disorders and visual impairment. This study presented a higher rate of dementia and old age depression. The interesting association with several sociodemographic factors as well as physical illnesses may have important implications for health planning.

Understanding the Molecular Mechanisms Underpinning Gene by Environment Interactions in Psychiatric Disorders: The FKBP5 Model.

PubMed

Matosin, Natalie; Halldorsdottir, Thorhildur; Binder, Elisabeth B

2018-05-15

Epidemiologic and genetic studies suggest common environmental and genetic risk factors for a number of psychiatric disorders, including depression, bipolar disorder, and schizophrenia. Genetic and environmental factors, especially adverse life events, not only have main effects on disease development but also may interact to shape risk and resilience. Such gene by adversity interactions have been described for FKBP5, an endogenous regulator of the stress-neuroendocrine system, conferring risk for a number of psychiatric disorders. In this review, we present a molecular and cellular model of the consequences of FKBP5 by early adversity interactions. We illustrate how altered genetic and epigenetic regulation of FKBP5 may contribute to disease risk by covering evidence from clinical and preclinical studies of FKBP5 dysregulation, known cell-type and tissue-type expression patterns of FKBP5 in humans and animals, and the role of FKBP5 as a stress-responsive molecular hub modulating many cellular pathways. FKBP5 presents the possibility to better understand the molecular and cellular factors contributing to a disease-relevant gene by environment interaction, with implications for the development of biomarkers and interventions for psychiatric disorders. Copyright © 2018 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Gambling problem severity and psychiatric disorders among Hispanic and white adults: findings from a nationally representative sample.

PubMed

Barry, Declan T; Stefanovics, Elina A; Desai, Rani A; Potenza, Marc N

2011-03-01

To examine differences in the associations of gambling problem severity and psychiatric disorders among a nationally representative sample of Hispanic and white adults. Chi-square tests and multinomial logistic regression analyses were performed on data obtained from the National Epidemiologic Survey on Alcohol and Related Conditions from 31,830 adult respondents (13% Hispanic; 87% white), who were categorized according to three levels of gambling problem severity (i.e., no gambling or low-frequency gambling [NG], low-risk or at-risk gambling [LRG], problem or pathological gambling [PPG]). Hispanic respondents in comparison to white respondents were more likely to exhibit PPG. Problem gambling severity was associated with past-year Axis I and lifetime Axis II psychiatric disorders in both Hispanic and white respondents, with the largest odds typically observed in association with the most severe gambling pathology. A stronger relationship between subsyndromal gambling and a broad range of Axis I disorders (mood, anxiety and substance use disorders) and Axis II disorders (particularly cluster B) was observed in Hispanic respondents as compared to white ones. Levels of problem gambling severity are associated with the prevalence of Axis I and Axis II psychiatric disorders in both Hispanics and whites. Differences in the patterns of co-occurring disorders between subsyndromal levels of gambling in Hispanic and white respondents indicate the importance of considering ethnicity/race-related factors related to subthreshold levels of gambling in developing improved mental health prevention and treatment strategies. Copyright © 2010 Elsevier Ltd. All rights reserved.

Mixed organic brain syndrome as a manifestation of systemic mastocytosis.

PubMed

Rogers, M P; Bloomingdale, K; Murawski, B J; Soter, N A; Reich, P; Austen, K F

1986-01-01

Systemic mastocytosis is a disease characterized by an excessive accumulation of mast cells, and associated with skin lesions, flushing, diarrhea, tachycardia, and psychiatric manifestations. In order to define more clearly the psychiatric manifestations, ten patients with this disorder underwent unstructured psychiatric interviews and a battery of psychologic testing. Both revealed a pattern of cognitive and affective changes in the majority of these patients, best categorized as an atypical or mixed organic brain syndrome. The cognitive changes consisted of diminished attention and memory, and the affective changes of anger, irritability, and, to a lesser extent, depression. These manifestations fluctuated with the level of disease activity, and appeared in some cases to respond to histamine antagonists and disodium cromoglycate, medications used to control the excessive mast cell activity. It is important for psychiatrists to be aware that mental status changes can represent psychiatric manifestations of mastocytosis, a readily treatable medical disorder.

LIFE EVENTS AND SOMATOFORM DISORDERS

PubMed Central

Chandrashekhar, C.R.; Reddy, Venkataswamy; Isaac, Mohan K.

1997-01-01

Presumptive Stressful Life Events Scale (PSLES) was administered to 69 physically ill, 23 patients with somatoform disorders and 45 patients with psychiatric disorders other than somatoform disorders who sought medical help in primary health care settings. The 137 patients were cluster analysed in orderto obtain the patterns of distribution of 39 life events. Five clusters emerged. All the patients in cluster Vhad somatoform disorders and life events had a significant occurrence and discrimination. PMID:21584065

Perinatal psychiatric episodes: a population-based study on treatment incidence and prevalence

PubMed Central

Munk-Olsen, T; Maegbaek, M L; Johannsen, B M; Liu, X; Howard, L M; di Florio, A; Bergink, V; Meltzer-Brody, S

2016-01-01

Perinatal psychiatric episodes comprise various disorders and symptom severity, which are diagnosed and treated in multiple treatment settings. To date, no studies have quantified the incidence and prevalence of perinatal psychiatric episodes treated in primary and secondary care, which we aimed to do in the present study. We designed a descriptive prospective study and included information from Danish population registers to study first-time ever and recurrent psychiatric episodes during the perinatal period, including treatment at psychiatric facilities and general practitioners (GPs). This was done for all women who had records of one or more singleton births from 1998 until 2012. In total, we had information on 822 439 children born to 491 242 unique mothers. Results showed first-time psychiatric episodes treated at inpatient facilities were rare during pregnancy, but increased significantly shortly following childbirth (0.02 vs 0.25 per 1000 births). In comparison, first-time psychiatric episodes treated at outpatient facilities were more common, and showed little variation across pregnancy and postpartum. For every single birth resulting in postpartum episodes treated at inpatient psychiatric facilities, 2.5 births were followed by an episode treated at outpatient psychiatric facility and 12 births by GP-provided pharmacological treatment. We interpret our results the following way: treated severe and moderate psychiatric disorders have different risk patterns in relation to pregnancy and childbirth, which suggests differences in the underlying etiology. We further speculate varying treatment incidence and prevalence in pregnancy vs postpartum may indicate that the current Diagnostic and Statistical Manual of Mental Disorders-5 peripartum specifier not adequately describes at-risk periods across moderate and severe perinatal psychiatric episodes. PMID:27754485

Co-morbidity and patterns of care in stimulant-treated children with ADHD in the Netherlands.

PubMed

Faber, Adrianne; Kalverdijk, Luuk J; de Jong-van den Berg, Lolkje T W; Hugtenburg, Jacqueline G; Minderaa, Ruud B; Tobi, Hilde

2010-02-01

This study aimed at investigating the use of psychosocial interventions and psychotropic co-medication among stimulant-treated children with attention-deficit hyperactivity disorder (ADHD) in relation to the presence of psychiatric co-morbidity. Stimulant users younger than 16 years were identified in 115 pharmacies and a questionnaire was sent to their stimulant prescribing physician. Of 773 questionnaires sent out, 556 were returned and were suitable for analysis (72%). The results are based on 510 questionnaires concerning stimulant-treated children for whom a diagnosis of ADHD was reported. Of the 510 children diagnosed with ADHD, 31% had also received one or more other psychiatric diagnoses, mainly pervasive developmental disorder or oppositional defiant disorder/conduct disorder. We found an association between the presence of co-morbidity and the use of psychosocial interventions for the child (P < 0.001) and the parents (P < 0.001). In the ADHD-only group, 26% did not receive any form of additional interventions, while psychosocial interventions varied from 8 to 18% in children with ADHD and psychiatric co-morbidity. The presence of diagnostic co-morbidity was also associated with the use of psychotropic co-medication (overall, P = 0.012) and antipsychotics (P < 0.001). Stimulant-treated youths with ADHD and psychiatric co-morbidity received more psychosocial interventions and psychotropic co-medication than children with ADHD-only. The type of psychosocial interventions and psychotropic co-medication received by the children and their parents, depended on the specific co-morbid psychiatric disorder being present.

Stuck on Screens: Patterns of Computer and Gaming Station Use in Youth Seen in a Psychiatric Clinic

PubMed Central

Baer, Susan; Bogusz, Elliot; Green, David A.

2011-01-01

Objective: Computer and gaming-station use has become entrenched in the culture of our youth. Parents of children with psychiatric disorders report concerns about overuse, but research in this area is limited. The goal of this study is to evaluate computer/gaming-station use in adolescents in a psychiatric clinic population and to examine the relationship between use and functional impairment. Method: 102 adolescents, ages 11–17, from out-patient psychiatric clinics participated. Amount of computer/gaming-station use, type of use (gaming or non-gaming), and presence of addictive features were ascertained along with emotional/functional impairment. Multivariate linear regression was used to examine correlations between patterns of use and impairment. Results: Mean screen time was 6.7±4.2 hrs/day. Presence of addictive features was positively correlated with emotional/functional impairment. Time spent on computer/gaming-station use was not correlated overall with impairment after controlling for addictive features, but non-gaming time was positively correlated with risky behavior in boys. Conclusions: Youth with psychiatric disorders are spending much of their leisure time on the computer/gaming-station and a substantial subset show addictive features of use which is associated with impairment. Further research to develop measures and to evaluate risk is needed to identify the impact of this problem. PMID:21541096

Psychiatric disorders and sleep issues.

PubMed

Sutton, Eliza L

2014-09-01

Sleep issues are common in people with psychiatric disorders, and the interaction is complex. Sleep disorders, particularly insomnia, can precede and predispose to psychiatric disorders, can be comorbid with and exacerbate psychiatric disorders, and can occur as part of psychiatric disorders. Sleep disorders can mimic psychiatric disorders or result from medication given for psychiatric disorders. Impairment of sleep and of mental health may be different manifestations of the same underlying neurobiological processes. For the primary care physician, key tools include recognition of potential sleep effects of psychiatric medications and familiarity with treatment approaches for insomnia in depression and anxiety. Copyright © 2014 Elsevier Inc. All rights reserved.

Daily weather variables and affective disorder admissions to psychiatric hospitals

NASA Astrophysics Data System (ADS)

McWilliams, Stephen; Kinsella, Anthony; O'Callaghan, Eadbhard

2014-12-01

Numerous studies have reported that admission rates in patients with affective disorders are subject to seasonal variation. Notwithstanding, there has been limited evaluation of the degree to which changeable daily meteorological patterns influence affective disorder admission rates. A handful of small studies have alluded to a potential link between psychiatric admission rates and meteorological variables such as environmental temperature (heat waves in particular), wind direction and sunshine. We used the Kruskal-Wallis test, ARIMA and time-series regression analyses to examine whether daily meteorological variables—namely wind speed and direction, barometric pressure, rainfall, hours of sunshine, sunlight radiation and temperature—influence admission rates for mania and depression across 12 regions in Ireland over a 31-year period. Although we found some very weak but interesting trends for barometric pressure in relation to mania admissions, daily meteorological patterns did not appear to affect hospital admissions overall for mania or depression. Our results do not support the small number of papers to date that suggest a link between daily meteorological variables and affective disorder admissions. Further study is needed.

Occupational Psychiatric Disorders in Korea

PubMed Central

Kang, Seong-Kyu

2010-01-01

We searched databases and used various online resources to identify and systematically review all articles on occupational psychiatric disorders among Korean workers published in English and Korean before 2009. Three kinds of occupational psychiatric disorders were studied: disorders related to job stress and mental illness, psychiatric symptoms emerging in victims of industrial injuries, and occupational psychiatric disorders compensated by Industrial Accident Compensation Insurance (IACI). Korea does not maintain official statistical records for occupational psychiatric disorders, but several studies have estimated the number of occupational psychiatric disorders using the Korea Workers' Compensation and Welfare Service (COMWEL, formerly KLWC) database. The major compensated occupational psychiatric disorders in Korea were "personality and behavioral disorders due to brain disease, damage, and dysfunction", "other mental disorders due to brain damage and dysfunction and to physical diseases", "reactions to severe stress and adjustment disorders", and "depressive episodes". The most common work-related psychiatric disorders, excluding accidents, were "neurotic, stress-related, and somatoform disorders" followed by "mood disorders". PMID:21258596

Clinical Utility and Lifespan Profiling of Neurological Soft Signs in Schizophrenia Spectrum Disorders.

PubMed

Chan, Raymond C K; Xie, Weizhen; Geng, Fu-lei; Wang, Ya; Lui, Simon S Y; Wang, Chuan-yue; Yu, Xin; Cheung, Eric F C; Rosenthal, Robert

2016-05-01

Neurological soft signs (NSSs) bear the promise for early detection of schizophrenia spectrum disorders. Nonetheless, the sensitivity and specificity of NSSs in the psychosis continuum remains a topic of controversy. It is also unknown how NSSs reveal neurodevelopmental abnormality in schizophrenia. We investigated the effect sizes of NSSs in differentiating individuals with schizophrenia spectrum disorders from individuals with other psychiatric conditions and from covariate-matched healthy subjects. We also investigated the partitioned age-related variations of NSSs in both schizophrenia and healthy individuals. NSSs were assessed by the abridged version of the Cambridge Neurological Inventory (CNI) in 3105 participants, consisting of healthy individuals (n=1577), unaffected first-degree relatives of schizophrenia patients (n= 155), individuals with schizotypal personality disorder (n= 256), schizophrenia patients (n= 738), and other psychiatric patients (n= 379). Exact matching and propensity score matching procedures were performed to control for covariates. Multiple regression was used to partition age-related variations. Individuals along the schizophrenia continuum showed elevated levels of NSSs, with moderate effect sizes, in contrast to other psychiatric patients who had minimal NSSs, as well as matched healthy controls. Furthermore, the age-and-NSS relationship in schizophrenia patients was represented by a flat but overall elevated pattern, in contrast to a U-shaped pattern in healthy individuals. In sum, NSSs capture a moderate portion of psychosis proneness with reasonable specificity. Lifespan profiling reveals an abnormal developmental trajectory of NSSs in schizophrenia patients, which supports the endophenotype hypothesis of NSSs by associating it with the neurodevelopmental model of schizophrenia. © The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Biological variations in depression and anxiety between East and West.

PubMed

Chen, Po-Yu; Wang, Sheng-Chang; Poland, Russell E; Lin, Keh-Ming

2009-01-01

Ethnicity and culture represent important factors in shaping psychopathology as well as pharmacotherapeutic responses in psychiatric patients. A large body of literature, accumulated over the past several decades, demonstrates that these factors not only determine the metabolism and disposition of medications (pharmacokinetics), but also their interactions with therapeutic targets (pharmacodynamics). This article focuses on the impact of such variations on the diagnosis and treatment of depression and anxiety disorders between East and West. Genes controlling the expression of drug metabolizing enzymes as well as the function of the brain are highly polymorphic, and the patterns and distribution of these polymorphisms are typically divergent across ethnic groups. To the extent that these genetic patterns determine drug response, ethnic variations in these genetic dispositions will lead to differential responses in clinical settings. In addition, the expression of these genes is significantly influenced by environmental factors including diet as well as exposure to other natural products. Superimposed on these biological influences, culturally determined beliefs and behavioral patterns also profoundly influence patients' expectations of treatment response, adherence, and interactions with clinicians. In addition to pharmacotherapeutic responses, emerging data also indicate that significant ethnic variations exist in genetic polymorphisms and neurobiologic correlates (biomarkers) that may be associated with the vulnerability to psychiatric disorders. These considerations argue for the importance of examining biological variations across ethnic groups, especially in the clinical context, in terms of the assessment and treatment of psychiatric patients, and in our understanding of psychiatric phenomenology and nosology.

Using deep learning to investigate the neuroimaging correlates of psychiatric and neurological disorders: Methods and applications.

PubMed

Vieira, Sandra; Pinaya, Walter H L; Mechelli, Andrea

2017-03-01

Deep learning (DL) is a family of machine learning methods that has gained considerable attention in the scientific community, breaking benchmark records in areas such as speech and visual recognition. DL differs from conventional machine learning methods by virtue of its ability to learn the optimal representation from the raw data through consecutive nonlinear transformations, achieving increasingly higher levels of abstraction and complexity. Given its ability to detect abstract and complex patterns, DL has been applied in neuroimaging studies of psychiatric and neurological disorders, which are characterised by subtle and diffuse alterations. Here we introduce the underlying concepts of DL and review studies that have used this approach to classify brain-based disorders. The results of these studies indicate that DL could be a powerful tool in the current search for biomarkers of psychiatric and neurologic disease. We conclude our review by discussing the main promises and challenges of using DL to elucidate brain-based disorders, as well as possible directions for future research. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Psychosocial correlates, outcome, and stability of abnormal adolescent eating behavior in community samples of young people.

PubMed

Steinhausen, Hans-Christoph; Gavez, Silvia; Winkler Metzke, Christa

2005-03-01

The current study investigated psychosocial correlates of abnormal adolescent eating behavior at three times during adolescence and young adulthood and its association with psychiatric diagnosis in young adulthood in a community sample. Sixty-four (10.5%) high-risk subjects (mean age 15 years) with abnormal eating behavior were identified at Time 1, another 252 (16.9%) were identified at Time 2 (mean age 16.2 years), and 164 (16.9%) were identified at Time 3 (mean age 19.7 years) and compared with three control groups matched for age and gender. Dependent measures included emotional and behavioral problems, life events, coping capacities, self-related cognition, social network, and family functions. Outcome was measured additionally by structured psychiatric interviews, and stability of abnormal eating behavior was studied in a longitudinal sample of 330 subjects. Few subjects showed more than one of five criteria of abnormal eating behavior. High-risk subjects shared a very similar pattern at all three times. They were characterized by higher scores for emotional and behavioral problems, more life events including more negative impact, less active coping, lower self-esteem, and less family cohesion. Among 10 major psychiatric disorders, only clinical eating disorders at Time 3 shared a significant association with abnormal eating disorder at the same time whereas high-risk status at Times 1 and 2 did not predict any psychiatric disorder at Time 3. Stability of abnormal eating behavior across time was very low. Stability of abnormal eating behavior across time was very low. Abnormal eating behavior in adolescence and young adulthood is clearly associated with various indicators of psychosocial maladaption. In adolescence, it does not significantly predict any psychiatric disorder including eating disorder in young adulthood and it is predominantly a transient feature. (c) 2005 by Wiley Periodicals, Inc.

Celiac Disease Is Associated with Childhood Psychiatric Disorders: A Population-Based Study.

PubMed

Butwicka, Agnieszka; Lichtenstein, Paul; Frisén, Louise; Almqvist, Catarina; Larsson, Henrik; Ludvigsson, Jonas F

2017-05-01

To determine the risk of future childhood psychiatric disorders in celiac disease, assess the association between previous psychiatric disorders and celiac disease in children, and investigate the risk of childhood psychiatric disorders in siblings of celiac disease probands. This was a nationwide registry-based matched cohort study in Sweden with 10 903 children (aged <18 years) with celiac disease and 12 710 of their siblings. We assessed the risk of childhood psychiatric disorders (any psychiatric disorder, psychotic disorder, mood disorder, anxiety disorder, eating disorder, psychoactive substance misuse, behavioral disorder, attention-deficit hyperactivity disorder [ADHD], autism spectrum disorder [ASD], and intellectual disability). HRs of future psychiatric disorders in children with celiac disease and their siblings was estimated by Cox regression. The association between previous diagnosis of a psychiatric disorder and current celiac disease was assessed using logistic regression. Compared with the general population, children with celiac disease had a 1.4-fold greater risk of future psychiatric disorders. Childhood celiac disease was identified as a risk factor for mood disorders, anxiety disorders, eating disorders, behavioral disorders, ADHD, ASD, and intellectual disability. In addition, a previous diagnosis of a mood, eating, or behavioral disorder was more common before the diagnosis of celiac disease. In contrast, siblings of celiac disease probands were at no increased risk of any of the investigated psychiatric disorders. Children with celiac disease are at increased risk for most psychiatric disorders, apparently owing to the biological and/or psychological effects of celiac disease. Copyright © 2017 Elsevier Inc. All rights reserved.

Psychiatric genetic research at the National Institute of Mental Health

DOE Office of Scientific and Technical Information (OSTI.GOV)

Berg, K.; Mullican, C.; Maestri, N.

For some time it has been known through the results of family, twin, and adoption studies that hereditary appears to play a significant casual role in many mental disorders, including schizophrenia, bipolar disorder, and other mood disorders, Alzheimer`s Disease, panic disorder, obsessive compulsive disorder, autism, dyslexia, and Tourette`s syndrome. The precise patterns of inheritance of these complex disorders have not been determined, nor have the relevant genes been localized or cloned. Because the genetics are complex and because there is also clearly an environmental contribution to behavior, we expect the analysis of the genetics of mental illness to be arduousmore » and not quickly resolved. There are several compelling reasons to continue to focus our attention on uncovering the genetic factors for severe mental illness. Prominent among these are the implications for better treatment of mental disorders. The National Institute of Mental Health supports a wide range of studies on psychiatric genetic research. 16 refs.« less

Panic disorder and subthreshold panic in the UK general population: epidemiology, comorbidity and functional limitation.

PubMed

Skapinakis, P; Lewis, G; Davies, S; Brugha, T; Prince, M; Singleton, N

2011-09-01

The epidemiology of panic disorder has not been investigated in the past in the UK using a nationally representative sample of the population. The aim of the present paper was to examine the epidemiology, comorbidity and functional impairment of subthreshold panic and panic disorder with or without agoraphobia. We used data from the 2000 Office for National Statistics Psychiatric Morbidity survey (N=8580). Panic disorder and agoraphobia were assessed with the Revised Clinical Interview Schedule (CIS-R). The prevalence of panic disorder with or without agoraphobia was 1.70% (95% confidence interval: 1.41-2.03%). Subthreshold panic was more common. Economic inactivity was consistently associated with all syndromes. The comorbidity pattern of the panic syndromes and the associated functional impairment show that panic-related conditions are important public health problems, even in subthreshold status. The findings show that efforts to reduce the disability associated with psychiatric disorders should include detection and management of panic disorder. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Shared molecular neuropathology across major psychiatric disorders parallels polygenic overlap.

PubMed

Gandal, Michael J; Haney, Jillian R; Parikshak, Neelroop N; Leppa, Virpi; Ramaswami, Gokul; Hartl, Chris; Schork, Andrew J; Appadurai, Vivek; Buil, Alfonso; Werge, Thomas M; Liu, Chunyu; White, Kevin P; Horvath, Steve; Geschwind, Daniel H

2018-02-09

The predisposition to neuropsychiatric disease involves a complex, polygenic, and pleiotropic genetic architecture. However, little is known about how genetic variants impart brain dysfunction or pathology. We used transcriptomic profiling as a quantitative readout of molecular brain-based phenotypes across five major psychiatric disorders-autism, schizophrenia, bipolar disorder, depression, and alcoholism-compared with matched controls. We identified patterns of shared and distinct gene-expression perturbations across these conditions. The degree of sharing of transcriptional dysregulation is related to polygenic (single-nucleotide polymorphism-based) overlap across disorders, suggesting a substantial causal genetic component. This comprehensive systems-level view of the neurobiological architecture of major neuropsychiatric illness demonstrates pathways of molecular convergence and specificity. Copyright © 2018 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

[Addictive internet use as a comorbid disorder among clients of an adolescent psychiatry - prevalence and psychopathological symptoms].

PubMed

Müller, Kai W; Ammerschläger, Marcella; Freisleder, Franz Joseph; Beutel, Manfred E; Wölfling, Klaus

2012-09-01

Excessive and addictive internet use fulfilling criteria of nonsubstance related addiction disorder is increasingly being discussed by scientists and clinicians alike. Its prevalence of about 3 % among minors points to a relatively frequent phenomenon that can lead to functional impairment and distress. However, there is still no evidence concerning its prevalence among underaged patients in psychiatric treatment. 81 patients between the age of 8 and 17 years were screened by a standardized instrument for internet addiction (AICA-S) to assess the prevalence of internet addiction among minors being treated in psychiatric inpatient settings. Their clinical symptoms were examined using Youth Self-Report and Child Behavior Checklist. 11.3 % of the patients fulfilled the criteria of addictive internet use. These patients were older and more often affected by anxiety and depression than patients without internet addiction. Data suggest that internet addiction is a relevant factor among minors in psychiatric institutions. Those with comorbid internet addiction show distinct patterns of psychopathology and may require disorder-specific treatment.

Cannabis Use and Risk of Psychiatric Disorders: Prospective Evidence From a US National Longitudinal Study.

PubMed

Blanco, Carlos; Hasin, Deborah S; Wall, Melanie M; Flórez-Salamanca, Ludwing; Hoertel, Nicolas; Wang, Shuai; Kerridge, Bradley T; Olfson, Mark

2016-04-01

With rising rates of marijuana use in the general population and an increasing number of states legalizing recreational marijuana use and authorizing medical marijuana programs, there are renewed clinical and policy concerns regarding the mental health effects of cannabis use. To examine prospective associations between cannabis use and risk of mental health and substance use disorders in the general adult population. A nationally representative sample of US adults aged 18 years or older was interviewed 3 years apart in the National Epidemiologic Survey on Alcohol and Related Conditions (wave 1, 2001-2002; wave 2, 2004-2005). The primary analyses were limited to 34 653 respondents who were interviewed in both waves. Data analysis was conducted from March 15 to November 30, 2015. We used multiple regression and propensity score matching to estimate the strength of independent associations between cannabis use at wave 1 and incident and prevalent psychiatric disorders at wave 2. Psychiatric disorders were measured with a structured interview (Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV). In both analyses, the same set of wave 1 confounders was used, including sociodemographic characteristics, family history of substance use disorder, disturbed family environment, childhood parental loss, low self-esteem, social deviance, education, recent trauma, past and present psychiatric disorders, and respondent's history of divorce. In the multiple regression analysis of 34 653 respondents (14 564 male [47.9% weighted]; mean [SD] age, 45.1 [17.3] years), cannabis use in wave 1 (2001-2002), which was reported by 1279 respondents, was significantly associated with substance use disorders in wave 2 (2004-2005) (any substance use disorder: odds ratio [OR], 6.2; 95% CI, 4.1-9.4; any alcohol use disorder: OR, 2.7; 95% CI, 1.9-3.8; any cannabis use disorder: OR, 9.5; 95% CI, 6.4-14.1; any other drug use disorder: OR, 2.6; 95% CI, 1.6-4.4; and nicotine dependence: OR, 1.7; 95% CI, 1.2-2.4), but not any mood disorder (OR, 1.1; 95% CI, 0.8-1.4) or anxiety disorder (OR, 0.9; 95% CI, 0.7-1.1). The same general pattern of results was observed in the multiple regression analyses of wave 2 prevalent psychiatric disorders and in the propensity score-matched analysis of incident and prevalent psychiatric disorders. Within the general population, cannabis use is associated with an increased risk for several substance use disorders. Physicians and policy makers should take these associations of cannabis use under careful consideration.

Youth Mental Health in a Populous City of the Developing World: Results from the Mexican Adolescent Mental Health Survey

ERIC Educational Resources Information Center

Benjet, Corina; Borges, Guilherme; Medina-Mora, Maria Elena; Zambrano, Joaquin; Aguilar-Gaxiola, Sergio

2009-01-01

Background: Because the epidemiologic data available for adolescents from the developing world is scarce, the objective is to estimate the prevalence and severity of psychiatric disorders among Mexico City adolescents, the socio-demographic correlates associated with these disorders and service utilization patterns. Methods: This is a multistage…

Depressed Adolescents and Comorbid Psychiatric Disorders: Are There Differences in the Presentation of Depression?

ERIC Educational Resources Information Center

Small, David Marc; Simons, Anne D.; Yovanoff, Paul; Silva, Susan G.; Lewis, Cara C.; Murakami, Jessica L.; March, John

2008-01-01

Patterns and correlates of comorbidity, as well as differences in manifest depressive profiles were investigated in a sample of depressed adolescents. A sub-sample of the youth were characterized as belonging to either a "Pure" depression group, an "Internalizing" group (depression and co-occurring internalizing disorders), or an "Externalizing"…

Religiousness, religious coping methods and distress level among psychiatric patients in Malaysia.

PubMed

Nurasikin, M S; Khatijah, L A; Aini, A; Ramli, M; Aida, S A; Zainal, N Z; Ng, C G

2013-06-01

Patients having psychiatric diagnoses often experience high level of distress. Religiousness is often used by them as part of their coping mechanism and problem-solving strategies. To determine the level of religious commitment and coping methods in psychiatric patients and its relationship with distress level. Religious commitment and coping patterns were measured with the Duke University Religious Index (DUREL) and Brief RCOPE, respectively. Psychopathology was assessed using the Brief Psychiatric Rating Scale (BPRS) and distress level was assessed with the Depressive, Anxiety and Stress Scale (DASS). Social support and experiences of recent threatening events were measured with the Multidimensional Scale of Perceived Social Support (MSPSS) and Life Threatening Events (LTE). A total of 228 patients were included in this study with a mean age of 40.2 years. The majority were male, Malay, Muslim, single and with psychotic disorder. The subjects had a high level of religious commitment and had used more positive coping methods. Negative religious coping, psychiatric symptoms and diagnosis of anxiety disorder or major depression were significantly associated with high distress level. Higher religious commitment was significantly associated with lower distress (p < .05). Psychiatric patients were religiously committed and used more positive religious coping methods. Practices of negative religious coping, severe psychiatric symptoms and anxiety/depression were associated with higher distress.

Alterations of Intrinsic Brain Connectivity Patterns in Depression and Bipolar Disorders: A Critical Assessment of Magnetoencephalography-Based Evidence

PubMed Central

Alamian, Golnoush; Hincapié, Ana-Sofía; Combrisson, Etienne; Thiery, Thomas; Martel, Véronique; Althukov, Dmitrii; Jerbi, Karim

2017-01-01

Despite being the object of a thriving field of clinical research, the investigation of intrinsic brain network alterations in psychiatric illnesses is still in its early days. Because the pathological alterations are predominantly probed using functional magnetic resonance imaging (fMRI), many questions about the electrophysiological bases of resting-state alterations in psychiatric disorders, particularly among mood disorder patients, remain unanswered. Alongside important research using electroencephalography (EEG), the specific recent contributions and future promise of magnetoencephalography (MEG) in this field are not fully recognized and valued. Here, we provide a critical review of recent findings from MEG resting-state connectivity within major depressive disorder (MDD) and bipolar disorder (BD). The clinical MEG resting-state results are compared with those previously reported with fMRI and EEG. Taken together, MEG appears to be a promising but still critically underexploited technique to unravel the neurophysiological mechanisms that mediate abnormal (both hyper- and hypo-) connectivity patterns involved in MDD and BD. In particular, a major strength of MEG is its ability to provide source-space estimations of neuromagnetic long-range rhythmic synchronization at various frequencies (i.e., oscillatory coupling). The reviewed literature highlights the relevance of probing local and interregional rhythmic synchronization to explore the pathophysiological underpinnings of each disorder. However, before we can fully take advantage of MEG connectivity analyses in psychiatry, several limitations inherent to MEG connectivity analyses need to be understood and taken into account. Thus, we also discuss current methodological challenges and outline paths for future research. MEG resting-state studies provide an important window onto perturbed spontaneous oscillatory brain networks and hence supply an important complement to fMRI-based resting-state measurements in psychiatric populations. PMID:28367127

Influence of Psychiatric and Personality Disorders on Smoking Cessation among Individuals in Opiate Dependence Treatment

PubMed Central

Cooperman, Nina A.; Lu, Shou-En; Richter, Kimber P.; Bernstein, Steven L.; Williams, Jill M.

2016-01-01

Objective We aimed to evaluate how psychiatric and personality disorders influence smoking cessation goals and attempts among people with opiate dependence who smoke. This information could aid the development of more effective cessation interventions for these individuals. Methods Participants (N=116) were recruited from two methadone clinics, completed the Millon Clinical Multiaxial Inventory–III, and were asked about their smoking behavior and quitting goals. We used the Least Absolute Shrinkage and Selection Operator (LASSO) method, a technique commonly used for studies with small sample sizes and large number of predictors, to develop models predicting having a smoking cessation goal, among those currently smoking daily, and ever making a quit attempt, among those who ever smoked. Results Almost all participants reported ever smoking (n = 115, 99%); 70% (n = 80) had made a serious quit attempt in the past; 89% (n = 103) reported current daily smoking; and, 59% (n = 61) had a goal of quitting smoking and staying off cigarettes. Almost all (n = 112, 97%) had clinically significant characteristics of a psychiatric or personality disorder. White race, anxiety, and a negativistic personality facet (expressively resentful) were negative predictors of having a cessation goal. Overall narcissistic personality pattern and a dependent personality facet (interpersonally submissive) were positive predictors of having a cessation goal. Somatoform disorder, overall borderline personality pattern, and a depressive personality facet (cognitively fatalistic) were negative predictors of ever making a quit attempt. Individual histrionic (gregarious self-image), antisocial (acting out mechanism), paranoid (expressively defensive), and sadistic (pernicious representations) personality disorder facets were positive predictors of ever making a quit attempt. Each model provided good discrimination for having a smoking cessation goal or not (C-statistic of .76, 95% CI[0.66, 0.85]) and ever making a quit attempt or not (C-statistic of .79, 95% CI[0.70, 0.88]). Conclusions Compared to existing treatments, smoking cessation treatments that can be tailored to address the individual needs of people with specific psychiatric disorders or personality disorder traits may better help those in opiate dependence treatment to set a cessation goal, attempt to quit, and eventually quit smoking. PMID:27064523

Common Questions About Cognitive Behavior Therapy for Psychiatric Disorders.

PubMed

Coffey, Scott F; Banducci, Anne N; Vinci, Christine

2015-11-01

Cognitive behavior therapy (CBT) is a time-limited, goal-oriented psychotherapy that has been extensively researched and has benefits in a number of psychiatric disorders, including anxiety, depression, posttraumatic stress disorder, attention-deficit/hyperactivity disorder, autism, obsessive-compulsive and tic disorders, personality disorders, eating disorders, and insomnia. CBT uses targeted strategies to help patients adopt more adaptive patterns of thinking and behaving, which leads to positive changes in emotions and decreased functional impairments. Strategies include identifying and challenging problematic thoughts and beliefs, scheduling pleasant activities to increase environmental reinforcement, and extended exposure to unpleasant thoughts, situations, or physiologic sensations to decrease avoidance and arousal associated with anxiety-eliciting stimuli. CBT can be helpful in the treatment of posttraumatic stress disorder by emphasizing safety, trust, control, esteem, and intimacy. Prolonged exposure therapy is a CBT technique that includes a variety of strategies, such as repeated recounting of the trauma and exposure to feared real-world situations. For attention-deficit/hyperactivity disorder, CBT focuses on establishing structures and routines, and clear rules and expectations within the home and classroom. Early intensive behavioral interventions should be initiated in children with autism before three years of age; therapy consists of 12 to 40 hours of intensive treatment per week, for at least one year. In many disorders, CBT can be used alone or in combination with medications. However, CBT requires a significant commitment from patients. Family physicians are well suited to provide collaborative care for patients with psychiatric disorders, in concert with cognitive behavior therapists.

Purinergic system in psychiatric diseases.

PubMed

Cheffer, A; Castillo, A R G; Corrêa-Velloso, J; Gonçalves, M C B; Naaldijk, Y; Nascimento, I C; Burnstock, G; Ulrich, H

2018-01-01

Psychiatric disorders are debilitating diseases, affecting >80 million people worldwide. There are no causal cures for psychiatric disorders and available therapies only treat the symptoms. The etiology of psychiatric disorders is unknown, although it has been speculated to be a combination of environmental, stress and genetic factors. One of the neurotransmitter systems implicated in the biology of psychiatric disorders is the purinergic system. In this review, we performed a comprehensive search of the literature about the role and function of the purinergic system in the development and predisposition to psychiatric disorders, with a focus on depression, schizophrenia, bipolar disorder, autism, anxiety and attention deficit/hyperactivity disorder. We also describe how therapeutics used for psychiatric disorders act on the purinergic system.

Actigraphy and motion analysis: new tools for psychiatry.

PubMed

Teicher, M H

1995-01-01

Altered locomotor activity is a cardinal sign of several psychiatric disorders. With advances in technology, activity can now be measured precisely. Contemporary studies quantifying activity in psychiatric patients are reviewed. Studies were located by a Medline search (1965 to present; English language only) cross-referencing motor activity and major psychiatric disorders. The review focused on mood disorders and attention-deficit hyperactivity disorder (ADHD). Activity levels are elevated in mania, agitated depression, and ADHD and attenuated in bipolar depression and seasonal depression. The percentage of low-level daytime activity is directly related to severity of depression, and change in this parameter accurately mirrors recovery. Demanding cognitive tasks elicit fidgeting in children with ADHD, and precise measures of activity and attention may provide a sensitive and specific marker for this disorder. Circadian rhythm analysis enhances the sophistication of activity measures. Affective disorders in children and adolescents are characterized by an attenuated circadian rhythm and an enhanced 12-hour harmonic rhythm (diurnal variation). Circadian analysis may help to distinguish between the activity patterns of mania (dysregulated) and ADHD (intact or enhanced). Persistence of hyperactivity or circadian dysregulation in bipolar patients treated with lithium appears to predict rapid relapse once medication is discontinued. Activity monitoring is a valuable research tool, with the potential to aid clinicians in diagnosis and in prediction of treatment response.

The pattern of psychiatric morbidity in a Victorian urban aboriginal general practice population.

PubMed

McKendrick, J; Cutter, T; Mackenzie, A; Chiu, E

1992-03-01

Victorian Aboriginal people, most of whom live an urban lifestyle, form a distinct cultural group within the wider Victorian community. This paper describes a unique psychosocial study of urban Aboriginal adults attending a general practitioner at the Victorian Aboriginal Health Service in Fitzroy. The frequency and nature of psychiatric disorders among survey respondents is reported, together with a discussion of the association between this morbidity and certain sociodemographic variables.

Reasons for referral and diagnostic concordance between physicians/surgeons and the consultation-liaison psychiatry team: An exploratory study from a tertiary care hospital in India

PubMed Central

Grover, Sandeep; Sahoo, Swapnajeet; Aggarwal, Shivali; Dhiman, Shallu; Chakrabarti, Subho; Avasthi, Ajit

2017-01-01

Background: Very few studies have evaluated the reasons for referral to consultation-liaison (CL) psychiatry teams. Aim: This study aimed to evaluate the psychiatric morbidity pattern, reasons for referral and diagnostic concordance between physicians/surgeons and the CL psychiatry team. Materials and Methods: Two hundred and nineteen psychiatric referrals made to the CL psychiatry team were assessed for reason for referral and diagnostic concordance in terms of reason of referral and psychiatric diagnosis made by the CL psychiatry team. Results: In 57% of cases, a specific psychiatric diagnosis was mentioned by the physician/surgeon. The most common specific psychiatric diagnoses considered by the physician/surgeon included depression, substance abuse, and delirium. Most common psychiatric diagnosis made by the CL psychiatric services was delirium followed by depressive disorders. Diagnostic concordance between physician/surgeon and psychiatrist was low (κ < 0.3) for depressive disorders and delirium and better for the diagnosis of substance dependence (κ = 0.678) and suicidality (κ = 0.655). Conclusions: The present study suggests that delirium is the most common diagnosis in referrals made to CL psychiatry team, and there is poor concordance between the psychiatric diagnosis considered by the physician/surgeon and the psychiatrist for delirium and depression; however, the concordance rates for substance dependence and suicidal behavior are acceptable. PMID:28827863

Identification of Common Neural Circuit Disruptions in Cognitive Control Across Psychiatric Disorders.

PubMed

McTeague, Lisa M; Huemer, Julia; Carreon, David M; Jiang, Ying; Eickhoff, Simon B; Etkin, Amit

2017-07-01

Cognitive deficits are a common feature of psychiatric disorders. The authors investigated the nature of disruptions in neural circuitry underlying cognitive control capacities across psychiatric disorders through a transdiagnostic neuroimaging meta-analysis. A PubMed search was conducted for whole-brain functional neuroimaging articles published through June 2015 that compared activation in patients with axis I disorders and matched healthy control participants during cognitive control tasks. Tasks that probed performance or conflict monitoring, response inhibition or selection, set shifting, verbal fluency, and recognition or working memory were included. Activation likelihood estimation meta-analyses were conducted on peak voxel coordinates. The 283 experiments submitted to meta-analysis included 5,728 control participants and 5,493 patients with various disorders (schizophrenia, bipolar or unipolar depression, anxiety disorders, and substance use disorders). Transdiagnostically abnormal activation was evident in the left prefrontal cortex as well as the anterior insula, the right ventrolateral prefrontal cortex, the right intraparietal sulcus, and the midcingulate/presupplementary motor area. Disruption was also observed in a more anterior cluster in the dorsal cingulate cortex, which overlapped with a network of structural perturbation that the authors previously reported in a transdiagnostic meta-analysis of gray matter volume. These findings demonstrate a common pattern of disruption across major psychiatric disorders that parallels the "multiple-demand network" observed in intact cognition. This network interfaces with the anterior-cingulo-insular or "salience network" demonstrated to be transdiagnostically vulnerable to gray matter reduction. Thus, networks intrinsic to adaptive, flexible cognition are vulnerable to broad-spectrum psychopathology. Dysfunction in these networks may reflect an intermediate transdiagnostic phenotype, which could be leveraged to advance therapeutics.

The nursing process in crisis-oriented psychiatric home care.

PubMed

Boomsma, J; Dingemans, C A; Dassen, T W

1997-08-01

Crisis-oriented psychiatric home care is a recent development in the Dutch mental health care system. Because of the difference between psychiatric care in the home and in the hospital, an action research project was initiated. This project was directed at the nursing process and the nurses' role and skills in psychiatric home care. The main goal of the project was to describe and to standardize nursing diagnoses and interventions used in crisis-oriented and long-term psychiatric home care. The development of supporting methods of assessment and intervention were also important aspects of this project. In this article a crisis-oriented psychiatric home care programme and the first developmental research activities within this programme are described. To support the nursing process, the development of a nursing record and an assessment-format, based on Gordon's Functional Health Patterns (FHP), took place. By means of content analysis of 61 nursing records, the most frequently stated nursing diagnoses, based upon the North American Nursing Diagnosis Association (NANDA) taxonomy, were identified. The psychiatric diagnostic categories of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) were also collected. The most common categories found were those of mood disorders and schizophrenia or psychotic disorders. Seventy-five per cent of the nursing diagnoses showed up within four FHP: role-relationship, coping-stress tolerance, self-perception/self-concept and activity-exercise. The nursing diagnosis of 'ineffective individual coping' was stated most frequently. This is not surprising because of the similarities in the definitions of this nursing diagnosis and the concept of 'crisis' to which the psychiatric home care programme is oriented. Further research activities will be focused on standardization of nursing diagnosis and the interventions that nurses undertake in this type of care.

The Psychiatric Consequences of Cannabinoids.

PubMed

De Aquino, Joao P; Sherif, Mohamed; Radhakrishnan, Rajiv; Cahill, John D; Ranganathan, Mohini; D'Souza, Deepak C

2018-04-17

With rising rates of cannabis use in the general population and an increasing number of US states legalizing both recreational and medical cannabis use, it is important to be informed about the adverse consequences of cannabinoids. This Commentary provides an overview of the psychiatric effects of plant-based and synthetic cannabinoids, differentiating acute effects from effects associated with persistent use. Cannabinoids produce multiphasic and dose-dependent effects on anxiety, mood, and perception, in addition to impairing cognition and psychomotor function. Generally, in healthy individuals, the acute negative psychiatric effects of cannabinoids are rated as milder in severity compared with those in individuals with pre-existing psychiatric disorders. With chronic exposure to cannabinoids, the probability of developing tolerance and dependence can increase. A problematic pattern of cannabis use can lead to clinically significant impairment and distress. Cessation of cannabis use in individuals who are tolerant and dependent can lead to a withdrawal syndrome. Studies report long-term cannabis exposure has been linked to psychiatric disorders, such as anxiety, psychotic and mood disorders. Limitations to the existing evidence notwithstanding, the plausibility of a causal relationship between cannabinoid exposure and persistent negative psychiatric outcomes, and the potential for long-term brain changes by regular exposure, especially for adolescents, are sufficient to warrant discussions with clinicians and the public. Implications for clinicians who certify, prescribe, or care for patients receiving cannabinoids are discussed, and a case is made for further research to better understand the impact of legalization on public mental health. Copyright © 2018. Published by Elsevier Inc.

Therapeutic approaches for survivors of disaster.

PubMed

Austin, L S; Godleski, L S

1999-12-01

Common psychiatric responses to disasters include depression, PTSD, generalized anxiety disorder, substance-abuse disorder, and somatization disorder. These symptom complexes may arise because of the various types of trauma experienced, including terror or horror, bereavement, and disruption of lifestyle. Because different types of disaster produce different patterns of trauma, clinical response should address the special characteristics of those affected. Traumatized individuals are typically resistant to seeking treatment, so treatment must be taken to the survivors, at locations within their communities. Most helpful is to train and support mental health workers from the affected communities. Interventions in groups have been found to be effective to promote catharsis, support, and a sense of identification with the group. Special groups to be considered include children, injured victims, people with pre-existing psychiatric histories, and relief workers.

Examining the Clinical Correlates of Autism Spectrum Disorder in Youth by Ascertainment Source

PubMed Central

Joshi, Gagan; Faraone, Stephen V; Wozniak, Janet; Petty, Carter; Fried, Ronna; Galdo, Maribel; Furtak, Stephannie L.; McDermott, Katie; Epstien, Cecily; Walker, Rosemary; Caron, Ashley; Feinberg, Leah; Biederman, Joseph

2014-01-01

Objective To examine whether presentation of autism spectrum disorder (ASD) and associated patterns of psychiatric comorbidity and dysfunction vary by referral source. Methods ASD youth referred to a specialized ambulatory program for ASD (N=143) were compared to ASD youth referred to a general child psychiatry clinic (N=217). Results More ASD clinic youth met criteria for a more robust form of ASD (autistic disorder); more youth referred to the psychiatry clinic met criteria for broader spectrum ASD (PDD-NOS). General psychiatry clinic youth with ASD suffered from a greater burden of psychopathologies and higher levels of dysfunction. Conclusion The presentation of ASD in psychiatrically referred youth differs between general and ASD-specialized clinics, though both referral populations have high levels of comorbidity and dysfunction. PMID:24566937

PSYCHIATRIC DISORDERS AND SLEEP

PubMed Central

Krystal, Andrew D.

2012-01-01

SYNOPSIS Psychiatric disorders and sleep are related in important ways. In contrast to the longstanding view of this relationship which viewed sleep problems as symptoms of psychiatric disorders, there is growing experimental evidence that the relationship between psychiatric disorders and sleep is complex and includes bi-directional causation. In this article we provide the evidence that supports this point of view, reviewing the data on the sleep disturbances seen in patients with psychiatric disorders but also reviewing the data on the impact of sleep disturbances on psychiatric conditions. Although much has been learned about the psychiatric disorders-sleep relationship, additional research is needed to better understand these relationships. This work promises to improve our ability to understand both of these phenomena and to allow us to better treat the many patients with sleep disorders and with psychiatric disorders. PMID:23099143

Trajectories and Correlates of Special Education Supports for Youth with Autism Spectrum Disorder and Psychiatric Comparisons

ERIC Educational Resources Information Center

Spaulding, Christine J.; Lerner, Matthew D.; Gadow, Kenneth D.

2017-01-01

Relatively little is known about patterns of school-based supportive services for youth with autism spectrum disorder. This study describes these supportive services and their correlates, both cross-sectionally and retrospectively, in a large sample (N = 283) of 6- to 18-year-old youth. To assess whether special education designation and classroom…

Examining the Clinical Correlates of Autism Spectrum Disorder in Youth by Ascertainment Source

ERIC Educational Resources Information Center

Joshi, Gagan; Faraone, Stephen V.; Wozniak, Janet; Petty, Carter; Fried, Ronna; Galdo, Maribel; Furtak, Stephannie L.; McDermott, Katie; Epstien, Cecily; Walker, Rosemary; Caron, Ashley; Feinberg, Leah; Biederman, Joseph

2014-01-01

To examine whether presentation of autism spectrum disorder (ASD) and associated patterns of psychiatric comorbidity and dysfunction vary by referral source. ASD youth referred to a specialized ambulatory program for ASD (N = 143) were compared to ASD youth referred to a general child psychiatry clinic (N = 217). More ASD clinic youth met criteria…

Psychiatric disorders and the labor market: an analysis by disorder profiles.

PubMed

Cowell, Alexander J; Luo, Zhehui; Masuda, Yuta J

2009-03-01

A key societal cost of mental illness is its impact on the labor market. In examining the relationship between psychiatric disorders and the labor market, the literature to date either examines psychiatric disorders in broad classes or focuses on the impact of specific conditions. The aim is to examine the relationships among meaningful profiles of concurrent past year disorders and labor market outcomes by gender. Data are from the National Epidemiologic Survey on Alcohol and Related Conditions for 2001/2002 (NESARC), a representative sample of the noninstitutionalized population aged 18 or older residing in the United States. The analysis sample contains 18,429 women and 16,426 men (unweighted). We examined the relationship between profiles of psychiatric disorders and three labor market outcomes: labor force participation; employment, conditional on labor force participation; and working full-time conditional on being employed. Because no attempt was made to control for potential endogeneity between the labor market outcomes and the psychiatric profiles, we are unable to establish the causal direction of the associations estimated. First, anxiety disorders among women appear to be associated with labor market outcomes (e.g., anxiety profile in employment outcome: OR=0.76, p<.05). Second, for employment among women large effects were seen for mood disorder and mood and anxiety; in contrast for men, these disorder profiles had significant associations with working full-time rather than employment. Third, for women, of the three labor market outcomes, employment status is particularly sensitive to the profiles of disorders. For men, no such pattern was found for any single labor market outcome. Concurrent psychiatric disorder profiles affect men and women differently in the labor market. The greatest differences are in (i) the relationship between labor market outcomes and profiles exhibiting anxiety disorders, and (ii) which labor market outcomes are influenced. The main methodological limitation is that the approach does not attempt to assert a direction of causation between mental health conditions and the labor market outcomes. Unobserved heterogeneity and endogeneity are both possible and likely to some degree. Other limitations pertain to the data, which are cross-sectional and exclude some relatively rare disorders (e.g., schizophrenia). The results may have significant implications for access to appropriate treatment, which may vary greatly by psychiatric disorder profile and by gender. In the United States, private third-party coverage for treatment is obtained either directly through working full-time at a medium to large firm or through a spouse being employed. The findings thus suggest that mental health policy may need to account for labor market policy. Additional research is needed to disentangle the findings presented. For example, it is important to separate the influence of substance use disorders from mood disorder and uncover the pathways by which the different conditions in substance use disorders may influence the job market.

Olfactory Disorder Pattern In Patients With Neurological Diseases Excluding Psychiatric And Traumatic Aetiologies.

PubMed

de Haro-Licer, Josep; González-Fernández, Adela; Planas-Comes, Albert; González-Ares, Josep Antón

2018-03-23

The most common cause of olfactory ENT disorders are colds and flu, chronic sinusitis, allergies and traumatic brain injury. Rarer aetiologies include certain neurological, psychiatric and metabolic injuries. The aim of this paper was to check the sort of olfactory disorders found in people who have suffered a brain injury, excluding: cranial traumas, psychiatric diseases, epilepsy, Parkinson's and Alzheimer's disease, and synaesthesia. A descriptive study based on 61 patients with diagnoses of various neurological injuries, which were tested by BAST-24 olfactometer. The results were compared with those of a control group (n= 120). The results show major impairment in these patients' olfactory sense. The neurological injury patients were able to detect from 60-77% of the odours, while the control group were able to detect between 98-100%. The neurological patients were able, at best, to identify, 11-32% of the odours correctly, while the control group were able to correctly detect between 59 -75%. The differences between odour detection and correct identification were statistically significant (p<.05). We concluded: a) Neurological injury, not caused by traumatic brain injury, psychiatric disorders or ENT diseases, ranged from 68-89% of the olfactory failures. b) We must bear in mind that these sorts of injuries can cause olfactory disorders. c) ENT and Neurologists should collaborate in the treatment of these disorders. Copyright © 2018 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Publicado por Elsevier España, S.L.U. All rights reserved.

High Rates of Psychiatric Disorders and Below Normal Mental Capacity Associated With Spastic Peroneal Flatfoot: A New Relationship.

PubMed

Kılıçoğlu, Önder İsmet; Salduz, Ahmet; Birişik, Fevzi; Bilgili, Fuat; Polat, Gökhan; Kaya, İlyas; Süleyman, Funda; Coşkun, Murat

Spastic peroneal flatfoot (SPFF) is a rare hindfoot pathology usually seen in the adolescent age group that is characterized by painful spasms in the peroneal muscles. We have clinically observed that patients with SPFF also have some behavioral and emotional difficulties and problems in their academic achievements. Because of these observations, we investigated the prevalence and patterns of psychiatric disorders and intellectual disability among young subjects with SPFF. Our cohort consisted of 16 patients with SPFF. Their mean age at presentation was 21 (range 13 to 31) years. Only 6 patients had a tarsal coalition as an underlying condition. The psychometric evaluation was conducted using validated instruments (Wechsler Intelligence Scale for Children-revised form, Stanford Binet intelligence quotient [IQ] test, and Cattell IQ test). Psychiatric disorders were assessed using a semistructured diagnostic instrument (Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version). The testers and psychiatrists were unaware of the orthopedic condition and the preliminary psychiatric diagnoses. The ethical committee approved the study protocol. The mean follow-up period was 41 (range 12 to 97) months. The mean IQ score of the patients was 75.1 ± 17.9 (range 52 to 107). Compared with the general population, the rate of intellectual disability was significantly greater (p = .0001) and the rate of normal intelligence significantly lower (p = .0015) in our patient group. Furthermore, according to the community schooling ratio, our cohort also had lower junior high and secondary education rates compared with the general population. The rate of most psychiatric disorders diagnosed in the SPFF patients was greater than that in the normal population. The most commonly identified psychiatric disorders were social phobia and attention deficit and hyperactivity disorder (75%). Timely interventions of the psychosocial and academic problems of patients with SPFF might increase their compliance with orthopedic treatment and help with their psychological well-being and academic achievement. In addition, this relationship might be a clue for uncovering the etiology of this disease, which has not yet been clarified. Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Comorbid psychiatric disorders in female adolescents with first-onset anorexia nervosa.

PubMed

Bühren, K; Schwarte, R; Fluck, F; Timmesfeld, N; Krei, M; Egberts, K; Pfeiffer, E; Fleischhaker, C; Wewetzer, C; Herpertz-Dahlmann, B

2014-01-01

Patients with anorexia nervosa (AN) exhibit high rates of psychiatric comorbidity. To disentangle the effects of duration of illness on comorbid psychiatric symptoms, we investigated the rates of comorbid psychiatric disorders, suicidality and self-harm behaviour in adolescent patients with a first onset of AN. In adolescent females (n = 148) with a first onset of AN, body mass index, psychiatric comorbidity (according to DSM-IV), depressive symptoms, suicidality and self-injurious behaviour were assessed. Seventy patients (47.3%) met the criteria for at least one comorbid psychiatric disorder. The binge-purging subtype was associated with increased rates of psychiatric comorbidity, suicidality and self-injurious behaviour. The severity of eating disorder-specific psychopathology influenced current psychiatric comorbidity and suicidal ideation. Prevalence rates of comorbid psychiatric disorders and suicidal ideation are considerably lower among adolescents with AN compared with adults. An early and careful assessment, along with adequate treatment of the eating disorder, might prevent the development of severe psychiatric comorbidities. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.

Pituitary gland in psychiatric disorders: a review of neuroimaging findings.

PubMed

Atmaca, Murad

2014-08-01

In this paper, it was reviewed neuroimaging results of the pituitary gland in psychiatric disorders, particularly schizophrenia, mood disorders, anxiety disorders, and somatoform disorders. The author made internet search in detail by using PubMed database including the period between 1980 and 2012 October. It was included in the articles in English, Turkish and French languages on pituitary gland in psychiatric disorders through structural or functional neuroimaging results. After searching mentioned in the Methods section in detail, investigations were obtained on pituitary gland neuroimaging in a variety of psychiatric disorders. There have been so limited investigations on pituitary neuroimaging in psychiatric disorders including major psychiatric illnesses like schizophrenia and mood disorders. Current findings are so far from the generalizability of the results. For this reason, it is required to perform much more neuroimaging studies of pituitary gland in all psychiatric disorders to reach the diagnostic importance of measuring it.

Suicidal Behavior and Alcohol Abuse

PubMed Central

Pompili, Maurizio; Serafini, Gianluca; Innamorati, Marco; Dominici, Giovanni; Ferracuti, Stefano; Kotzalidis, Giorgio D.; Serra, Giulia; Girardi, Paolo; Janiri, Luigi; Tatarelli, Roberto; Sher, Leo; Lester, David

2010-01-01

Suicide is an escalating public health problem, and alcohol use has consistently been implicated in the precipitation of suicidal behavior. Alcohol abuse may lead to suicidality through disinhibition, impulsiveness and impaired judgment, but it may also be used as a means to ease the distress associated with committing an act of suicide. We reviewed evidence of the relationship between alcohol use and suicide through a search of MedLine and PsychInfo electronic databases. Multiple genetically-related intermediate phenotypes might influence the relationship between alcohol and suicide. Psychiatric disorders, including psychosis, mood disorders and anxiety disorders, as well as susceptibility to stress, might increase the risk of suicidal behavior, but may also have reciprocal influences with alcohol drinking patterns. Increased suicide risk may be heralded by social withdrawal, breakdown of social bonds, and social marginalization, which are common outcomes of untreated alcohol abuse and dependence. People with alcohol dependence or depression should be screened for other psychiatric symptoms and for suicidality. Programs for suicide prevention must take into account drinking habits and should reinforce healthy behavioral patterns. PMID:20617037

Sleep and psychiatry

PubMed Central

Abad, Vivien C.; Guilleminault, Christian

2005-01-01

Psychiatric disorders constitute 15.4% of the disease burden in established market economies. Many psychiatric disorders are associated with sleep disturbances, and the relationship is often bidirectional. This paper reviews the prevalence of various psychiatric disorders, their clinical presentation, and their association with sleep disorders. Among the psychiatric disorders reviewed are affective disorders, psychosis, anxiety disorders (including post-traumatic stress disorder), substance abuse disorders, eating disorders, and attention deficit/hyperactivity disorders. The spectrum of associated sleep disorders includes insomnia, hypersomnia, nocturnal panic, sleep paralysis, hypnagogic hallucinations, restless legs/periodic limb movements of sleep, obstructive sleep apnea, and parasomnias. The effects on sleep of various psychotropic medications utilized to treat the above psychiatric disorders are summarized. PMID:16416705

Psychiatric disorder and work life: A longitudinal study of intra-generational social mobility.

PubMed

Tiikkaja, Sanna; Sandin, Sven; Hultman, Christina M; Modin, Bitte; Malki, Ninoa; Sparén, Pär

2016-03-01

Intra-generational social mobility, which describes the mobility within an individual's own working life, is seldom studied among employees with psychiatric disorders (EPD). There is need of knowledge of the intra-generational mobility patterns, in a broader perspective, among EPD. To investigate intra-generational social mobility in employed individuals diagnosed with affective disorder, personality disorder, schizophrenia and drug dependence in a national Swedish cohort. We identified a national sample of employed Swedish adults born in 1939-1949 (N = 876, 738), and among them individuals with a first-time hospital admission for affective psychosis, neurosis and personality disorder, alcoholism, drug dependence or schizophrenia in 1964-1980 (N = 18, 998). Employed individuals without hospital admission for such diagnoses were utilised as a comparison group (N = 866, 442). Intra-individual social class changes between 1980 and 1990 among EPD and the comparison group were described through summary statistics and graphs. EPD more often held Low manual occupations at baseline in 1980 than the comparison group (44% vs. 28%), although parental social class was similar. In 1990, 19% of EPD and 4% of the comparison group had lost contact with the labour market. Social stability was less common among EPD (49 %) than in the comparison group (67%). Mobility out of the labour force increased and social stability decreased by number of inpatient admissions. Employees diagnosed with affective psychosis or neurosis and personality disorder fared better in the labour market than employees with schizophrenia. Employees suffering from psychiatric disorder do not maintain their social class or remain in the labour force to the same extent as individuals without those problems, irrespective of their parental class. Our results support the social drift hypothesis that individuals with poor psychiatric health move downward in the social hierarchy. © The Author(s) 2015.

Association of child and adolescent psychiatric disorders with somatic or biomedical diagnoses: do population-based utilization study results support the adverse childhood experiences study?

PubMed

Wilkes, T C R; Guyn, Lindsay; Li, Bing; Lu, Mingshan; Cawthorpe, David

2012-01-01

Few population-based studies have examined the relationship between psychiatric and somatic or biomedical disorders. We examined the effect of the presence or absence of any psychiatric disorder on somatic or biomedical diagnosis disorder costs. Guided by the Kaiser Permanente and Centers for Disease Control and Prevention Adverse Childhood Experiences (ACE) Study, we examined our administrative data to test if psychiatric disorder is associated with a higher level of somatic disorder. A dataset containing registration data for 205,281 patients younger than age 18 years was randomly selected from administrative data based on these patients never having received any specialized, publicly funded ambulatory, emergency or inpatient admission for treatment of a psychiatric disorder. All physician billing records (8,724,714) from the 16 fiscal years April 1993 to March 2009 were collected and grouped on the basis of presence or absence of any International Classification of Diseases (ICD) psychiatric disorder. We compared 2 groups (with or without any psychiatric disorder: dependent variable) on the cumulative 16-year mean cost for somatic (biomedical, nonpsychiatric) ICD diagnoses (independent variable). Billing costs related to somatic and biomedical disorders (nonpsychiatric costs) were 1.8 times greater for those with psychiatric disorders than for those without psychiatric disorders. Somatic costs peaked before the age of 6 years and remained higher than the groupings without psychiatric disorders in each age range. In support of the ACE study, ICD psychiatric disorders (as an index of developmental adversity) are associated with substantially greater ICD somatic disorders. The findings have implications for health care practice.

Psychiatric Disorders Differently Correlate with Physical Self-Rated Health across Ethnic Groups.

PubMed

Assari, Shervin

2017-11-13

In this study, we compared 10 ethnic groups for associations between psychiatric disorders and physical self-rated health (SRH) in the United States. Data came from the Collaborative Psychiatric Epidemiology Surveys (CPES), 2001-2003. The study included 7587 non-Latino White, 4746 African American, 1442 Mexican, 1106 other Hispanic, 656 other Asian, 600 Chinese, 577 Cuban, 520 Vietnamese, 508 Filipino, and 495 Puerto Rican individuals. The Composite International Diagnostic Interview (CIDI) was used to measure psychiatric disorders, including major depressive disorder (MDD), general anxiety disorder (GAD), social phobia, panic disorder, post-traumatic stress disorder (PTSD), alcohol abuse, and binge eating disorders. A single-item measure was used to estimate physical SRH. Demographic (age and gender) and socioeconomic (education and income) factors were also measured. Unadjusted and adjusted correlations between psychiatric disorders and physical SRH were calculated. Major ethnic variations were found in the correlation between psychiatric disorders and physical SRH; as well as the role of demographic and socioeconomic status (SES) factors in explaining these associations. non-Hispanic Whites, Cubans, and African Americans showed more correlations between psychiatric disorders and physical SRH than other ethnic groups. In non-Hispanic Whites, the associations between psychiatric disorders and physical SRH were explained by demographic factors. In African Americans, the link between psychiatric disorders and poor physical SRH were explained by SES indicators. In conclusion , although single-item physical SRH measures are traditionally assumed to reflect the physical health needs of populations, they may also indicate psychiatric disorders in some ethnic groups, such as non-Hispanic Whites, Cubans, and African Americans. Demographic and socioeconomic factors also have differential roles in explaining the link between psychiatric disorders and physical SRH. Physical SRH does not exclusively reflect physical health, and it may be more biased by mental health across some ethnic groups.

Microendophenotypes of psychiatric disorders: phenotypes of psychiatric disorders at the level of molecular dynamics, synapses, neurons, and neural circuits.

PubMed

Kida, S; Kato, T

2015-01-01

Psychiatric disorders are caused not only by genetic factors but also by complicated factors such as environmental ones. Moreover, environmental factors are rarely quantitated as biological and biochemical indicators, making it extremely difficult to understand the pathological conditions of psychiatric disorders as well as their underlying pathogenic mechanisms. Additionally, we have actually no other option but to perform biological studies on postmortem human brains that display features of psychiatric disorders, thereby resulting in a lack of experimental materials to characterize the basic biology of these disorders. From these backgrounds, animal, tissue, or cell models that can be used in basic research are indispensable to understand biologically the pathogenic mechanisms of psychiatric disorders. In this review, we discuss the importance of microendophenotypes of psychiatric disorders, i.e., phenotypes at the level of molecular dynamics, neurons, synapses, and neural circuits, as targets of basic research on these disorders.

Comorbidity of autoimmune thyroid disorders and psychiatric disorders during the postpartum period: a Danish nationwide register-based cohort study.

PubMed

Bergink, V; Pop, V J M; Nielsen, P R; Agerbo, E; Munk-Olsen, T; Liu, X

2018-06-01

The postpartum period is well-known risk period for the first onset of autoimmune thyroid disorders (AITDs) as well as first onset of psychiatric disorders. These two disorders are some of the most prevalent medical conditions postpartum, often misdiagnosed and disabling if left untreated. Our study was designed to explore the possible bidirectional association between AITDs and psychiatric disorders during the postpartum period. A population-based cohort study through linkage of Danish national registers, which comprised 312 779 women who gave birth to their first child during 1997-2010. We conducted Poisson regression analysis to estimate the incidence rate ratio (IRR) of psychiatric disorders among women with first-onset AITDs, the IRR of AITDs among women with first-onset psychiatric disorders as well as the overlap between these disorders using a comorbidity index. Women with first-onset AITDs postpartum were more likely to have first-onset psychiatric disorders than women who did not have postpartum AITDs (IRR = 1.88, 95% confidence interval (CI): 1.25-2.81). Women with first-onset postpartum psychiatric disorders had a higher risk of AITDs than women with no psychiatric disorders (IRR = 2.16, 95% CI: 1.45-3.20). The comorbidity index 2 years after delivery was 2.26 (95% CI: 1.61-2.90), indicating a comorbidity between first-onset AITDs and psychiatric disorders. First-onset AITDs and psychiatric disorders co-occur in the postpartum period, which has relevance to further studies on the etiologies of these disorders and why childbirth in particular triggers the onset.

Epidemiology of psychiatric disability without posttraumatic stress disorder among U.S. Army and Marine Corps personnel evaluated for disability discharge.

PubMed

Piccirillo, Amanda L; Packnett, Elizabeth R; Boivin, Michael R; Cowan, David N

2015-12-01

Psychiatric disorders are a common reason for disability discharge from the U.S. military. Research on psychiatric disorders in military personnel evaluated for disability discharge has historically focused on posttraumatic stress disorder (PTSD), yet 40% of service members evaluated for a psychiatric-related disability do not have PTSD. This study's objective was to describe characteristics and correlates of disability in Army and Marine Corps personnel diagnosed with psychiatric disorders other than PTSD. In this cross-sectional study, the chi-square and Wilcoxon-Mann-Whitney tests compared the distribution of demographic, disability and deployment characteristics between those evaluated for non-PTSD psychiatric disability (N = 9125) versus those evaluated for any other non-psychiatric condition (N = 78,072). Multivariate logistic regression examined associations between disability retirement and demographic and disability characteristics. Results show a significantly higher prevalence of disability retirement, deployment, and comorbidity among Army and Marine Corps personnel evaluated for disability discharge related to a non-PTSD psychiatric disorder. Mood disorders, anxiety disorders and dementia were the most commonly evaluated psychiatric disorders. Characteristics associated with increased odds of non-PTSD psychiatric-related disability retirement includes being in the Marine Corps (OR = 1.24), being black (OR = 1.29) or other race (OR = 1.33), having a combat-related condition (OR = 2.50), and older age. Service members evaluated for a non-PTSD psychiatric disability have similar rates of disability retirement as those evaluated for PTSD, suggesting non-PTSD psychiatric disorders cause a severe and highly compensated disability. Additional research is needed describing the epidemiology of specific non-PTSD psychiatric disorders, such as depression, in service members evaluated for disability discharge. Copyright © 2015 Elsevier Ltd. All rights reserved.

High Rates of Psychiatric Comorbidity in Narcolepsy: Findings From the Burden of Narcolepsy Disease (BOND) Study of 9,312 Patients in the United States.

PubMed

Ruoff, Chad M; Reaven, Nancy L; Funk, Susan E; McGaughey, Karen J; Ohayon, Maurice M; Guilleminault, Christian; Black, Jed

2017-02-01

To evaluate psychiatric comorbidity patterns in patients with a narcolepsy diagnosis in the United States. Truven Health Analytics MarketScan Research Databases were accessed to identify individuals ≥ 18 years of age with ≥ 1 ICD-9 diagnosis code(s) for narcolepsy continuously insured between 2006 and 2010 and non-narcolepsy controls matched 5:1 (age, gender, region, payer). Extensive subanalyses were conducted to confirm the validity of narcolepsy definitions. Narcolepsy subjects and controls were compared for frequency of psychiatric comorbid conditions (based on ICD-9 codes/Clinical Classification Software [CCS] level 2 categories) and psychiatric medication use. The final population included 9,312 narcolepsy subjects and 46,559 controls (each group, mean age = 46.1 years; 59% female). All categories of mental illness were significantly more prevalent in patients with narcolepsy versus controls, with the highest excess prevalence noted for CCS 5.8 Mood disorders (37.9% vs 13.8%; odds ratio [OR] = 4.0; 95% CI, 3.8-4.2), CCS 5.8.2 Depressive disorders (35.8% vs 13.0%; OR = 3.9; 95% CI, 3.7-4.1), and CCS 5.2 Anxiety disorders (25.1% vs 11.9%; OR = 2.5; 95% CI, 2.4-2.7). Excess prevalence of anxiety and mood disorders (narcolepsy vs controls) was higher in younger age groups versus older age groups. Psychiatric medication usage was higher in the narcolepsy group versus controls in the following categories: selective serotonin reuptake inhibitors (36% vs 17%), anxiolytic benzodiazepines (34% vs 19%), hypnotics (29% vs 13%), serotonin-norepinephrine reuptake inhibitors (21% vs 6%), and tricyclic antidepressants (13% vs 4%) (all P values < .0001). Narcolepsy is associated with significant comorbid psychiatric illness burden and higher psychiatric medication usage compared with the non-narcolepsy population. © Copyright 2016 Physicians Postgraduate Press, Inc.

Clinical Utility and Lifespan Profiling of Neurological Soft Signs in Schizophrenia Spectrum Disorders

PubMed Central

Chan, Raymond C. K.; Xie, Weizhen; Geng, Fu-lei; Wang, Ya; Lui, Simon S. Y.; Wang, Chuan-yue; Yu, Xin; Cheung, Eric F. C.; Rosenthal, Robert

2016-01-01

Neurological soft signs (NSSs) bear the promise for early detection of schizophrenia spectrum disorders. Nonetheless, the sensitivity and specificity of NSSs in the psychosis continuum remains a topic of controversy. It is also unknown how NSSs reveal neurodevelopmental abnormality in schizophrenia. We investigated the effect sizes of NSSs in differentiating individuals with schizophrenia spectrum disorders from individuals with other psychiatric conditions and from covariate-matched healthy subjects. We also investigated the partitioned age-related variations of NSSs in both schizophrenia and healthy individuals. NSSs were assessed by the abridged version of the Cambridge Neurological Inventory (CNI) in 3105 participants, consisting of healthy individuals (n =1577), unaffected first-degree relatives of schizophrenia patients (n = 155), individuals with schizotypal personality disorder (n = 256), schizophrenia patients (n = 738), and other psychiatric patients (n = 379). Exact matching and propensity score matching procedures were performed to control for covariates. Multiple regression was used to partition age-related variations. Individuals along the schizophrenia continuum showed elevated levels of NSSs, with moderate effect sizes, in contrast to other psychiatric patients who had minimal NSSs, as well as matched healthy controls. Furthermore, the age-and-NSS relationship in schizophrenia patients was represented by a flat but overall elevated pattern, in contrast to a U-shaped pattern in healthy individuals. In sum, NSSs capture a moderate portion of psychosis proneness with reasonable specificity. Lifespan profiling reveals an abnormal developmental trajectory of NSSs in schizophrenia patients, which supports the endophenotype hypothesis of NSSs by associating it with the neurodevelopmental model of schizophrenia. PMID:26712863

The predictive power of family history measures of alcohol and drug problems and internalizing disorders in a college population.

PubMed

Kendler, Kenneth S; Edwards, Alexis; Myers, John; Cho, Seung Bin; Adkins, Amy; Dick, Danielle

2015-07-01

A family history (FH) of psychiatric and substance use problems is a potent risk factor for common internalizing and externalizing disorders. In a large web-based assessment of mental health in college students, we developed a brief set of screening questions for a FH of alcohol problems (AP), drug problems (DP) and depression-anxiety in four classes of relatives (father, mother, aunts/uncles/grandparents, and siblings) as reported by the student. Positive reports of a history of AP, DP, and depression-anxiety were substantially correlated within relatives. These FH measures predicted in the student, in an expected pattern, dimensions of personality and impulsivity, alcohol consumption and problems, smoking and nicotine dependence, use of illicit drugs, and symptoms of depression and anxiety. Using the mean score from the four classes of relatives was more predictive than using a familial/sporadic dichotomy. Interactions were seen between the FH of AP, DP, and depression-anxiety and peer deviance in predicting symptoms of alcohol and tobacco dependence. As the students aged, the FH of AP became a stronger predictor of alcohol problems. While we cannot directly assess the validity of these FH reports, the pattern of findings suggest that our brief screening items were able to assess, with some accuracy, the FH of substance misuse and internalizing psychiatric disorders in relatives. If correct, these measures can play an important role in the creation of developmental etiologic models for substance and internalizing psychiatric disorders which constitute one of the central goals of the overall project. © 2015 Wiley Periodicals, Inc.

A Window into the Brain: Advances in Psychiatric fMRI

PubMed Central

Zhan, Xiaoyan

2015-01-01

Functional magnetic resonance imaging (fMRI) plays a key role in modern psychiatric research. It provides a means to assay differences in brain systems that underlie psychiatric illness, treatment response, and properties of brain structure and function that convey risk factor for mental diseases. Here we review recent advances in fMRI methods in general use and progress made in understanding the neural basis of mental illness. Drawing on concepts and findings from psychiatric fMRI, we propose that mental illness may not be associated with abnormalities in specific local regions but rather corresponds to variation in the overall organization of functional communication throughout the brain network. Future research may need to integrate neuroimaging information drawn from different analysis methods and delineate spatial and temporal patterns of brain responses that are specific to certain types of psychiatric disorders. PMID:26413531

Association analysis of the monoamine oxidase A gene in bipolar affective disorder by using family-based internal controls

DOE Office of Scientific and Technical Information (OSTI.GOV)

Noethen, M.M.; Eggermann, K.; Propping, P.

1995-10-01

It is well accepted that association studies are a major tool in investigating the contribution of single genes to the development of diseases that do not follow simple Mendelian inheritance pattern (so-called complex traits). Such major psychiatric diseases as bipolar affective disorder and schizophrenia clearly fall into this category of diseases. 7 refs., 1 tab.

Prevalence and risk factors of psychiatric disorders in early adolescence: 2004 Pelotas (Brazil) birth cohort.

PubMed

La Maison, Carolina; Munhoz, Tiago N; Santos, Iná S; Anselmi, Luciana; Barros, Fernando C; Matijasevich, Alicia

2018-04-13

The present study aimed to evaluate the prevalence of psychiatric disorders in early adolescence, to examine the distribution of psychiatric disorders by maternal and child characteristics and to evaluate the occurrence of psychiatric comorbidities. This was a prospective cohort study of all live births in the city of Pelotas, Brazil, in 2004 (n = 4231). A total of 3562 subjects were evaluated at 11 years of age. Psychiatric disorders were assessed using the Development and Well-Being Assessment. Crude and adjusted logistic regression was used to investigate risk factors for any psychiatric disorder. According to DSM-5 criteria, the overall prevalence of psychiatric disorders was 13.2% (n = 471), 15.6% among the boys and 10.7% among the girls. The most common disorders were anxiety disorders (4.3%), any attention deficit/hyperactivity disorder (4.0%) and any conduct/oppositional disorder (2.8%). Low maternal education, smoking during pregnancy, the presence of moods symptoms during pregnancy or maternal chronic and severe depressive symptoms in the first years of the adolescent´s life, male gender, 5-min Apgar score < 7 at birth and preterm birth were associated with higher odds of any psychiatric disorder at age 11. Psychiatric comorbidities were observed in 107 subjects (22.7%), of whom 73, 24, and 10 had two, three, and four psychiatric diagnoses, respectively. Our results underscore the importance of psychiatric disorders as a prevalent condition in early adolescence, which has a direct impact on the planning of public policies and specific mental health care services in this age group.

Traumatization in Deaf and Hard-of-Hearing Adult Psychiatric Outpatients.

PubMed

Øhre, Beate; Uthus, Mette Perly; von Tetzchner, Stephen; Falkum, Erik

2015-07-01

Deaf and hard-of-hearing persons are at risk for experiencing traumatic events and such experiences are associated with symptoms of mental disorder. We investigated the prevalence of traumatic events and subsequent traumatization in adults referred to specialized psychiatric outpatient units for deaf and hard-of-hearing patients. Sixty-two patients were diagnosed with mental disorders and assessed for potential traumatic experiences in their preferred language and mode of communication using instruments translated into Norwegian Sign Language. All patients reported traumatic events, with a mean of 6.2 different types; 85% reported subsequent traumatization not significantly associated with either residential school setting or communicative competence of childhood caregivers. Traumatization patterns in both sexes were similar to those in hearing clinical samples. Findings indicate that psychiatric intake interviews should routinely assess potentially traumatic events and their impacts, and that mental health professionals working with deaf and hard-of-hearing patients should be able to treat trauma-related disorders. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The Twenty-Year Trajectory of Suicidal Activity among Post-Hospital Psychiatric Men and Women with Mood Disorders and Schizophrenia

PubMed Central

Kaplan, Kalman J.; Harrow, Martin; Clews, Kelsey

2016-01-01

The Chicago Follow-up Study has followed the course of severe mental illness among psychiatric patients for over 20 years after their index hospitalization. Among these patients are 97 schizophrenia patients, 45 patients with schizoaffective disorders, 102 patients with unipolar nonpsychotic depression, and 53 patients with a bipolar disorder. Maximum suicidal activity (suicidal ideation, suicidal attempts and suicide completions) generally declines over the three time periods (early, middle, and late follow-ups) following discharge from the acute psychiatric hospitalization for both males and females across diagnostic categories with two exceptions: female schizophrenia patients and female bipolar patients. A weighted mean suicidal activity score tended to decrease across follow-ups for male patients in the schizophrenia, schizoaffective and depressive diagnostic groups with an uneven trend in this direction for the male bipolars. No such pattern emerges for our female patients except for female depressives. Males’ suicidal activity seems more triggered by psychotic symptoms and potential chronic disability while females’ suicidal activity seems more triggered by affective symptoms. PMID:26881891

Pattern recognition and functional neuroimaging help to discriminate healthy adolescents at risk for mood disorders from low risk adolescents.

PubMed

Mourão-Miranda, Janaina; Oliveira, Leticia; Ladouceur, Cecile D; Marquand, Andre; Brammer, Michael; Birmaher, Boris; Axelson, David; Phillips, Mary L

2012-01-01

There are no known biological measures that accurately predict future development of psychiatric disorders in individual at-risk adolescents. We investigated whether machine learning and fMRI could help to: 1. differentiate healthy adolescents genetically at-risk for bipolar disorder and other Axis I psychiatric disorders from healthy adolescents at low risk of developing these disorders; 2. identify those healthy genetically at-risk adolescents who were most likely to develop future Axis I disorders. 16 healthy offspring genetically at risk for bipolar disorder and other Axis I disorders by virtue of having a parent with bipolar disorder and 16 healthy, age- and gender-matched low-risk offspring of healthy parents with no history of psychiatric disorders (12-17 year-olds) performed two emotional face gender-labeling tasks (happy/neutral; fearful/neutral) during fMRI. We used Gaussian Process Classifiers (GPC), a machine learning approach that assigns a predictive probability of group membership to an individual person, to differentiate groups and to identify those at-risk adolescents most likely to develop future Axis I disorders. Using GPC, activity to neutral faces presented during the happy experiment accurately and significantly differentiated groups, achieving 75% accuracy (sensitivity = 75%, specificity = 75%). Furthermore, predictive probabilities were significantly higher for those at-risk adolescents who subsequently developed an Axis I disorder than for those at-risk adolescents remaining healthy at follow-up. We show that a combination of two promising techniques, machine learning and neuroimaging, not only discriminates healthy low-risk from healthy adolescents genetically at-risk for Axis I disorders, but may ultimately help to predict which at-risk adolescents subsequently develop these disorders.

Making psychiatric semiology great again: A semiologic, not nosologic challenge.

PubMed

Micoulaud-Franchi, J-A; Quiles, C; Batail, J-M; Lancon, C; Masson, M; Dumas, G; Cermolacce, M

2018-06-06

This article analyzes whether psychiatric disorders can be considered different from non-psychiatric disorders on a nosologic or semiologic point of view. The supposed difference between psychiatric and non-psychiatric disorders relates to the fact that the individuation of psychiatric disorders seems more complex than for non-psychiatric disorders. This individuation process can be related to nosologic and semiologic considerations. The first part of the article analyzes whether the ways of constructing classifications of psychiatric disorders are different than for non-psychiatric disorders. The ways of establishing the boundaries between the normal and the pathologic, and of classifying the signs and symptoms in different categories of disorder, are analyzed. Rather than highlighting the specificity of psychiatric disorders, nosologic investigation reveals conceptual notions that apply to the entire field of medicine when we seek to establish the boundaries between the normal and the pathologic and between different disorders. Psychiatry is thus very important in medicine because it exemplifies the inherent problem of the construction of cognitive schemes imposed on clinical and scientific medical information to delineate a classification of disorders and increase its comprehensibility and utility. The second part of this article assesses whether the clinical manifestations of psychiatric disorders (semiology) are specific to the point that they are entities that are different from non-psychiatric disorders. The attribution of clinical manifestations in the different classifications (Research Diagnostic Criteria, Diagnostic Statistic Manual, Research Domain Criteria) is analyzed. Then the two principal models on signs and symptoms, i.e. the latent variable model and the causal network model, are assessed. Unlike nosologic investigation, semiologic analysis is able to reveal specific psychiatric features in a patient. The challenge, therefore, is to better define and classify signs and symptoms in psychiatry based on a dual and mutually interactive biological and psychological perspective, and to incorporate semiologic psychiatry into an integrative, multilevel and multisystem brain and cognitive approach. Copyright © 2018 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Examining the impact of psychiatric diagnosis and comorbidity on the medical lethality of adolescent suicide attempts.

PubMed

McManama O'Brien, Kimberly H; Berzin, Stephanie C

2012-08-01

Specific psychiatric diagnoses and comorbidity patterns were examined to determine if they were related to the medical lethality of suicide attempts among adolescents presenting to an urban general hospital (N=375). Bivariate analysis showed that attempters with substance abuse disorders had higher levels of lethality than attempters without substance abuse. Regression results indicated having depression comorbid with any other diagnosis was not associated with medical lethality. However, having a substance abuse disorder was associated with higher suicide attempt lethality, highlighting the importance of substance abuse as a risk factor for lethal suicide attempts in adolescents. This finding stimulates critical thinking around the understanding of suicidal behavior in youth and the development and implementation of treatment strategies for suicidal adolescents with substance abuse disorders. © 2012 The American Association of Suicidology.

Suicide ideation and attempts in children with psychiatric disorders and typical development.

PubMed

Dickerson Mayes, Susan; Calhoun, Susan L; Baweja, Raman; Mahr, Fauzia

2015-01-01

Children and adolescents with psychiatric disorders are at increased risk for suicide behavior. This is the first study to compare frequencies of suicide ideation and attempts in children and adolescents with specific psychiatric disorders and typical children while controlling for comorbidity and demographics. Mothers rated the frequency of suicide ideation and attempts in 1,706 children and adolescents with psychiatric disorders and typical development, 6-18 years of age. For the typical group, 0.5% had suicide behavior (ideation or attempts), versus 24% across the psychiatric groups (bulimia 48%, depression or anxiety disorder 34%, oppositional defiant disorder 33%, ADHD-combined type 22%, anorexia 22%, autism 18%, intellectual disability 17%, and ADHD-inattentive type 8%). Most alarming, 29% of adolescents with bulimia often or very often had suicide attempts, compared with 0-4% of patients in the other psychiatric groups. It is important for professionals to routinely screen all children and adolescents who have psychiatric disorders for suicide ideation and attempts and to treat the underlying psychiatric disorders that increase suicide risk.

Population heterogeneity of trait anger and differential associations of trait anger facets with borderline personality features, neuroticism, depression, Attention Deficit Hyperactivity Disorder (ADHD), and alcohol problems

PubMed Central

Lubke, Gitta H.; Ouwens, Klaasjan G.; de Moor, Marleen H.M.; Trull, Timothy J.; Boomsma, Dorret I.

2015-01-01

Anger is an emotion consisting of feelings of variable intensity ranging from mild irritation to intense fury. High levels of trait anger are associated with a range of psychiatric, interpersonal, and health problems. The objectives of this study were to explore heterogeneity of anger as measured by the Spielberger Trait Anger Scale (STAS), and to assess the association of the different anger facets with a selection of psychiatric disorders covering externalizing and internalizing problems, personality disorders, and substance use. Factor mixture models differentiated between a high and low scoring class (28% vs. 72%), and between three factors (anger-temperament, anger-reaction, and immediacy of an anger response). Whereas all psychiatric scales correlated significantly with the STAS total score, regressing the three STAS factors on psychiatric behaviors model showed a more detailed pattern. Only borderline affect instability and depression were significantly associated with all three factors in both classes whereas other problem behaviors were associated only with 1 or 2 of the factors. Alcohol problems were associated with immediacy only in the high scoring class, indicating a non-linear relation in the total sample. Taking into account these more specific associations is likely to be beneficial when investigating differential treatment strategies. PMID:26454404

Psychiatric diagnosis and antiretroviral adherence among adolescent Medicaid beneficiaries diagnosed with human immunodeficiency virus/acquired immunodeficiency syndrome.

PubMed

Walkup, James; Akincigil, Ayse; Bilder, Scott; Rosato, Nancy Scotto; Crystal, Stephen

2009-05-01

Research on adults with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has suggested that psychiatric and substance abuse comorbidities are prevalent in this population, and that these may sometimes be associated with use of antiretroviral therapy (ART) and adherence. For adolescents with HIV/AIDS, much less is known about patterns of mental health comorbidity, and even fewer data are available that compare them to socioeconomically comparable youth without HIV/AIDS. Using medical and pharmacy data from 1999 to 2000 Medicaid claims (Medicaid Analytic Extract) from 4 states for beneficiaries aged 12 to 17 years, we identified 833 youth under care for HIV/AIDS meeting study criteria within the HIV/AIDS group, receipt of ART was less likely for youth who had diagnoses of substance abuse, conduct disorders, or emotional disorders than for others. Once ART was initiated, adherence did not significantly differ between adolescents living with a psychiatric condition, and those who were not, with the exception of an association between conduct disorder and lower adherence. Among those with HIV/AIDS, ART use and adherence were more common among youth with higher rates of service use, regardless of psychiatric status. Associations between race and adherence varied by gender: compared with their white counterparts, minority girls had lower, and minority boys had higher adherence.

Neurological and psychiatric disorders in thyroid dysfunctions. The role of nuclear medicine: SPECT and PET imaging.

PubMed

Lass, P; Slawek, J; Derejko, M; Rubello, D

2008-06-01

Thyroid dysfunctions may be accompanied by numerous neurological and psychiatric disorders. The most known is cognitive impairment and depression in hypothyroid patients, as well as an increased risk of cerebrovascular accidents. A separate, although a rare entity, is Hashimoto's encephalopathy. In hyperthyroidism there is an increased incidence of psychiatric disorders, including apathetic hyperthyroidism and hyperthyroid dementia. Functional imaging of cerebral blood flow and metabolism helped establish both global and/or regional decrease of both cerebral blood flow and metabolism in hypothyroidism, particularly in regions mediating attention, motor speed and visuospatial processing. Hypothyroid dementia may be mediated by neurocircuitry different from that in major depression. Less is known on flow/metabolism changes in hyperthyroidism. Global blood flow may be slightly increased, with regional deficits of blood flow, particular in hyperthyroid dementia. As presented above radionuclide functional imaging showed some metabolic patterns in thyroid dysfunctions, but still many issues remain unresolved. In particular little is known about the underlying pathology of cognitive impairment and depression in hypothyroidism, which may differ from ones in euthyroid patients. Also little is known about the reversibility of changes in cerebral blood flow following thyroid replacement therapy. In hyperthyroid patients functional imaging might contribute to elucidate the background of apathetic hyperthyroidism and potential different background of psychiatric complications.

Sterile Inflammation of Brain, due to Activation of Innate Immunity, as a Culprit in Psychiatric Disorders

PubMed Central

Ratajczak, Mariusz Z.; Pedziwiatr, Daniel; Cymer, Monika; Kucia, Magda; Kucharska-Mazur, Jolanta; Samochowiec, Jerzy

2018-01-01

Evidence has accumulated that the occurrence of psychiatric disorders is related to chronic inflammation. In support of this linkage, changes in the levels of circulating pro-inflammatory cytokines and chemokines in the peripheral blood (PB) of psychiatric patients as well as correlations between chronic inflammatory processes and psychiatric disorders have been described. Furthermore, an inflammatory process known as “sterile inflammation” when initiated directly in brain tissue may trigger the onset of psychoses. In this review, we will present the hypothesis that prolonged or chronic activation of the complement cascade (ComC) directly triggers inflammation in the brain and affects the proper function of this organ. Based on the current literature and our own work on mechanisms activating the ComC we hypothesize that inflammation in the brain is initiated by the mannan-binding lectin pathway of ComC activation. This activation is triggered by an increase in brain tissue of danger-associated molecular pattern (DAMP) mediators, including extracellular ATP and high-mobility group box 1 (HMGB1) protein, which are recognized by circulating pattern-recognition receptors, including mannan-binding lectin (MBL), that activate the ComC. On the other hand, this process is controlled by the anti-inflammatory action of heme oxygenase 1 (HO-1). In this review, we will try to connect changes in the release of DAMPs in the brain with inflammatory processes triggered by the innate immunity involving activation of the ComC as well as the inflammation-limiting effects of the anti-inflammatory HO-1 pathway. We will also discuss parallel observations that during ComC activation subsets of stem cells are mobilized into PB from bone marrow that are potentially involved in repair mechanisms. PMID:29541038

Sterile Inflammation of Brain, due to Activation of Innate Immunity, as a Culprit in Psychiatric Disorders.

PubMed

Ratajczak, Mariusz Z; Pedziwiatr, Daniel; Cymer, Monika; Kucia, Magda; Kucharska-Mazur, Jolanta; Samochowiec, Jerzy

2018-01-01

Evidence has accumulated that the occurrence of psychiatric disorders is related to chronic inflammation. In support of this linkage, changes in the levels of circulating pro-inflammatory cytokines and chemokines in the peripheral blood (PB) of psychiatric patients as well as correlations between chronic inflammatory processes and psychiatric disorders have been described. Furthermore, an inflammatory process known as "sterile inflammation" when initiated directly in brain tissue may trigger the onset of psychoses. In this review, we will present the hypothesis that prolonged or chronic activation of the complement cascade (ComC) directly triggers inflammation in the brain and affects the proper function of this organ. Based on the current literature and our own work on mechanisms activating the ComC we hypothesize that inflammation in the brain is initiated by the mannan-binding lectin pathway of ComC activation. This activation is triggered by an increase in brain tissue of danger-associated molecular pattern (DAMP) mediators, including extracellular ATP and high-mobility group box 1 (HMGB1) protein, which are recognized by circulating pattern-recognition receptors, including mannan-binding lectin (MBL), that activate the ComC. On the other hand, this process is controlled by the anti-inflammatory action of heme oxygenase 1 (HO-1). In this review, we will try to connect changes in the release of DAMPs in the brain with inflammatory processes triggered by the innate immunity involving activation of the ComC as well as the inflammation-limiting effects of the anti-inflammatory HO-1 pathway. We will also discuss parallel observations that during ComC activation subsets of stem cells are mobilized into PB from bone marrow that are potentially involved in repair mechanisms.

[Adult attention deficit/hyperactivity disorder, associated symptoms and comorbid psychiatric disorders: diagnosis and pharmacological treatment].

PubMed

Paslakis, G; Schredl, M; Alm, B; Sobanski, E

2013-08-01

Adult attention deficit/hyperactivity disorder (ADHD) is characterised by inattention and/or hyperactivity and impulsivity and is a frequent psychiatric disorder with childhood onset. In addition to core symptoms, patients often experience associated symptoms like emotional dysregulation or low self-esteem and suffer from comorbid disorders, particularly depressive episodes, substance abuse, anxiety or sleep disorders. It is recommended to include associated symptoms and comorbid psychiatric disorders in the diagnostic set-up and in the treatment plan. Comorbid psychiatric disorders should be addressed with disorder-specific therapies while associated symptoms also often improve with treatment of the ADHD core symptoms. The most impairing psychiatric disorder should be treated first. This review presents recommendations for differential diagnosis and treatment of adult ADHD with associated symptoms and comorbid psychiatric disorders with respect to internationally published guidelines, clinical trials and expert opinions. © Georg Thieme Verlag KG Stuttgart · New York.

Association between income trajectories in childhood and psychiatric disorder: a Swedish population-based study.

PubMed

Björkenstam, Emma; Cheng, Siwei; Burström, Bo; Pebley, Anne R; Björkenstam, Charlotte; Kosidou, Kyriaki

2017-07-01

Childhood family income variation is an understudied aspect of households' economic context that may have distinct consequences for children. We identified trajectories of childhood family income over a 12-year period, and examined associations between these trajectories and later psychiatric disorders, among individuals born in Sweden between 1987 and 1991 (n=534 294). We used annual income data between the ages of 3-14 years and identified 5 trajectories (2 high-income upward, 1 downward and 2 low-income upward trajectories). Psychiatric disorders in the follow-up period after age 15 were defined from International Classification of Disease (ICD)-codes in a nationwide patient register. Multiadjusted risks for all psychiatric disorders, as well as for specific psychiatric diagnoses, were calculated as HRs with 95% CIs. Of the 5 identified income trajectories, the constant low and the downward trajectories were particularly associated with later psychiatric disorder. Children with these trajectories had increased risks for psychiatric disorder, including mood, anxiety, psychotic disorders and attention deficit/hyperactivity disorder. The association remained, even after adjusting for important variables including parental psychiatric disorder. In contrast, the relationship was reversed for eating disorders, for which children in higher income trajectories had elevated risks. Findings show that children growing up in a household characterised by low or decreasing family income have an increased risk for psychiatric disorder. Continued work is needed to reduce socioeconomic inequalities in psychiatric disorders. Policies and interventions for psychiatric disorders should consider the socioeconomic background of the family as an important risk or protective factor. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Posttraumatic stress disorder in adult attention-deficit/hyperactivity disorder: clinical features and familial transmission.

PubMed

Antshel, Kevin M; Kaul, Prashant; Biederman, Joseph; Spencer, Thomas J; Hier, Bridget O; Hendricks, Kaitlin; Faraone, Stephen V

2013-03-01

Attention-deficit/hyperactivity disorder (ADHD) is characterized by clinically significant functional impairment due to symptoms of inattention and/or hyperactivity and impulsivity. Previous research suggests a link, in child samples, between ADHD and posttraumatic stress disorder (PTSD), which is characterized by (1) chronically reexperiencing a traumatic event, (2) hyperarousal, and (3) avoiding stimuli associated with the trauma while exhibiting numbed responsiveness. This study sought to address the link between ADHD and PTSD in adults by providing a comprehensive comparison of ADHD patients with and without PTSD across multiple variables including demographics, patterns of psychiatric comorbidities, functional impairments, quality of life, social adjustment, and familial transmission. Participants in our controlled family study conducted between 1998 and 2003 were 190 adults with DSM-IV ADHD who were attending an outpatient mental health clinic in Boston, Massachusetts; 16 adults with DSM-IV ADHD who were recruited by advertisement from the greater Boston area; and 123 adult controls without ADHD who were recruited by advertisement from the greater Boston area. All available first-degree relatives also participated. Subjects completed a large battery of self-report measures (the Quality of Life Enjoyment and Satisfaction Questionnaire, items from the Current Behavior Scale, the Social Adjustment Scale Self-Report, and the Four Factor Index of Social Status) designed to assess various psychiatric and functional parameters. Diagnoses were made using data obtained from structured psychiatric interviews (Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version, and the Schedule for Affective Disorders and Schizophrenia for School-Aged Children-Epidemiologic Version). The lifetime prevalence of PTSD was significantly higher among adults with ADHD compared with controls (10.0% vs 1.6%; P = .004). Participants with ADHD and those with ADHD + PTSD did not differ in core symptoms of ADHD nor in age at onset, but those with ADHD + PTSD had higher rates of psychiatric comorbidity than those with ADHD only (including higher lifetime rates of major depressive disorder, oppositional defiant disorder, social phobia, agoraphobia, and generalized anxiety disorder) and worse quality of life ratings for all domains. Familial risk analysis revealed that relatives of ADHD probands without PTSD had elevated rates of both ADHD (51%) and PTSD (12%) that significantly differed from rates among relatives of controls (7% [P ≤ .001] and 0% [P ≤ .05], respectively). A similar pattern of elevated risk for ADHD and PTSD (80% and 40%) was observed in relatives of probands with ADHD + PTSD (P ≤ .001 for both conditions). The comorbidity of PTSD and ADHD in adults leads to greater clinical severity in terms of psychiatric comorbidity and psychosocial functioning. The familial coaggregation of the 2 disorders suggests that these disorders share familial risk factors and that their co-occurrence is not due to diagnostic errors. © Copyright 2013 Physicians Postgraduate Press, Inc.

Prevalence and comorbidity of psychiatric disorders among 6-year-old children: 2004 Pelotas Birth Cohort.

PubMed

Petresco, Sandra; Anselmi, Luciana; Santos, Iná S; Barros, Aluísio J D; Fleitlich-Bilyk, Bacy; Barros, Fernando C; Matijasevich, Alicia

2014-06-01

Most studies published on the prevalence of psychiatric disorders in children were conducted in high-income countries despite the fact that nearly 90 % of the world's population aged under 18 live in low- and middle-income countries. The study aimed to assess the prevalence of psychiatric disorders among children of 6 years of age, to examine the distribution of psychiatric disorders by gender and socioeconomic status and to evaluate the occurrence of psychiatric comorbidities. The 2004 Pelotas Birth Cohort originally comprised 4,231 live births from Pelotas, southern Brazil. A total of 3,585 (84.7 % of 4,231 births) children aged 6 years were assessed using the Development and Well-Being Assessment (DAWBA). Nearly 13 % of the children presented a psychiatric diagnosis according to DSM-IV, being more prevalent among males than females (14.7 and 11.7 %, respectively, p = 0.009). Anxiety disorders were the most prevalent of all disorders (8.8 %) and specific phobias (5.4 %) and separation anxiety disorder (3.2 %) were the most common subtypes. Attention deficit hyperactivity disorder (2.6 %), oppositional defiant disorder/conduct disorder (2.6 %), and depression (1.3 %) were also diagnosed. More than one psychiatric disorder was presented by 17 % of children. Socioeconomically disadvantaged children had a higher prevalence of psychiatric disorders. Our findings underline the early onset of psychiatric disorders among children and the frequent occurrence of psychiatric comorbidity. Early prevention is needed in the field of mental health in Brazil and should start during infancy.

Characteristics of unrecognised bipolar disorder in patients treated for major depressive disorder in China: general versus psychiatric hospitals.

PubMed

Chen, F Z; Xiang, Y T; Lu, Z; Wang, G; Hu, C; Kilbourne, A M; Ungvari, G S; Fang, Y R; Si, T M; Yang, H C; Lai, K Yc; Hu, J; Chen, Z Y; Huang, Y; Sun, J; Wang, X P; Li, H C; Zhang, J B; Zhang, X Y; Chiu, H F K

2013-12-01

Bipolar disorder is often misdiagnosed as major depressive disorder. Such misdiagnosis partly depends on the type of treatment setting. This study compared general hospital psychiatric units with psychiatric hospitals in China with respect to basic demographic and clinical characteristics of patients with unrecognised bipolar disorder who are treated for major depressive disorder. Patients treated for major depressive disorder were consecutively examined in 13 health centres (6 general hospital psychiatric units and 7 psychiatric hospitals) in China. Their socio-demographic and clinical features were recorded using a standardised protocol and data collection procedure. The DSM-IV diagnoses were established using the Mini-International Neuropsychiatric Interview. Of the 1487 patients included in the study, 309 (20.8%) were diagnosed with bipolar disorder. There was no significant difference between general hospital psychiatric units and psychiatric hospitals in the ratio of all types of unrecognised bipolar disorders (χ2 = 0.008, degrees of freedom = 1, p = 0.9) and bipolar II disorders (χ2 = 3.1, degrees of freedom = 1, p = 0.08). The proportions of unrecognised bipolar I disorders (χ2 = 4.1, degrees of freedom = 1, p = 0.04) differed significantly between the 2 types of study site. Multivariate analyses showed that patients with bipolar I disorders with more seasonal depressive episodes were more likely to receive treatment in general hospital psychiatric units (odds ratio = 3.3, 95% confidence interval = 1.1-9.8). Patients with bipolar I disorders receiving treatment in general hospital psychiatric units had different clinical characteristics compared to their counterparts treated in psychiatric hospitals in China.

Tobacco Use Disorders.

PubMed

Camenga, Deepa R; Klein, Jonathan D

2016-07-01

Tobacco use is a pervasive public health problem and the leading cause of preventable morbidity and mortality in the United States. This article reviews the epidemiology of tobacco use in youth, with a description of cigarettes, alternative tobacco product, and polytobacco use patterns among the general population and among adolescents with psychiatric and/or substance use disorders. The article also provides an update on the diagnosis and assessment of tobacco use disorder in adolescents, with a particular focus on the clinical management of tobacco use in adolescents with co-occurring disorders. Copyright © 2016 Elsevier Inc. All rights reserved.

[Sleep psychiatry].

PubMed

Chiba, Shigeru

2013-01-01

Sleep disorders are serious issues in modern society. There has been marked scientific interest in sleep for a century, with the discoveries of the electrical activity of the brain (EEG), sleep-wake system, rapid eye movement (REM) sleep, and circadian rhythm system. Additionally, the advent of video-polysomnography in clinical research has revealed some of the consequences of disrupted sleep and sleep deprivation in psychiatric disorders. Decades of clinical research have demonstrated that sleep disorders are intimately tied to not only physical disease (e. g., lifestyle-related disease) but psychiatric illness. According to The International Classification of Sleep Disorders (2005), sleep disorders are classified into 8 major categories: 1) insomnia, 2) sleep-related breathing disorders, 3) hypersomnias of central origin, 4) circadian rhythm sleep disorders, 5) parasomnias, 6) sleep-related movement disorders, 7) isolated symptoms, and 8) other sleep disorders. Several sleep disorders, including obstructive sleep apnea syndrome, restless legs syndrome, periodic limb movement disorder, sleepwalking, REM sleep behavior disorder, and narcolepsy, may be comorbid or possibly mimic numerous psychiatric disorders, and can even occur due to psychiatric pharmacotherapy. Moreover, sleep disorders may exacerbate underlying psychiatric disorders when left untreated. Therefore, psychiatrists should pay attention to the intimate relationship between sleep disorders and psychiatric symptoms. Sleep psychiatry is an academic field focusing on interrelations between sleep medicine and psychiatry. This mini-review summarizes recent findings in sleep psychiatry. Future research on the bidirectional relation between sleep disturbance and psychiatric symptoms will shed light on the pathophysiological view of psychiatric disorders and sleep disorders.

Pattern of comorbidity among anxious and odd personality disorders: the case of obsessive-compulsive personality disorder.

PubMed

Rossi, A; Marinangeli, M G; Butti, G; Kalyvoka, A; Petruzzi, C

2000-09-01

The aim of this study was to examine the pattern of comorbidity among obsessive-compulsive personality disorder (OCPD) and other personality disorders (PDs) in a sample of 400 psychiatric inpatients. PDs were assessed using the Semistructured Clinical Interview for DSM-III-R Personality Disorders (SCID-II). Odds ratios (ORs) were calculated to determine significant comorbidity among OCPD and other axis II disorders. The most elevated odds ratios were found for the cooccurrence of OCPD with cluster A PDs (the "odd" PDs, or paranoid and schizoid PDs). These results are consistent with those of previous studies showing a higher cooccurrence of OCPD with cluster A than with cluster C ("anxious") PDs. In light of these observations, issues associated with the nosologic status of OCPD within the Diagnostic and Statistical Manual of Mental Disorders clustering system remain unsettled.

[Psychiatric disorders and neurological comorbidity in children with intellectual disability].

PubMed

Wriedt, Elke; Wiberg, Anja; Sakar, Vehbi; Noterdaeme, Michele

2010-05-01

This article gives an overview of the consultant child and adolescent psychiatric services in the region of Upper Bavaria (Germany). The data of 257 children and adolescents with intellectual disability and psychiatric disorders were evaluated. About 14% of the children with ID in special schools or day care centers, and 40% of the children with ID in residential care showed a definite psychiatric disorder. The most frequently diagnosed disorders were adjustment disorders, hyperkinetic disorders and conduct disorders, as well as emotional problems and pervasive developmental disorders. Children with severe intellectual disability had more additional somatic disorders and were more impaired in their psychosocial functions. The results show the need for psychiatric services for children and adolescents with intellectual disability and psychiatric disorders. The development and implementation of integrative and interdisciplinary models is necessary to allow for adequate medical care for these patients.

The quality of life and psychiatric morbidity in patients operated for Arnold-Chiari malformation type I.

PubMed

Bakim, Bahadir; Goksan Yavuz, Burcu; Yilmaz, Adem; Karamustafalioglu, Oguz; Akbiyik, Meral; Yayla, Sinan; Yuce, Ismail; Alpak, Gokay; Tankaya, Onur

2013-10-01

There are some case reports that highlight the association of Arnold-Chiari malformation (ACM) with psychiatric symptoms. We assessed the association between ACM and psychiatric symptoms and risk factors in terms of psychiatric morbidity and evaluated the quality of life after surgery. This study consisted of sixteen patients who underwent decompression operation at the Department of Neurosurgery of Sisli Etfal Hospital. The MINI plus, Short-Form McGill Pain Questionnaire and WHOQOL-BREF-TR were administered to patients. About 43.8% of the patients had a psychiatric disorder. About 50% of the patients had co-existing syringomyelia of which 50% with syringomyelia had a psychiatric disorder. Patients with syringomyelia without any psychiatric disorder had significantly lower scores on physical domain of WHOQOL-BREF-TR (p = 0.02) than the patients without syringomyelia and psychiatric disorder. Subjects with a psychiatric disorder had lower scores on four domains of WHOQOL-BREF-TR. The patients with psychiatric diagnoses had significantly higher scores on affective pain index (p = 0.021) and total pain index (p = 0.037) than the patients without any psychiatric disorder. The presence of a psychiatric condition influences not only the physical aspect but also deteriorates the psychological and social relations and environmental aspect. Moreover the presence of a psychiatric disorder increases the perception of pain and causes more discomfort.

Psychiatric disorders in candidates for surgery for epilepsy.

PubMed Central

Manchanda, R; Schaefer, B; McLachlan, R S; Blume, W T; Wiebe, S; Girvin, J P; Parrent, A; Derry, P A

1996-01-01

OBJECTIVE--To provide a descriptive analysis of the prevalence and pattern of psychiatric morbidity among 300 consecutive epileptic patients refractive to treatment and admitted during a six year period for evaluation of their candidature for surgery. METHODS--Patients underwent detailed observation of their seizure and standardised psychiatric assessment. Patients were considered to be refractory to treatment if they continued to manifest seizures with an average frequency of at least once every month even with polytherapy using up to three different anti-convulsants for a period of at least two years. Of the 300 patients, 231 had a temporal lobe focus, 43 had a non-temporal lobe focus, and 26 patients had a generalised and multifocal seizure onset. RESULTS AND CONCLUSIONS--With the DSM-III-R criteria 142 (47.3%) patients emerged as psychiatric cases. A principal axis I diagnosis was made in 88 (29.3%), and an axis II diagnosis (personality disorder) in another 54 (18.0%) patients. The most common axis I diagnosis was anxiety disorders (10.7%). A schizophrenia-like psychosis was seen in 13 (4.3%). Most patients with personality disorders showed dependent and avoidant personality traits. There was a significantly higher psychotic subscore on the present state examination in the temporal than with the non-temporal group of patients. These findings were not significant when compared with patients with a generalised and multifocal seizure disorder. There were no significant findings between the different seizure focus groups on the neurotic subscores. The findings with regard to laterality of seizure focus and the neurotic or psychotic subscores were not significant. PMID:8676167

Psychiatric Disorders Differently Correlate with Physical Self-Rated Health across Ethnic Groups

PubMed Central

2017-01-01

In this study, we compared 10 ethnic groups for associations between psychiatric disorders and physical self-rated health (SRH) in the United States. Data came from the Collaborative Psychiatric Epidemiology Surveys (CPES), 2001–2003. The study included 7587 non-Latino White, 4746 African American, 1442 Mexican, 1106 other Hispanic, 656 other Asian, 600 Chinese, 577 Cuban, 520 Vietnamese, 508 Filipino, and 495 Puerto Rican individuals. The Composite International Diagnostic Interview (CIDI) was used to measure psychiatric disorders, including major depressive disorder (MDD), general anxiety disorder (GAD), social phobia, panic disorder, post-traumatic stress disorder (PTSD), alcohol abuse, and binge eating disorders. A single-item measure was used to estimate physical SRH. Demographic (age and gender) and socioeconomic (education and income) factors were also measured. Unadjusted and adjusted correlations between psychiatric disorders and physical SRH were calculated. Major ethnic variations were found in the correlation between psychiatric disorders and physical SRH; as well as the role of demographic and socioeconomic status (SES) factors in explaining these associations. non-Hispanic Whites, Cubans, and African Americans showed more correlations between psychiatric disorders and physical SRH than other ethnic groups. In non-Hispanic Whites, the associations between psychiatric disorders and physical SRH were explained by demographic factors. In African Americans, the link between psychiatric disorders and poor physical SRH were explained by SES indicators. In conclusion, although single-item physical SRH measures are traditionally assumed to reflect the physical health needs of populations, they may also indicate psychiatric disorders in some ethnic groups, such as non-Hispanic Whites, Cubans, and African Americans. Demographic and socioeconomic factors also have differential roles in explaining the link between psychiatric disorders and physical SRH. Physical SRH does not exclusively reflect physical health, and it may be more biased by mental health across some ethnic groups. PMID:29137173

[The Relationship of Suicide Attempts with Affective Temperament and Relevant Clinical Features in Patients with Mood Disorders].

PubMed

Ekşioğlu, Sevgin; Güleç, Hüseyin; Şimşek, Gülnihal; Semiz, Ümit Başar

2015-01-01

In this study, patients with affective disorders with or without suicide attempts were examined according to whether their disorder was unipolar or bipolar. An analysis was made of their socio-demographic variables, comorbid psychiatric symptoms, and affective temperament dimensions in order to understand the effects of these variables on suicide risk. The study populations consisted of 246 inpatients with affective disorders who had been admitted to the Erenköy Research and Training Hospital for Mental and Neurological Disorders (93 patients with unipolar disorders, 153 with bipolar disorders). The TEMPS-A (Temperament Evaluation of Memphis, Pisa, Paris and San Diego Auto-questionnaire), the Beck Hopelessness Scale (BHS) and the Symptom Checklist-90-Revised (SCL-90-R) psychological symptom screening tests were applied to all patients. In order to determine the affective disorder diagnosis and to identify suicide attempts, a Mini International Neuropsychiatric Interview (MINI) was performed during the first 48 hours of hospitalization. The cyclothymic and anxious temperament dimensions measured using TEMPS-A, somatic symptoms obtained from a symptom checklist, and psychiatric disorders in the family were found to be good indicators of suicide attempts in patients with unipolar disorders in this study. An investigation of predictors of suicide attempts in bipolar patients showed that cyclothymic temperament pattern, paranoid symptoms, evaluated through symptom screening test and having a psychiatric disorder in the family are good predictors of a suicide attempt. The findings are expected to guadiance to preventing suicide in patients with affective disorders. The inclusion in this study of patients with different index episodes of illness, including manic, depressive and mixed periods, can be accepted as a significant limitation of this study.

Psychiatric disorders and treatment among newly homeless young adults with histories of foster care.

PubMed

Thompson, Ronald G; Hasin, Deborah

2012-09-01

Although foster care placement is often preceded by stressful events such as child abuse, foster care itself often exposes children to additional severe stressors. A history of foster care, as well as the childhood abuse that often precedes it, is common among homeless young adults. This study examined whether a history of foster care was associated with psychiatric disorders, prior psychiatric counseling, prescription of psychiatric medications, and prior psychiatric hospitalization among newly homeless young adults. A consecutive sample of 423 adults aged 18 to 21 years who sought emergency shelter for the first time between October 1, 2007, and February 29, 2008, were assessed at intake. Logistic regression analyses determined the associations between foster care and any psychiatric disorder (affective, anxiety, personality, and psychotic) and psychiatric treatment. The analyses adjusted for demographic characteristics, childhood abuse, substance use, prior arrest, unemployment, lack of high school diploma, and histories of psychiatric disorders and drug abuse among biological relatives. Homeless young adults with histories of foster care were 70% more likely than those without such histories to report any psychiatric disorder. They were more than twice as likely to have received mental health counseling for a psychiatric disorder, to have been prescribed psychiatric medication, and to have been hospitalized for psychiatric problems. Histories of foster care among homeless young adults should trigger screening for psychiatric disorders to aid in the provision of treatment (counseling, medication, and hospitalization) tailored to the psychiatric needs of this highly vulnerable population.

Psychiatric disorders and treatment in low-income pregnant women.

PubMed

Cook, Cynthia A Loveland; Flick, Louise H; Homan, Sharon M; Campbell, Claudia; McSweeney, Maryellen; Gallagher, Mary Elizabeth

2010-07-01

This study estimated the prevalence of twenty-two 12-month and lifetime psychiatric disorders in a sample of 744 low-income pregnant women and the frequency that women with psychiatric disorders received treatment. To identify psychiatric disorders, the Diagnostic Interview Schedule (DIS) was administered to Medicaid or Medicaid-eligible pregnant women enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). The sample was stratified by the rural or urban location of the WIC sites in southeastern Missouri and the city of St. Louis. Eligible women were enrolled at each site until their numbers were proportional to the racial distribution of African American and Caucasian pregnant women served there. The 12-month prevalence of one or more psychiatric disorders was 30.9%. Most common were affective disorders (13.6%), particularly major depressive disorder (8.2%) and bipolar I disorder (5.2%). Only 24.3% of those with a psychiatric disorder reported that they received treatment in the past year. Lifetime prevalence of at least one disorder was 45.6%, with affective disorders being the most frequent (23.5%). Caucasian women were more likely than African Americans to have at least one 12-month disorder, with the difference largely accounted for by nicotine dependence. Higher prevalence of lifetime disorders was also found in Caucasian women, particularly affective disorders and substance use disorders. There were no differences in the prevalence of 12-month or lifetime psychiatric disorders by the urban or rural residence of subjects. With nearly one third of pregnant women meeting criteria for a 12-month psychiatric disorder and only one fourth receiving any type of mental health treatment, comprehensive psychiatric screening during pregnancy is needed along with appropriate treatment.

Sleep complaints and psychiatric symptoms in children evaluated at a pediatric mental health clinic.

PubMed

Ivanenko, Anna; Crabtree, Valerie McLaughlin; Obrien, Louise Margaret; Gozal, David

2006-01-15

To examine the association of sleep problems with psychiatric symptoms in children evaluated at a university-based outpatient child psychiatry clinic. Parents of 174 children attending psychiatric services completed a 47-item Childhood Sleep Questionnaire and the Behavioral Assessment System for Children. Psychiatric diagnosis was obtained through retrospective chart review. Sleep characteristics were compared among 4 diagnostic subcategories: attention-deficit/hyperactivity disorder (ADHD) alone (n=29), ADHD with comorbid mood and anxiety disorders (ADHD+; n=50), mood and anxiety disorders alone (n=67), and other psychiatric disorders (n= 28). Data from sleep habits survey of 174 community children without reported psychiatric history served as controls. Children with psychiatric disorders had a significantly higher prevalence of sleep complaints compared with nonpsychiatric controls. Children with ADHD had frequent nocturnal awakenings, bad dreams, and bedtime struggles. In addition, the presence of leg jerks during sleep was particularly frequent in patients with ADHD compared with any other psychiatric disorder. More frequent nighttime awakenings were present in children with mood and anxiety disorders. Sleep duration and sleep latency strongly correlated with aggression, hyperactivity, and depression. Restless sleep scores highly correlated with all psychiatric symptoms. Sleep problems are highly prevalent among children with psychiatric disorders. Children with ADHD and comorbid anxiety or mood disorders are more likely to report sleep disturbances. Restless sleep, long sleep latency, short sleep duration, and frequent nocturnal awakenings correlate with the severity of psychiatric symptoms.

Protective Effects of Psychological Strengths Against Psychiatric Disorders Among Soldiers.

PubMed

Shrestha, Alice; Cornum, B G Rhonda; Vie, Loryana L; Scheier, Lawrence M; Lester, M A J Paul B; Seligman, Martin E P

2018-03-01

This study prospectively examined psychological strengths targeted in U.S. Army training programs as predictors of psychiatric diagnosis in active duty soldiers. At baseline, the cohort (140,584 soldiers) was without psychiatric disorder. Soldiers were then followed for 2 yr and classified as healthy, or acquiring a psychiatric diagnosis (adjustment disorder, anxiety disorder, depression, or post-traumatic stress disorder), or being prescribed psychotropic medication without a psychiatric diagnosis. Soldiers who remained healthy reported significantly higher strengths scores at baseline, compared with soldiers who were diagnosed with a psychiatric disorder. In addition, soldiers in the worst strengths decile were twice as likely to develop a psychiatric disorder, compared with soldiers in the top 50% on baseline strengths. Strengths afforded the greatest protection against depression. Offering tailored resilience training programs could help the Army steel vulnerable soldiers against the challenges of life, military training, and combat.

Psychiatric service use and psychiatric disorders in adults with intellectual disability.

PubMed

Bhaumik, S; Tyrer, F C; McGrother, C; Ganghadaran, S K

2008-11-01

UK policies aim to facilitate access to general psychiatric services for adults with intellectual disability (ID). If this is to be achieved, it is important to have a clear idea of the characteristics and proportion of people with ID who currently access specialist psychiatric services and the nature and extent of psychiatric disorders in this population. A cross-sectional study was carried out on all adults with ID using specialist services in Leicestershire and Rutland, UK, between 2001 and 2006. Characteristics of individuals seen by psychiatric services and the nature and prevalence of psychiatric disorders were investigated. Of 2711 adults identified, 1244 (45.9%) accessed specialist psychiatric services at least once during the study period. Individuals attending psychiatric services were more likely to be older and to live in residential settings; they were less likely to be south Asian or to have mild/moderate ID. The prevalence of psychiatric disorders among the total study population was 33.8%; the most common disorders were behaviour disorder (19.8%) and autistic spectrum disorders (8.8%). Epilepsy was highly prevalent (60.8%) among those attending psychiatric services without a mental health diagnosis. Behaviour disorders and autistic spectrum disorders were more common in men and in adults with severe/profound ID, whereas schizophrenia and organic disorders were more common in women and in adults with mild/moderate ID. Depression was also more common in women with ID. Psychiatric disorders and specialist health problems are common among adults with ID and the profile of psychiatric disorders differs from that found in general psychiatry. Close collaboration between general and specialist service providers is needed if the current move towards use of general psychiatric services in this population is to be achieved. The measures should include a clear care pathway for people with ID and mental health problems to facilitate the smooth transfer of patients between specialist and generic mental health services and arrangements for joint working where input from both services is required. The commissioning framework for such processes should be in place with appropriate pooling of resources.

[Differences in access to Internet and Internet-based information seeking according to the type of psychiatric disorder].

PubMed

Brunault, P; Bray, A; Rerolle, C; Cognet, S; Gaillard, P; El-Hage, W

2017-04-01

Internet has become a major tool for patients to search for health-related information and to communicate on health. We currently lack data on how patients with psychiatric disorders access and use Internet to search for information on their mental health. This study aimed to assess, in patients followed for a psychiatric disorder (schizophrenia, bipolar disorder, mood and anxiety disorder, substance-related and addictive disorders and eating disorders), prevalence of Internet access and use, and patient expectations and needs regarding the use of Internet to search for mental-health information depending on the psychiatric disorder. We conducted this cross-sectional study between May 2013 and July 2013 in 648 patients receiving psychiatric care in 8 hospitals from the Region Centre, France. We used multivariate logistic regression adjusted for age, gender, socio-educational level and professional status to compare use, expectations and needs regarding Internet-based information about the patient's psychiatric disorder (65-items self-administered questionnaires) as a function of the psychiatric disorders. We identified patients clusters with multiple correspondence analysis and ascending hierarchical classification. Although 65.6% of our population accessed Internet at home, prevalence for Internet access varied depending on the type of psychiatric disorder and was much more related to limited access to a computer and low income than to a lack of interest in the Internet. Most of the patients who used Internet were interested in having access to reliable Internet-based information on their health (76.8%), and most used Internet to search for Internet based health-information about their psychiatric disorder (58.8%). We found important differences in terms of expectations and needs depending on the patient's psychiatric disorder (e.g., higher interest in Internet-based information among patients with bipolar disorder, substance-related and addictive disorders and eating disorders). We identified three clusters: younger patients with depressive or anxiety disorders and higher Internet access and Internet use; older patients with low socio-economical status and low Internet access and Internet use; patients receiving long-term care for schizophrenia, with low Internet access and Internet use. Patients with psychiatric disorders reported average use, needs and expectations for Internet-based health information comparable to the overall population. However, Internet use, needs and expectations for Internet-based mental health information differed between patients depending on their psychiatric disorder. Internet-based information and communication for mental health should be designed specifically for each psychiatric disorder. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Assessing the evidence for shared genetic risks across psychiatric disorders and traits.

PubMed

Martin, Joanna; Taylor, Mark J; Lichtenstein, Paul

2017-12-04

Genetic influences play a significant role in risk for psychiatric disorders, prompting numerous endeavors to further understand their underlying genetic architecture. In this paper, we summarize and review evidence from traditional twin studies and more recent genome-wide molecular genetic analyses regarding two important issues that have proven particularly informative for psychiatric genetic research. First, emerging results are beginning to suggest that genetic risk factors for some (but not all) clinically diagnosed psychiatric disorders or extreme manifestations of psychiatric traits in the population share genetic risks with quantitative variation in milder traits of the same disorder throughout the general population. Second, there is now evidence for substantial sharing of genetic risks across different psychiatric disorders. This extends to the level of characteristic traits throughout the population, with which some clinical disorders also share genetic risks. In this review, we summarize and evaluate the evidence for these two issues, for a range of psychiatric disorders. We then critically appraise putative interpretations regarding the potential meaning of genetic correlation across psychiatric phenotypes. We highlight several new methods and studies which are already using these insights into the genetic architecture of psychiatric disorders to gain additional understanding regarding the underlying biology of these disorders. We conclude by outlining opportunities for future research in this area.

Neuroplasticity as a target for the pharmacotherapy of anxiety disorders, mood disorders, and schizophrenia

PubMed Central

Krystal, John H.; Tolin, David F.; Sanacora, Gerard; Castner, Stacy; Williams, Graham; Aikins, Deane; Hoffman, Ralph; D’Souza, D. Cyril

2009-01-01

Current treatments for psychiatric disorders were developed with the aim of providing symptomatic relief rather than reversing underlying abnormalities in neuroplasticity or neurodevelopment that might contribute to psychiatric disorders. This review considers the possibility that psychiatric treatments might be developed that target neuroplasticity deficits or that manipulate neuroplasticity in novel ways. These treatments might not provide direct symptomatic relief. However, they might complement or enhance current pharmacotherapies and psychotherapies aimed at the prevention and treatment of psychiatric disorders. In considering neuroplasticity as a target for the treatment of psychiatric disorders, we build on exciting new findings in the areas of anxiety disorders, mood disorders, and schizophrenia. PMID:19460458

Anxiety-depressive disorders among irritable bowel syndrome patients in Guilan, Iran

PubMed Central

2012-01-01

Background Psychiatric disorders are common in irritable bowel syndrome (IBS) patients. The prevalence of psychiatric disorders in IBS patients varies in different cultures. We conducted this study to determine the prevalence of psychiatric disorders Methods In a cross-sectional study, 256 IBS patients were selected (using the criteria of Rome III) and evaluated for psychiatric disorders. In the first phase, subjects were screened using the General Health Questionnaire 28 (GHQ28). In the second phase, those who had scores ≥ 23 were assessed through semi-structured psychiatric interviews. Results Thirty out of 256 subjects had no significant psychiatric symptoms after performing GHQ28. In further psychiatric evaluation of the remaining subjects (226) who suffered from some degree of a psychiatric problem, 36 were diagnosed without Anxiety/Depressive disorder. Thus 66 subjects (25.8%) were known as a group without any significant psychiatric problem. A total of 190 subjects (74.2%) with anxiety-depressive problems were diagnosed; 89 were suffering from pure anxiety disorders, 41 were suffering from depressive disorders and 60 had co-morbid anxiety-depressive disorders. When comparing anxiety-depressive patients (n = 190) with normal subjects (n = 66), gender (P = 0.016), occupation (P = 0.002) and intensity of IBS (P < 0.001) showed statistically significant differences. Conclusion The high prevalence of anxiety-depressive disorders in this study indicates the necessity of psychiatric assessment, early diagnosis and treatment of the patients with IBS. It may improve management of the patients suffering from IBS. PMID:22353390

Anxiety-depressive disorders among irritable bowel syndrome patients in Guilan, Iran.

PubMed

Modabbernia, Mohamad-Jafar; Mansour-Ghanaei, Fariborz; Imani, Ali; Mirsafa-Moghaddam, Seyed-Alireza; Sedigh-Rahimabadi, Massih; Yousefi-Mashhour, Mahmoud; Joukar, Farahnaz; Atrkar-Roushan, Zahra; Bidel, Siamak

2012-02-21

Psychiatric disorders are common in irritable bowel syndrome (IBS) patients. The prevalence of psychiatric disorders in IBS patients varies in different cultures. We conducted this study to determine the prevalence of psychiatric disorders In a cross-sectional study, 256 IBS patients were selected (using the criteria of Rome III) and evaluated for psychiatric disorders. In the first phase, subjects were screened using the General Health Questionnaire 28 (GHQ28). In the second phase, those who had scores ≥ 23 were assessed through semi-structured psychiatric interviews. Thirty out of 256 subjects had no significant psychiatric symptoms after performing GHQ28. In further psychiatric evaluation of the remaining subjects (226) who suffered from some degree of a psychiatric problem, 36 were diagnosed without Anxiety/Depressive disorder. Thus 66 subjects (25.8%) were known as a group without any significant psychiatric problem. A total of 190 subjects (74.2%) with anxiety-depressive problems were diagnosed; 89 were suffering from pure anxiety disorders, 41 were suffering from depressive disorders and 60 had co-morbid anxiety-depressive disorders. When comparing anxiety-depressive patients (n = 190) with normal subjects (n = 66), gender (P = 0.016), occupation (P = 0.002) and intensity of IBS (P < 0.001) showed statistically significant differences. The high prevalence of anxiety-depressive disorders in this study indicates the necessity of psychiatric assessment, early diagnosis and treatment of the patients with IBS. It may improve management of the patients suffering from IBS.

Prevalence of psychiatric morbidity among cancer patients – hospital-based, cross-sectional survey

PubMed Central

Gopalan, Mohan Roy; Karunakaran, Vidhukumar; Prabhakaran, Anil; Jayakumar, Krishnannair Lalithamma

2016-01-01

Aim: To study the prevalence of Psychiatric disorders in cancer patients and to find out the factors associated with Psychiatric disorders in Cancer Patients. Settings and Design: Department of Radiotherapy, Medical College, Thiruvananthapuram, cross sectional survey design was used. Methods and Material: Adult patients (18 years of age and above), having a diagnosis of carcinoma were selected by consecutive sampling method.A questionnaire which included back ground data, socio economic variables, treatment variables like type of malignancy, exposure to radiation & chemotherapy prior to the evaluation and current treatment, co occurring medical illness & treatment and past & family history of psychiatric illness was used to collect data. Delirium rating scale and MINI International neuropsychiatric interview were used to assess Psychiatric disorders and delirium. Statistical Analysis Used: Chi square and logistics regression tests were used for analysis. Results: Of the 384 assessed, 160(41.7%) had psychiatric disorders. Adjustment disorders were seen in 22.6%. 10.9% of subjects had major depressive disorder. Thus a total of 33.5% of patients had a diagnosis of either anxiety or depressive disorder. Proportion of patients having delirium was 6.5%. Hypomania was seen in small (1.6%) of patients. Multivariate analysis for various parameters for psychiatric disorders showed that age, past history of chemotherapy, past history of radiotherapy, & surgical treatment of carcinomas are significant predictors of psychiatric disorders. Conclusions: Psychiatric disorders are seen in a significant proportion of Psychiatric patients. PMID:28066004

Social genomics of healthy and disordered internet gaming.

PubMed

Snodgrass, Jeffrey G; Dengah Ii, H J François; Lacy, Michael G; Else, Robert J; Polzer, Evan R; Arevalo, Jesusa M G; Cole, Steven W

2018-06-20

To combine social genomics with cultural approaches to expand understandings of the somatic health dynamics of online gaming, including in the controversial nosological construct of internet gaming disorder (IGD). In blood samples from 56 U.S. gamers, we examined expression of the conserved transcriptional response to adversity (CTRA), a leukocyte gene expression profile activated by chronic stress. We compared positively engaged and problem gamers, as identified by an ethnographically developed measure, the Positive and Negative Gaming Experiences Scale (PNGE-42), and also by a clinically derived IGD scale (IGDS-SF9). CTRA profiles showed a clear relationship with PNGE-42, with a substantial linkage to offline social support, but were not meaningfully associated with disordered play as measured by IGDS-SF9. Our study advances understanding of the psychobiology of play, demonstrating via novel transcriptomic methods the association of negatively experienced internet play with biological measures of chronic threat, uncertainty, and distress. Our findings are consistent with the view that problematic patterns of online gaming are a proxy for broader patterns of biopsychosocial stress and distress such as loneliness, rather than a psychiatric disorder sui generis, which might exist apart from gamers' other life problems. By confirming the biological correlates of certain patterns of internet gaming, culturally-sensitive genomics approaches such as this can inform both evolutionary theorizing regarding the nature of play, as well as current psychiatric debates about the appropriateness of modeling distressful gaming on substance addiction and problem gambling. © 2018 Wiley Periodicals, Inc.

Comorbid psychiatric disorders in 201 cases of encopresis.

PubMed

Unal, Fatih; Pehlivantürk, Berna

2004-01-01

Although encopresis is a common and complex disorder, relatively few studies have evaluated the comorbid psychiatric disorders in this condition. This study was performed to investigate the comorbid psychiatric disorders in encopresis. One hundred and sixty boys (79.6%) and 41 girls (20.4%) fulfilled the diagnostic criteria for encopresis according to DSM-IV. There was at least one comorbid diagnosis in 149 (74.1%) patients. The most frequent comorbid diagnosis was enuresis (55.2%). Clinical and demographical data were compared between patients with comorbid disorders and others. Primary encopresis was significantly more frequent in patients with comorbid disorders, and the mean age at admission was lower in these patients. The mean interval between the onset of symptoms and the diagnosis was significantly shorter in secondary encopretic patients with comorbid disorders. Furthermore, there were significantly more psychiatric disorders in the first-degree relatives of patients with comorbid disorders. Encopresis is frequently accompanied with a psychiatric disorder. Clinicians need to inquire about symptoms of other psychiatric disorders in patients who present with encopresis and vice versa.

Burden of psychiatric morbidity among attendees of a secondary level hospital in Northern India: Implications for integration of mental health care at subdistrict level.

PubMed

Haldar, Partha; Sagar, Rajesh; Malhotra, Sumit; Kant, Shashi

2017-01-01

There is little information available on the type, pattern, trend, and demographic differentials of psychiatric cases attending a subdistrict level facility in India. Our objectives were to describe the sociodemographic profile of the patients availing the psychiatric outpatient department services and document the diagnosis. This study is based on a retrospective analysis of routinely recorded administrative data collected during psychiatry consultations that took place between January 2010 and June 2014, at the subdistrict level hospital, Ballabgarh, Faridabad district, Haryana, Northern India. The data were abstracted in Microsoft Excel, scrutinized for duplicates, and cleaned in terms of the International Classification of Diseases 10 th Revision coding. Descriptive analysis was done for dependent variables and continuous variables were compared using independent t -test. A total of 2806 people (new registrations) were provided psychiatric consultations between January 2010 and June 2014. The mean age of males was 33.7 years (95% confidence interval [CI], 32.9, 34.5) and of females was 35.6 years (95% CI, 34.9, 36.3). Neurotic, stress-related, and somatoform disorders (F40-F48) comprised the major category of diagnoses with 661 cases (24%), followed by unspecified mental disorders (F99) with 528 cases (19%), mood (affective) disorders (F30-F39) with 448 cases (16%), and episodic and paroxysmal disorders (G40-G47) with 334 cases (12%). We reported an increase in level and trend in the monthly attendance of patients who required psychiatric at a secondary care hospital in Northern India. We suggest that setting up of mental health units only at district hospital might not be a sufficient health system's approach as has been envisaged under the District Mental Health Program.

Understanding migraine and psychiatric comorbidity.

PubMed

Seng, Elizabeth K; Seng, Cynthia D

2016-06-01

This article describes recent trends in our understanding of the role of psychiatric disorders in the experience and treatment of migraine, and the role of migraine in the experience and treatment of psychiatric disorders. Although the majority of studies evaluating psychiatric comorbidity in migraine have focused on depression, anxiety, and bipolar disorders are highly associated with migraine and relevant for prognosis and treatment planning. Comorbid psychiatric disorders may be associated with poorer treatment response for some acute pharmacotherapies; however, people with comorbid migraine and mood or anxiety disorders can achieve large responses to preventive pharmacologic and behavioral therapies. Emerging research is developing and evaluating behavioral treatments designed to manage cooccurring migraine and mood or anxiety disorders. Stigma related to psychiatric disorders has been well characterized, and could exacerbate extant migraine-related stigma. Anxiety and mood disorders are prevalent in people with migraine, although not ubiquitous. Psychiatric comorbidity is associated with greater migraine symptoms and disability; however, people with comorbid depression or anxiety are amenable to preventive migraine treatment. Research regarding migraine treatment strategies optimized for people with comorbid psychiatric disorders is critical to advancing care and reducing stigma for this important subpopulation of people with migraine.

Clinical study of the relation of borderline personality disorder to Briquet's syndrome (hysteria), somatization disorder, antisocial personality disorder, and substance abuse disorders.

PubMed

Hudziak, J J; Boffeli, T J; Kreisman, J J; Battaglia, M M; Stanger, C; Guze, S B; Kriesman, J J

1996-12-01

The criteria for borderline personality disorder seem to select patients with very high rates of Briquet's syndrome (hysteria), somatization disorder, antisocial personality disorder, and substance abuse disorders. This study was undertaken to determine whether systematic assessment of patients with borderline personality disorder would reveal characteristic features of that condition which would distinguish it from these other disorders. Eighty-seven white female patients (75 in St. Louis and 12 in Milan, Italy) who had borderline personality disorder according to both the DSM-III-R criteria and the Revised Diagnostic Interview for Borderlines were further examined with the DSM-III-R Checklist and the Perley-Guze Hysteria Checklist to determine their patterns of psychiatric comorbidity. Every patient had at least one additional DSM diagnosis. Patients in St. Louis and Milan averaged five and four additional diagnoses, respectively. Eighty-four percent of the patients in St. Louis met criteria for either somatization disorder, Briquet's syndrome, antisocial personality disorder, or substance abuse disorders. Patterns of comorbidity for panic (51%), generalized anxiety disorder (55%), and major depression (87%) in St. Louis were consistent with those in other studies. The data indicate that the boundaries for the borderline condition are not specific and identify a high percentage of patients with these other disorders. Furthermore, the comorbidity profiles closely resemble the psychiatric profiles of patients with these disorders. If the borderline syndrome is meant to include all of these disorders, its usefulness as a diagnosis is limited. Until the fundamental features of borderline personality disorder that distinguish it from the others are identified, it is recommended that clinicians carefully assess patients for these other diagnoses. Efforts should be made to change the borderline personality disorder criteria by shifting away from overlap with the criteria for the other disorders.

Academic Accommodations for Students with Psychiatric Disabilities.

ERIC Educational Resources Information Center

Souma, Alfred; Rickerson, Nancy; Burgstahler, Sheryl

This brief paper summarizes the literature on academic accommodations for students with psychiatric disabilities. A definition of psychiatric disability precedes a brief summary of the following specific psychiatric diagnoses: depression, bipolar affective disorder; borderline personality disorder; schizophrenia; and anxiety disorders. Also noted…

Psychiatric disorders among adolescents from Lebanon: prevalence, correlates, and treatment gap.

PubMed

Maalouf, Fadi T; Ghandour, Lilian A; Halabi, Fadi; Zeinoun, Pia; Shehab, Al Amira Safa; Tavitian, Lucy

2016-08-01

Adolescence is a critical age for the development of psychiatric disorders. Although Lebanon, a low-to-middle income country, has suffered from decades of war and political instability, the burden of psychiatric disorders among adolescents in Lebanon remains unclear. This study aims to estimate the prevalence of psychiatric disorders among adolescents in the Lebanese capital, Beirut, and to study the correlates and treatment seeking behavior associated with these disorders. Through a multistage cluster sampling design, 510 adolescents, aged 11-17 years were recruited from a household sample in Beirut in 2012. Parents and adolescents completed a battery of self-reported questionnaires and interviews including the Development and Well-being Assessment (DAWBA), the Peer-Relations Questionnaire (PRQ), and a demographic/clinical information questionnaire. Logistic regression models were used to study the correlates of psychiatric disorders. The 30-day prevalence of psychiatric disorders was 26.1 %, with anxiety disorders (13.1 %) and ADHD (10.2 %) being the most prevalent disorders. Only 6 % of those with disorders reported seeking professional help. Parental marital status, not attending school, having a chronic medical condition, having a family history of psychiatric disorders, as well as propensity to bullying and to being victimized by peers emerged as correlates of having psychiatric disorders. A clear treatment gap is evident with a high 30-day prevalence of psychiatric disorders among adolescents in Beirut coupled with a very low percentage seeking treatment. Scaling up mental health services and addressing potential barriers to seeking care would be important to close this gap.

Psychiatric disorders and traumatic brain injury

PubMed Central

Schwarzbold, Marcelo; Diaz, Alexandre; Martins, Evandro Tostes; Rufino, Armanda; Amante, Lúcia Nazareth; Thais, Maria Emília; Quevedo, João; Hohl, Alexandre; Linhares, Marcelo Neves; Walz, Roger

2008-01-01

Psychiatric disorders after traumatic brain injury (TBI) are frequent. Researches in this area are important for the patients’ care and they may provide hints for the comprehension of primary psychiatric disorders. Here we approach epidemiology, diagnosis, associated factors and treatment of the main psychiatric disorders after TBI. Finally, the present situation of the knowledge in this field is discussed. PMID:19043523

Psychiatric Disorders in Adolescents and Adults with Autism and Intellectual Disability: A Representative Study in One County in Norway

ERIC Educational Resources Information Center

Bakken, Trine L.; Helverschou, Sissel B; Eilertsen, Dag E.; Heggelund, Trond; Myrbakk, Even; Martinsen, Harald

2010-01-01

Few studies assess psychiatric disorders in representative samples of individuals with autism and ID. Symptoms of autism and psychiatric disorders have been confounded. PAC, a conceptually analysed and validated screening instrument, was used. Aims: Assess prevalence of psychiatric disorders in individuals with intellectual disability only…

Comorbidity of Psychiatric Disorders and Nicotine Dependence among Adolescents: Findings from a Prospective, Longitudinal Study

ERIC Educational Resources Information Center

Griesler, Pamela C.; Hu, Mei-Chen; Schaffram, Christine; Kandel, Denise B.

2008-01-01

The relationship between nicotine dependence and DSM-IV psychiatric disorders in 1,039 adolescents is examined. Findings revealed that psychiatric disorders most usually predicted the onset of the first basis of nicotine dependence while nicotine dependence does not appear to have an influence on the onset of psychiatric disorders. Other…

Autobiographical memory: a candidate latent vulnerability mechanism for psychiatric disorder following childhood maltreatment

PubMed Central

McCrory, Eamon J.; Puetz, Vanessa B.; Maguire, Eleanor A.; Mechelli, Andrea; Palmer, Amy; Gerin, Mattia I.; Kelly, Philip A.; Koutoufa, Iakovina; Viding, Essi

2017-01-01

Background Altered autobiographical memory (ABM) functioning has been implicated in the pathogenesis of depression and post-traumatic stress disorder and may represent one mechanism by which childhood maltreatment elevates psychiatric risk. Aims To investigate the impact of childhood maltreatment on ABM functioning. Method Thirty-four children with documented maltreatment and 33 matched controls recalled specific ABMs in response to emotionally valenced cue words during functional magnetic resonance imaging. Results Children with maltreatment experience showed reduced hippocampal and increased middle temporal and parahippocampal activation during positive ABM recall compared with peers. During negative ABM recall they exhibited increased amygdala activation, and greater amygdala connectivity with the salience network. Conclusions Childhood maltreatment is associated with altered ABM functioning, specifically reduced activation in areas encoding specification of positive memories, and greater activation of the salience network for negative memories. This pattern may confer latent vulnerability to future depression and post-traumatic stress disorder. PMID:28882830

Onset of Maternal Psychiatric Disorders after the Birth of a Child with Autism Spectrum Disorder: A Retrospective Cohort Study

ERIC Educational Resources Information Center

Fairthorne, Jenny; Jacoby, Peter; Bourke, Jenny; de Klerk, Nick; Leonard, Helen

2016-01-01

Background: Mothers of a child with autism spectrum disorder have more psychiatric disorders after the birth of their child. This might be because they have more psychiatric disorders before the birth, or the increase could be related to the burden of caring for their child. Aims: We aimed to calculate the incidence of a psychiatric diagnosis in…

SUICIDAL IDEATORS IN THE PSYCHIATRIC FACILITY OF A GENERAL HOSPITAL - A PSYCHODEMOGRAPHIC PROFILE

PubMed Central

Unni, Sadanandan K.E.; Mani, Annie J.

1996-01-01

As a part of the basis for planning of prevention of suicide and suicide attempt, 154 suicidal ideators registered between 1988 and 1991, were recruited for an analysis of their psychiatric morbidity pattern. 59.74% had depression. The representation of substance abuse disorder and psychoses were 9.74% each 7.14% had neurotic disorders. 9.09% had bipolar affective disorder and 0.65% had normal mental status. 40% of the sample were housewives. Majority of them were between the age group of 16 and45years, having an educational status below 10th Standard The four year follow up findings showed that 8 of the sample completed suicide, of which four were suffering from psychosis. Repeaters suffered from disociation disorder. 15 of the depressives had resistant depression with nonremittent suicidal ideas. Psychotic patients and patients with somatic complaints were not free communicators of their suicidal idea. Implication of the results in the cunicalmanagement and further research on these patients are discussed. PMID:21584150

The changing profile of eating disorders at a tertiary psychiatric clinic in Hong Kong (1987-2007).

PubMed

Lee, Sing; Ng, King Lam; Kwok, Kathleen; Fung, Corina

2010-05-01

To examine the clinical profile of Chinese eating disorder patients at a tertiary psychiatric clinic in Hong Kong from 1987 to 2007. Data on 195 consecutive patients were retrieved from a standardized intake interview by an eating disorder specialist. Patients seen between 1987-1997 (n = 67) and 1998-2007 (n = 128) and fat-phobic (n = 76) and nonfat-phobic (n = 39) anorexic patients were compared. Patients were predominantly single (91.8%), female (99.0%), in their early-20s and suffered from anorexia (n = 115; 59.0%) or bulimia (n = 78; 40.0%) nervosa. The number of patients increased twofold across the two periods. Bulimia nervosa became more common while anorexia nervosa exhibited an increasingly fat-phobic pattern. Nonfat-phobic anorexic patients exhibited significantly lower premorbid body weight, less body dissatisfaction, less weight control behavior, and lower EAT-26 scores than fat-phobic anorexic patients. The clinical profile of eating disorders in Hong Kong has increasingly conformed to that of Western countries. 2009 by Wiley Periodicals, Inc.

Experience of nervousness and anxiety disorders in Puerto Rican women: psychiatric and ethnopsychological perspectives.

PubMed

Koss-Chioino, J D

1989-01-01

Analyses of case materials describe variations in the experiences of Puerto Rican women diagnosed as having an anxiety disorder, in treatment with mental health clinicians, physicians, or traditional healers. Their common complaints are examined as core symbolic elements in culturally patterned complexes of meanings focused around personal trauma, stressful life events, personal and social reactions, expectations about treatment, and the course of illness. Many of these women report themselves to be "nervous," to be "sick from nerves," or to have had an "ataque de nervios." "Nervousness" is the base symbolic domain in Puerto Rico of what psychiatry labels "anxiety disorder," although it is also a common complaint of many disorders. What "nervousness" means to patients/clients and their clinicians or healers is examined within the frames of multilayered popular and biomedical interpretations. The special difficulties of women in Puerto Rico are highlighted, and psychiatric and ethnopsychological (Spiritist) models of etiology and treatment are compared.

PTSD symptom severity and psychiatric comorbidity in recent motor vehicle accident victims: a latent class analysis.

PubMed

Hruska, Bryce; Irish, Leah A; Pacella, Maria L; Sledjeski, Eve M; Delahanty, Douglas L

2014-10-01

We conducted a latent class analysis (LCA) on 249 recent motor vehicle accident (MVA) victims to examine subgroups that differed in posttraumatic stress disorder (PTSD) symptom severity, current major depressive disorder and alcohol/other drug use disorders (MDD/AoDs), gender, and interpersonal trauma history 6-weeks post-MVA. A 4-class model best fit the data with a resilient class displaying asymptomatic PTSD symptom levels/low levels of comorbid disorders; a mild psychopathology class displaying mild PTSD symptom severity and current MDD; a moderate psychopathology class displaying severe PTSD symptom severity and current MDD/AoDs; and a severe psychopathology class displaying extreme PTSD symptom severity and current MDD. Classes also differed with respect to gender composition and history of interpersonal trauma experience. These findings may aid in the development of targeted interventions for recent MVA victims through the identification of subgroups distinguished by different patterns of psychiatric problems experienced 6-weeks post-MVA. Copyright © 2014 Elsevier Ltd. All rights reserved.

PTSD Symptom Severity and Psychiatric Comorbidity in Recent Motor Vehicle Accident Victims: A Latent Class Analysis

PubMed Central

Hruska, Bryce; Irish, Leah A.; Pacella, Maria L.; Sledjeski, Eve M.; Delahanty, Douglas L.

2014-01-01

We conducted a latent class analysis (LCA) on 249 recent motor vehicle accident (MVA) victims to examine subgroups that differed in posttraumatic stress disorder (PTSD) symptom severity, current major depressive disorder and alcohol/other drug use disorders (MDD/AoDs), gender, and interpersonal trauma history 6-weeks post-MVA. A 4-class model best fit the data with a resilient class displaying asymptomatic PTSD symptom levels/low levels of comorbid disorders; a mild psychopathology class displaying mild PTSD symptom severity and current MDD; a moderate psychopathology class displaying severe PTSD symptom severity and current MDD/AoDs; and a severe psychopathology class displaying extreme PTSD symptom severity and current MDD. Classes also differed with respect to gender composition and history of interpersonal trauma experience. These findings may aid in the development of targeted interventions for recent MVA victims through the identification of subgroups distinguished by different patterns of psychiatric problems experienced 6-weeks post-MVA. PMID:25124501

Co-morbidity in Attention-Deficit Hyperactivity Disorder: A Clinical Study from India.

PubMed

Jacob, P; Srinath, S; Girimaji, S; Seshadri, S; Sagar, J V

2016-12-01

To assess the prevalence of neurodevelopmental and psychiatric co-morbidities in children and adolescents diagnosed with attention-deficit hyperactivity disorder at a tertiary care child and adolescent psychiatry centre. A total of 63 children and adolescents who were diagnosed with attention-deficit hyperactivity disorder and fulfilled the inclusion criteria were comprehensively assessed for neurodevelopmental and psychiatric co-morbidities. The tools used included the Mini-International Neuropsychiatric Interview for Children and Adolescents, Attention Deficit Hyperactivity Disorder Rating Scale IV (ADHD-RS), Children's Global Assessment Scale, Clinical Global Impression Scale, Vineland Social Maturity Scale, and Childhood Autism Rating Scale. All except 1 subject had neurodevelopmental and / or psychiatric disorder co-morbid with attention-deficit hyperactivity disorder; 66.7% had both neurodevelopmental and psychiatric disorders. Specific learning disability was the most common co-existing neurodevelopmental disorder and oppositional defiant disorder was the most common psychiatric co-morbidity. The mean baseline ADHD-RS scores were significantly higher in the group with psychiatric co-morbidities, especially in the group with oppositional defiant disorder. Co-morbidity is present at a very high frequency in clinic-referred children diagnosed with attention-deficit hyperactivity disorder. Psychiatric co-morbidity, specifically oppositional defiant disorder, has an impact on the severity of attention-deficit hyperactivity disorder. Co-morbidity needs to be explicitly looked for during evaluation and managed appropriately.

Psychiatric disorders in individuals with high-functioning autism and Asperger's disorder: similarities and differences.

PubMed

Mukaddes, Nahit Motavalli; Hergüner, Sabri; Tanidir, Canan

2010-12-01

To investigate and compare the rate and type of psychiatric co-morbidity in individuals with diagnosis of high functioning autism (HFA) and Asperger's disorder (AS). This study includes 30 children and adolescents with diagnosis of HFA and 30 with diagnosis of AS. Diagnoses of HFA and AS were made using strict DSM-IV criteria. Psychiatric co-morbidity was assessed using the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL-T). The rate of comorbid psychiatric disorders was very high in both groups (93.3% in HFA and 100% in AS). The most common disorder in both groups was attention deficit hyperactivity disorder. There was no statistically significant difference between groups in the rate of associated psychiatric disorders, except for major depressive disorder (P = 0.029) and ADHD-combined type (P = 0.030). The AS group displayed greater comorbidity with depressive disorders and ADHD-CT. From a clinical perspective, it could be concluded that both disorders involve a high risk for developing psychiatric disorders, with AS patients at greater risk for depression. From a nosological perspective, the substantial similarities in terms of psychiatric comorbidity may support the idea that both disorders are on the same spectrum and differs in some aspects.

White Matter Integrity Reductions in Intermittent Explosive Disorder

PubMed Central

Lee, Royce; Arfanakis, Konstantinos; Evia, Arnold M; Fanning, Jennifer; Keedy, Sarah; Coccaro, Emil F

2016-01-01

Intermittent explosive disorder (IED), as described in DSM-5, is the categorical expression of pathological impulsive aggression. Previous work has identified neurobiological correlates of the disorder in patterns of frontal-limbic brain activity and dysregulation of serotonergic neurotransmission. Given the importance of short- and-long range white matter connections of the brain in social and emotional behavior, studies of white matter connectivity in impulsive aggression are warranted. Diffusion tensor imaging (DTI) studies in the related conditions of antisocial and borderline personality disorder have produced preliminary evidence of disturbed white matter connectivity in these disorders, but to date there have been no DTI studies in IED. A total of 132 male and female adults between the ages of 18 and 55 years underwent Turboprop-DTI on a 3-Tesla MRI scanner. Of these, 42 subjects had IED, 40 were normal controls, and 50 were clinical psychiatric controls with psychiatric disorders without IED. All subjects were free of alcohol, psychotropic medications, or drugs of abuse. The diffusion tensor was calculated in each voxel and maps of fractional anisotropy (FA) were generated. Tract-based spatial statistics (TBSS) were used to compare FA along the white matter skeleton among the three subject groups. IED was associated with lower FA in two clusters located in the superior longitudinal fasciculus (SLF) when compared with the psychiatric and healthy controls. Impulsive aggression and borderline personality disorder, but not psychopathy or antisocial personality disorder, was associated with lower FA in the two clusters within the SLF. In conclusion, IED was associated with lower white matter integrity in long-range connections between the frontal and temporoparietal regions. PMID:27206265

White Matter Integrity Reductions in Intermittent Explosive Disorder.

PubMed

Lee, Royce; Arfanakis, Konstantinos; Evia, Arnold M; Fanning, Jennifer; Keedy, Sarah; Coccaro, Emil F

2016-10-01

Intermittent explosive disorder (IED), as described in DSM-5, is the categorical expression of pathological impulsive aggression. Previous work has identified neurobiological correlates of the disorder in patterns of frontal-limbic brain activity and dysregulation of serotonergic neurotransmission. Given the importance of short- and-long range white matter connections of the brain in social and emotional behavior, studies of white matter connectivity in impulsive aggression are warranted. Diffusion tensor imaging (DTI) studies in the related conditions of antisocial and borderline personality disorder have produced preliminary evidence of disturbed white matter connectivity in these disorders, but to date there have been no DTI studies in IED. A total of 132 male and female adults between the ages of 18 and 55 years underwent Turboprop-DTI on a 3-Tesla MRI scanner. Of these, 42 subjects had IED, 40 were normal controls, and 50 were clinical psychiatric controls with psychiatric disorders without IED. All subjects were free of alcohol, psychotropic medications, or drugs of abuse. The diffusion tensor was calculated in each voxel and maps of fractional anisotropy (FA) were generated. Tract-based spatial statistics (TBSS) were used to compare FA along the white matter skeleton among the three subject groups. IED was associated with lower FA in two clusters located in the superior longitudinal fasciculus (SLF) when compared with the psychiatric and healthy controls. Impulsive aggression and borderline personality disorder, but not psychopathy or antisocial personality disorder, was associated with lower FA in the two clusters within the SLF. In conclusion, IED was associated with lower white matter integrity in long-range connections between the frontal and temporoparietal regions.

Psychiatric Disorders and Health-Related Quality of Life in Children With Type 1 Diabetes Mellitus.

PubMed

Butwicka, Agnieszka; Fendler, Wojciech; Zalepa, Adam; Szadkowska, Agnieszka; Zawodniak-Szalapska, Malgorzata; Gmitrowicz, Agnieszka; Mlynarski, Wojciech

2016-01-01

Type 1 diabetes mellitus (T1DM) is a chronic condition with major effect on health-related quality of life (HRQoL) and mental health. In 1990s, high rates of psychiatric disorders were reported among children with T1DM. Little is known, however, about current prevalence of psychiatric disorders in children with T1DM and the relation between psychiatric diagnosis and HRQoL. The aim of the study was to determine the prevalence of Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) psychiatric disorders and the association between psychiatric comorbidity and HRQoL in the pediatric population with T1DM. We conducted a cross-sectional study of 207 children, aged 8-18 years, diagnosed with T1DM. The presence of psychiatric disorders has been assessed by the standard diagnostic interview according to Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) criteria. HRQoL was measured by the general and diabetes mellitus-specific modules of the Paediatric Quality of Life Inventory. Of the evaluated patients, 26.6% (N = 55) met the criteria for psychiatric disorders at the time of evaluation. The most common diagnoses were anxiety (N = 32; 15.5%) and mood disorders (N = 8; 3.9%). One-third of the patients (N = 66, 31.9%) met the criteria for at least 1 psychiatric diagnosis in their lifetime. The presence of psychiatric disorders was related to an elevated hemoglobin A1c level (8.6% vs 7.6%) and a lowered HRQoL level in the general pediatric quality of life inventory. In the diabetes mellitus-specific pediatric quality of life inventory, children with psychiatric disorders revealed more symptoms of diabetes mellitus, treatment barriers, and lower adherence than children without psychiatric disorders. T1DM in children is associated with a very high prevalence of psychiatric comorbidity, which is related to elevated hemoglobin A1c and lower HRQoL levels. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Comparison of the Prevalence of Psychiatric Disorders in Performance-Enhancing Drug Users and Nonuser Bodybuilders.

PubMed

Ostovar, Afshin; Haerinejad, Mohammad Javad; Akbarzadeh, Samad; Keshavarz, Mojtaba

2017-10-01

Objective: The present study aimed at comparing the prevalence of major psychiatric disorders including major depressive disorder, bipolar disorder, schizophrenia, and generalized anxiety disorder between performance-enhancing drug users and nonuser bodybuilders. Moreover, the prevalence of major psychiatric disorders in bodybuilders was also reported. Method: In this study, 453 athletes were recruited from Bushehr bodybuilding gyms from February to May 2015. A structured questionnaire was used to collect the participants' information, including demographic characteristics, sports' status and performance-enhancing drug use. According to the condition of performance-enhancing drug use, the participants were divided into current users, non-current users, and nonusers. The psychiatric status of the participants was evaluated using DSM-IV diagnostic criteria for major depressive disorder, bipolar disorder, generalized anxiety disorder, and schizophrenia. We also asked about the acute psychotic disturbances after using performance-enhancing drugs, alcohol use, and history of aggressive behavior in bodybuilders. Data were analyzed using one-way analysis of variance and chi-square tests. Results: Prevalence of major depressive disorder, bipolar disorder, schizophrenia, generalized anxiety disorder, and the overall prevalence of psychiatric disorders in the bodybuilders was 19.7%, 3.8%, 1.5%, 16.6%, and 26.7%, respectively. After using performance-enhancing drugs, 33% of the bodybuilders had experienced acute psychological disturbances. There were no significant differences between current, non-current, and nonuser bodybuilding athletes in the measured psychiatric disorders. Conclusion: Prevalence of psychiatric disorders was not significantly different in performance-enhancing drug users and nonusers. Thus, it can be concluded that performance-enhancing drugs do not increase the risk of psychiatric disorders in bodybuilders.

Psychopathology in methamphetamine-dependent adults 3 years after treatment.

PubMed

Glasner-Edwards, Suzette; Mooney, Larissa J; Marinelli-Casey, Patricia; Hillhouse, Maureen; Ang, Alfonso; Rawson, Richard A

2010-01-01

Although psychiatric symptoms are frequently observed in methamphetamine (MA) users, little is known about the prevalence of psychiatric disorders in MA-dependent individuals. This is the first study to examine the association of psychiatric disorders with substance use and psychosocial functioning in a large sample of MA users 3 years after treatment. We predicted that psychiatric diagnoses and severity would be associated with substance use and poorer overall functioning over the 3 year post-treatment course. Participants (N = 526) received psychosocial treatment for MA dependence as part of the Methamphetamine Treatment Project and were reassessed for psychosocial functioning and substance use at a mean of 3 years after treatment initiation. DSM-IV psychiatric diagnoses were assessed at follow-up using the Mini-International Neuropsychiatric Interview. Psychosocial functioning was assessed using the Addiction Severity Index. Overall, 48.1% of the sample met criteria for a current or past psychiatric disorder other than a substance use disorder. Consistent with prior reports from clinical samples of cocaine users, this rate was largely accounted for by mood disorders, anxiety disorders and antisocial personality. Those with an Axis I psychiatric disorder evidenced increased MA use and greater functional impairment over time relative to those without a psychiatric disorder. This initial investigation of psychiatric diagnoses in MA users after treatment indicates elevated rates of Axis I and II disorders in this population and underscores the need for integrated psychiatric assessment and intervention in drug abuse treatment settings.

Demographic Characteristics and Psychiatric Comorbidity of Children and Adolescents Diagnosed with ADHD in Specialized Healthcare.

PubMed

Joelsson, Petteri; Chudal, Roshan; Gyllenberg, David; Kesti, Anna-Kaisa; Hinkka-Yli-Salomäki, Susanna; Virtanen, Juha-Pekka; Huttunen, Jukka; Ristkari, Terja; Parkkola, Kai; Gissler, Mika; Sourander, Andre

2016-08-01

Recent studies have shown an increasing incidence of attention-deficit/hyperactivity disorder (ADHD) among children diagnosed in specialized services. This study aims to describe children with ADHD in Finnish specialized healthcare by reporting the demographic characteristics, time trends in diagnosis, psychiatric comorbidity, and the validity of register-based diagnoses. All the singletons born in Finland between 1991 and 2005 and diagnosed with ADHD by 2011 were identified and their psychiatric comorbidity data was obtained from the Finnish Hospital Discharge Register (FHDR). Parents of 69 patients were interviewed via telephone for a diagnostic validation. A total of 10,409 children were identified with ADHD, with a male: female ratio of 5.3:1 and a psychiatric comorbidity rate of 76.7 %. Of the validation sample 88 % met the diagnostic criteria of ADHD for DSM-IV. There is an increasing trend of ADHD diagnosis among both males and females. Psychiatric comorbidity is common and includes a wide range of disorders among children with ADHD. There was an increase of ADHD diagnoses especially among boys. More attention is needed to detect ADHD among girls in health services. Diagnoses in the FHDR show diagnostic validity and their sociodemographic patterns are in line with previous studies.

High prevalence of psychiatric disorders in patients with skin-restricted lupus: a case-control study.

PubMed

Jalenques, I; Rondepierre, F; Massoubre, C; Haffen, E; Grand, J P; Labeille, B; Perrot, J L; Aubin, F; Skowron, F; Mulliez, A; D'Incan, M

2016-05-01

Psychiatric disorders have been extensively documented in patients with systemic lupus erythematosus (SLE). However, the prevalence of psychiatric disorders in patients with skin-restricted lupus (SRL) remains unknown, although SRL is more common than SLE. To assess current and lifetime prevalence of Axis I psychiatric disorders among outpatients with SRL and to examine the factors associated with psychiatric disorders among such patients. A multicentre case-control study involving outpatients with SRL and controls matched for sex, age and education level. The Mini International Neuropsychiatric Interview was used for psychiatric evaluation. We evaluated 75 patients and 150 controls. Of these, 49% of patients vs. 13% of controls fulfilled the criteria for at least one current psychiatric disorder (P < 0·001). The following disorders were significantly more frequent among patients than controls: current and lifetime major depressive disorder (9% vs. 0%, P < 0·001 and 44% vs. 26%, P = 0·01), generalized anxiety disorder (23% vs. 3%, P < 0·001 and 35% vs. 19%, P = 0·03), panic disorder (7% vs. 0%, P = 0·004 and 21% vs. 3%, P < 0·001), current suicide risk (24% vs. 7%, P = 0·003), alcohol dependence (7% vs. 0%, P = 0·004) and lifetime agoraphobia (20% vs. 9%, P = 0·01). Lupus duration and lupus past treatment by thalidomide were significantly higher among patients with current psychiatric disorders. This study demonstrates a high prevalence of several psychiatric disorders (anxiety, depression, suicide risk, alcohol dependence) in patients with SRL. © 2016 British Association of Dermatologists.

The impact of epidemic violence on the prevalence of psychiatric disorders in Sao Paulo and Rio de Janeiro, Brazil.

PubMed

Ribeiro, Wagner Silva; Mari, Jair de Jesus; Quintana, Maria Inês; Dewey, Michael E; Evans-Lacko, Sara; Vilete, Liliane Maria Pereira; Figueira, Ivan; Bressan, Rodrigo Affonseca; de Mello, Marcelo Feijó; Prince, Martin; Ferri, Cleusa P; Coutinho, Evandro Silva Freire; Andreoli, Sérgio Baxter

2013-01-01

Violence and other traumatic events, as well as psychiatric disorders are frequent in developing countries, but there are few population studies to show the actual impact of traumatic events in the psychiatric morbidity in low and middle-income countries (LMIC). To study the relationship between traumatic events and prevalence of mental disorders in São Paulo and Rio de Janeiro, Brazil. Cross-sectional survey carried out in 2007-2008 with a probabilistic representative sample of 15- to 75-year-old residents in Sao Paulo and Rio de Janeiro, Brazil, using the Composite International Diagnostic Interview. The sample comprised 3744 interviews. Nearly 90% of participants faced lifetime traumatic events. Lifetime prevalence of any disorders was 44% in Sao Paulo and 42.1% in Rio de Janeiro. One-year estimates were 32.5% and 31.2%. One-year prevalence of traumatic events was higher in Rio de Janeiro than Sao Paulo (35.1 vs. 21.7; p<0.001). Participants from Rio de Janeiro were less likely to have alcohol dependence (OR = 0.55; p = 0.027), depression (OR = 0.6; p = 0.006) generalized anxiety (OR = 0.59; p = 0.021) and post-traumatic stress disorder (OR = 0.62; p = 0.027). Traumatic events correlated with all diagnoses--e.g. assaultive violence with alcohol dependence (OR = 5.7; p<0.001) and with depression (OR = 1.7; p = 0.001). Our findings show that psychiatric disorders and traumatic events, especially violence, are extremely common in Sao Paulo and Rio de Janeiro, supporting the idea that neuropsychiatric disorders and external causes have become a major public health priority, as they are amongst the leading causes of burden of disease in low and middle-income countries. The comparison between the two cities regarding patterns of violence and psychiatric morbidity suggests that environmental factors may buffer the negative impacts of traumatic events. Identifying such factors might guide the implementation of interventions to improve mental health and quality of life in LMIC urban centers.

The Impact of Epidemic Violence on the Prevalence of Psychiatric Disorders in Sao Paulo and Rio de Janeiro, Brazil

PubMed Central

Ribeiro, Wagner Silva; Mari, Jair de Jesus; Quintana, Maria Inês; Dewey, Michael E.; Evans-Lacko, Sara; Vilete, Liliane Maria Pereira; Figueira, Ivan; Bressan, Rodrigo Affonseca; de Mello, Marcelo Feijó; Prince, Martin; Ferri, Cleusa P.; Coutinho, Evandro Silva Freire; Andreoli, Sérgio Baxter

2013-01-01

Background Violence and other traumatic events, as well as psychiatric disorders are frequent in developing countries, but there are few population studies to show the actual impact of traumatic events in the psychiatric morbidity in low and middle-income countries (LMIC). Aims To study the relationship between traumatic events and prevalence of mental disorders in São Paulo and Rio de Janeiro, Brazil. Methods Cross-sectional survey carried out in 2007–2008 with a probabilistic representative sample of 15- to 75-year-old residents in Sao Paulo and Rio de Janeiro, Brazil, using the Composite International Diagnostic Interview. Results The sample comprised 3744 interviews. Nearly 90% of participants faced lifetime traumatic events. Lifetime prevalence of any disorders was 44% in Sao Paulo and 42.1% in Rio de Janeiro. One-year estimates were 32.5% and 31.2%. One-year prevalence of traumatic events was higher in Rio de Janeiro than Sao Paulo (35.1 vs. 21.7; p<0.001). Participants from Rio de Janeiro were less likely to have alcohol dependence (OR = 0.55; p = 0.027), depression (OR = 0.6; p = 0.006) generalized anxiety (OR = 0.59; p = 0.021) and post-traumatic stress disorder (OR = 0.62; p = 0.027). Traumatic events correlated with all diagnoses – e.g. assaultive violence with alcohol dependence (OR = 5.7; p<0.001) and with depression (OR = 1.7; p = 0.001). Conclusion Our findings show that psychiatric disorders and traumatic events, especially violence, are extremely common in Sao Paulo and Rio de Janeiro, supporting the idea that neuropsychiatric disorders and external causes have become a major public health priority, as they are amongst the leading causes of burden of disease in low and middle-income countries. The comparison between the two cities regarding patterns of violence and psychiatric morbidity suggests that environmental factors may buffer the negative impacts of traumatic events. Identifying such factors might guide the implementation of interventions to improve mental health and quality of life in LMIC urban centers. PMID:23667636

Do race, ethnicity, and psychiatric diagnoses matter in the prevalence of multiple chronic medical conditions?

PubMed

Cabassa, Leopoldo J; Humensky, Jennifer; Druss, Benjamin; Lewis-Fernández, Roberto; Gomes, Arminda P; Wang, Shuai; Blanco, Carlos

2013-06-01

The proportion of people in the United States with multiple chronic medical conditions (MCMC) is increasing. Yet, little is known about the relationship that race, ethnicity, and psychiatric disorders have on the prevalence of MCMCs in the general population. This study used data from wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (N=33,107). Multinomial logistic regression models adjusting for sociodemographic variables, body mass index, and quality of life were used to examine differences in the 12-month prevalence of MCMC by race/ethnicity, psychiatric diagnosis, and the interactions between race/ethnicity and psychiatric diagnosis. Compared to non-Hispanic Whites, Hispanics reported lower odds of MCMC and African Americans reported higher odds of MCMC after adjusting for covariates. People with psychiatric disorders reported higher odds of MCMC compared with people without psychiatric disorders. There were significant interactions between race and psychiatric diagnosis associated with rates of MCMC. In the presence of certain psychiatric disorders, the odds of MCMC were higher among African Americans with psychiatric disorders compared to non-Hispanic Whites with similar psychiatric disorders. Our study results indicate that race, ethnicity, and psychiatric disorders are associated with the prevalence of MCMC. As the rates of MCMC rise, it is critical to identify which populations are at increased risk and how to best direct services to address their health care needs.

Psychiatric Symptoms in Youth with a History of Autism and Optimal Outcome

ERIC Educational Resources Information Center

Orinstein, Alyssa; Tyson, Katherine E.; Suh, Joyce; Troyb, Eva; Helt, Molly; Rosenthal, Michael; Barton, Marianne L.; Eigsti, Inge-Marie; Kelley, Elizabeth; Naigles, Letitia; Schultz, Robert T.; Stevens, Michael C.; Fein, Deborah A.

2015-01-01

Since autism spectrum disorder (ASD) is often comorbid with psychiatric disorders, children who no longer meet criteria for ASD (optimal outcome; OO) may still be at risk for psychiatric disorders. A parent interview for DSM-IV psychiatric disorders (K-SADS-PL) for 33 OO, 42 high-functioning autism (HFA) and 34 typically developing (TD) youth,…

Psychiatric disorders in children at one year after the tsunami disaster in Thailand.

PubMed

Piyasil, Vinadda; Ketumarn, Panom; Prubrukarn, Ratanotai; Pacharakaew, Siripapa; Dumrongphol, Hattaya; Rungsri, Sarinee; Sitdhiraksa, Nantawat; Pitthayaratsathien, Nattorn; Prasertvit, Jiraporn; Sudto, Korapin; Theerawongseree, Siriporn; Aowjinda, Sumitra; Thaeramanophab, Somchit; Jotipanu, Vajiraporn; Chatchavalitsakul, Wilairatana

2008-10-01

The tsunami that struck Thailand on 26th December 2004 was the greatest natural disaster in the country's history. It left in its wake unprecedented damage and destruction. Children suffered the loss of parents or guardians, and survivors were left to cope with psychological trauma of the disaster To assess the psychiatric disorders in tsunami victim children at one year after the event. A cross sectional study was done. One thousand three hundred and sixty-four students from 2 schools were enrolled. Three tests were used according to the students' grades, pediatric symptoms checklist, Childhood Depressive Inventory and the Revised Child Impact of Events scale (CRIES). Psychiatric disorders were diagnosed by child and adolescent psychiatrists, using criteria from the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM IV). Analysis data by using SPSS version 10.0 and Chi-square test. The results were presented as percentage and p-value. Psychiatric disorders were found in 142 students or 10.4 percents of all students at one year after the tsunami disaster. Not all the students who had psychiatric disorders developed them as the result of the tsunami disaster However, ninety students or 6.3 percent of all the students did have psychiatric disorders resulting from the tsunami disaster The most common psychiatric problem was post traumatic stress disorder Ten percent of grade 4-6 students and 11 percent of grade 7-9 students had psychiatric disorders. The prevalence was lower in kindergarten and grade 1-3 students of which the percentage was 2.3 and 3.8 respectively. The prevalence of psychiatric disorders at 1 year after the tsunami disaster was 10.4 percent of all the students or 33.1 percent of victims. The prevalence of psychiatric disorders in grade 4-6 and 7-9 students was higher than in kindergarten and grade 1-3 students. The most common psychiatric problem is post traumatic stress disorder.

Prescribing Pattern of Antidepressants in Children and Adolescents: Findings from the Research on Asia Psychotropic Prescription Pattern.

PubMed

Chee, K Y; Tripathi, A; Avasthi, A; Chong, M Y; Xiang, Y T; Sim, K; Kanba, S; He, Y L; Lee, M S; Chiu, H F K; Yang, S Y; Kuga, H; Udomratn, P; Tanra, A J; Maramis, M M; Grover, S; Mahendran, R; Kallivayalil, R A; Shen, W W; Shinfuku, N; Tan, C H; Sartorius, N

2016-03-01

Pharmacotherapy of depression in children and adolescents is complex. In the absence of research into the efficacy and safety of antidepressants in this group of patients, their off-label prescription is common. This paper aimed to illustrate the prescription pattern of antidepressants in children and adolescents from major psychiatric centres in Asia. The Research on Asia Psychotropic Prescription Pattern on Antidepressants worked collaboratively in 2013 to study the prescription pattern of antidepressants in Asia using a unified research protocol and questionnaire. Forty psychiatric centres from 10 Asian countries / regions participated and 2321 antidepressant prescriptions were analysed. A total of 4.7% antidepressant prescriptions were for children and adolescents. Fluoxetine, sertraline, and escitalopram were the most common antidepressants prescribed for children and adolescents. Almost one-third (30.3%) of prescriptions were for diagnoses other than depressive and anxiety disorders. There was less antidepressant polypharmacy and concomitant use of benzodiazepine, but more concomitant use of antipsychotics in children and adolescents compared with adults. Off-label use of antidepressants in children and adolescents was reported by 40 Asian psychiatric institutions that participated in the study. In-service education and regulatory mechanisms should be reinforced to ensure efficacy and safety of antidepressants in children and adolescents.

Alcohol addiction and the attachment system: an empirical study of attachment style, alexithymia, and psychiatric disorders in alcoholic inpatients.

PubMed

De Rick, Ann; Vanheule, Stijn; Verhaeghe, Paul

2009-01-01

This study aims at investigating alcoholic inpatients' attachment system by combining a measurement of adult attachment style (AAQ, Hazan and Shaver, 1987. Journal of Personality and Social Psychology, 52(3): 511-524) and the degree of alexithymia (BVAQ, Bermond and Vorst, 1998. Bermond-Vorst Alexithymia Questionnaire, Unpublished data). Data were collected from 101 patients (71 men, 30 women) admitted to a psychiatric hospital in Belgium for alcohol use-related problems, between September 2003 and December 2004. To investigate the research question, cluster analyses and regression analyses are performed. We found that it makes sense to distinguish three subgroups of alcoholic inpatients with different degrees of impairment of the attachment system. Our results also reveal a pattern of correspondence between the severity of psychiatric symptoms-personality disorder traits (ADP-IV), anxiety (STAI), and depression (BDI-II-Nl)-and the severity of the attachment system's impairment. Limitations of the study and suggestions for further research are highlighted and implications for diagnosis and treatment are discussed.

Psychiatric disorders associated with Cushing's syndrome.

PubMed

Bratek, Agnieszka; Koźmin-Burzyńska, Agnieszka; Górniak, Eliza; Krysta, Krzysztof

2015-09-01

Cushing's syndrome is the term used to describe a set of symptoms associated with hypercortisolism, which in most cases is caused by hypophysial microadenoma over-secreting adrenocorticotropic hormone. This endocrine disorder is often associated with psychiatric comorbidities. The most important include mood disorders, psychotic disorders, cognitive dysfunctions and anxiety disorders. The aim of this article was to review the prevalence, symptoms and consequences of psychiatric disorders in the course of Cushing's syndrome. We therefore performed a literature search using the following keywords: Cushing's syndrome and psychosis, Cushing's syndrome and mental disorders, Cushing's syndrome and depression, Cushing's syndrome and anxiety. The most prevalent psychiatric comorbidity of Cushing's syndrome is depression. Psychiatric manifestations can precede the onset of full-blown Cushing's syndrome and therefore be misdiagnosed. Despite the fact that treatment of the underlying endocrine disease in most cases alleviates psychiatric symptoms, the loss of brain volume persists. It is important to be alert to the symptoms of hypercortisolism in psychiatric patients to avoid misdiagnosis and enable them receiving adequate treatment.

Neurobiological and clinical relationship between psychiatric disorders and chronic pain.

PubMed

Bras, Marijana; Dordević, Veljko; Gregurek, Rudolf; Bulajić, Masa

2010-06-01

Pain is one of the most ubiquitous problems of today's world, its impact being far-reaching. Current conceptualizations of pain medicine adopt a bio-psycho-social perspective. In this model, pain is best described as an interactive, psycho-physiological behavioral pattern that cannot be divided into independent psycho-social and physical components. Neurophysiologic substrates of the pain experience can be broken down into the pain transmission elements emanating from peripheral, spinal, and supra-spinal processes. There are many complex mechanisms involved in pain processing within the central nervous system, being influenced by genetics, interaction of neurotransmitters and their receptors, and pain- augmenting and pain-inhibiting neural circuits. The patient's emotional experiences, beliefs and expectations may determine the outcome of treatment, and are fully emphasized in the focus of treatment interventions. There are several common psychiatric disorders accompanying and complicating the experience of pain that warrant clinical attention and that can be the focus of psychiatric treatment. These include depression, anxiety, sleep disorders, somatoform disorders, substance-related disorders and personality disorders. Complex and disabling pain conditions often require comprehensive pain treatment programs, involving interdisciplinary and multimodal treatment approaches. There are many roles that the psychiatrist can perform in the assessment and treatment of the patients with pain, individually tailored to meet the specific needs of the patient. Rational poly-pharmacy is of a high importance in the treatment of patients with chronic pain, with antidepressants and anticonvulsants contributing as the important adjuvant analgesic agents.

Psychiatric disorders among people living with HIV/AIDS in IRAN: Prevalence, severity, service utilization and unmet mental health needs.

PubMed

Shadloo, Behrang; Amin-Esmaeili, Masoumeh; Motevalian, Abbas; Mohraz, Minoo; Sedaghat, Abbas; Gouya, Mohammad Mehdi; Rahimi-Movaghar, Afarin

2018-07-01

HIV and psychiatric disorders are closely correlated and are accompanied by some similar risk factors. The aim of this study was to assess psychiatric comorbidity and health service utilization for mental problems among people living with HIV/AIDS in Iran. A total of 250 cases were randomly selected from a large referral center for HIV treatment and care in Tehran, Iran. Psychiatric disorders in the past 12 months including mood, anxiety, and substance use disorders were assessed through face-to-face interview, using a validated Persian translation of the Composite International Diagnostic Interview (CIDI v2.1). Severity of psychiatric disorders, social support, socio-economic status, service utilization and HIV-related indicators were assessed. Participants consisted of 147 men and 103 women. Psychiatric disorders were found in 50.2% (95% confidence interval: 43.8-56.6) of the participants. Major depressive disorder was the most prevalent diagnosis (32.1%), followed by substance use disorders (17.1%). In bivariate analysis, psychiatric disorders were significantly higher among male gender, single and unemployed individuals and those with lower social support. In multivariate regression analysis, only social support was independently associated with psychiatric disorders. Among those with a psychiatric diagnosis, 41.1% had used a health service for mental problems and 53% had received minimally adequate treatment. The findings of the study highlight the importance of mental health services in the treatment of people living with HIV/AIDS. Copyright © 2018 Elsevier Inc. All rights reserved.

Demographic and clinical characteristics of current comorbid psychiatric disorders in a randomized clinical trial for adults with stimulant use disorders

PubMed Central

Warden, Diane; Sanchez, Katherine; Greer, Tracy; Carmody, Thomas; Walker, Robrina; Cruz, Adriane dela; Toups, Marisa; Rethorst, Chad; Trivedi, Madhukar H.

2017-01-01

This study aimed to determine if current comorbid psychiatric disorders differ in adults with cocaine use disorder, other stimulant (primarily methamphetamine) use disorder, or both, and identify demographic and clinical characteristics in those with increasing numbers of comorbid disorders. Baseline data from a randomized controlled trial beginning in residential settings (N=302) was used. Mood disorders were present in 33.6%, and anxiety disorders in 29.6%, with no differences among stimulant use disorder groups. Panic disorder was more frequently present with other stimulant use disorder. Those with two or more comorbid psychiatric disorders were more often female, White, had more symptoms of depression, greater propensity and risk for suicidal behavior, lower functioning in psychiatric and family domains, lower quality of life, more symptoms with stimulant abstinence and greater likelihood of marijuana dependence. Those with one or more comorbid disorders had more medical disorder burden, lower cognitive and physical functioning, greater pain, and higher rates of other drug dependence. With current comorbid psychiatric disorders, the morbidity of stimulant use disorders increases. Use of validated assessments near treatment entry, and a treatment plan targeting not only substance use and comorbid psychiatric disorders, but functional impairments, medical disorder burden and pain, may be useful. PMID:27693866

Relationship of bipolar disorder with psychiatric comorbidity in the postpartum period-a scoping review.

PubMed

Sharma, Verinder

2018-04-01

Childbirth can trigger a variety of psychiatric disorders; however, no disorder is as profoundly affected by childbirth as bipolar disorder. Rates of psychiatric comorbidity especially anxiety disorders, obsessive compulsive disorder, and substance use disorders are quite high in individuals with bipolar disorder. The purpose of this scoping review is to ascertain the effect of childbirth on the relationship between the onset of bipolar disorder and comorbid psychiatric disorders. On June 27, 2017, a search of the Medline, PsycINFO, CINHAL, EMBASE, SCOPUS, COCHRANE, and ISI-Web of Science (WOS) databases was performed using the terms mental disorders, mental disease, major depressive disorder, major depression, depression, panic disorder, bipolar disorder, comorbidity, anxiety disorders, obsessive compulsive disorder, post-traumatic stress disorder, schizophrenia, eating disorders, reactive attachment disorder, childbirth, parturition, puerperium, postpartum, postpartum period and postnatal period. Reference lists of identified papers were manually searched, and all relevant papers published in English were included. A total of eight relevant articles were identified and included in the review. There is some evidence to suggest that occurrence of certain psychiatric disorders in the postpartum period may predict later onset of bipolar disorder. It is unknown whether childbirth raises the risk of postpartum recurrence of comorbid disorders. Whether patients who have past histories of psychiatric disorders are at increased risk for onset of bipolar disorder in the postpartum period also remains unclear. Additional research is needed to increase our understanding of the impact of childbirth on bipolar disorder and comorbid psychiatric disorders. A better understanding of this issue could lead to more accurate and timely detection, improved treatment planning, and optimal delivery of care for these disorders.

Prescribing patterns of psychotropic medications and clinical features in patients with major depressive disorder with and without comorbid dysthymia in China.

PubMed

Feng, Yuan; Sha, Sha; Hu, Chen; Wang, Gang; Ungvari, Gabor S; Chiu, Helen F K; Ng, Chee H; Si, Tian-Mei; Chen, Da-Fang; Fang, Yi-Ru; Lu, Zheng; Yang, Hai-Chen; Hu, Jian; Chen, Zhi-Yu; Huang, Yi; Sun, Jing; Wang, Xiao-Ping; Li, Hui-Chun; Zhang, Jin-Bei; Xiang, Yu-Tao

2017-03-01

Little has been reported about the demographic and clinical features of major depressive disorder (MDD) with comorbid dysthymia in Chinese patients. This study examined the frequency of comorbid dysthymia in Chinese MDD patients together with the demographic and clinical correlates and prescribing patterns of psychotropic drugs. Consecutively collected sample of 1178 patients with MDD were examined in 13 major psychiatric hospitals in China. Patients' demographic and clinical characteristics and psychotropic drugs prescriptions were recorded using a standardized protocol and data collection procedure. The diagnosis of dysthymia was established using the Mini International Neuropsychiatric Interview. Medications ascertained included antidepressants, antipsychotics, benzodiazepines, and mood stabilizers. One hundred and three (8.7%) patients fulfilled criteria for dysthymia. In multiple logistic regression analyses, compared to non-dysthymia counterparts, MDD patients with dysthymia had more depressive episodes with atypical features including increased appetite, sleep, and weight gain, more frequent lifetime depressive episodes, and less likelihood of family history of psychiatric disorders. There was no significant difference in the pattern of psychotropic prescription between the 2 groups. There are important differences in the demographic and clinical features of comorbid dysthymia in Chinese MDD patients compared with previous reports. The clinical profile found in this study has implications for treatment decisions. © 2016 John Wiley & Sons Australia, Ltd.

Population heterogeneity of trait anger and differential associations of trait anger facets with borderline personality features, neuroticism, depression, Attention Deficit Hyperactivity Disorder (ADHD), and alcohol problems.

PubMed

Lubke, Gitta H; Ouwens, Klaasjan G; de Moor, Marleen H M; Trull, Timothy J; Boomsma, Dorret I

2015-12-15

Anger is an emotion consisting of feelings of variable intensity ranging from mild irritation to intense fury. High levels of trait anger are associated with a range of psychiatric, interpersonal, and health problems. The objectives of this study were to explore heterogeneity of anger as measured by the Spielberger Trait Anger Scale (STAS), and to assess the association of the different anger facets with a selection of psychiatric disorders covering externalizing and internalizing problems, personality disorders, and substance use. Factor mixture models differentiated between a high and low scoring class (28% vs. 72%), and between three factors (anger-temperament, anger-reaction, and immediacy of an anger response). Whereas all psychiatric scales correlated significantly with the STAS total score, regressing the three STAS factors on psychiatric behaviors model showed a more detailed pattern. Only borderline affect instability and depression were significantly associated with all three factors in both classes whereas other problem behaviors were associated only with 1 or 2 of the factors. Alcohol problems were associated with immediacy only in the high scoring class, indicating a non-linear relation in the total sample. Taking into account these more specific associations is likely to be beneficial when investigating differential treatment strategies. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Towards a second-person neuropsychiatry

PubMed Central

Schilbach, Leonhard

2016-01-01

Psychiatric disorders can affect our ability to successfully and enjoyably interact with others. Conversely, having difficulties in social relations is known to increase the risk of developing a psychiatric disorder. In this article, the assumption that psychiatric disorders can be construed as disorders of social interaction is reviewed from a clinical point of view. Furthermore, it is argued that a psychiatrically motivated focus on the dynamics of social interaction may help to provide new perspectives for the field of social neuroscience. Such progress may be crucial to realize social neuroscience's translational potential and to advance the transdiagnostic investigation of the neurobiology of psychiatric disorders. PMID:26644599

Comorbid forms of psychopathology: key patterns and future research directions.

PubMed

Cerdá, Magdalena; Sagdeo, Aditi; Galea, Sandro

2008-01-01

The purpose of this review is to systematically appraise the peer-reviewed literature about clustered forms of psychopathology and to present a framework that can be useful for studying comorbid psychiatric disorders. The review focuses on four of the most prevalent types of mental health problems: anxiety, depression, conduct disorder, and substance abuse. The authors summarize existing empirical research on the distribution of concurrent and sequential comorbidity in children and adolescents and in adults, and they review existing knowledge about exogenous risk factors that influence comorbidity. The authors include articles that used a longitudinal study design and used psychiatric definitions of the disorders. A total of 58 articles met the inclusion criteria and were assessed. Current evidence demonstrates a reciprocal, sequential relation between most comorbid pairs, although the mechanisms that mediate such links remain to be explained. Methodological concerns include the inconsistency of measurement of the disorders across studies, small sample sizes, and restricted follow-up times. Given the significant mental health burden placed by comorbid disorders, and their high prevalence across populations, research on the key risk factors for clustering of psychopathology is needed.

Parental Psychiatric Disease and Risks of Attempted Suicide and Violent Criminal Offending in Offspring: A Population-Based Cohort Study.

PubMed

Mok, Pearl L H; Pedersen, Carsten Bøcker; Springate, David; Astrup, Aske; Kapur, Nav; Antonsen, Sussie; Mors, Ole; Webb, Roger T

2016-10-01

Self-directed and interpersonal violence share some common risk factors such as a parental history of mental illness. However, relationships between the full spectrum of parental psychiatric disease and these 2 related outcomes are unclear. To examine associations between the full spectrum of parental psychiatric disease and risks of attempted suicide and violent offending among offspring. Population-based cohort study of all persons born in Denmark 1967 through 1997, followed up from their 15th birthday until occurrence of adverse outcome or December 31, 2012, whichever came first. Array of parental psychiatric disorders and parental suicide attempt, delineated from records of secondary care treatments. Using survival analyses techniques, incidence rate ratios were estimated for offspring suicide attempt and violent offending. We examined 1 743 525 cohort members (48.7% female; total follow-up, 27.2 million person-years). Risks for offspring suicide attempt and violent offending were elevated across virtually the full spectrum of parental psychiatric disease. Incidence rate ratios were the most elevated for parental diagnoses of antisocial personality disorder (suicide attempt, 3.96; 95% CI, 3.72-4.21; violent offending, 3.62; 95% CI, 3.41-3.84) and cannabis misuse (suicide attempt, 3.57; 95% CI, 3.25-3.92; violent offending, 4.05; 95% CI, 3.72-4.39), and for parental suicide attempt (suicide attempt, 3.42; 95% CI, 3.29-3.55; violent offending, 3.31; 95% CI, 3.19-3.44). Parental mood disorders (and bipolar disorder in particular) conferred more modest risk increases. A history of mental illness or suicide attempt in both parents was associated with double the risks compared with having just 1 affected parent. Associations between parental psychiatric disease and offspring violent offending were stronger for female than for male offspring, whereas little sex difference in risk was found for offspring suicide attempt. The similarities in risk patterns observed between the 2 outcomes may evidence a shared etiology. Early interventions to tackle parental mental disorders may be beneficial to both parents and children.

Euthanasia for people with psychiatric disorders or dementia in Belgium: analysis of officially reported cases.

PubMed

Dierickx, Sigrid; Deliens, Luc; Cohen, Joachim; Chambaere, Kenneth

2017-06-23

Euthanasia for people who are not terminally ill, such as those suffering from psychiatric disorders or dementia, is legal in Belgium under strict conditions but remains a controversial practice. As yet, the prevalence of euthanasia for people with psychiatric disorders or dementia has not been studied and little is known about the characteristics of the practice. This study aims to report on the trends in prevalence and number of euthanasia cases with a psychiatric disorder or dementia diagnosis in Belgium and demographic, clinical and decision-making characteristics of these cases. We analysed the anonymous databases of euthanasia cases reported to the Federal Control and Evaluation Committee Euthanasia from the implementation of the euthanasia law in Belgium in 2002 until the end of 2013. The databases we received provided the information on all euthanasia cases as registered by the Committee from the official registration forms. Only those with one or more psychiatric disorders or dementia and no physical disease were included in the analysis. We identified 179 reported euthanasia cases with a psychiatric disorder or dementia as the sole diagnosis. These consisted of mood disorders (N = 83), dementia (N = 62), other psychiatric disorders (N = 22) and mood disorders accompanied by another psychiatric disorder (N = 12). The proportion of euthanasia cases with a psychiatric disorder or dementia diagnosis was 0.5% of all cases reported in the period 2002-2007, increasing from 2008 onwards to 3.0% of all cases reported in 2013. The increase in the absolute number of cases is particularly evident in cases with a mood disorder diagnosis. The majority of cases concerned women (58.1% in dementia to 77.1% in mood disorders). All cases were judged to have met the legal requirements by the Committee. While euthanasia on the grounds of unbearable suffering caused by a psychiatric disorder or dementia remains a comparatively limited practice in Belgium, its prevalence has risen since 2008. If, as this study suggests, people with psychiatric conditions or dementia are increasingly seeking access to euthanasia, the development of practice guidelines is all the more desirable if physicians are to respond adequately to these highly delicate requests.

Meige's Syndrome: Rare Neurological Disorder Presenting as Conversion Disorder.

PubMed

Debadatta, Mohapatra; Mishra, Ajay K

2013-07-01

Meige's syndrome is a rare neurological syndrome characterized by oromandibular dystonia and blepharospasm. Its pathophysiology is not clearly determined. A 35-year-old female presented to psychiatric department with blepharospasm and oromandibular dystonia with clinical provisional diagnosis of psychiatric disorder (Conversion Disorder). After thorough physical examination including detailed neurological exam and psychiatric evaluation no formal medical or psychiatric diagnosis could be made. The other differential diagnoses of extra pyramidal symptom, tardive dyskinesia, conversion disorder, anxiety disorder were ruled out by formal diagnostic criteria. Consequently with suspicion of Meige's syndrome she was referred to the department of Neurology and the diagnosis was confirmed. Hence, Meige's syndrome could be misdiagnosed as a psychiatric disorder such as conversion disorder or anxiety disorder because clinical features of Meige's syndrome are highly variable and affected by psychological factors and also can be inhibited voluntarily to some extent.

Predictors of Psychiatric Disorders in Combat Veterans

DTIC Science & Technology

2013-05-07

Naval Health Research Center Predictors of Psychiatric Disorders in Combat Veterans Stephanie Booth-Kewley Emily A. Schmied Robin M...ARTICLE Open Access Predictors of psychiatric disorders in combat veterans Stephanie Booth-Kewley1*, Emily A Schmied1, Robyn M Highfill-McRoy1, Gerald E...examined predictors of actual mental health diagnoses. The objective of this longitudinal investigation was to identify predictors of psychiatric disorders

The epidemiology of chronic major depressive disorder and dysthymic disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions.

PubMed

Blanco, Carlos; Okuda, Mayumi; Markowitz, John C; Liu, Shang-Min; Grant, Bridget F; Hasin, Deborah S

2010-12-01

To examine the prevalence of chronic major depressive disorder (CMDD) and dysthymic disorder, their sociodemographic correlates, patterns of 12-month and lifetime psychiatric comorbidity, lifetime risk factors, psychosocial functioning, and mental health service utilization. Face-to-face interviews were conducted in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (n = 43,093). The 12-month and lifetime prevalences were greater for CMDD (1.5% and 3.1%, respectively) than for dysthymic disorder (0.5% and 0.9%, respectively). Individuals with CMDD and dysthymic disorder shared most sociodemographic correlates and lifetime risk factors for major depressive disorder. Individuals with CMDD and dysthymic disorder had almost identically high rates of Axis I and Axis II comorbid disorders. However, individuals with CMDD received higher rates of all treatment modalities than individuals with dysthymic disorder. Individuals with CMDD and dysthymic disorder share many sociodemographic correlates, comorbidity patterns, risk factors, and course. Individuals with chronic depressive disorders, especially those with dysthymic disorder, continue to face substantial unmet treatment needs. © Copyright 2010 Physicians Postgraduate Press, Inc.

Factors protecting against the development of adjustment difficulties in young adults exposed to childhood sexual abuse.

PubMed

Lynskey, M T; Fergusson, D M

1997-12-01

The aims of this study were to identify the factors which discriminated young people exposed to childhood sexual abuse (CSA) who developed psychiatric disorder or adjustment difficulties in young adulthood from those young people exposed to CSA who did not develop psychiatric disorder or adjustment difficulties by age 18. Data were gathered on a birth cohort of 1,025 New Zealand children studied from birth to the age of 18 on (a) exposure to CSA; (b) patterns of psychiatric disorder and adjustment difficulties at age 18 years; (c) factors that may have influenced responses to CSA including characteristics of the abuse, parental bonding, parental characteristics, and adolescent peer affiliations. Just over 10% of the cohort reported CSA. Those reporting CSA were at increased risks of a range of difficulties at age 18 (depression, anxiety, conduct disorder, alcohol abuse/dependence, other substance abuse/dependence, post sexual abuse trauma, attempted suicide). However, not all of those exposed to CSA developed difficulties and approximately a quarter of those exposed to CSA did not meet criteria for any adjustment difficulty. Further analysis suggested that the extent of adjustment difficulties in those exposed to CSA was influenced by two additional factors: (a) the extent of affiliations with delinquent or substance using peers in adolescence; and (b) the extent of paternal care or support in childhood. The findings of this study suggest that while young people exposed to CSA are at increased risks of psychiatric disorder and adjustment difficulties in young adulthood, not all individuals exposed to CSA will develop adjustment difficulties. Important factors protecting against the development of adjustment difficulties in young people experiencing CSA appear to be the nature and quality of peer and family relationships.

[Prevalence of sleep-related breathing disorders of inpatients with psychiatric disorders].

PubMed

Behr, M; Acker, J; Cohrs, S; Deuschle, M; Danker-Hopfe, H; Göder, R; Norra, C; Richter, K; Riemann, D; Schilling, C; Weeß, H-G; Wetter, T C; Wollenburg, L M; Pollmächer, T

2018-06-06

Sleep-related breathing disorders seriously impair well-being and increase the risk for relevant somatic and psychiatric disorders. Moreover, risk factors for sleep-related breathing disorders are highly prevalent in psychiatric patients. The aim of this study was for the first time in Germany to study the prevalence of obstructive sleep apnea syndrome (OSAS) as the most common form of sleep-related breathing disorder in patients with psychiatric disorders. In 10 psychiatric hospitals in Germany and 1 hospital in Switzerland, a total of 249 inpatients underwent an 8‑channel sleep polygraphy to investigate the prevalence of sleep apnea in this group of patients. With a conspicuous screening result of 23.7% of the subjects, a high prevalence of sleep-related breathing disorders was found to occur among this group of patients. Male gender, higher age and high body mass index (BMI) were identified as positive risk factors for the detection of OSAS. The high prevalence indicates that sleep apnea is a common sleep disorder among psychiatric patients. Although OSAS can lead to substantial disorders of the mental state and when untreated is accompanied by serious somatic health problems, screening procedures are not part of the routine work-up in psychiatric hospitals; therefore, sleep apnea is presumably underdiagnosed in psychiatric patients. In view of the results of this and previous studies, this topic complex should be the subject of further research studies.

Comparison of the Prevalence of Psychiatric Disorders in Performance-Enhancing Drug Users and Nonuser Bodybuilders

PubMed Central

Ostovar, Afshin; Haerinejad, Mohammad Javad; Akbarzadeh, Samad; Keshavarz, Mojtaba

2017-01-01

Objective: The present study aimed at comparing the prevalence of major psychiatric disorders including major depressive disorder, bipolar disorder, schizophrenia, and generalized anxiety disorder between performance-enhancing drug users and nonuser bodybuilders. Moreover, the prevalence of major psychiatric disorders in bodybuilders was also reported. Method: In this study, 453 athletes were recruited from Bushehr bodybuilding gyms from February to May 2015. A structured questionnaire was used to collect the participants’ information, including demographic characteristics, sports’ status and performance-enhancing drug use. According to the condition of performance-enhancing drug use, the participants were divided into current users, non-current users, and nonusers. The psychiatric status of the participants was evaluated using DSM-IV diagnostic criteria for major depressive disorder, bipolar disorder, generalized anxiety disorder, and schizophrenia. We also asked about the acute psychotic disturbances after using performance-enhancing drugs, alcohol use, and history of aggressive behavior in bodybuilders. Data were analyzed using one-way analysis of variance and chi-square tests. Results: Prevalence of major depressive disorder, bipolar disorder, schizophrenia, generalized anxiety disorder, and the overall prevalence of psychiatric disorders in the bodybuilders was 19.7%, 3.8%, 1.5%, 16.6%, and 26.7%, respectively. After using performance-enhancing drugs, 33% of the bodybuilders had experienced acute psychological disturbances. There were no significant differences between current, non-current, and nonuser bodybuilding athletes in the measured psychiatric disorders. Conclusion: Prevalence of psychiatric disorders was not significantly different in performance-enhancing drug users and nonusers. Thus, it can be concluded that performance-enhancing drugs do not increase the risk of psychiatric disorders in bodybuilders. PMID:29472947

[Prevalence of mental disorder and related treatments in a local jail: a 20-month consecutive case study].

PubMed

Carrà, Giuseppe; Giacobone, Caterina; Pozzi, Florinda; Alecci, Pasquale; Barale, Francesco

2004-01-01

To define the prevalence of mental disorder within an Italian local jail and to describe main psychiatric treatments provided. Cross-sectional study of consecutive male prisoners referred, over a twenty-month period, for a clinical psychiatric assessment, among population (N = 990) of Casa circondariale "Torre del Gallo", Pavia (I); clinical DSM-IV diagnostic assessment and retrospective analysis of provided psychiatric treatments (i.e. psychiatric visits and pharmacological prescriptions). 191 men (19.3%) had one or more current mental disorders (excluding substance misuse), including 13 (1.3%) psychosis; 53 (5.4%) mood disorder; 24 (2.4%) anxiety disorder; 26 (2.6%) adjustment disorder; 40 (4.1%) personality disorder; 32 (3.2%) personality disorder plus mood disorder; 3 (0.3%) mental retardation. Substance- (N = 89, 47%) and HIV-related (N = 19, 10%) disorders comorbidity is recognised. Psychiatric visits are mainly provided to psychosis and personality disorder plus mood disorder subgroups. Off-label antipsychotics prescriptions are frequent. The prevalence of mental disorder in this population is higher than US and EU averages, and for particular diagnostic subgroups it could be underestimated. Psychiatric management in prison should be reorganized according to national and European health guidelines.

On the association between diabetes and mental disorders in a community sample: results from the German National Health Interview and Examination Survey.

PubMed

Kruse, Johannes; Schmitz, Norbert; Thefeld, Wolfgang

2003-06-01

To determine the relationship between mental disorders and diabetes in a representative community sample. This was a cross-sectional study. Data on diabetes and HbA(1c) values were obtained by structured questionnaires and by laboratory assessments. Current psychiatric disorders were diagnosed by a modified version of the Composite International Diagnostic Interview (CIDI). People with diabetes (PWD) were not more likely to meet Diagnostic and Statistical Manual of Psychiatric Disorders, 4th edition (DSM-IV) criteria for at least one mental disorder than were individuals without diabetes. However, a different diagnostic pattern occurred compared with the general population: odds ratios (ORs) for anxiety disorders in PWD were higher (OR 1.93, 95% CI 1.19-3.14). Although PWD had higher prevalence rates of affective disorders, the relationship between diabetes and affective disorders was not statistically significant after controlling for age, sex, marital status, and socioeconomic status. In contrast, the relationship between diabetes and anxiety disorders remained significant after controlling for these variables. In contrast to individuals without mental disorders, PWD with affective or anxiety disorders more frequently had adequate glycemic control. Diabetes was associated with an increased likelihood of anxiety disorders. The association between mental disorders, diabetes, and glycemic control should be evaluated carefully in terms of potentially confounding sociodemographic variables, sample characteristics, and definitions of the disorders.

Socio-demographic patterns of posttraumatic stress disorder in Medellin, Colombia and the context of lifetime trauma exposure

PubMed Central

Gaviria, Silvia Lucia; Espinola, Maria; Restrepo, Diana; Lotero, Juliana; Berbesi, Dedsy Y.; Sierra, Gloria Maria; Chaskel, Roberto; Espinel, Zelde; Shultz, James M.

2016-01-01

ABSTRACT Colombia, South America is currently transitioning to post-conflict status following 6 decades of armed conflict. The population has experienced extensive exposures to potentially traumatic events throughout the lifespan. Sources of trauma exposure include the prolonged armed insurgency, narco-trafficking violence, urban gang violence, violent actions of criminal bands, intra-familial violence, gender-based violence, and sex trafficking. Exposure to potentially traumatic events is related to a variety of psychiatric outcomes, in particular, posttraumatic stress disorder. Given this context of lifetime trauma exposure, socio-demographic patterns of posttraumatic stress disorder were explored in a sample of residents of Medellin, Colombia, the nation's second largest city and a nexus for multiple types of trauma exposure. PMID:28265488

Association between childhood psychiatric disorders and psychotic experiences in adolescence: A population-based longitudinal study.

PubMed

Siebald, Caroline; Khandaker, Golam M; Zammit, Stanley; Lewis, Glyn; Jones, Peter B

2016-08-01

Adolescent psychotic experiences (PEs) are common, and are associated with both psychotic and non-psychotic illnesses. In order to examine psychopathological and cognitive antecedents of adolescent PEs, we have conducted a longitudinal study of common childhood psychiatric disorders and subsequent adolescent PEs in the population-based prospective ALSPAC birth cohort. Depression, anxiety, attention deficit hyperactivity disorder, oppositional defiant or conduct disorder, and pervasive developmental disorder were diagnosed according to DSM-IV criteria in 8253 participants at age 8years. IQ was assessed by WISC-III also at 8years. PEs, depressive and anxiety symptoms were assessed at 13years. Logistic regression calculated odds ratio (OR) for PEs at 13years associated with psychiatric disorders at 8years. Linear regression calculated mean difference in IQ between groups with and without psychiatric disorder. Mediating effects of IQ, mood and anxiety symptoms on the psychiatric disorder-PEs relationship were examined. In total, 599 children were assessed to have a DSM-IV psychiatric disorder at 8years (7.2%). These children compared with those without any psychiatric disorder performed worse on all measures of IQ; adjusted mean difference in total IQ -6.17 (95% CI, -7.86, -4.48). Childhood psychiatric disorders were associated with PEs subsequently in adolescence; adjusted OR 1.96 (95% CI, 1.47-2.68). The association between psychiatric disorder and subsequent PEs was partly mediated by, independently, IQ deficit at 8years and depressive and anxiety symptoms at 13years. The findings indicate that adolescent PEs are associated with general cognitive ability and past and present psychopathological factors. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Treating patients with bipolar disorder and substance dependence: lessons learned.

PubMed

Weiss, Roger D

2004-12-01

Although bipolar disorder is the Axis I psychiatric disorder associated with the highest rate of co-occurring substance use disorders, little research has focused on treatments specifically designed for these patients. The author and his colleagues have developed and studied Integrated Group Therapy (IGT) for this population. This paper describes common themes that have emerged in carrying out IGT for patients with bipolar disorder and substance dependence. These include the strong emphasis on depression, as opposed to mania; the predominance of hopelessness; specific patterns of medication noncompliance; and the implications of patients' labeling their substance use as self-medication. Therapeutic aspects involved in addressing these themes are discussed.

Late Preterm Birth, Maternal Depression, and Risk of Preschool Psychiatric Disorders

ERIC Educational Resources Information Center

Rogers, Cynthia E.; Lenze, Shannon N.; Luby, Joan L.

2013-01-01

Objective: Preterm children are at greater risk for psychiatric disorders, including anxiety disorders and attention-deficit/hyperactivity disorder (ADHD), than their term-born peers. Prior research has focused primarily on children born at early gestational ages. Less is known about the rate of psychiatric disorders among late preterm or early…

Use of psychotropic medications in São Paulo Metropolitan Area, Brazil: pattern of healthcare provision to general population.

PubMed

Campanha, Angela Maria; Siu, Erica Rosanna; Milhorança, Igor André; Viana, Maria Carmen; Wang, Yuan-Pang; Andrade, Laura Helena

2015-11-01

We estimate the proportion of psychotropic medication use (PMU) among adults in São Paulo Metropolitan Area, Brazil. We investigated whether socio-demographic factors, comorbidity, and disease severity influence PMU among individuals with psychiatric disorders. Data are from the São Paulo Megacity Mental Health Survey, a cross-sectional, population-based study, the Brazilian branch of the World Mental Health Survey Initiative. Trained lay interviewers face-to-face assessed psychiatric disorders and PMU through the Composite International Diagnostic Interview. Respondents were asked about use of healthcare service and prescribed medications for mental disorders in the previous year. Information on PMU was collected for 2935 adult residents in the area and among those with disorders who received treatment. Around 6% of respondents reported PMU in the past year: hypnotics or sedatives were used by 3.7% and antidepressants by 3.5%. Among individuals with 12-month disorders, only 14% reported past year PMU. Gender, age, education, income, occupational status, comorbidity, and severity were significant predictors for PMU. Among those with 12-month DSM-IV disorders who obtained treatment in healthcare settings, almost 40% received medication only. Among those treated in specialty mental health service, around 23% received combination of medication and psychotherapy. Our study has pointed out that the recent trend of access to mental healthcare in Brazil depicts unmet needs, characterized by a low prevalence of PMU among individuals with psychiatric disorders. Policies that improve appropriate access to prescribed drugs for those most in need are urgent public health priority. Copyright © 2015 John Wiley & Sons, Ltd.

Transgenic Mouse Models of Childhood Onset Psychiatric Disorders

PubMed Central

Robertson, Holly R.; Feng, Guoping

2011-01-01

Childhood onset psychiatric disorders, such as Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), Mood Disorders, Obsessive Compulsive Spectrum Disorders (OCSD), and Schizophrenia (SZ), affect many school age children leading to a lower quality of life, including difficulties in school and personal relationships that persists into adulthood. Currently, the causes of these psychiatric disorders are poorly understood resulting in difficulty diagnosing affected children, and insufficient treatment options. Family and twin studies implicate a genetic contribution for ADHD, ASD, Mood Disorders, OCSD, and SZ. Identification of candidate genes and chromosomal regions associated with a particular disorder provide targets for directed research, and understanding how these genes influence the disease state will provide valuable insights for improving the diagnosis and treatment of children with psychiatric disorders. Animal models are one important approach in the study of human diseases, allowing for the use of a variety of experimental approaches to dissect the contribution of a specific chromosomal or genetic abnormality in human disorders. While it is impossible to model an entire psychiatric disorder in a single animal model, these models can be extremely valuable in dissecting out the specific role of a gene, pathway, neuron subtype, or brain region in a particular abnormal behavior. In this review we discuss existing transgenic mouse models for childhood onset psychiatric disorders. We compare the strength and weakness of various transgenic animal models proposed for each of the common childhood onset psychiatric disorders, and discuss future directions for the study of these disorders using cutting-edge genetic tools. PMID:21309772

Psychiatric disorders and violent reoffending: a national cohort study of convicted prisoners in Sweden

PubMed Central

Chang, Zheng; Larsson, Henrik; Lichtenstein, Paul; Fazel, Seena

2015-01-01

Summary Background Reoffending and presence of psychiatric disorders are common in prisoners worldwide. However, whether psychiatric disorders are risk factors for reoffending is still unknown. We aimed to examine the association between psychiatric disorders, including substance use disorder, and violent reoffending. Methods We did a longitudinal cohort study of 47 326 prisoners who were imprisoned since Jan 1, 2000, and released before Dec 31, 2009, in Sweden. We obtained data for diagnosed psychiatric disorders from both inpatient and outpatient registers, and sociodemographic and criminological factors from other population-based registers. We calculated hazard ratios (HRs) for violent reoffending with Cox regression. To control for potential familial confounding, we compared sibling prisoners with and without psychiatric disorders. We calculated population attributable fraction to assess the population effect. Findings Diagnosed psychiatric disorders were associated with an increased hazard of violent reoffending in male (adjusted HR 1·63 [95% CI 1·57–1·70]) and female (2·02 [1·54–2·63]) prisoners, and these associations were independent of measured sociodemographic and criminological factors, and, in men, remained substantial after adjustment for unmeasured familial factors (2·01 [1·66–2·43]). However, findings differed between individual diagnoses and sex. We found some evidence of stronger effects on violent reoffending of alcohol and drug use disorders and bipolar disorder than of other psychiatric disorders. Alcohol use disorder seemed to have a greater effect in women than in men (women 2·08 [1·66–2·60]; men 1·63 [1·56–1·71]). The overall effects of psychiatric disorders did not differ with severity of crime. The hazard of violent reoffending increased in a stepwise way with the number of diagnosed psychiatric disorders. Assuming causality, up to 20% (95% CI 19–22) of violent reoffending in men and 40% (27–52) in women was attributable to the diagnosed psychiatric disorders that we investigated. Interpretation Certain psychiatric disorders are associated with a substantially increased hazard of violent reoffending. Because these disorders are prevalent and mostly treatable, improvements to prison mental health services could counteract the cycle of reoffending and improve both public health and safety. National violence prevention strategies should consider the role of prison health. Funding Wellcome Trust, Swedish Research Council, and Swedish Research Council for Health, Working Life and Welfare. PMID:26342957

Pervasive pleiotropy between psychiatric disorders and immune disorders revealed by integrative analysis of multiple GWAS

PubMed Central

Wang, Qian; Yang, Can; Gelernter, Joel; Zhao, Hongyu

2015-01-01

Although some existing epidemiological observations and molecular experiments suggested that brain disorders in the realm of psychiatry may be influenced by immune dysregulation, the degree of genetic overlap between psychiatric disorders and immune disorders has not been well established. We investigated this issue by integrative analysis of genome-wide association studies of 18 complex human traits/diseases (five psychiatric disorders, seven immune disorders, and others) and multiple genome-wide annotation resources (Central nervous system genes, immune-related expression-quantitative trait loci (eQTL) and DNase I hypertensive sites from 98 cell-lines). We detected pleiotropy in 24 of the 35 psychiatric-immune disorder pairs. The strongest pleiotropy was observed for schizophrenia-rheumatoid arthritis with MHC region included in the analysis (p = 3.9 × 10−285), and schizophrenia-Crohns disease with MHC region excluded (p = 1.1 × 10−36). Significant enrichment (>1.4 fold) of immune-related eQTL was observed in four psychiatric disorders. Genomic regions responsible for pleiotropy between psychiatric disorders and immune disorders were detected. The MHC region on chromosome 6 appears to be the most important with other regions, such as cytoband 1p13.2, also playing significant roles in pleiotropy. We also found that most alleles shared between schizophrenia and Crohns disease have the same effect direction, with similar trend found for other disorder pairs, such as bipolar-Crohn’s disease. Our results offer a novel birds-eye view of the genetic relationship and demonstrate strong evidence for pervasive pleiotropy between psychiatric disorders and immune disorders. Our findings might open new routes for prevention and treatment strategies for these disorders based on a new appreciation of the importance of immunological mechanisms in mediating risk of many psychiatric diseases. PMID:26340901

Psychiatric disorders, HIV infection and HIV/hepatitis co-infection in the correctional setting.

PubMed

Baillargeon, J G; Paar, D P; Wu, H; Giordano, T P; Murray, O; Raimer, B G; Avery, E N; Diamond, P M; Pulvino, J S

2008-01-01

Psychiatric disorders such as bipolar disorder, schizophrenia and depression have long been associated with risk behaviors for HIV, hepatitis C virus (HCV) and hepatitis B virus (HBV). The US prison population is reported to have elevated rates of HIV, hepatitis and most psychiatric disorders. This study examined the association of six major psychiatric disorders with HIV mono-infection, HIV/HCV co-infection and HIV/HBV co-infection in one of the nation's largest prison populations. The study population consisted of 370,511 Texas Department of Criminal Justice inmates who were incarcerated for any duration between January 1, 2003 and July 1, 2006. Information on medical conditions and sociodemographic factors was obtained from an institution-wide electronic medical information system. Offenders diagnosed with HIV mono-infection, HIV/HCV, HIV/HBV and all HIV combined exhibited elevated rates of major depression, bipolar disorder, schizophrenia, schizoaffective disorder, non-schizophrenic psychotic disorder and any psychiatric disorder. In comparison to offenders with HIV mono-infection, those with HIV/HCV co-infection had an elevated prevalence of any psychiatric disorder. This cross-sectional study's finding of positive associations between psychiatric disease and both HIV infection and hepatitis co-infection among Texas prison inmates holds both clinical and public health relevance. It will be important for future investigations to examine the extent to which psychiatric disorders serve as a barrier to medical care, communication with clinicians and adherence to prescribed medical regimens among both HIV-mono-infected and HIV/hepatitis-co-infected inmates.

College Students with Psychiatric Disabilities

ERIC Educational Resources Information Center

Singh, Delar K.

2011-01-01

This paper focuses on college students with psychiatric disabilities. It defines and discusses various psychiatric conditions such as mood disorders, anxiety disorders, eating disorders, and personality disorders. It concludes with accommodations that a college professor can make to help these students succeed in higher education. (Contains 1…

Full spectrum of psychiatric disorders related to foreign migration: a Danish population-based cohort study.

PubMed

Cantor-Graae, Elizabeth; Pedersen, Carsten B

2013-04-01

Although increased risk for schizophrenia among immigrants is well established, knowledge of the broader spectrum of psychiatric disorders associated with a foreign migration background is lacking. To examine the full range of psychiatric disorders associated with any type of foreign migration background among persons residing in Denmark, including foreign-born adoptees, first- and second-generation immigrants, native Danes with a history of foreign residence, and persons born abroad to Danish expatriates. Danish population-based cohort study. Persons were followed up from their 10th birthday for the development of mental disorders based on outpatient and inpatient data. All persons born between January 1, 1971, and December 31, 2000 (N = 1 859 419) residing in Denmark by their 10th birthday with follow-up data to December 31, 2010. Incidence rate ratios (IRRs) and cumulative incidences for psychiatric outcomes. All categories of foreign migration background, except persons born abroad to Danish expatriates, were associated with increased risk for at least 1 psychiatric disorder. Foreign-born adoptees had increased IRRs for all psychiatric disorders and had the highest IRRs for these disorders compared with other foreign migration categories. First- and second-generation immigrants having 2 foreign-born parents had significantly increased IRRs for schizophrenia and schizophrenia spectrum disorders and had similar risk magnitudes. Second-generation immigrants having 1 foreign-born parent had significantly increased IRRs for all psychiatric disorders. Native Danes with a history of foreign residence had increased IRRs for bipolar affective disorder, affective disorders, personality disorders, and schizophrenia spectrum disorders. The extent to which a background of foreign migration confers an increased risk for the broad spectrum of psychiatric disorders varies according to parental origin, with greatest risks for foreign-born adoptees. The spectrum of psychiatric disorders showed greater variation within the second-generation immigrant group than between first-generation vs second-generation immigrants, and the spectrum differed according to whether individuals had 1 or 2 foreign-born parents.

Coping in Chest Pain Patients with and without Psychiatric Disorders.

ERIC Educational Resources Information Center

Vitaliano, Peter P.; And Others

1989-01-01

Examined relations between psychiatric disorder and coronary heart disease (CHD) in 77 patients with chest pain, and compared coping profiles of chest pain patients with and without psychiatric disorders and CHD. Psychiatric patients with no medical disease were also studied. Results are discussed in the context of illness behavior and…

Childhood-Onset Bipolar Disorder: Evidence for Increased Familial Loading of Psychiatric Illness

ERIC Educational Resources Information Center

Rende, Richard; Birmaher, Boris; Axelson, David; Strober, Michael; Gill, Mary Kay; Valeri, Sylvia; Chiappetta, Laurel; Ryan, Neal; Leonard, Henrietta; Hunt, Jeffrey; Iyengar, Satish; Keller, Martin

2007-01-01

Objective: To determine whether childhood-onset bipolar disorder (BP) is associated with an increased psychiatric family history compared with adolescent-onset BP. Method: Semistructured psychiatric interviews were conducted for 438 youth with BP spectrum disorders. To evaluate the effects of age at onset and psychiatric family history, the sample…

Patterns of caffeine consumption in psychiatric patients. An Italian study.

PubMed

Ciapparelli, A; Paggini, R; Carmassi, C; Taponecco, C; Consoli, G; Ciampa, G; Ramacciotti, C E; Marazziti, D; Dell'Osso, L

2010-05-01

The aim of the present study was to explore and compare the caffeine intake, intoxication, withdrawal and dependence prevalence in Italian psychiatric patients and healthy subjects. Three hundred and sixty-nine out- and inpatients, suffering from different psychiatric disorders, and 104 healthy subjects were included in the study. They were assessed by the SCID and by a structured interview for caffeine intoxication and withdrawal and for substance dependence applied to caffeine use. Patients and healthy subjects did not differ in terms of current caffeine intake (mg/day, mean+/-SD: 281+/-325 vs. 288+/-148, respectively), while the maximum lifetime intake of caffeine was significantly higher in the first group (mg/day, mean SD: 630+/-549 vs. 504+/-344, respectively; F=4.897, p=.03) where it was significantly related to the CGI severity item scores (rho=.107; p=.04). In both patients and healthy subjects, a lower age was related to a higher current caffeine intake, while both current and maximum lifetime caffeine intake in the healthy subjects were significantly higher in men than in women. The patients suffering from eating disorders reported higher current caffeine intake than those with anxiety or mood disorders. The prevalence of dependence and intoxication was significantly higher in the patients than in the healthy subjects, without inter-group differences. Healthy subjects showed a trend towards a higher prevalence of withdrawal. Our study highlights the need that a more accurate attention should be paid to the caffeine use which seems to be strongly, although generically, related to different psychiatric disorders. (c) 2009 Elsevier Masson SAS. All rights reserved.

Psychiatric comorbidities in adolescents with attention-deficit hyperactivity disorder and their siblings.

PubMed

Yang, Li-Kuang; Shang, Chi-Yung; Gau, Susan Shur-Fen

2011-05-01

Despite high psychiatric comorbidities in adolescents with clinical diagnosis of attention-deficit hyperactivity disorder (ADHD), little is known about psychiatric comorbidities in their siblings. We investigated the psychiatric comorbid conditions in adolescents with ADHD, their siblings, and healthy control subjects from their school. The sample included 136 adolescent probands with ADHD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), diagnostic criteria; 136 siblings (47 affected and 89 unaffected) and 136 age- and sex-matched healthy school control subjects. All participants and their parents received the structured psychiatric interviews for current and lifetime DSM-IV psychiatric disorders of the participants. The rate of ADHD (34.6%) in the siblings of probands with ADHD was about 7 times higher than in the general population. Probands with ADHD were significantly more likely than unaffected siblings (OR 6.38; 95% CI 3.43 to 11.88) and healthy school control subjects (OR 9.60; 95% CI 5.31 to 17.34) to have a DSM-IV psychiatric disorder, including oppositional defiant disorder (ODD), conduct disorder (CD), tic disorders, major depressive disorder, specific phobia (more than control subjects only), nicotine use disorder, and sleep disorders. The affected siblings were significantly more likely than healthy school control subjects to have ODD, CD, specific phobia, and to have consumed alcohol (ORs ranging from 2.30 to 20.16). Our findings suggest that siblings of probands with ADHD have increased risks for ADHD and that the affected siblings have more psychiatric comorbidities than healthy school control subjects. It warrants early identification of ADHD symptoms and other psychiatric comorbid conditions as well in siblings of adolescents with ADHD.

Antidepressant use during pregnancy and psychiatric disorders in offspring: Danish nationwide register based cohort study

PubMed Central

Agerbo, Esben; Ingstrup, Katja G; Musliner, Katherine; Meltzer-Brody, Samantha; Bergink, Veerle; Munk-Olsen, Trine

2017-01-01

Objective To investigate the association between in utero exposure to antidepressants and risk of psychiatric disorders. Design Population based cohort study. Setting Danish national registers. Participants 905 383 liveborn singletons born during 1998-2012 in Denmark and followed from birth until July 2014, death, emigration, or date of first psychiatric diagnosis, whichever came first. The children were followed for a maximum of 16.5 years and contributed 8.1×106 person years at risk. Exposures for observational studies Children were categorised into four groups according to maternal antidepressant use within two years before and during pregnancy: unexposed, antidepressant discontinuation (use before but not during pregnancy), antidepressant continuation (use both before and during pregnancy), and new user (use only during pregnancy). Main outcome measure First psychiatric diagnosis in children, defined as first day of inpatient or outpatient treatment for psychiatric disorders. Hazard ratios of psychiatric disorders were estimated using Cox regression models. Results Overall, psychiatric disorders were diagnosed in 32 400 children. The adjusted 15 year cumulative incidence of psychiatric disorders was 8.0% (95% confidence interval 7.9% to 8.2%) in the unexposed group, 11.5% (10.3% to 12.9%) in the antidepressant discontinuation group, 13.6% (11.3% to 16.3%) in the continuation group, and 14.5% (10.5% to 19.8%) in the new user group. The antidepressant continuation group had an increased risk of psychiatric disorders (hazard ratio 1.27, 1.17 to 1.38), compared with the discontinuation group. Conclusions In utero exposure to antidepressants was associated with increased risk of psychiatric disorders. The association may be attributable to the severity of underlying maternal disorders in combination with antidepressant exposure in utero. The findings suggest that focusing solely on a single psychiatric disorder among offspring in studies of in utero antidepressant exposure may be too restrictive. PMID:28877907

Psychiatric emergencies (part II): psychiatric disorders coexisting with organic diseases.

PubMed

Testa, A; Giannuzzi, R; Sollazzo, F; Petrongolo, L; Bernardini, L; Dain, S

2013-02-01

In this Part II psychiatric disorders coexisting with organic diseases are discussed. "Comorbidity phenomenon" defines the not univocal interrelation between medical illnesses and psychiatric disorders, each other negatively influencing morbidity and mortality. Most severe psychiatric disorders, such as schizophrenia, bipolar disorder and depression, show increased prevalence of cardiovascular disease, related to poverty, use of psychotropic medication, and higher rate of preventable risk factors such as smoking, addiction, poor diet and lack of exercise. Moreover, psychiatric and organic disorders can develop together in different conditions of toxic substance and prescription drug use or abuse, especially in the emergency setting population. Different combinations with mutual interaction of psychiatric disorders and substance use disorders are defined by the so called "dual diagnosis". The hypotheses that attempt to explain the psychiatric disorders and substance abuse relationship are examined: (1) common risk factors; (2) psychiatric disorders precipitated by substance use; (3) psychiatric disorders precipitating substance use (self-medication hypothesis); and (4) synergistic interaction. Diagnostic and therapeutic difficulty concerning the problem of dual diagnosis, and legal implications, are also discussed. Substance induced psychiatric and organic symptoms can occur both in the intoxication and withdrawal state. Since ancient history, humans selected indigene psychotropic plants for recreational, medicinal, doping or spiritual purpose. After the isolation of active principles or their chemical synthesis, higher blood concentrations reached predispose to substance use, abuse and dependence. Abuse substances have specific molecular targets and very different acute mechanisms of action, mainly involving dopaminergic and serotoninergic systems, but finally converging on the brain's reward pathways, increasing dopamine in nucleus accumbens. The most common substances producing an addiction status may be assembled in depressants (alcohol, benzodiazepines, opiates), stimulants (cocaine, amphetamines, nicotine, caffeine, modafinil), hallucinogens (mescaline, LSD, ecstasy) and other substances (cannabis, dissociatives, inhalants). Anxiety disorders can occur in intoxication by stimulants, as well as in withdrawal syndrome, both by stimulants and sedatives. Substance induced mood disorders and psychotic symptoms are as much frequent conditions in ED, and the recognition of associated organic symptoms may allow to achieve diagnosis. Finally, psychiatric and organic symptoms may be caused by prescription and doping medications, either as a direct effect or after withdrawal. Adverse drug reactions can be divided in type A, dose dependent and predictable, including psychotropic drugs and hormones; and type B, dose independent and unpredictable, usually including non psychotropic drugs, more commonly included being cardiovascular, antibiotics, anti-inflammatory and antineoplastic medications.

Military deployment to the Gulf War as a risk factor for psychiatric illness among US troops.

PubMed

Fiedler, Nancy; Ozakinci, Gozde; Hallman, William; Wartenberg, Daniel; Brewer, Noel T; Barrett, Drue H; Kipen, Howard M

2006-05-01

Several studies document an excess of psychiatric symptoms among veterans of the the 1991 Gulf War. However, little is known about the prevalence of psychiatric disorders in those who were deployed to that conflict. To compare the 12-month prevalence and associated risk factors for DSM Axis I psychiatric diagnoses between random samples of Gulf War-deployed veterans and veterans of the same era not deployed to the Persian Gulf (era veterans). Interview data from 967 Gulf War veterans and 784 era veterans were examined to determine current health status, medical conditions, symptoms and Axis I psychiatric disorders. Logistic regression models evaluated risk factors for psychiatric disorder. Gulf War veterans had a significantly higher prevalence of psychiatric diagnoses, with twice the prevalence of anxiety disorders and depression. Lower rank, female gender and divorced or single marital status were significant independent predictors of psychiatric disorder. Deployment to the Gulf War is associated with a range of mental health outcomes more than 10 years after deployment.

Classifying adolescent attention-deficit/hyperactivity disorder (ADHD) based on functional and structural imaging.

PubMed

Iannaccone, Reto; Hauser, Tobias U; Ball, Juliane; Brandeis, Daniel; Walitza, Susanne; Brem, Silvia

2015-10-01

Attention-deficit/hyperactivity disorder (ADHD) is a common disabling psychiatric disorder associated with consistent deficits in error processing, inhibition and regionally decreased grey matter volumes. The diagnosis is based on clinical presentation, interviews and questionnaires, which are to some degree subjective and would benefit from verification through biomarkers. Here, pattern recognition of multiple discriminative functional and structural brain patterns was applied to classify adolescents with ADHD and controls. Functional activation features in a Flanker/NoGo task probing error processing and inhibition along with structural magnetic resonance imaging data served to predict group membership using support vector machines (SVMs). The SVM pattern recognition algorithm correctly classified 77.78% of the subjects with a sensitivity and specificity of 77.78% based on error processing. Predictive regions for controls were mainly detected in core areas for error processing and attention such as the medial and dorsolateral frontal areas reflecting deficient processing in ADHD (Hart et al., in Hum Brain Mapp 35:3083-3094, 2014), and overlapped with decreased activations in patients in conventional group comparisons. Regions more predictive for ADHD patients were identified in the posterior cingulate, temporal and occipital cortex. Interestingly despite pronounced univariate group differences in inhibition-related activation and grey matter volumes the corresponding classifiers failed or only yielded a poor discrimination. The present study corroborates the potential of task-related brain activation for classification shown in previous studies. It remains to be clarified whether error processing, which performed best here, also contributes to the discrimination of useful dimensions and subtypes, different psychiatric disorders, and prediction of treatment success across studies and sites.

The effects of daily weather variables on psychosis admissions to psychiatric hospitals

NASA Astrophysics Data System (ADS)

McWilliams, Stephen; Kinsella, Anthony; O'Callaghan, Eadbhard

2013-07-01

Several studies have noted seasonal variations in admission rates of patients with psychotic illnesses. However, the changeable daily meteorological patterns within seasons have never been examined in any great depth in the context of admission rates. A handful of small studies have posed interesting questions regarding a potential link between psychiatric admission rates and meteorological variables such as environmental temperature (especially heat waves) and sunshine. In this study, we used simple non-parametric testing and more complex ARIMA and time-series regression analysis to examine whether daily meteorological patterns (wind speed and direction, barometric pressure, rainfall, sunshine, sunlight and temperature) exert an influence on admission rates for psychotic disorders across 12 regions in Ireland. Although there were some weak but interesting trends for temperature, barometric pressure and sunshine, the meteorological patterns ultimately did not exert a clinically significant influence over admissions for psychosis. Further analysis is needed.

Clock Genes and Altered Sleep–Wake Rhythms: Their Role in the Development of Psychiatric Disorders

PubMed Central

Charrier, Annaëlle; Olliac, Bertrand; Roubertoux, Pierre; Tordjman, Sylvie

2017-01-01

In mammals, the circadian clocks network (central and peripheral oscillators) controls circadian rhythms and orchestrates the expression of a range of downstream genes, allowing the organism to anticipate and adapt to environmental changes. Beyond their role in circadian rhythms, several studies have highlighted that circadian clock genes may have a more widespread physiological effect on cognition, mood, and reward-related behaviors. Furthermore, single nucleotide polymorphisms in core circadian clock genes have been associated with psychiatric disorders (such as autism spectrum disorder, schizophrenia, anxiety disorders, major depressive disorder, bipolar disorder, and attention deficit hyperactivity disorder). However, the underlying mechanisms of these associations remain to be ascertained and the cause–effect relationships are not clearly established. The objective of this article is to clarify the role of clock genes and altered sleep–wake rhythms in the development of psychiatric disorders (sleep problems are often observed at early onset of psychiatric disorders). First, the molecular mechanisms of circadian rhythms are described. Then, the relationships between disrupted circadian rhythms, including sleep–wake rhythms, and psychiatric disorders are discussed. Further research may open interesting perspectives with promising avenues for early detection and therapeutic intervention in psychiatric disorders. PMID:28468274

Clock Genes and Altered Sleep-Wake Rhythms: Their Role in the Development of Psychiatric Disorders.

PubMed

Charrier, Annaëlle; Olliac, Bertrand; Roubertoux, Pierre; Tordjman, Sylvie

2017-04-29

In mammals, the circadian clocks network (central and peripheral oscillators) controls circadian rhythms and orchestrates the expression of a range of downstream genes, allowing the organism to anticipate and adapt to environmental changes. Beyond their role in circadian rhythms, several studies have highlighted that circadian clock genes may have a more widespread physiological effect on cognition, mood, and reward-related behaviors. Furthermore, single nucleotide polymorphisms in core circadian clock genes have been associated with psychiatric disorders (such as autism spectrum disorder, schizophrenia, anxiety disorders, major depressive disorder, bipolar disorder, and attention deficit hyperactivity disorder). However, the underlying mechanisms of these associations remain to be ascertained and the cause-effect relationships are not clearly established. The objective of this article is to clarify the role of clock genes and altered sleep-wake rhythms in the development of psychiatric disorders (sleep problems are often observed at early onset of psychiatric disorders). First, the molecular mechanisms of circadian rhythms are described. Then, the relationships between disrupted circadian rhythms, including sleep-wake rhythms, and psychiatric disorders are discussed. Further research may open interesting perspectives with promising avenues for early detection and therapeutic intervention in psychiatric disorders.

Serotonin transporter gene polymorphism and psychiatric disorders: Is there a link?

PubMed Central

Margoob, Mushtaq A.; Mushtaq, Dhuha

2011-01-01

Though still in infancy, the field of psychiatric genetics holds great potential to contribute to the development of new diagnostic and therapeutic options to treat these disorders. Among a large number of existing neurotransmitter systems, the serotonin system dysfunction has been implicated in many psychiatric disorders and therapeutic efficacy of many drugs is also thought to be based on modulation of serotonin. Serotonin transporter gene polymorphism is one of the most extensively studied polymorphisms in psychiatric behavioral genetics. In this article, we review the status of evidence for association between the serotonin gene polymorphism and some common mental disorders like affective disorders, post-traumatic stress disorder, obsessive-compulsive disorder, suicide, autism, and other anxiety and personality disorders. Going beyond traditional association studies, gene-environment interaction, currently gaining momentum, is also discussed in the review. While the existing information of psychiatric genetics is inadequate for putting into practice genetic testing in the diagnostic work-up of the psychiatric patient, if consistent in future research attempts, such results can be of great help to improve the clinical care of a vast majority of patients suffering from such disorders. PMID:22303036

Autism spectrum disorder - childhood disintegrative disorder

MedlinePlus

... part of the larger developmental disorder category of autism spectrum disorder . ... American Psychiatric Association. Autism spectrum disorder. ... ed. Arlington, VA: American Psychiatric Publishing: 2013;50-59. ...

Lower Sensitivity to Happy and Angry Facial Emotions in Young Adults with Psychiatric Problems

PubMed Central

Vrijen, Charlotte; Hartman, Catharina A.; Lodder, Gerine M. A.; Verhagen, Maaike; de Jonge, Peter; Oldehinkel, Albertine J.

2016-01-01

Many psychiatric problem domains have been associated with emotion-specific biases or general deficiencies in facial emotion identification. However, both within and between psychiatric problem domains, large variability exists in the types of emotion identification problems that were reported. Moreover, since the domain-specificity of the findings was often not addressed, it remains unclear whether patterns found for specific problem domains can be better explained by co-occurrence of other psychiatric problems or by more generic characteristics of psychopathology, for example, problem severity. In this study, we aimed to investigate associations between emotion identification biases and five psychiatric problem domains, and to determine the domain-specificity of these biases. Data were collected as part of the ‘No Fun No Glory’ study and involved 2,577 young adults. The study participants completed a dynamic facial emotion identification task involving happy, sad, angry, and fearful faces, and filled in the Adult Self-Report Questionnaire, of which we used the scales depressive problems, anxiety problems, avoidance problems, Attention-Deficit Hyperactivity Disorder (ADHD) problems and antisocial problems. Our results suggest that participants with antisocial problems were significantly less sensitive to happy facial emotions, participants with ADHD problems were less sensitive to angry emotions, and participants with avoidance problems were less sensitive to both angry and happy emotions. These effects could not be fully explained by co-occurring psychiatric problems. Whereas this seems to indicate domain-specificity, inspection of the overall pattern of effect sizes regardless of statistical significance reveals generic patterns as well, in that for all psychiatric problem domains the effect sizes for happy and angry emotions were larger than the effect sizes for sad and fearful emotions. As happy and angry emotions are strongly associated with approach and avoidance mechanisms in social interaction, these mechanisms may hold the key to understanding the associations between facial emotion identification and a wide range of psychiatric problems. PMID:27920735

[Movement disorders is psychiatric diseases].

PubMed

Hidasi, Zoltan; Salacz, Pal; Csibri, Eva

2014-12-01

Movement disorders are common in psychiatry. The movement disorder can either be the symptom of a psychiatric disorder, can share a common aetiological factor with it, or can be the consequence of psychopharmacological therapy. Most common features include tic, stereotypy, compulsion, akathisia, dyskinesias, tremor, hypokinesia and disturbances of posture and gait. We discuss characteristics and clinical importance of these features. Movement disorders are frequently present in mood disorders, anxiety disorders, schizophrenia, catatonia, Tourette-disorder and psychogenic movement disorder, leading to differential-diagnostic and therapeutical difficulties in everyday practice. Movement disorders due to psychopharmacotherapy can be classified as early-onset, late-onset and tardive. Frequent psychiatric comorbidity is found in primary movement disorders, such as Parkinson's disease, Wilson's disease, Huntington's disease, diffuse Lewy-body disorder. Complex neuropsychiatric approach is effective concerning overlapping clinical features and spectrums of disorders in terms of movement disorders and psychiatric diseases.

Mood lability and psychopathology in youth.

PubMed

Stringaris, A; Goodman, R

2009-08-01

Mood lability is a concept widely used. However, data on its prevalence and morbid associations are scarce. We sought to establish the occurrence and importance of mood lability in a large community sample of children and adolescents by testing a priori hypotheses. Cross-sectional data were taken from a national mental health survey including 5326 subjects aged 8-19 years in the UK. The outcomes were prevalence and characteristics of mood lability and its associations with psychopathology and overall impairment. Mood lability occurred in more than 5% of the population of children and adolescents, both by parent and self-report. Mood lability was strongly associated with a wide range of psychopathology and was linked to significant impairment even in the absence of psychiatric disorders. Mood lability was particularly strongly associated with co-morbidity between internalizing and externalizing disorders, even when adjusting for the association with individual disorders. The pattern of results did not change after excluding youth with bipolar disorder or with episodes of elated mood. Clinically significant mood lability is relatively common in the community. Our findings indicate that mood lability is not a mere consequence of other psychopathology in that it is associated with significant impairment even in the absence of psychiatric diagnoses. Moreover, the pattern of association of mood lability with co-morbidity suggests that it could be a risk factor shared by both internalizing and externalizing disorders. Our data point to the need for greater awareness of mood lability and its implications for treatment.

Skin diseases in patients with primary psychiatric conditions: a hospital based study.

PubMed

Moftah, Nayera H; Kamel, Abeer M; Attia, Hussein M; El-Baz, Mona Z; Abd El-Moty, Hala M

2013-09-01

Although the relationship between skin diseases in patients with primary psychiatric conditions is important for patient management, studies on this issue are limited. To detect the frequency and type of cutaneous disorders among patients with primary psychiatric conditions. This analytic cross-sectional study was conducted on a total of 400 subjects - 200 patients with primary psychiatric disorders and 200 age and sex matched individuals free from primary psychiatric disorders. Patients included in the study were diagnosed according to The Diagnostic and Statistical Manual of Mental Disorders (DMS IV) Criteria. A specially designed questionnaire including socio-demographic data, medical history, family history and dermatological examination was applied. The data were statistically analyzed. There was a significant statistical increase in the prevalence of skin diseases in general and infectious skin diseases in particular in psychiatric patients compared with non-psychiatric patients (71.5% versus 22%, P<0.001) and (48% versus 11%, P<0.001), respectively. Parasitic infestations (42.7%) were the most common infectious skin diseases in psychiatric patients (P<0.001). Infectious skin diseases in psychiatric patients were seen most in patients diagnosed with schizophrenia (83.6%) and least in obsessive compulsive disorders (30%)(P<0.001). Psychogenic skin disorders were found in 8.4% of psychiatric patients with skin diseases; delusional parasitosis was the most common (50%). Health education of psychiatric patients and/or of their caregiver and periodic monthly inspection of psychiatric patients are highly indicated for the prevention and control of infectious skin diseases in primary psychiatric patients. Copyright © 2013 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

Misophonia: A new mental disorder?

PubMed

Taylor, Steven

2017-06-01

Misophonia, a phenomenon first described in the audiology literature, is characterized by intense emotional reactions (e.g., anger, rage, anxiety, disgust) in response to highly specific sounds, particularly sounds of human origin such as oral or nasal noises made by other people (e.g., chewing, sniffing, slurping, lip smacking). Misophonia is not listed in any of the contemporary psychiatric classification systems. Some investigators have argued that misophonia should be regarded as a new mental disorder, falling within the spectrum of obsessive-compulsive related disorders. Other researchers have disputed this claim. The purpose of this article is to critically examine the proposition that misophonia should be classified as a new mental disorder. The clinical and research literature on misophonia was examined and considered in the context of the broader literature on what constitutes a mental disorder. There have been growing concerns that diagnostic systems such as DSM-5 tend to over-pathologize ordinary quirks and eccentricities. Accordingly, solid evidence is required for proposing a new psychiatric disorder. The available evidence suggests that (a) misophonia meets many of the general criteria for a mental disorder and has some evidence of clinical utility as a diagnostic construct, but (b) the nature and boundaries of the syndrome are unclear; for example, in some cases misophonia might be simply one feature of a broader pattern of sensory intolerance, and (c) considerably more research is required, particularly work concerning diagnostic validity, before misophonia, defined as either as a disorder or as a key feature of some broader syndrome of sensory intolerance, should be considered as a diagnostic construct in the psychiatric nomenclature. A research roadmap is proposed for the systematic evaluation as to whether misophonia should be considered for future editions of DSM or ICD. Copyright © 2017 Elsevier Ltd. All rights reserved.

Psychiatric disorders, acne and systemic retinoids: comparison of risks.

PubMed

Le Moigne, M; Bulteau, S; Grall-Bronnec, Marie; Gerardin, M; Fournier, Jean-Pascal; Jonville-Bera, A P; Jolliet, Pascale; Dreno, Brigitte; Victorri-Vigneau, C

2017-09-01

The link between isotretinoin, treatment of a severe form of acne, and psychiatric disorders remains controversial, as acne itself could explain the occurrence of psychiatric disorders. This study aims at assessing the disproportionality of psychiatric adverse events reported with isotretinoin in the French National PharmacoVigilance Database, compared with other systemic acne treatments and systemic retinoids. Data were extracted from the French National PharmacoVigilance Database for systemic acne treatments, systemic retinoids and drugs used as comparators. Each report was subjected to double-blind analysis by two psychiatric experts. A disproportionality analysis was performed, calculating the number of psychiatric ADRs divided by the total number of notifications for each drug of interest. Concerning acne systemic treatments: all 71 reports of severe psychiatric disorders involved isotretinoin, the highest proportion of mild/moderate psychiatric adverse events was reported with isotretinoin (14.1%). Among systemic retinoids, the highest proportion of severe and mild/moderate psychiatric events occurred with isotretinoin and alitretinoin. Our study raises the hypothesis that psychiatric disorders associated with isotretinoin are related to a class effect of retinoids, as a signal emerges for alitretinoin. Complementary studies are necessary to estimate the risk and further determine at-risk populations.

Prevalence, comorbidity and predictors of anxiety disorders in children and adolescents in rural north-eastern Uganda

PubMed Central

2013-01-01

Background Child and adolescent anxiety disorders are the most prevalent form of childhood psychopathology. Research on child and adolescent anxiety disorders has predominantly been done in westernized societies. There is a paucity of data on the prevalence, comorbidity, and predictors of anxiety disorders in children and adolescents in non-western societies including those in sub-Saharan Africa. This paper investigates the prevalence, comorbidity, and predictors of anxiety disorders in children and adolescents in north-eastern Uganda. Objective To determine the prevalence of DSM-IV anxiety disorders, as well as comorbidity patterns and predictors in children and adolescents aged 3 to 19 years in north-eastern Uganda. Methods Four districts (Lira, Tororo, Kaberamaido and Gulu) in rural north-eastern Uganda participated in this study. Using a multi-stage sampling procedure, a sample of 420 households with children aged 3–19 years from each district was enrolled into the study. The MINI International Neuropsychiatric Interview for children and adolescents (MINI KID) was used to assess for psychiatric disorders in 1587 of 1680 respondents. Results The prevalence of anxiety disorders was 26.6%, with rates higher in females (29.7%) than in males (23.1%). The most common disorders in both males and females were specific phobia (15.8%), posttraumatic stress disorder (PTSD) (6.6%) and separation anxiety disorder (5.8%). Children below 5 years of age were significantly more likely to have separation anxiety disorder and specific phobias, while those aged between 14–19 were significantly more likely to have PTSD. Anxiety disorders were more prevalent among respondents with other psychiatric disorders; in respondents with two or more co-morbid psychiatric disorders the prevalence of anxiety disorders was 62.1%. Predictors of anxiety disorders were experience of war trauma (OR = 1.93, p < 0.001) and a higher score on the emotional symptom scale of the SDQ (OR = 2.58, p < 0.001). Significant socio-demograghic associations of anxiety disorders were found for female gender, guardian unemployment, living in permanent housing, living without parents, and having parents without education. Conclusion The prevalence of anxiety disorders in children and adolescents in rural north-eastern Uganda is high, but consistent in terms of gender ratio and progression over time with a range of prior work in other contexts. Patterns of comorbidity and predictors of anxiety disorders in this setting are also broadly consistent with previous findings from western community studies. Both psychosocial stressors and exposure to war trauma are significant predictors of anxiety disorders.Prevention and treatment strategies need to be put in place to address the high prevalence rates of anxiety disorders in children and adolescents in Uganda. PMID:23841918

The impact of psychiatric diagnosis on treatment adherence and duration among victimized children and adolescents in São Paulo, Brazil

PubMed Central

Scivoletto, Sandra; Silva, Thiago F.; Cunha, Paulo Jannuzzi; Rosenheck, Robert A.

2012-01-01

OBJECTIVE: Despite the high prevalence of substance abuse and mood disorders among victimized children and adolescents, few studies have investigated the association of these disorders with treatment adherence, represented by numbers of visits per month and treatment duration. We aimed to investigate the effects of substance abuse and mood disorders on treatment adherence and duration in a special program for victimized children in São Paulo, Brazil. METHODS: A total of 351 participants were evaluated for psychiatric disorders and classified into one of five groups: mood disorders alone; substance abuse disorders alone; mood and substance abuse disorders; other psychiatric disorders; no psychiatric disorders. The associations between diagnostic classification and adherence to treatment and the duration of program participation were tested with logistic regression and survival analysis, respectively. RESULTS: Children with mood disorders alone had the highest rate of adherence (79.5%); those with substance abuse disorders alone had the lowest (40%); and those with both disorders had an intermediate rate of adherence (50%). Those with other psychiatric disorders and no psychiatric disorders also had high rates of adherence (75.6% and 72.9%, respectively). Living with family significantly increased adherence for children with substance abuse disorders but decreased adherence for those with no psychiatric disorders. The diagnostic correlates of duration of participation were similar to those for adherence. CONCLUSIONS: Mood and substance abuse disorders were strong predictive factors for treatment adherence and duration, albeit in opposite directions. Living with family seems to have a positive effect on treatment adherence for patients with substance abuse disorders. More effective treatment is needed for victimized substance-abusing youth. PMID:22249474

MAOA Variants and Genetic Susceptibility to Major Psychiatric Disorders.

PubMed

Liu, Zichao; Huang, Liang; Luo, Xiong-Jian; Wu, Lichuan; Li, Ming

2016-09-01

Monoamine oxidase A (MAOA) is a mitochondrial enzyme involved in the metabolism of several biological amines such as dopamine, norepinephrine, and serotonin, which are important neurochemicals in the pathogenesis of major psychiatric illnesses. MAOA is regarded as a functional plausible susceptibility gene for psychiatric disorders, whereas previous hypothesis-driven association studies obtained controversial results, a reflection of small sample size, genetic heterogeneity, or true negative associations. In addition, MAOA is not analyzed in most of genome-wide association studies (GWAS) on psychiatric disorders, since it is located on Chromosome Xp11.3. Therefore, the effects of MAOA variants on genetic predisposition to psychiatric disorders remain obscure. To fill this gap, we collected psychiatric phenotypic (schizophrenia, bipolar disorder, and major depressive disorder) and genetic data in up to 18,824 individuals from diverse ethnic groups. We employed classical fixed (or random) effects inverse variance weighted methods to calculate summary odds ratios (OR) and 95 % confidence intervals (CI). We identified a synonymous SNP rs1137070 showing significant associations with major depressive disorder (p = 0.00067, OR = 1.263 for T allele) and schizophrenia (p = 0.0039, OR = 1.225 for T allele) as well as a broad spectrum of psychiatric phenotype (p = 0.000066, OR = 1.218 for T allele) in both males and females. The effect size was similar between different ethnic populations and different gender groups. Collectively, we confirmed that MAOA is a risk gene for psychiatric disorders, and our results provide useful information toward a better understanding of genetic mechanism involving MAOA underlying risk of complex psychiatric disorders.

Psychiatric disorders and symptoms severity in pre-school children with cow's milk allergy.

PubMed

Topal, E; Catal, F; Soylu, N; Ozcan, O O; Celiksoy, M H; Babayiğit, A; Erge, D; Karakoç, H T E; Sancak, R

2016-01-01

Psychiatric disorders are seen frequently in atopic diseases. The present study aims to evaluate the frequency of psychiatric disorders and the severity of psychiatric symptoms in pre-school children with cow's milk allergy. The parents of the pre-school children with cow's milk allergy were interviewed in person and asked to fill out the Early Childhood Inventory-4 form. The cow's milk allergy group included 40 children (27 male, 13 female) with mean age, 44.5±14.7 months, and the control group included 41 children (25 male, 16 female) with mean age, 47.6±15.2 months. It was established that 65% of the group with cow's milk allergy received at least one psychiatric diagnosis, while 36.6% of the control group received at least one psychiatric diagnosis, with a statistically significant difference (p=0.02). Within the psychiatric disorders, attention deficit hyperactivity disorders (odds ratio: 4.9, 95% CI: 1.472-16.856, p=0.006), oppositional defiant disorder (odds ratio: 5.6, 95% CI: 1.139-28.128, p=0.026), and attachment disorder (odds ratio: 4.8, 95% CI: 1.747-13.506, p=0.004) were found significantly higher compared with the healthy control group. When the groups were compared in terms of psychiatric symptom severity scores, calculated by using the Early Childhood Inventory-4 form, attention deficit hyperactivity disorders severity (p=0.006) and oppositional defiant disorder severity (p=0.037) were found to be higher in the cow's milk allergy group. Psychiatric disorders are frequent and severe in pre-school children with cow's milk allergy. Copyright © 2016 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

Freiburg Questionnaire of linguistic pragmatics (FQLP): psychometric properties based on a psychiatric sample.

PubMed

Riedel, Andreas; Suh, Heejung; Haser, Verena; Hermann, Ismene; Ebert, Dieter; Riemann, Dieter; Bubl, Emanuel; Tebartz van Elst, Ludger; Hölzel, Lars P

2014-12-24

Asperger's Syndrome (AS) is an autism spectrum disorder that is characterized by significant difficulties in social interaction and nonverbal communication, and restricted and repetitive patterns of behavior and interests. Difficulties with respect to pragmatic speech, reading emotional and social cues, differentiating between fact and fiction, and taking into account the influence of context on a statement are commonly described features. However, hitherto established questionnaires did not focus on these symptoms. In this study we present a short (11 questions) questionnaire which focuses on self-rated pragmatic speech abilities, the Freiburg Questionnaire of linguistic pragmatics (FQLP). Psychometric properties of the questionnaire were explored in a sample of 57 patients with Asperger's Syndrome, 66 patients with other psychiatric disorders, and a convenience sample of 56 people. Reliability analysis showed a high Cronbach's α. Strong correlations could be demonstrated for the FQLP with the Autism Quotient and the Empathy Quotient. Concerning divergent validity a moderate correlation was found between the FQLP and self-rated symptoms of personality disorders. No significant correlation was found between the FQLP and the vocabulary skills. The receiver operating characteristics curve showed an excellent diagnostic accuracy of the FQLP (.97). As the control group consisted of people without mental disorder and patients with different psychiatric disorders, the results indicate that the construct examined by the FQLP is quite specific to the peculiarities of AS. The FQLP is a reliable, brief and valid instrument. First results regarding sensitivity and specificity are highly promising.

Use of general medical services among Medicaid patients with severe and persistent mental illness.

PubMed

Salsberry, Pamela J; Chipps, Esther; Kennedy, Carol

2005-04-01

The aim of this study was to examine patterns of use of general medical services among persons with a severe and persistent mental illness enrolled in Medicaid from 1996 to 1998. A total of 669 persons with a severe and persistent mental illness were identified by using statewide clinical criteria. A three-year database of Medicaid claims was developed to examine service use. The main outcome measures were use of outpatient services for a general medical problem, use of dental and vision services, and use of screening tests for women. Service use was examined by primary psychiatric diagnosis (schizophrenic, affective, paranoid, and anxiety disorders), and analyses controlled for the presence of a chronic medical condition, age, race, and sex. This study found high levels of service use for outpatient services but very low levels for primary and preventive services. Although 78 percent of persons with a schizophrenic disorder had an office-based visit during the three-year period, all persons with an anxiety disorder had such a visit. Sixty-nine percent of persons with a schizophrenic disorder had at least one emergency department visit, whereas 83 percent of those with an anxiety disorder had such a visit. Dental and vision visits and the use of mammograms and pap tests followed the same pattern; persons with a schizophrenic disorder had fewer visits and had less overall use than the other diagnostic groups. The use patterns across the four groups were significantly different in outpatient service use, dental and vision service use, and screening tests for women. Compared with persons with a schizophrenic disorder, those with an anxiety disorder were more likely to have had an office-based visit and to have received vision services, those with a paranoid disorder were more likely to have used dental services or received a mammogram, and those with an affective disorder were more likely to have had a pap test. Although this group of Medicaid patients with severe and persistent mental illness had access to providers, they received an unacceptably low level of preventive care. Use of health services for general medical problems differed somewhat by primary psychiatric illness.

The effectiveness of anticonvulsants in psychiatric disorders

PubMed Central

Grunze, Heinz C. R.

2008-01-01

Anticonvulsant drugs are widely used in psychiatric indications. These include mainly alcohol and benzodiazepine withdrawal syndromes, panic and anxiety disorders, dementia, schizophrenia, affective disorders, bipolar affective disorders in particular, and, to some extent, personality disorders, A further area in which neurology and psychiatry overlap is pain conditions, in which some anticonvulsants, and also typical psychiatric medications such as antidepressants, are helpful. From the beginning of their psychiatric use, anticonvulsants have also been used to ameliorate specific symptoms of psychiatric disorders independently of their causality and underlying illness, eg, aggression, and, more recently, cognitive impairment, as seen in affective disorders and schizophrenia. With new anticonvulsants currently under development, it is likely that their use in psychiatry will further increase, and that psychiatrists need to learn about their differential efficacy and safety profiles to the same extent as do neurologists. PMID:18472486

Adult Diagnostic and Functional Outcomes of DSM-5 Disruptive Mood Dysregulation Disorder

PubMed Central

Copeland, William E.; Shanahan, Lilly; Egger, Helen; Angold, Adrian; Costello, E. Jane

2014-01-01

Objective Disruptive mood dysregulation disorder is a new disorder for DSM-5 that is uncommon and frequently co-occurs with other psychiatric disorders. Here, we test whether meeting diagnostic criteria for this disorder in childhood predicts adult diagnostic and functional outcomes. Methods In a prospective, population-based study, subjects were assessed with structured interviews up to 6 times in childhood and adolescence (ages 10 to 16; 5336 observations of 1420 subjects) for symptoms of disruptive mood dysregulation disorder and 3 times in young adulthood (ages 19, 21, and 24-26; 3215 observations of 1273 subjects) for psychiatric and functional outcomes (health, risky/illegal behavior, financial/educational and social functioning). Results Young adults with a history of childhood disruptive mood dysregulation disorders had elevated rates of anxiety and depression and were more likely to meet criteria for more than one adult disorder as compared to controls with no history of childhood psychiatric problems (noncases) or subjects meeting criteria for psychiatric disorders other than disruptive mood dysregulation disorder in childhood/adolescence (psychiatric controls). Participants with a history of disruptive mood dysregulation disorder also were more likely to have adverse health outcomes, be impoverished, have reported police contact, and have low educational attainment as adults compared to either psychiatric or noncase controls. Conclusions The long-term prognosis of children with disruptive mood dysregulation disorder cases is one of pervasive impaired functioning that in many cases is worse than that of other childhood psychiatric cases. PMID:24781389

Psychiatric disorders in women and men up to five years after undergoing assisted reproductive technology treatment - a prospective cohort study.

PubMed

Volgsten, Helena; Schmidt, Lone; Skoog Svanberg, Agneta; Ekselius, Lisa; Sundström Poromaa, Inger

2018-05-17

This is a prospective cohort study with the objective to describe psychiatric disorders, such as any mood and anxiety disorders, in both women and men five years after assisted reproductive technology (ART). The Primary Care Evaluation of Mental Disorders (PRIME-MD) questionnaire, based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), was used as the diagnostic tool to evaluate psychiatric disorders. Logistic regression analysis was used to calculate odds ratios (ORs) and confidence interval (CI) for factors associated with psychiatric disorders at the follow-up. Overall, 278 (63.3%) women and 183 (41.7%) men filled in and returned the questionnaire. Approximately 11.5% of women and 5.5% of men fulfilled the criteria for any psychiatric diagnosis. Of these, any mood disorder was present in 9.4% of women and 4.4% of men. The major risk factor for mood or anxiety disorders at follow-up was mood or anxiety disorders at the time of the index ART. Mood disorders were not more common in women who remained childless after ART. In conclusion, these findings indicate that psychiatric disorders at five years follow-up after ART are less common than at the baseline assessment in conjunction with the ART.

The relationship between psychiatric morbidity and quality of life: interview study of Norwegian tsunami survivors 2 and 6 years post-disaster.

PubMed

Hussain, Ajmal; Nygaard, Egil; Siqveland, Johan; Heir, Trond

2016-05-31

The study investigated the impact of psychiatric disorders on Quality of Life (QOL) cross-sectionally and longitudinally in a group of Norwegian tourists severely exposed to the 2004 tsunami. Sixty-two adult Norwegian tsunami survivors were interviewed face to face 2 years post-tsunami (T1) and 58 were interviewed again by telephone 6 years post-tsunami (T2). The majority (81 %) reported direct exposure to the waves, and 14 participants (23 %) lost a close family member in the tsunami. Psychiatric morbidity was measured by structured clinical interviews and QOL was assessed with WHO's Quality of Life-Bref scale. Multiple linear regression analyses were performed to assess the independent effects of psychiatric disorders on QOL 2 and 6 years after the tsunami. Psychiatric disorders, especially depression, but also PTSD and other anxiety disorders, were associated with reduced QOL. Psychiatric disorders were more strongly related to QOL at 6 years after the tsunami than at 2 years. Psychiatric disorders, and especially depression, is related to reduced QOL in a disaster exposed population. Post-disaster psychiatric disorders, such as PTSD and especially depression, should be addressed properly in the aftermath of disasters.

Adolescents and Dual Diagnosis in a Psychiatric Emergency Service.

PubMed

Matali, José Luis; Andión, Oscar; Pardo, Marta; Iniesta, Raquel; Serrano, Eduard; San, Luis

2016-03-02

In recent years, both the prevalence of drug use and related child and adolescent psychiatric emergencies have risen sharply. There are few studies about the impact on child and adolescent emergency services. This study has a twofold aim. The first is to describe the prevalence of substance use disorders, mental disorders and dual diagnosis (substance use problems plus mental disorder) in adolescents in psychiatric emergency service. The second is to analyze clinical and healthcare differences between patients with dual diagnosis and patients with a mental disorder without substance use disorder.We retrospectively reviewed 4012 discharge forms for emergencies treated at the psychiatric emergency department during the period 2007-2009. We obtained a sample of 1795 visits. This sample was divided into two groups: the dual diagnosis group (n = 477) and the psychiatric disorder group (n = 1318).The dual diagnosis group accounted for 26.5% of psychiatric emergencies analyzed. Compared to the psychiatric disorder group,the dual diagnosis group had significantly more conduct disorders, social problems, involuntariness in the visit, less hospital admissions and less connection with the healthcare network.Adolescents with a dual diagnosis account for a high percentage of visits at child and adolescent psychiatric emergency services. This patient group requires specialized care both at emergency services and in specific units. Accordingly, these units should play a triple role when handling dual diagnosis: detection, brief treatment and referral to a specialised unit.

A review of Quality of Life studies in Nigerian patients with psychiatric disorders.

PubMed

Aloba, O; Fatoye, O; Mapayi, B; Akinsulore, S

2013-09-01

The concept of Quality of Life is becoming an increasingly important measure of the impact of psychiatric disorders and is now recognized as useful in the healthcare evaluation of patients with psychiatric disorders. The aim of this review was to document and analyze the research data on quality of life in Nigerian patients with psychiatric disorders. The electronic databases, Medline and Pubmed were searched for published articles on quality of life in Nigerian patients with psychiatric disorders. A total of 6 studies met the inclusion criteria. All the studies employed the generic World Health Organization Quality of Life Scale - Brief version, which is the only quality of life instrument whose psychometric properties have been evaluated among Nigerian patients with psychiatric disorders. Some of the studies revealed that quality of life was significantly associated with socio demographic factors such marital and employment status and social support. Poor quality of life was reported to be associated with illness related factors such as co morbid medical problems, presence of anxiety and depressive symptoms and non adherence to medications. All the studies with the exception of two were conducted in centers located in South-western Nigeria. Quality of life in Nigerian patients suffering from psychiatric disorders is under-researched. There is need for more studies to prospectively investigate quality of life and associated factors among Nigerian patients with psychiatric disorders.

Associations of specific psychiatric disorders with isolated focal dystonia, and monogenic and idiopathic Parkinson's disease.

PubMed

Steinlechner, Susanne; Hagenah, Johann; Rumpf, Hans-Jürgen; Meyer, Christian; John, Ulrich; Bäumer, Tobias; Brüggemann, Norbert; Kasten, Meike; Münchau, Alexander; Klein, Christine; Lencer, Rebekka

2017-06-01

Comorbidity of psychiatric disorders in patients with movement disorders is common. Often, psychiatric symptoms manifest before the onset of the movement disorder, thus not representing a mere reaction to its burden. How the disease mechanisms of psychiatric and movement disorders are related is still poorly understood. The aim of the present study was to compare prevalence rates of specific psychiatric disorders between different movement disorders including isolated focal dystonia (IFD, N = 91), monogenic Parkinson's disease (PD, N = 41), idiopathic PD (N = 45), and a sample from a Northern Germany general population (TACOS Study; N = 4075). Our results indicate an odds ratio (OR) of 2.6 [confidence interval (CI) 1.7-4.0] for general axis I disorders in IFD, an OR of 2.5 (CI 1.4-4.7) in monogenic PD, and an OR of 1.4 (CI 0.8-2.6) in idiopathic PD. More specifically, the monogenic PD group showed the highest ORs for affective disorders including depression (OR = 4.9), bipolar disorder (OR = 17.4), and hypomanic episodes (OR = 17.0), whereas IFD expressed the highest rates of anxiety disorders (OR = 3.3). Psychotic symptoms were only observed in the PD groups but not in IFD. Our findings underline the notion that psychiatric disorders are part of the phenotypic spectrum of movement disorders. Moreover, they suggest that IFD, monogenic PD, and idiopathic PD are associated with specific psychiatric disorders indicating disturbances in a different neural circuitry for sensorimotor control.

Ethnic Disparities in School-Based Behavioral Health Service Use for Children with Psychiatric Disorders

ERIC Educational Resources Information Center

Locke, Jill; Kang-Yi, Christina D.; Pellecchia, Melanie; Marcus, Steven; Hadley, Trevor; Mandell, David S.

2017-01-01

Background: We examined racial/ethnic disparities in school-based behavioral health service use for children with psychiatric disorders. Methods: Medicaid claims data were used to compare the behavioral healthcare service use of 23,601 children aged 5-17 years by psychiatric disorder (autism, attention deficit hyperactivity disorder [ADHD],…

Restricted and Repetitive Behaviors and Psychiatric Symptoms in Youth with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Stratis, Elizabeth A.; Lecavalier, Luc

2013-01-01

Children with autism spectrum disorders (ASD) are at high risk for co-occurring psychiatric disorders. Previous research has suggested that restricted and repetitive behaviors (RRB) are associated with symptoms of co-occurring psychiatric disorders in individuals with ASD, but this relationship is not well understood. The current study…

Psychiatric Comorbidity and Medication Use in Adults with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Buck, Tara R.; Viskochil, Joseph; Farley, Megan; Coon, Hilary; McMahon, William M.; Morgan, Jubel; Bilder, Deborah A.

2014-01-01

The purpose of this study was to investigate comorbid psychiatric disorders and psychotropic medication use among adults with autism spectrum disorder (ASD) ascertained as children during a 1980's statewide Utah autism prevalence study (n = 129). Seventy-three individuals (56.6%) met criteria for a current psychiatric disorder; 89 participants…

Parental warmth and psychiatric disorders among Puerto Rican children in two different socio-cultural contexts.

PubMed

Santesteban-Echarri, Olga; Ramos-Olazagasti, María A; Eisenberg, Ruth E; Wei, Chiaying; Bird, Héctor R; Canino, Glorisa; Duarte, Cristiane S

2017-04-01

Parental warmth (PW) has a strong influence on child development and may precede the onset of psychiatric disorders in children. PW is interconnected with other family processes (e.g., coercive discipline) that may also influence the development of psychiatric disorders in children. We prospectively examined the association between PW and child psychiatric disorders (anxiety, major depression disorder, ADHD, disruptive behavior disorders) over the course of three years among Puerto Rican youth, above and beyond the influence of other family factors. Boricua Youth Study participants, Puerto Rican children 5 to 13 years of age at Wave 1 living in the South Bronx (New York) (SB) and San Juan and Canguas (PR) (n = 2,491), were followed for three consecutive years. Youth psychiatric disorders were measured by the Diagnostic Interview Schedule for Children-IV (DISC-IV). Generalized Linear Mixed models tested the association between PW (Wave 1) and psychiatric disorders in the next two years adjusting for demographic characteristics and family processes. Higher levels of PW were related to lower odds of child anxiety and major depressive disorder over time (OR = 0.69[0.60; 0.79]; 0.49[0.41; 0.58], respectively). The strength of the association between PW and ADHD and disruptive behavior disorder declined over time, although it was still significant in the last assessment (OR = 0.44[0.37; 0.52]; 0.46[0.39; 0.54], respectively). PW had a unique influence on psychiatric disorders beyond the influence of other parenting and family processes. Stronger associations were observed among girls for depression and ADHD. Incorporating PW behaviors such as acceptance, support, and comforting into interventions focused on parenting skills may help prevent child psychiatric disorders. Copyright © 2016. Published by Elsevier Ltd.

Obesity and psychiatric disorders: commonalities in dysregulated biological pathways and their implications for treatment.

PubMed

Lopresti, Adrian L; Drummond, Peter D

2013-08-01

Rates of obesity are higher than normal across a range of psychiatric disorders, including major depressive disorder, bipolar disorder, schizophrenia and anxiety disorders. While the problem of obesity is generally acknowledged in mental health research and treatment, an understanding of their bi-directional relationship is still developing. In this review the association between obesity and psychiatric disorders is summarised, with a specific emphasis on similarities in their disturbed biological pathways; namely neurotransmitter imbalances, hypothalamus-pituitary-adrenal axis disturbances, dysregulated inflammatory pathways, increased oxidative and nitrosative stress, mitochondrial disturbances, and neuroprogression. The applicability and effectiveness of weight-loss interventions in psychiatric populations are reviewed along with their potential efficacy in ameliorating disturbed biological pathways, particularly those mediating inflammation and oxidative stress. It is proposed that weight loss may not only be an effective intervention to enhance physical health but may also improve mental health outcomes and slow the rate of neuroprogressive disturbances in psychiatric disorders. Areas of future research to help expand our understanding of the relationship between obesity and psychiatric disorders are also outlined. Copyright © 2013 Elsevier Inc. All rights reserved.

Risk of psychiatric disorders in offspring of parents with a history of homelessness during childhood and adolescence in Denmark: a nationwide, register-based, cohort study.

PubMed

Nilsson, Sandra Feodor; Laursen, Thomas Munk; Hjorthøj, Carsten; Thorup, Anne; Nordentoft, Merete

2017-12-01

Children and adolescents from deprived backgrounds have high rates of psychiatric problems. Parental and social factors are crucial for children's healthy and positive development, but whether psychiatric morbidity is associated with parental social marginalisation is unknown. We aimed to analyse the association between mother's and father's history of homelessness and the offspring's risk of psychiatric disorders, including substance use disorder, during childhood and adolescence. We did a nationwide, register-based cohort study of 1 072 882 children and adolescents aged 0-16 years, who were living or born in Denmark between Jan 1, 1999, and Dec 31, 2015. Parental homelessness was the primary exposure, data on which were obtained from the Danish Homeless Register. The Danish Civil Registration System was used to extract the population and link offspring to parental information, and the outcome, psychiatric disorders in the offspring, was obtained from the Danish Psychiatric Central Research Register and the Danish National Patient Register. We analysed the association between parental history of homelessness and risk of psychiatric disorders in offspring by survival analysis using Poisson regression and incidence rate ratios (IRRs), adjusted for year and offspring characteristics, and additionally adjusted for parental factors (age at offspring's birth and parental psychiatric disorders). 17 238 (2%) offspring had either one or two parents with a history of homelessness, and 56 330 (5%) children and adolescents were diagnosed with any psychiatric disorder during the study period. The incidence of any psychiatric disorder was 15·1 cases per 1000 person-years (95% CI 14·4-15·8) in offspring with at least one parent with a history of homelessness, compared with 6·0 per 1000 person-years (95% CI 6·0-6·1) in those whose parents had no such history (IRR 2·5 [95% CI 2·3-2·7] for mother homeless, 2·3 [2·2-2·5] for father homeless, and 2·8 [2·4-3·2] for both parents homeless, after adjustment for year and offspring characteristics). This risk remained elevated after additional adjustment for factors including parental psychiatric disorders. IRRs in offspring were increased for most specific psychiatric disorders, with the highest risk for attachment disorder when both parents had a history of homelessness (IRR 32·5 [95% CI 24·6-42·9]) and substance use disorder when only the mother had a history of homelessness (6·9 [4·9-9·7]). In offspring whose mothers had a history of both homelessness and a psychiatric disorder, 35·9% (95% CI 27·1-44·8) had been diagnosed with a psychiatric disorder by the age of 15 years. Parental homelessness was associated with an increased risk of psychiatric disorders in offspring during childhood and adolescence. These findings have important implications for public health and policy because they suggest a need for improvement in the support of socially marginalised families to help prevent psychiatric illness in offspring. University of Copenhagen, The Lundbeck Foundation Initiative for Integrated Psychiatric Research (iPSYCH). Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

A comparison of clinical characteristics of older adults treated with antidepressants in general and psychiatric hospitals in Asia.

PubMed

Wang, Yuan-Yuan; Xiang, Yu-Tao; Ungvari, Gabor S; Ng, Chee H; Chiu, Helen F K; Yim, Larina C L; Si, Tian-Mei; Chee, Kok-Yoon; Avasthi, Ajit; Grover, Sandeep; Chong, Mian-Yoon; Sim, Kang; Kanba, Shigenobu; He, Yan-Ling; Lee, Min-Soo; Yang, Shu-Yu; Udomratn, Pichet; Kallivayalil, Roy A; Tanra, Andi J; Maramis, Margarita M; Shen, Winston W; Sartorius, Norman; Mahendran, Rathi; Teng, Jia-Ying; Tan, Chay-Hoon; Shinfuku, Naotaka

2017-11-01

This study compared the demographics, clinical characteristics, and antidepressant prescription patterns between Asian patients aged 50 years and older attending psychiatric hospitals and those attending general hospitals. In total, 955 patients (604 in general hospitals, 351 in psychiatric hospitals) aged 50 years or older treated with antidepressants in 10 Asian countries and territories were examined. Patients' demographics, clinical features, and prescriptions of psychotropic drugs were recorded using a standardized protocol and data collection procedure. Binary logistic regression revealed that high income and diagnosis of schizophrenia were independently associated with psychiatric hospital treatment, whereas outpatient care, diagnosis of anxiety disorders, and multiple major medical conditions were independently associated with general hospital treatment. In addition, tetracyclic and noradrenergic and specific serotonergic antidepressants were more likely to be prescribed in general hospitals. Older adults treated with antidepressants showed different demographic and clinical features between general hospitals and psychiatric hospitals in Asia. © 2017 Japanese Psychogeriatric Society.

Comparison of familial and psychological factors in groups of encopresis patients with constipation and without constipation.

PubMed

Çengel-Kültür, S Ebru; Akdemir, Devrim; Saltık-Temizel, İnci N

2014-01-01

The study aimed to evaluate the differences between groups of encopresis patients with constipation and without constipation. The Symptom Checklist- 90-Revised, the COPE Questionnaire, the Relationship Scales Questionnaire, the McMaster Family Assessment Device and the Parenting Style Scale were used to evaluate, respectively, maternal psychiatric symptoms, coping abilities, attachment style, family functioning and children's perceptions of parenting behaviors. Psychiatric diagnoses were evaluated using the K-SADS. A higher level of maternal psychiatric symptoms, impaired role and affective involvement functioning of the family and less psychological autonomy were observed in the group of encopresis patients with constipation than in the group of encopresis patients without constipation. No significant differences were found between the groups in psychiatric comorbidities, maternal coping abilities and attachment style. The two groups had a similar pattern of comorbid psychiatric disorders and maternal psychological factors, although some familial factors-related mainly to parental authority-were differentiated in the encopresis with constipation group.

Reliability and Validity of the "Children's Interview for Psychiatric Syndromes-Parent Version" in Autism Spectrum Disorders

ERIC Educational Resources Information Center

Witwer, Andrea N.; Lecavalier, Luc; Norris, Megan

2012-01-01

The "Children's Interview for Psychiatric Syndromes-Parent Version" (P-ChIPS) is a structured psychiatric interview designed to assess the presence of psychiatric disorders in children and adolescents. This study examined the reliability and validity of the P-ChIPS in 61 youngsters (6- to 17-years-old) with Autism Spectrum Disorders. Reliability…

Substance abuse treatment and psychiatric comorbidity: do benefits spill over? analysis of data from a prospective trial among cocaine-dependent homeless persons

PubMed Central

Kertesz, Stefan G; Madan, Alok; Wallace, Dennis; Schumacher, Joseph E; Milby, Jesse B

2006-01-01

Background Comorbid psychiatric illness can undermine outcomes among homeless persons undergoing addiction treatment, and psychiatric specialty care is not always readily available. The prognosis for nonsubstance abuse psychiatric diagnoses among homeless persons receiving behaviorally-based addiction treatment, however, is little studied. Results Data from an addiction treatment trial for 95 cocaine-dependent homeless persons (1996–1998) were used to profile psychiatric diagnoses at baseline and 6 months, including mood-related disorders (e.g. depression) and anxiety-related disorders (e.g. post-traumatic stress disorder). Treatment interventions, including systematic reinforcement for goal attainment, were behavioral in orientation. There was a 32% reduction in the prevalence of comorbid non-addiction psychiatric disorder from baseline to 6 months, with similar reductions in the prevalence of mood (-32%) and anxiety-related disorders (-20%) (p = 0.12). Conclusion Among cocaine-dependent homeless persons with psychiatric comorbidity undergoing behavioral addiction treatment, a reduction in comorbid psychiatric disorder prevalence was observed over 6 months. Not all participants improved, suggesting that even evidence-based addiction treatment will prove insufficient for a meaningful proportion of the dually diagnosed homeless population. PMID:16965639

Substance abuse treatment and psychiatric comorbidity: do benefits spill over? Analysis of data from a prospective trial among cocaine-dependent homeless persons.

PubMed

Kertesz, Stefan G; Madan, Alok; Wallace, Dennis; Schumacher, Joseph E; Milby, Jesse B

2006-09-11

Comorbid psychiatric illness can undermine outcomes among homeless persons undergoing addiction treatment, and psychiatric specialty care is not always readily available. The prognosis for nonsubstance abuse psychiatric diagnoses among homeless persons receiving behaviorally-based addiction treatment, however, is little studied. Data from an addiction treatment trial for 95 cocaine-dependent homeless persons (1996-1998) were used to profile psychiatric diagnoses at baseline and 6 months, including mood-related disorders (e.g. depression) and anxiety-related disorders (e.g. post-traumatic stress disorder). Treatment interventions, including systematic reinforcement for goal attainment, were behavioral in orientation. There was a 32% reduction in the prevalence of comorbid non-addiction psychiatric disorder from baseline to 6 months, with similar reductions in the prevalence of mood (-32%) and anxiety-related disorders (-20%) (p = 0.12). Among cocaine-dependent homeless persons with psychiatric comorbidity undergoing behavioral addiction treatment, a reduction in comorbid psychiatric disorder prevalence was observed over 6 months. Not all participants improved, suggesting that even evidence-based addiction treatment will prove insufficient for a meaningful proportion of the dually diagnosed homeless population.

Epidemiology of Psychiatric Disorders in Iranian Children and Adolescents (IRCAP) and Its Relationship with Social Capital, Life Style and Parents' Personality Disorders: Study Protocol.

PubMed

Mohammadi, Mohammad Reza; Ahmadi, Nastaran; Kamali, Koorosh; Khaleghi, Ali; Ahmadi, Ameneh

2017-01-01

Objective: We aimed at designing a cross sectional study to investigate the prevalence of psychiatric disorders in Iranian children and adolescents (IRCAP) and to determine its relationship with social capital, life style, and parents' personality disorders. Method: This cross sectional study was a national project implemented in all provinces of Iran. In this community-based study, using ‎multistage cluster sampling method, we selected 1000 children and adolescents aged 6 to 18 years in each province. The total sample size reached to 31 000. ‎We randomly collected 170 blocks. Then, of each cluster head, we selected 6 cases including 3 cases of each gender in ‎different age groups (6- 9 years, 10- 14 years, and 15- 18 years). The clinical psychologists instructed the participants to complete the Persian version of Kiddie-Sads-‎Present and Lifetime Version (K-SADS-PL). In addition, demographic data (gender, age, education, parent education, and economic situation) and information on lifestyle, social capital, and parents' personality disorders were obtained from the participants. Discussion: IRCAP study presents a protocol for an epidemiological survey on the first estimates for the prevalence of psychiatric disorders in children and adolescents across the country. This large body of data, on a range of individual behavioural and emotional items and scores, allows us to compare the rates and patterns of deviance between urban and rural places of residence in 31 provinces of Iran with non Iranian samples surveyed with the same measures.

Psychiatric and psychotherapeutic literacy: attitudes to, and knowledge of, psychotherapy.

PubMed

Furnham, Adrian

2009-11-01

Whereas there is now a rapidly emerging literature on psychiatric literacy (Jorm, 2000), there is much less work on the public's knowledge of, and beliefs about the purpose of, and processes involved in, psychotherapy. This study looked at what lay people think happens during psychotherapy; what the processes and aims are; and the aetiology, treatment and prognosis for a mood and psychotic (bipolar, schizophrenia) and two neurotic (depression, obsessive-compulsive) disorders. In total 185 British adults, recruited by a market research company, completed a four-part questionnaire, lasting about 20 minutes. Participants were generally very positive about psychotherapy believing the experience to be highly beneficial. Schizophrenia was seen to have a biological basis; depression and bipolar disorder were perceived to have family, work and other stress-related causal issues; obsessive-compulsive disorder was seen to be caused by stress and family-related issues. Participants thought psychotherapy a very effective treatment but drug treatments more effective for schizophrenia and bipolar disorder. 'Talking it over' was judged highly relevant, specifically to depression. Participants believed that depression had a good chance of cure, and remission, but that neither schizophrenia nor bipolar disorder had much chance of an effective cure. Lay people show a curious pattern on insight, ignorance and naivety with regard to the cause and cure of mental disorders. They appear to have a modestly realistic but somewhat naive view of the process and efficacy of psychotherapy. This may influence how they react to their own and others' mental illness. It has clear implications for education in psychiatric literacy.

Ayahuasca in adolescence: a preliminary psychiatric assessment.

PubMed

Da Silveira, Dartiu Xavier; Grob, Charles S; de Rios, Marlene Dobkin; Lopez, Enrique; Alonso, Luisa K; Tacla, Cristiane; Doering-Silveira, Evelyn

2005-06-01

Ayahuasca is believed to be harmless for those (including adolescents) drinking it within a religious setting. Nevertheless controlled studies on the mental/ psychiatric status of ritual hallucinogenic ayahuasca concoction consumers are still lacking. In this study, 40 adolescents from a Brazilian ayahuasca sect were compared with 40 controls matched on sex, age, and educational background for psychiatric symptomatology. Screening scales for depression, anxiety, alcohol consumption patterns (abuse), attentional problems, and body dysmorphic disorders were used. It was found that, compared to controls, considerable lower frequencies of positive scoring for anxiety, body dismorphism, and attentional problems were detected among ayahuasca-using adolescents despite overall similar psychopathological profiles displayed by both study groups. Low frequencies of psychiatric symptoms detected among adolescents consuming ayahuasca within a religious context may reflect a protective effect due to their religious affiliation. However further studies on the possible interference of other variables in the outcome are necessary.

Autism spectrum disorder - Asperger syndrome

MedlinePlus

... part of the larger developmental disorder category of autism spectrum disorder . ... American Psychiatric Association. Autism spectrum disorder. ... VA: American Psychiatric Publishing: 2013;50-59. Raviola GJ, ...

[Differential diagnosis between dissociative disorders and schizophrenia].

PubMed

Shibayama, Masatoshi

2011-01-01

The differential diagnosis of dissociative disorders includes many psychiatric disorders, such as schizophrenia, bipolar disorders (especially bipolar II disorder), depressive disorder (especially atypical depression), epilepsy, Asperger syndrome, and borderline personality disorder. The theme of this paper is the differential diagnosis between dissociative disorders and schizophrenia. Schneiderian first-rank symptoms in schizophrenia are common in dissociative disorders, especially in dissociative identity disorder (DID). Many DID patients have been misdiagnosed as schizophrenics and treated with neuroleptics. We compared and examined Schneiderian symptoms of schizophrenia and those of dissociative disorders from a structural viewpoint. In dissociative disorders, delusional perception and somatic passivity are not seen. "Lateness" and "Precedence of the Other" originated from the concept of "Pattern Reversal" (H. Yasunaga)" is characteristic of schizophrenia. It is important to check these basic structure of schizophrenia in subjective experiences in differential diagnosis between dissociative disorders and schizophrenia.

Migraine and its psychiatric comorbidities.

PubMed

Minen, Mia Tova; Begasse De Dhaem, Olivia; Kroon Van Diest, Ashley; Powers, Scott; Schwedt, Todd J; Lipton, Richard; Silbersweig, David

2016-07-01

Migraine is a highly prevalent and disabling neurological disorder associated with a wide range of psychiatric comorbidities. In this manuscript, we provide an overview of the link between migraine and several comorbid psychiatric disorders, including depression, anxiety and post-traumatic stress disorder. We present data on psychiatric risk factors for migraine chronification. We discuss the evidence, theories and methods, such as brain functional imaging, to explain the pathophysiological links between migraine and psychiatric disorders. Finally, we provide an overview of the treatment considerations for treating migraine with psychiatric comorbidities. In conclusion, a review of the literature demonstrates the wide variety of psychiatric comorbidities with migraine. However, more research is needed to elucidate the neurocircuitry underlying the association between migraine and the comorbid psychiatric conditions and to determine the most effective treatment for migraine with psychiatric comorbidity. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Toward developmental models of psychiatric disorders in zebrafish

PubMed Central

Norton, William H. J.

2013-01-01

Psychiatric disorders are a diverse set of diseases that affect all aspects of mental function including social interaction, thinking, feeling, and mood. Although psychiatric disorders place a large economic burden on society, the drugs available to treat them are often palliative with variable efficacy and intolerable side-effects. The development of novel drugs has been hindered by a lack of knowledge about the etiology of these diseases. It is thus necessary to further investigate psychiatric disorders using a combination of human molecular genetics, gene-by-environment studies, in vitro pharmacological and biochemistry experiments, animal models, and investigation of the non-biological basis of these diseases, such as environmental effects. Many psychiatric disorders, including autism spectrum disorder, attention-deficit/hyperactivity disorder, mental retardation, and schizophrenia can be triggered by alterations to neural development. The zebrafish is a popular model for developmental biology that is increasingly used to study human disease. Recent work has extended this approach to examine psychiatric disorders as well. However, since psychiatric disorders affect complex mental functions that might be human specific, it is not possible to fully model them in fish. In this review, I will propose that the suitability of zebrafish for developmental studies, and the genetic tools available to manipulate them, provide a powerful model to study the roles of genes that are linked to psychiatric disorders during neural development. The relative speed and ease of conducting experiments in zebrafish can be used to address two areas of future research: the contribution of environmental factors to disease onset, and screening for novel therapeutic compounds. PMID:23637652

Relational Aggression in Children with Preschool Onset (PO) Psychiatric Disorders

PubMed Central

Belden, Andy C.; Gaffrey, Michael S.; Luby, Joan L.

2012-01-01

Objective The role of preschool onset (PO) psychiatric disorders as correlates and/or risk factors for relational aggression during kindergarten or 1st grade was tested in a sample of N = 146 preschool-age children (3 to 5.11). Method Axis-I diagnoses and symptom scores were derived using the Preschool Age Psychiatric Assessment. Children’s roles in relational aggression as aggressor, victim, aggressive-victim, or non-aggressor/non-victim were determined at preschool and again 24 months later at elementary school entry. Results Preschoolers diagnosed with PO-psychiatric disorders were 3 times as likely as the healthy preschoolers to be classified aggressors, victims, or aggressive-victims. Children diagnosed with PO-disruptive, depressive, and/or anxiety disorders were at least 6 times as likely as children without PO-psychiatric disorders to become aggressive-victims during elementary school after covarying for other key risk factors. Conclusions Findings suggested that PO-psychiatric disorders differentiated preschool and school-age children’s roles in relational aggression based on teacher-report. Recommendations for future research and preventative intervention aimed at minimizing the development of relational aggression in early childhood by identifying and targeting PO-psychiatric disorders are made. PMID:22917202

Prevalence of psychiatric disorders in patients with diabetes types 1 and 2.

PubMed

Maia, Ana Claudia C de Ornelas; Braga, Arthur de Azevedo; Brouwers, Amanda; Nardi, Antonio Egidio; Oliveira e Silva, Adriana Cardoso de

2012-11-01

Diabetes mellitus, classified into types 1 and 2, is a chronic disease that shows high comorbidity with psychiatric disorders. Insulin-dependent patients show a higher prevalence of psychiatric disorders than do patients with type 2 diabetes. This research involved the participation of 200 subjects divided into 2 groups: 100 patients with diabetes type 1 and 100 patients with diabetes type 2. This study used the Mini International Neuropsychiatric Interview for the identification of psychiatric disorders. Of the 200 participants, 85 (42.5%) were found to have at least 1 psychiatric disorder. The most prevalent disorders were generalized anxiety disorder (21%), dysthymia (15%), social phobia (7%), current depression (5.5%), lifelong depression (3.5%), panic disorder (2.5%), and risk of suicide (2%). Other disorders with lower prevalence were also identified. The groups showed a statistically significant difference in the presence of dysthymia, current depression, and panic disorder, which were more prevalent in patients with diabetes type 1. The high prevalence of psychiatric disorders in diabetic patients points to the need for greater investment in appropriate diagnostic evaluation of patients that considers mental issues. The difference identified between the groups shows that preventive measures and therapeutic projects should consider the specific demands of each type of diabetes. Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.

Psychiatric disorders moderate the relationship between insomnia and cognitive problems in military soldiers.

PubMed

Brownlow, Janeese A; Klingaman, Elizabeth A; Boland, Elaine M; Brewster, Glenna S; Gehrman, Philip R

2017-10-15

There has been a great deal of research on the comorbidity of insomnia and psychiatric disorders, but much of the existing data is based on small samples and does not assess the full diagnostic criteria for each disorder. Further, the exact nature of the relationship between these conditions and their impact on cognitive problems are under-researched in military samples. Data were collected from the All Army Study of the Army Study to Assess Risk and Resilience in Service members (unweighted N = 21, 449; weighted N = 674,335; 18-61 years; 13.5% female). Participants completed the Brief Insomnia Questionnaire to assess for insomnia disorder and a self-administered version of the Composite International Diagnostic Interview Screening Scales to assess for psychiatric disorders and cognitive problems. Military soldiers with current major depressive episode (MDE) had the highest prevalence of insomnia disorder (INS; 85.0%), followed by current generalized anxiety disorder (GAD; 82.6%) and current posttraumatic stress disorder (PTSD; 69.7%), respectively. Significant interactions were found between insomnia and psychiatric disorders; specifically, MDE, PTSD, and GAD status influenced the relationship between insomnia and memory/concentration problems. Cross-sectional nature of the assessment and the absence of a comprehensive neurocognitive battery. Psychiatric disorders moderated the relationship between insomnia and memory/concentration problems, suggesting that psychiatric disorders contribute unique variance to cognitive problems even though they are associated with insomnia disorder. Results highlight the importance of considering both insomnia and psychiatric disorders in the diagnosis and treatment of cognitive deficits in military soldiers. Copyright © 2017 Elsevier B.V. All rights reserved.

All-Cause Mortality in Women With Severe Postpartum Psychiatric Disorders

PubMed Central

Johannsen, Benedicte Marie Winther; Larsen, Janne Tidselbak; Laursen, Thomas Munk; Bergink, Veerle; Meltzer-Brody, Samantha; Munk-Olsen, Trine

2017-01-01

Objective The postpartum period is associated with a high risk of psychiatric episodes. The authors studied mortality in women with first-onset severe psychiatric disorders following childbirth and compared their mortality rates with those in women from the background population including other female psychiatric patients (mothers and childless women). Method In a register-based cohort study with linked information from Danish population registers, the authors identified women with first psychiatric inpatient or outpatient contacts 0–3 months postpartum. The main outcome measure was mortality rate ratios (MRRs): deaths from natural causes (diseases and medical conditions) or unnatural causes (suicides, accidents, and homicides). The cohort included 1,545,857 women representing 68,473,423 person-years at risk. Results In total, 2,699 women had first-onset psychiatric disorders 0–3 months postpartum, and 96 of these died during follow-up. Women with postpartum psychiatric disorders had a higher MRR (3.74; 95% CI=3.06–4.57) than non-postpartum-onset mothers (MRR=2.73; 95% CI=2.67–2.79) when compared with mothers with no psychiatric history. However, childless women with psychiatric diagnoses had the highest MRR (6.15; 95% CI=5.94–6.38). Unnatural cause of death represented 40.6% of fatalities among women with postpartum psychiatric disorders, and within the first year after diagnosis, suicide risk was drastically increased (MRR=289.42; 95% CI=144.02–581.62) when compared with mothers with no psychiatric history. Conclusions Women with severe postpartum psychiatric disorders had increased MRRs compared with mothers without psychiatric diagnoses, and the first year after diagnosis represents a time of particularly high relative risk for suicide in this vulnerable group. PMID:26940804

[Related, induced and associated psychiatric disorders to cannabis].

PubMed

Laqueille, Xavier

2005-01-15

Cannabis disorders, according to the DSM-IV and the ICD-10 criteria, include cannabis intoxication, cannabis abuse, cannabis dependence, and cannabis-related disorders (anxiety disorders, psychotic disorders, cannabis intoxication delirium). Although cannabis withdrawal syndrome has clinical importance, it is not included in these classifications. The amotivational syndrome remains controversial. The psychiatric disorders related to cannabis use are anxiety disorders, depressive disorders and psychotic disorders. Cannabis use could be closely linked with the neurobiology of schizophrenia. As the other psychoactive substances, cannabis use worsens the psychiatric outcomes and is associated with poorer treatment compliance.

Suicidal Behavior in Juvenile Delinquents: The Role of ADHD and Other Comorbid Psychiatric Disorders.

PubMed

Ruchkin, Vladislav; Koposov, Roman A; Koyanagi, Ai; Stickley, Andrew

2017-10-01

This study evaluated the role of psychiatric morbidity in relation to a history of suicidal behavior, with a particular focus on attention-deficit/hyperactivity disorder (ADHD). Suicidality and psychiatric diagnoses were assessed in 370 incarcerated male juvenile delinquents from Northern Russia using the semi-structured K-SADS-PL psychiatric interview. A lifetime history of suicidal ideation only (24.7 %) and suicidal ideation with suicide attempts (15.7 %) was common. Binary logistic regression analysis was used to assess the role of ADHD and other psychiatric disorders in suicidal ideation and suicide attempts. A history of suicidal ideation and of suicide attempts were associated with higher rates of psychiatric morbidity and with the number of comorbid psychiatric disorders. An ADHD diagnosis was associated with an increased risk for both suicidal ideation and for suicide attempts. The comorbidity of ADHD with drug dependence further increased the risk for suicidal ideation, while ADHD and alcohol dependence comorbidity increased the risk for suicide attempts. Our findings highlight the importance of adequately detecting and treating psychiatric disorders in vulnerable youths, especially when they are comorbid with ADHD.

The recognition of diagnosable psychiatric disorders in suicide cases' last medical contacts.

PubMed

Pan, Yi-Ju; Lee, Ming-Been; Chiang, Hung-Chi; Liao, Shih-Cheng

2009-01-01

The objective of this study is to examine physicians' awareness of diagnosable psychiatric disorders in suicide cases' last medical contacts (MCs). The contact rates and proportions of both psychiatric and somatic diagnoses in a national cohort of suicide subjects (N=3468) in Taiwan seeking psychiatric or nonpsychiatric medical services within 1 month and 1 year preceding death were examined. The overall rates of MCs were 72.6% within 1 month and 89.2% within 1 year preceding suicide. While around 99.9% of the suicide subjects who contacted psychiatrists within 1 month preceding death were diagnosed as having psychiatric disorders, only 19.7% of those visiting nonpsychiatric physicians had psychiatric diagnoses. Suicide subjects, however, frequently complained of somatic symptoms, for example, gastrointestinal discomfort, headache/dizziness and back problem during their contacts with nonpsychiatric physicians within 1 month preceding death. Despite the high rates of MCs preceding suicide, the majority of suicide subjects were not diagnosed. Emphasizing psychosomatic manifestations of psychiatric disorders in physician education programs may help enhance the awareness of psychiatric disorders/suicide risk in clinical settings.

Adolescent Male Conduct-Disordered Patients in Substance Use Disorder Treatment: Examining the "Limited Prosocial Emotions" Specifier.

PubMed

Sakai, Joseph T; Mikulich-Gilbertson, Susan K; Young, Susan E; Rhee, Soo Hyun; McWilliams, Shannon K; Dunn, Robin; Salomonsen-Sautel, Stacy; Thurstone, Christian; Hopfer, Christian J

2016-01-01

To our knowledge, this is the first study to examine the DSM-5-defined conduct disorder (CD) with limited prosocial emotions (LPE) among adolescents in substance use disorder (SUD) treatment, despite the high rates of CD in this population. We tested previously published methods of LPE categorization in a sample of male conduct-disordered patients in SUD treatment (n=196). CD with LPE patients did not demonstrate a distinct pattern in terms of demographics or co-morbidity regardless of the categorization method utilized. In conclusion, LPE, as operationalized here, does not identify a distinct subgroup of patients based on psychiatric comorbidity, SUD diagnoses, or demographics.

Patterns of cannabis use and clinical correlates among individuals with Major Depressive Disorder and Bipolar Disorder.

PubMed

Taub, Sharon; Feingold, Daniel; Rehm, Jürgen; Lev-Ran, Shaul

2018-01-01

Major Depressive Disorder (MDD) and Bipolar Disorder (BPD) are the most severe mood disorders globally. Previous reports indicate high co-occurrence of cannabis use and cannabis use disorders (CUDs) associated with both disorders, yet studies comparing patterns of cannabis use between individuals with MDD and BPD are scarce. Data were drawn from Wave 1 (2001-2002) of the National Epidemiologic survey on Alcohol and Related Conditions (NESARC). Cannabis users who qualified for a diagnosis of past-year MDD (N=217) were compared to those with BPD (N=168) in frequency and daily dose of cannabis use, rates of comorbid psychiatric disorders including specific criteria of CUDs, treatment utilization and suicidality. Among past-year cannabis users, individuals with BPD reported using cannabis more frequently and smoking more joints per day compared to those with MDD. They were also more likely to suffer from comorbid personality disorders and qualify for specific CUD-criteria, including use in physically hazardous situations and unsuccessful efforts to control substance use. Our results indicate that individuals with BPD may present more intensive patterns of cannabis use compared to those with MDD. This may have potential effects on the course of BPD and should be further explored in longitudinal studies. Copyright © 2017 Elsevier Inc. All rights reserved.

Hypersomnolence, Hypersomnia, and Mood Disorders.

PubMed

Barateau, Lucie; Lopez, Régis; Franchi, Jean Arthur Micoulaud; Dauvilliers, Yves

2017-02-01

Relationships between symptoms of hypersomnolence, psychiatric disorders, and hypersomnia disorders (i.e., narcolepsy and idiopathic hypersomnia) are complex and multidirectional. Hypersomnolence is a common complaint across mood disorders; however, patients suffering from mood disorders and hypersomnolence rarely have objective daytime sleepiness, as assessed by the current gold standard test, the Multiple Sleep Latency Test. An iatrogenic origin of symptoms of hypersomnolence, and sleep apnea syndrome must be considered in a population of psychiatric patients, often overweight and treated with sedative drugs. On the other hand, psychiatric comorbidities, especially depression symptoms, are often reported in patients with hypersomnia disorders, and an endogenous origin cannot be ruled out. A great challenge for sleep specialists and psychiatrists is to differentiate psychiatric hypersomnolence and a central hypersomnia disorder with comorbid psychiatric symptoms. The current diagnostic tools seem to be limited in that condition, and further research in that field is warranted.

Psychiatric Disorders and Treatments: A Primer for Teachers.

ERIC Educational Resources Information Center

Forness, Steven R.; Walker, Hill M.; Kavale, Kenneth A.

2003-01-01

This article for teachers provides basic information on psychiatric disorders and treatments. It covers oppositional defiant and conduct disorders, attention deficit/hyperactivity disorder, depression or other mood disorders, anxiety disorders, schizophrenia or other psychotic disorders, and autistic spectrum disorders. Insets provide additional…

Misophonia: diagnostic criteria for a new psychiatric disorder.

PubMed

Schröder, Arjan; Vulink, Nienke; Denys, Damiaan

2013-01-01

Some patients report a preoccupation with a specific aversive human sound that triggers impulsive aggression. This condition is relatively unknown and has hitherto never been described, although the phenomenon has anecdotally been named misophonia. 42 patients who reported misophonia were recruited by our hospital website. All patients were interviewed by an experienced psychiatrist and were screened with an adapted version of the Y-BOCS, HAM-D, HAM-A, SCL-90 and SCID II. The misophonia patients shared a similar pattern of symptoms in which an auditory or visual stimulus provoked an immediate aversive physical reaction with anger, disgust and impulsive aggression. The intensity of these emotions caused subsequent obsessions with the cue, avoidance and social dysfunctioning with intense suffering. The symptoms cannot be classified in the current nosological DSM-IV TR or ICD-10 systems. We suggest that misophonia should be classified as a discrete psychiatric disorder. Diagnostic criteria could help to officially recognize the patients and the disorder, improve its identification by professional health carers, and encourage scientific research.

Misophonia: current perspectives

PubMed Central

Cavanna, Andrea E; Seri, Stefano

2015-01-01

Misophonia is characterized by a negative reaction to a sound with a specific pattern and meaning to a given individual. In this paper, we review the clinical features of this relatively common yet underinvestigated condition, with focus on co-occurring neurodevelopmental disorders. Currently available data on the putative pathophysiology of the condition can inform our understanding and guide the diagnostic process and treatment approach. Tinnitus retraining therapy and cognitive behavior therapy have been proposed as the most effective treatment strategies for reducing symptoms; however, current treatment algorithms should be validated in large population studies. At the present stage, competing paradigms see misophonia as a physiological state potentially inducible in any subject, an idiopathic condition (which can present with comorbid psychiatric disorders), or a symptomatic manifestation of an underlying psychiatric disorder. Agreement on the use of standardized diagnostic criteria would be an important step forward in terms of both clinical practice and scientific inquiry. Areas for future research include phenomenology, epidemiology, modulating factors, neurophysiological underpinnings, and treatment trials. PMID:26316758

Misophonia: current perspectives.

PubMed

Cavanna, Andrea E; Seri, Stefano

2015-01-01

Misophonia is characterized by a negative reaction to a sound with a specific pattern and meaning to a given individual. In this paper, we review the clinical features of this relatively common yet underinvestigated condition, with focus on co-occurring neurodevelopmental disorders. Currently available data on the putative pathophysiology of the condition can inform our understanding and guide the diagnostic process and treatment approach. Tinnitus retraining therapy and cognitive behavior therapy have been proposed as the most effective treatment strategies for reducing symptoms; however, current treatment algorithms should be validated in large population studies. At the present stage, competing paradigms see misophonia as a physiological state potentially inducible in any subject, an idiopathic condition (which can present with comorbid psychiatric disorders), or a symptomatic manifestation of an underlying psychiatric disorder. Agreement on the use of standardized diagnostic criteria would be an important step forward in terms of both clinical practice and scientific inquiry. Areas for future research include phenomenology, epidemiology, modulating factors, neurophysiological underpinnings, and treatment trials.

Successful anterior capsulotomy in comorbid anorexia nervosa and obsessive-compulsive disorder: case report.

PubMed

Barbier, Johan; Gabriëls, Loes; van Laere, Koen; Nuttin, Bart

2011-09-01

State-of-the-art treatment of anorexia nervosa (AN) and obsessive-compulsive disorder (OCD) often proves ineffective. Both disorders have common features, and anterior capsulotomy is a last-resort treatment for OCD. We document the effect of bilateral anterior capsulotomy in a patient with comorbid AN and OCD. A 38-year-old woman with life-threatening, chronic, treatment-refractory AN and OCD underwent anterior capsulotomy. Psychiatric and neuropsychological evaluations at baseline and at follow-up document the severity and progress of the case. Bilateral anterior capsulotomy resulted in normalization of eating pattern and weight and a significant decrease of food-related and overall obsessive-compulsive symptoms. Psychiatric evaluations and exposure to food cues confirmed the clinical improvement that was evident immediately after surgery and sustained at 3-month follow-up. This case report suggests that bilateral anterior capsulotomy can be a therapeutic option for patients with comorbid AN and OCD. However, a well-controlled study is warranted.

Psychiatric comorbidity in injecting drug users in Asia and Africa.

PubMed

Iskandar, Shelly; Kamal, Rama; De Jong, Cor A

2012-05-01

The prevalence of psychiatric co-morbidity in injecting drug users (IDUs) in the Western countries is high and is associated with lower quality of life and reduces the effectiveness of treatment programs. The aim of this study is to provide a review about psychiatric comorbidity in IDUs in Asia and Africa, where HIV prevalence is high and still increasing. Studies focusing on psychiatric comorbidity in Asia and Africa are scarce. The prevalence of psychiatric comorbidity is comparable with the prevalence in western countries. Psychiatric disorders can occur before or during drug abuse and are also associated with substance abuse and physical comorbidity and its treatments. Childhood trauma followed by post-traumatic disorders is a significant risk factor for substance abuse. Psychiatric co-occurring disorders influence the adherence to the physical and drug use treatment. Evidence-based treatment for psychiatric comorbidity in IDUs is still limited. A better understanding of the prevalence of psychiatric disorders in IDUs and its impact on the overall treatments is growing. However, more studies focusing on the treatment for psychiatric comorbidity in IDUs in Asia and Africa are needed.

Maternal Psychiatric Disorder and the Risk of Autism Spectrum Disorder or Intellectual Disability in Subsequent Offspring

ERIC Educational Resources Information Center

Fairthorne, Jenny; Hammond, Geoff; Bourke, Jenny; de Klerk, Nick; Leonard, Helen

2016-01-01

Psychiatric disorders are more common in the mothers of children with autism spectrum disorder (ASD) or intellectual disability (ID) after the birth of their child. We aimed to assess the relationship between women's psychiatric contacts and subsequent offspring with ASD/ID. We linked three Western Australian registers to investigate pre-existing…

Genetic relationship between five psychiatric disorders estimated from genome-wide SNPs.

PubMed

Lee, S Hong; Ripke, Stephan; Neale, Benjamin M; Faraone, Stephen V; Purcell, Shaun M; Perlis, Roy H; Mowry, Bryan J; Thapar, Anita; Goddard, Michael E; Witte, John S; Absher, Devin; Agartz, Ingrid; Akil, Huda; Amin, Farooq; Andreassen, Ole A; Anjorin, Adebayo; Anney, Richard; Anttila, Verneri; Arking, Dan E; Asherson, Philip; Azevedo, Maria H; Backlund, Lena; Badner, Judith A; Bailey, Anthony J; Banaschewski, Tobias; Barchas, Jack D; Barnes, Michael R; Barrett, Thomas B; Bass, Nicholas; Battaglia, Agatino; Bauer, Michael; Bayés, Mònica; Bellivier, Frank; Bergen, Sarah E; Berrettini, Wade; Betancur, Catalina; Bettecken, Thomas; Biederman, Joseph; Binder, Elisabeth B; Black, Donald W; Blackwood, Douglas H R; Bloss, Cinnamon S; Boehnke, Michael; Boomsma, Dorret I; Breen, Gerome; Breuer, René; Bruggeman, Richard; Cormican, Paul; Buccola, Nancy G; Buitelaar, Jan K; Bunney, William E; Buxbaum, Joseph D; Byerley, William F; Byrne, Enda M; Caesar, Sian; Cahn, Wiepke; Cantor, Rita M; Casas, Miguel; Chakravarti, Aravinda; Chambert, Kimberly; Choudhury, Khalid; Cichon, Sven; Cloninger, C Robert; Collier, David A; Cook, Edwin H; Coon, Hilary; Cormand, Bru; Corvin, Aiden; Coryell, William H; Craig, David W; Craig, Ian W; Crosbie, Jennifer; Cuccaro, Michael L; Curtis, David; Czamara, Darina; Datta, Susmita; Dawson, Geraldine; Day, Richard; De Geus, Eco J; Degenhardt, Franziska; Djurovic, Srdjan; Donohoe, Gary J; Doyle, Alysa E; Duan, Jubao; Dudbridge, Frank; Duketis, Eftichia; Ebstein, Richard P; Edenberg, Howard J; Elia, Josephine; Ennis, Sean; Etain, Bruno; Fanous, Ayman; Farmer, Anne E; Ferrier, I Nicol; Flickinger, Matthew; Fombonne, Eric; Foroud, Tatiana; Frank, Josef; Franke, Barbara; Fraser, Christine; Freedman, Robert; Freimer, Nelson B; Freitag, Christine M; Friedl, Marion; Frisén, Louise; Gallagher, Louise; Gejman, Pablo V; Georgieva, Lyudmila; Gershon, Elliot S; Geschwind, Daniel H; Giegling, Ina; Gill, Michael; Gordon, Scott D; Gordon-Smith, Katherine; Green, Elaine K; Greenwood, Tiffany A; Grice, Dorothy E; Gross, Magdalena; Grozeva, Detelina; Guan, Weihua; Gurling, Hugh; De Haan, Lieuwe; Haines, Jonathan L; Hakonarson, Hakon; Hallmayer, Joachim; Hamilton, Steven P; Hamshere, Marian L; Hansen, Thomas F; Hartmann, Annette M; Hautzinger, Martin; Heath, Andrew C; Henders, Anjali K; Herms, Stefan; Hickie, Ian B; Hipolito, Maria; Hoefels, Susanne; Holmans, Peter A; Holsboer, Florian; Hoogendijk, Witte J; Hottenga, Jouke-Jan; Hultman, Christina M; Hus, Vanessa; Ingason, Andrés; Ising, Marcus; Jamain, Stéphane; Jones, Edward G; Jones, Ian; Jones, Lisa; Tzeng, Jung-Ying; Kähler, Anna K; Kahn, René S; Kandaswamy, Radhika; Keller, Matthew C; Kennedy, James L; Kenny, Elaine; Kent, Lindsey; Kim, Yunjung; Kirov, George K; Klauck, Sabine M; Klei, Lambertus; Knowles, James A; Kohli, Martin A; Koller, Daniel L; Konte, Bettina; Korszun, Ania; Krabbendam, Lydia; Krasucki, Robert; Kuntsi, Jonna; Kwan, Phoenix; Landén, Mikael; Långström, Niklas; Lathrop, Mark; Lawrence, Jacob; Lawson, William B; Leboyer, Marion; Ledbetter, David H; Lee, Phil H; Lencz, Todd; Lesch, Klaus-Peter; Levinson, Douglas F; Lewis, Cathryn M; Li, Jun; Lichtenstein, Paul; Lieberman, Jeffrey A; Lin, Dan-Yu; Linszen, Don H; Liu, Chunyu; Lohoff, Falk W; Loo, Sandra K; Lord, Catherine; Lowe, Jennifer K; Lucae, Susanne; MacIntyre, Donald J; Madden, Pamela A F; Maestrini, Elena; Magnusson, Patrik K E; Mahon, Pamela B; Maier, Wolfgang; Malhotra, Anil K; Mane, Shrikant M; Martin, Christa L; Martin, Nicholas G; Mattheisen, Manuel; Matthews, Keith; Mattingsdal, Morten; McCarroll, Steven A; McGhee, Kevin A; McGough, James J; McGrath, Patrick J; McGuffin, Peter; McInnis, Melvin G; McIntosh, Andrew; McKinney, Rebecca; McLean, Alan W; McMahon, Francis J; McMahon, William M; McQuillin, Andrew; Medeiros, Helena; Medland, Sarah E; Meier, Sandra; Melle, Ingrid; Meng, Fan; Meyer, Jobst; Middeldorp, Christel M; Middleton, Lefkos; Milanova, Vihra; Miranda, Ana; Monaco, Anthony P; Montgomery, Grant W; Moran, Jennifer L; Moreno-De-Luca, Daniel; Morken, Gunnar; Morris, Derek W; Morrow, Eric M; Moskvina, Valentina; Muglia, Pierandrea; Mühleisen, Thomas W; Muir, Walter J; Müller-Myhsok, Bertram; Murtha, Michael; Myers, Richard M; Myin-Germeys, Inez; Neale, Michael C; Nelson, Stan F; Nievergelt, Caroline M; Nikolov, Ivan; Nimgaonkar, Vishwajit; Nolen, Willem A; Nöthen, Markus M; Nurnberger, John I; Nwulia, Evaristus A; Nyholt, Dale R; O'Dushlaine, Colm; Oades, Robert D; Olincy, Ann; Oliveira, Guiomar; Olsen, Line; Ophoff, Roel A; Osby, Urban; Owen, Michael J; Palotie, Aarno; Parr, Jeremy R; Paterson, Andrew D; Pato, Carlos N; Pato, Michele T; Penninx, Brenda W; Pergadia, Michele L; Pericak-Vance, Margaret A; Pickard, Benjamin S; Pimm, Jonathan; Piven, Joseph; Posthuma, Danielle; Potash, James B; Poustka, Fritz; Propping, Peter; Puri, Vinay; Quested, Digby J; Quinn, Emma M; Ramos-Quiroga, Josep Antoni; Rasmussen, Henrik B; Raychaudhuri, Soumya; Rehnström, Karola; Reif, Andreas; Ribasés, Marta; Rice, John P; Rietschel, Marcella; Roeder, Kathryn; Roeyers, Herbert; Rossin, Lizzy; Rothenberger, Aribert; Rouleau, Guy; Ruderfer, Douglas; Rujescu, Dan; Sanders, Alan R; Sanders, Stephan J; Santangelo, Susan L; Sergeant, Joseph A; Schachar, Russell; Schalling, Martin; Schatzberg, Alan F; Scheftner, William A; Schellenberg, Gerard D; Scherer, Stephen W; Schork, Nicholas J; Schulze, Thomas G; Schumacher, Johannes; Schwarz, Markus; Scolnick, Edward; Scott, Laura J; Shi, Jianxin; Shilling, Paul D; Shyn, Stanley I; Silverman, Jeremy M; Slager, Susan L; Smalley, Susan L; Smit, Johannes H; Smith, Erin N; Sonuga-Barke, Edmund J S; St Clair, David; State, Matthew; Steffens, Michael; Steinhausen, Hans-Christoph; Strauss, John S; Strohmaier, Jana; Stroup, T Scott; Sutcliffe, James S; Szatmari, Peter; Szelinger, Szabocls; Thirumalai, Srinivasa; Thompson, Robert C; Todorov, Alexandre A; Tozzi, Federica; Treutlein, Jens; Uhr, Manfred; van den Oord, Edwin J C G; Van Grootheest, Gerard; Van Os, Jim; Vicente, Astrid M; Vieland, Veronica J; Vincent, John B; Visscher, Peter M; Walsh, Christopher A; Wassink, Thomas H; Watson, Stanley J; Weissman, Myrna M; Werge, Thomas; Wienker, Thomas F; Wijsman, Ellen M; Willemsen, Gonneke; Williams, Nigel; Willsey, A Jeremy; Witt, Stephanie H; Xu, Wei; Young, Allan H; Yu, Timothy W; Zammit, Stanley; Zandi, Peter P; Zhang, Peng; Zitman, Frans G; Zöllner, Sebastian; Devlin, Bernie; Kelsoe, John R; Sklar, Pamela; Daly, Mark J; O'Donovan, Michael C; Craddock, Nicholas; Sullivan, Patrick F; Smoller, Jordan W; Kendler, Kenneth S; Wray, Naomi R

2013-09-01

Most psychiatric disorders are moderately to highly heritable. The degree to which genetic variation is unique to individual disorders or shared across disorders is unclear. To examine shared genetic etiology, we use genome-wide genotype data from the Psychiatric Genomics Consortium (PGC) for cases and controls in schizophrenia, bipolar disorder, major depressive disorder, autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD). We apply univariate and bivariate methods for the estimation of genetic variation within and covariation between disorders. SNPs explained 17-29% of the variance in liability. The genetic correlation calculated using common SNPs was high between schizophrenia and bipolar disorder (0.68 ± 0.04 s.e.), moderate between schizophrenia and major depressive disorder (0.43 ± 0.06 s.e.), bipolar disorder and major depressive disorder (0.47 ± 0.06 s.e.), and ADHD and major depressive disorder (0.32 ± 0.07 s.e.), low between schizophrenia and ASD (0.16 ± 0.06 s.e.) and non-significant for other pairs of disorders as well as between psychiatric disorders and the negative control of Crohn's disease. This empirical evidence of shared genetic etiology for psychiatric disorders can inform nosology and encourages the investigation of common pathophysiologies for related disorders.

Comorbid trajectories of substance use as predictors of Antisocial Personality Disorder, Major Depressive Episode, and Generalized Anxiety Disorder.

PubMed

Brook, Judith S; Zhang, Chenshu; Rubenstone, Elizabeth; Primack, Brian A; Brook, David W

2016-11-01

To determine longitudinal associations between patterns of comorbid cigarette, alcohol, and marijuana use and Antisocial Personality Disorder (ASPD), Major Depressive Episode (MDE), and Generalized Anxiety Disorder (GAD) in adulthood. A random community-based sample [X̅ age=36.6 (SD=2.8)] from the Children and Adults in the Community Study, an on-going investigation of substance use and psychiatric disorders. Data were collected at six time waves. Conjoint trajectories of cigarette, alcohol, and marijuana use spanning adolescence to adulthood were determined; multivariable logistic regression analyses assessed associations between trajectory group membership and having ASPD, MDE, or GAD in adulthood. Five conjoint trajectory groups were obtained: HHH (chronic cigarette, alcohol, and marijuana use), DDD (delayed/late-starting cigarette, alcohol, and marijuana use), LML (low/no smoking, moderate alcohol use, occasional marijuana use), HMN (chronic smoking, moderate alcohol use, no marijuana use), and NON (occasional alcohol use only). Compared with members of the NON group, those in the HHH group had significantly greater odds for having ASPD (Adjusted Odds Ratio [AOR]=28.52, 95% Confidence Interval [CI]=9.44-86.17), MDE (AOR=2.67, 95% CI=1.14-6.26), and GAD (AOR=6.39, 95% CI=2.62-15.56). Members of the DDD, LML, and HMN groups had weaker and less consistent associations with the three psychiatric outcomes. In a large, community-based sample, long-term concurrent use of more than one substance was associated with both externalizing and internalizing psychiatric disorders in adulthood. Prevention and treatment programs might target individuals in the community and general clinical populations with comorbid substance use, even if they haven't been identified as having a substance use disorder. Copyright © 2016 Elsevier Ltd. All rights reserved.

Comorbid Trajectories of Substance Use as Predictors of Antisocial Personality Disorder, Major Depressive Episode, and Generalized Anxiety Disorder

PubMed Central

Brook, Judith S.; Zhang, Chenshu; Rubenstone, Elizabeth; Primack, Brian A.; Brook, David W.

2016-01-01

Objective To determine longitudinal associations between patterns of comorbid cigarette, alcohol, and marijuana use and Antisocial Personality Disorder (ASPD), Major Depressive Episode (MDE), and Generalized Anxiety Disorder (GAD) in adulthood. Method A random community-based sample [X̄ age=36.6 (SD=2.8)] from the Children and Adults in the Community Study, an on-going investigation of substance use and psychiatric disorders. Data were collected at six time waves. Conjoint trajectories of cigarette, alcohol, and marijuana use spanning adolescence to adulthood were determined; multivariable logistic regression analyses assessed associations between trajectory group membership and having ASPD, MDE, or GAD in adulthood. Results Five conjoint trajectory groups were obtained: HHH (chronic cigarette, alcohol, and marijuana use), DDD (delayed/late-starting cigarette, alcohol, and marijuana use), LML (low/no smoking, moderate alcohol use, occasional marijuana use), HMN (chronic smoking, moderate alcohol use, no marijuana use), and NON (occasional alcohol use only). Compared with members of the NON group, those in the HHH group had significantly greater odds for having ASPD (Adjusted Odds Ratio [AOR]=28.52, 95% Confidence Interval [CI]=9.44–86.17), MDE (AOR=2.67, 95% CI=1.14–6.26), and GAD (AOR=6.39, 95% CI=2.62–15.56). Members of the DDD, LML, and HMN groups had weaker and less consistent associations with the three psychiatric outcomes. Conclusions In a large, community-based sample, long-term concurrent use of more than one substance was associated with both externalizing and internalizing psychiatric disorders in adulthood. Prevention and treatment programs might target individuals in the community and general clinical populations with comorbid substance use, even if they haven’t been identified as having a substance use disorder. PMID:27344118

Disrupted White Matter Microstructure and Mood Disorders after Traumatic Brain Injury.

PubMed

Spitz, Gershon; Alway, Yvette; Gould, Kate Rachel; Ponsford, Jennie L

2017-02-15

Traumatic brain injury (TBI) is associated with an elevated frequency of mood disorders that may, in part, be explained by changes in white-matter microstructure. This study is the first to examine the relationship between mood disorders and white-matter pathology in a sample of patients with mild to severe TBI using a standardized psychiatric interview. This study reports on a sub-sample of 29 individuals recruited from a large prospective study that examined the evolution of psychiatric disorders following complicated, mild to severe TBI. Individuals with TBI were also compared with 23 healthy control participants. Individuals were invited to complete the Structured Clinical Interview for DSM-IV Disorders (SCID) to diagnose psychiatric disorders. Participants who developed a mood disorder within the first 3 years were categorized into a TBI-Mood group. Diffusion tensor tractography assessed white matter microstructure using atlas-based tract-averaged and along-tract approaches. Fractional anisotropy (FA) was used as the measure of white-matter microstructure. TBI participants with and without a mood disorder did not differ in regard to injury severity and other background factors. Nevertheless, TBI participants diagnosed with a mood disorder displayed significantly lower tract-averaged FA values for the right arcuate fasciculus (p = 0.011), right inferior longitudinal fasciculus (p = 0.009), and anterior segments I (p = 0.0004) and II (p = 0.007) of the corpus callosum, as well as the left (p = 0.014) and right (p = 0.015) fronto-occipital longitudinal fasciculi. The pattern of white matter disruption identified in the current study provides further support for a neurobiological basis of post-TBI mood disorders. Greater understanding of individuals' underlying neuropathology may enable better characterization and prediction of mood disorders. Integration of neuropathology may also inform the potential efficacy of pharmacological and psychological interventions.

[BIPOLAR DISORDER AS A MULTI-SYSTEM ILLNESS].

PubMed

Fenchel, Daphna; Levkovitz, Yechiel; Kotler, Moshe

2017-12-01

Bipolar disorder is a chronic condition, characterized by high distress in patients and high suicide rates (30%). Most patients suffer from medical and other psychiatric comorbidities, which worsen the psychiatric symptoms and decrease the likelihood of remission. More than 70% of bipolar patients have cardio-metabolic symptoms, with higher rates compared to other psychiatric disorders. Cardiovascular disease is the major cause of high mortality rates in these patients, with 1.5-2 fold increased risk of mortality, compared to the general population without psychiatric symptoms. The rates of cardiovascular risk factors and their resulting increased mortality rates are similar to those found in schizophrenia. In addition to cardio-metabolic conditions, 50% of patients with bipolar disorder suffer from other medical symptoms, which are also associated with worse outcomes. Therefore, the current perspective is that bipolar disorder is not only a psychiatric disorder, but rather a multi-system illness, affecting the entire body. The optimal treatment for these patients should include diagnosis, monitoring and treatment of both psychiatric and physical symptoms, which would improve their prognosis.

The clinical presentation of attention deficit-hyperactivity disorder (ADHD) in children with 22q11.2 deletion syndrome.

PubMed

Niarchou, Maria; Martin, Joanna; Thapar, Anita; Owen, Michael J; van den Bree, Marianne B M

2015-12-01

Although attention deficit-hyperactivity disorder (ADHD) is the most prevalent psychiatric disorder in children with 22q11.2DS, it remains unclear whether its clinical presentation is similar to that in children with idiopathic ADHD. The aim of this study is to compare the ADHD phenotype in children with and without 22q11.2DS by examining ADHD symptom scores, patterns of psychiatric comorbidity, IQ and gender distribution. Forty-four children with 22q11.2DS and ADHD (mean age = 9.6), 600 clinic children (mean age = 10.8) and 77 children with ADHD from a population cohort (mean age = 10.8) participated in the study. Psychopathology was assessed using parent-report research diagnostic instruments. There was a higher proportion of females in the 22q11.2DS ADHD sample in relation to the clinical sample (χ(2)  = 18.2, P < 0.001). The 22q11.2DS group showed a higher rate of ADHD inattentive subtype (χ(2)  = 114.76, P < 0.001), and fewer hyperactive-impulsive symptoms compared to the clinical group (z = 8.43, P < 0.001). The 22q11.2DS ADHD group parents reported fewer oppositional defiant disorder/conduct disorder symptoms (z = 6.33, P < 0.001) and a higher rate of generalized anxiety disorder (χ(2)  = 4.56, P = 0.03) in relation to the clinical group. Two percent of the 22q11.2 DS ADHD sample had received ADHD treatment. The results were similar when the 22q11.2 ADHD group was compared to the population cohort ADHD group. The clinical presentation of ADHD and patterns of co-morbidity in 22q11.2DS is different from that in idiopathic ADHD. This could lead to clinical under-recognition of ADHD in this group. Examining psychopathology in 22q11.2DS can provide insights into the genetic origins of psychiatric problems with implications beyond the 22q11.2DS population. © 2015 Wiley Periodicals, Inc.

[Sickness absence and disability due to psychiatric disorders from a gender perspective - a systematic literature review].

PubMed

Dietrich, S; Stengler, K

2013-06-01

This work is aimed at providing a review of the literature on gender differences in the prevalence of mental disorders at the workplace. A systematic literature search of all original works on sickness absence and disability due to psychiatric disorders published in PubMed from 2000 through to 2011 was undertaken. Female employees have more frequent and longer sickness absences due to psychiatric disorders. Male employees are at a high risk of disability due to psychiatric disorders. Gender-specific prevention strategies at the workplace should target the prevention of short and long-term consequences for female employees and the long-term impact of psychiatric disorders in male employees. However, there is still a lack of knowledge about implications for gender specific prevention strategies at the workplace. © Georg Thieme Verlag KG Stuttgart · New York.

Psychiatric symptoms in preclinical behavioural-variant frontotemporal dementia in MAPT mutation carriers.

PubMed

Cheran, Gayathri; Silverman, Hannah; Manoochehri, Masood; Goldman, Jill; Lee, Seonjoo; Wu, Liwen; Cines, Sarah; Fallon, Emer; Kelly, Brendan Desmond; Olszewska, Diana Angelika; Heidebrink, Judith; Shair, Sarah; Campbell, Stephen; Paulson, Henry; Lynch, Timothy; Cosentino, Stephanie; Huey, Edward D

2018-05-01

To characterise psychiatric symptoms in preclinical and early behavioural-variant frontotemporal dementia (bvFTD), a neurodegenerative disorder whose symptoms overlap with and are often mistaken for psychiatric illness. The present study reports findings from a systematic, global, prospective evaluation of psychiatric symptoms in 12 preclinical carriers of pathogenic MAPT mutations, not yet meeting bvFTD diagnostic criteria, and 46 familial non-carrier controls. Current psychiatric symptoms, informant-reported symptoms and lifetime prevalence of psychiatric disorders were assessed with The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and the Neuropsychiatric Inventory Questionnaire. Fisher exact test was used to compare carriers and non-carriers' lifetime prevalence of six DSM-IV disorders: major depressive disorder, panic attacks, alcohol abuse, generalised anxiety disorder, panic disorder, and depressive disorder not otherwise specified. Other DSM-IV disorders had insufficient prevalence across our sample for between-group comparisons, but are reported. Non-carriers had greater prevalence of mood and anxiety disorders than has been reported for a general reference population. Preclinical carriers had lower lifetime prevalence of mood and anxiety disorders than non-carriers, except for depressive disorder not otherwise specified, an atypical syndrome comprising clinically significant depressive symptoms which fail to meet criteria for major depressive disorder. Findings suggest that early psychiatric symptoms of emergent bvFTD may manifest as emotional blunting or mood changes not cleanly conforming to criteria for a DSM-defined mood disorder. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Trends of indigenous healing among people with psychiatric disorders: comparative study of Arabic and Kurdish ethnicities in Iraq.

PubMed

Rahim, Twana Abdulrahman; Saeed, Banaz Adnan; Farhan, Hafidh Muhammed; Aziz, Rosh Rauf

2015-02-01

Indigenous healing is commonly practiced in Middle East. Little is known about trends of indigenous therapies among patients with psychiatric disorders in Iraq. To determine and compare rates and predictors of indigenous healings by individuals with psychiatric disorders, and the practiced rituals among Arabic and Kurdish ethnicities in Iraq, patients aged 18 year and older attending outpatients in Erbil and Najaf were assessed for their prior contacts with indigenous healers. About 48.9 % had indigenous healer's consultations before visiting their psychiatrists; the figure was three times higher among Arabs than Kurds. Higher consultation rate was detected among younger and less formally educated patients. Fourteen types of religious therapeutic rituals have been practiced. Indigenous healing is widespread in Iraq. It is more common among Arabs, younger and less educated people with psychiatric disorders. Participants consider indigenous healing for their psychiatric more than non-psychiatric disorders.

A reverse-translational study of dysfunctional exploration in psychiatric disorders: from mice to men.

PubMed

Perry, William; Minassian, Arpi; Paulus, Martin P; Young, Jared W; Kincaid, Meegin J; Ferguson, Eliza J; Henry, Brook L; Zhuang, Xiaoxi; Masten, Virginia L; Sharp, Richard F; Geyer, Mark A

2009-10-01

Bipolar mania and schizophrenia are recognized as separate disorders but share many commonalities, which raises the question of whether they are the same disorder on different ends of a continuum. The lack of distinct endophenotypes of bipolar mania and schizophrenia has complicated the development of animal models that are specific to these disorders. Exploration is fundamental to survival and is dysregulated in these 2 disorders. Although exploratory behavior in rodents has been widely studied, surprisingly little work has examined this critical function in humans. To quantify the exploratory behavior of individuals with bipolar mania and schizophrenia and to identify distinctive phenotypes of these illnesses. Static group comparison by the use of a novel human open field paradigm, the human Behavioral Pattern Monitor (BPM). Psychiatric hospital. Fifteen patients with bipolar mania and 16 patients with schizophrenia were compared with 26 healthy volunteers in the human BPM. The effects of amphetamine sulfate, the selective dopamine transporter inhibitor GBR12909, and the genetic knockdown of the dopamine transporter were compared with controls in the mouse BPM. The amount of motor activity, spatial patterns of activity, and exploration of novel stimuli were quantified in both the human and mouse BPMs. Patients with bipolar mania demonstrated a unique exploratory pattern, characterized by high motor activity and increased object exploration. Patients with schizophrenia did not show the expected habituation of motor activity. Selective genetic or pharmacologic inhibition of the dopamine transporter matched the mania phenotype better than the effects of amphetamine, which has been the criterion standard for animal models of mania. These findings validate the human open field paradigm and identify defining characteristics of bipolar mania that are distinct from those of schizophrenia. This cross-species study of exploration calls into question an accepted animal model of mania and should help to develop more accurate human and animal models, which are essential to the identification of the neurobiological underpinnings of neuropsychiatric disorders.

A reverse translational study of dysfunctional exploration in psychiatric disorders: from mice to men

PubMed Central

Perry, William; Minassian, Arpi; Paulus, Martin P.; Young, Jared W.; Kincaid, Meegin J.; Ferguson, Eliza J.; Henry, Brook L.; Zhuang, Xiaoxi; Masten, Virginia L.; Sharp, Richard F.; Geyer, Mark A.

2009-01-01

Context Bipolar mania and schizophrenia are recognized as separate disorders but share many commonalities, raising the question of whether they are in fact the same disorder on different ends of a continuum. The lack of distinct endophenotypes of bipolar mania and schizophrenia has complicated the development of animal models that are specific to these disorders. Exploration is fundamental to survival and is dysregulated in these two disorders. Although exploratory behavior in rodents has been widely studied, surprisingly little work has examined this critical function in humans. Objective We used a novel human open field paradigm, the human Behavioral Pattern Monitor (BPM), to quantify exploratory behavior of individuals with bipolar mania and schizophrenia and to identify distinctive phenotypes of these illnesses. Design Static group comparison. Setting Psychiatric hospital. Participants 15 bipolar mania and 16 schizophrenia subjects were compared to 26 healthy volunteers in the human BPM. The effects of amphetamine, the selective dopamine transporter (DAT) inhibitor GBR12909, and genetic knockdown of the DAT were compared to controls in the mouse BPM. Measures The amount of motor activity, spatial patterns of activity, and exploration of novel stimuli were quantified in both the human and mouse BPMs. Results Bipolar manic subjects demonstrated a unique exploratory pattern, characterized by high motor activity and increased object exploration. Schizophrenia subjects did not show the expected habituation of motor activity. Selective genetic or pharmacological inhibition of the DAT matched the mania phenotype better than the “gold standard” model of mania (amphetamine). Conclusion These findings validate the human open field paradigm and identify defining characteristics of bipolar mania that are distinct from schizophrenia. This cross-species study of exploration calls into question an accepted animal model of mania and should help to develop more accurate human and animal models, which are essential to identify neurobiological underpinnings of neuropsychiatric disorders. PMID:19805697

Research Applications of Magnetic Resonance Spectroscopy (MRS) to Investigate Psychiatric Disorders

PubMed Central

Dager, SR; Oskin, NM; Richards, TL; Posse, S

2009-01-01

Advances in magnetic resonance spectroscopy (MRS) methodology and related analytic strategies allow sophisticated testing of neurobiological models of disease pathology in psychiatric disorders. An overview of principles underlying MRS, methodological considerations and investigative approaches is presented. A review of recent research is presented that highlights innovative approaches applying MRS, in particular 1H MRS, to systematically investigate specific psychiatric disorders, including autism spectrum disorders, schizophrenia, panic disorder, major depression and bipolar disorder. PMID:19363431

Compulsive sexual behaviors--difficult aeromedical disposition.

PubMed

Koffman, R L; Berg, J S; Moore, J

1998-10-01

Axis I psychiatric disorders generally are considered incompatible with both the issuance and subsequent maintenance of aeromedical clearance certificates. Little doubt exists as to the impact that conditions such as anxiety disorders, mood disorders, or substance-related disorders have on the conduct of safe flight. Nevertheless, different compulsive sexual behaviors (CSBs), which now are thought to share similar origins and associated comorbidity, can similarly affect impulse control, judgment, concentration, and insight. Yet, these conditions frequently are handled administratively (if not legally). Moreover, in practice CSBs fall within a spectrum of behaviors from "normative" nonparaphilic sexuality to more deviant paraphilic behavior. Through the presentation of five selected cases seen at the Naval Operational Medicine Institute, this article explores examiner difficulty in establishing a diagnosis, discusses models useful in understanding the origins of these disorders, and highlights critical elements in establishing aeromedical disposition. The authors conclude that CSBs may be associated with anxiety, dysphoria, a pattern of increased risk taking, a high threshold for arousal, and poor judgment, which may impact the safety of flight. A comprehensive psychiatric evaluation is essential in determining aeromedical disposition, and consideration should be given to reviewing these cases from a medical perspective prior to any administrative disposition.

Parent-infant vocalisations at 12 months predict psychopathology at 7 years.

PubMed

Allely, C S; Purves, D; McConnachie, A; Marwick, H; Johnson, P; Doolin, O; Puckering, C; Golding, J; Gillberg, C; Wilson, P

2013-03-01

This study investigated the utility of adult and infant vocalisation in the prediction of child psychopathology. Families were sampled from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. Vocalisation patterns were obtained from 180 videos (60 cases and 120 randomly selected sex-matched controls) of parent-infant interactions when infants were one year old. Cases were infants who had been subsequently diagnosed aged seven years, with at least one psychiatric diagnostic categorisation using the Development and Wellbeing Assessment. Psychopathologies included in the case group were disruptive behaviour disorders, oppositional-conduct disorders, Attention Deficit Hyperactivity Disorder, pervasive development disorder, and emotional disorders. Associations between infant and parent vocalisations and later psychiatric diagnoses were investigated. Low frequencies of maternal vocalisation predicted later development of infant psychopathology. A reduction of five vocalisations per minute predicted a 44% (95%CI: 11-94%; p-value=0.006) increase in the odds of an infant being a case. No association was observed between infant vocalisations and overall case status. In sum, altered vocalisation frequency in mother-infant interactions at one year is a potential risk marker for later diagnosis of a range of child psychopathologies. Copyright © 2012 Elsevier Ltd. All rights reserved.

Psychiatric comorbidity and plasma levels of 2-acyl-glycerols in outpatient treatment alcohol users. Analysis of gender differences.

PubMed

García Marchena, Nuria; Araos, Pedro; Pavón, Francisco Javier; Ponce, Guillermo; Pedraz, María; Serrano, Antonia; Arias, Francisco; Romero-Sanchiz, Pablo; Suárez, Juan; Pastor, Antoni; De la Torre, Rafael; Torrens, Marta; Rubio, Gabriel; Rodríguez de Fonseca, Fernando

2016-09-29

Alcohol addiction is associated with high psychiatric comorbidity. Objective stratification of patients is necessary to optimize care and improve prognosis. The present study is designed to gain insights into this challenge by addressing the following objectives: a) to estimate the prevalence of psychiatric comorbidities in a sample of outpatients seeking treatment for alcohol use disorder, b) to describe the existence of gender differences and c) to validate 2-acyl-glycerols as biomarkers of alcohol use disorder and/or psychiatric comorbidity. One hundred and sixty-two patients were recruited and evaluated with the semi-structured interview PRISM. The presence of psychopathology was associated with a greater number of criteria for alcohol abuse and dependence according to DSM-IV-TR. We found gender differences in psychiatric comorbidity, e.g., mood disorder, as well as in comorbid substance use disorders. The prevalence of lifetime psychiatric comorbidity was 68.5%, with mood disorders the most frequent (37%), followed by attention deficit disorder (24.7%) and anxiety disorders (17.9%). Substance-induced disorders were more frequent in mood and psychotic disorders, whereas the primary disorders were more prevalent in patients with comorbid anxiety disorders. We found that 2-acyl-glycerols were significantly decreased in comorbid anxiety disorders in alcohol dependent patients in the last year, which makes them a potential biomarker for this psychopathological condition.

Traditional Chinese Medicine as a Basis for Treating Psychiatric Disorders: A Review of Theory with Illustrative Cases

PubMed Central

Aung, Steven K.H.; Fay, Heather

2013-01-01

Abstract Background: Integrative medicine is becoming increasingly accepted in the global scheme of health care. Traditional Chinese Medicine (TCM) is often included among integrative medicine modalities. Objective: This article provides a background for integration of acupuncture and other TCM-derived approaches to managing psychiatric conditions. Methods: Classical theories of TCM that pertain to psychiatric conditions are reviewed, focusing on concepts of energetic imbalance, the implications of mind–body–spirit connections, and treatment strategies that involve TCM modalities. An example of correlation between TCM patterns of disharmony and the Western diagnosis of generalized anxiety disorder (GAD) is given, along with an illustrative case in which counseling, medications, and acupuncture were combined in treatment. TCM principles are incorporated in certain energy psychology modalities, such as Emotional Freedom Technique (EFT). A case is presented demonstrating the integration of energy psychology with acupuncture, Qigong and hypnosis as an avenue for releasing pathogenic emotions. In classical TCM theory, assessing and treating spiritual disharmonies is fundamental for dealing with emotional disorders. Practical application in a clinical case is described. Conclusions: TCM offers a cogent theoretical basis for assessing and clinically managing patients presenting with mental health issues. TCM principles integrate well with other systems, including Western medicine. PMID:24761185

A common cognitive, psychiatric, and dysmorphic phenotype in carriers of NRXN1 deletion

PubMed Central

Viñas-Jornet, Marina; Esteba-Castillo, Susanna; Gabau, Elisabeth; Ribas-Vidal, Núria; Baena, Neus; San, Joan; Ruiz, Anna; Coll, Maria Dolors; Novell, Ramon; Guitart, Miriam

2014-01-01

Deletions in the 2p16.3 region that includes the neurexin (NRXN1) gene are associated with intellectual disability and various psychiatric disorders, in particular, autism and schizophrenia. We present three unrelated patients, two adults and one child, in whom we identified an intragenic 2p16.3 deletion within the NRXN1 gene using an oligonucleotide comparative genomic hybridization array. The three patients presented dual diagnosis that consisted of mild intellectual disability and autism and bipolar disorder. Also, they all shared a dysmorphic phenotype characterized by a long face, deep set eyes, and prominent premaxilla. Genetic analysis of family members showed two inherited deletions. A comprehensive neuropsychological examination of the 2p16.3 deletion carriers revealed the same phenotype, characterized by anxiety disorder, borderline intelligence, and dysexecutive syndrome. The cognitive pattern of dysexecutive syndrome with poor working memory and reduced attention switching, mental flexibility, and verbal fluency was the same than those of the adult probands. We suggest that in addition to intellectual disability and psychiatric disease, NRXN1 deletion is a risk factor for a characteristic cognitive and dysmorphic profile. The new cognitive phenotype found in the 2p16.3 deletion carriers suggests that 2p16.3 deletions might have a wide variable expressivity instead of incomplete penetrance. PMID:25614873

Current psychiatric disorders in patients with epilepsy are predicted by maltreatment experiences during childhood.

PubMed

Labudda, Kirsten; Illies, Dominik; Herzig, Cornelia; Schröder, Katharina; Bien, Christian G; Neuner, Frank

2017-09-01

Childhood maltreatment has been shown to be a risk factor for the development of psychiatric disorders. Although the prevalence of psychiatric disorders is high in epilepsy patients, it is unknown if childhood maltreatment experiences are elevated compared to the normal population and if early maltreatment is a risk factor for current psychiatric comorbidities in epilepsy patients. This is the main purpose of this study. Structured interviews were used to assess current Axis I diagnoses in 120 epilepsy patients from a tertiary Epilepsy Center (34 TLE patients, 86 non-TLE patients). Childhood maltreatment in the family and peer victimization were assessed with validated questionnaires. Patients' maltreatment scores were compared with those of a representative matched control group. Logistic regression analysis was conducted to assess the potential impact of childhood maltreatment on current psychiatric comorbidity in epilepsy patients. Compared to a matched control group, epilepsy patients had higher emotional and sexual maltreatment scores. Patients with a current psychiatric diagnosis reported more family and peer maltreatment than patients without a psychiatric disorder. Family maltreatment scores predicted the likelihood of a current psychiatric disorder. TLE patients did not differ from non-TLE patients according to maltreatment experiences and rates of current psychiatric disorders. Our findings suggest that in epilepsy patients emotional and sexual childhood maltreatment is experienced more often than in the normal population and that early maltreatment is a general risk factor for psychiatric comorbidities in this group. Copyright © 2017 Elsevier B.V. All rights reserved.

What kinds of things are psychiatric disorders?

PubMed

Kendler, K S; Zachar, P; Craver, C

2011-06-01

This essay explores four answers to the question 'What kinds of things are psychiatric disorders?' Essentialist kinds are classes whose members share an essence from which their defining features arise. Although elegant and appropriate for some physical (e.g. atomic elements) and medical (e.g. Mendelian disorders) phenomena, this model is inappropriate for psychiatric disorders, which are multi-factorial and 'fuzzy'. Socially constructed kinds are classes whose members are defined by the cultural context in which they arise. This model excludes the importance of shared physiological mechanisms by which the same disorder could be identified across different cultures. Advocates of practical kinds put off metaphysical questions about 'reality' and focus on defining classes that are useful. Practical kinds models for psychiatric disorders, implicit in the DSM nosologies, do not require that diagnoses be grounded in shared causal processes. If psychiatry seeks to tie disorders to etiology and underlying mechanisms, a model first proposed for biological species, mechanistic property cluster (MPC) kinds, can provide a useful framework. MPC kinds are defined not in terms of essences but in terms of complex, mutually reinforcing networks of causal mechanisms. We argue that psychiatric disorders are objectively grounded features of the causal structure of the mind/brain. MPC kinds are fuzzy sets defined by mechanisms at multiple levels that act and interact to produce the key features of the kind. Like species, psychiatric disorders are populations with central paradigmatic and more marginal members. The MPC view is the best current answer to 'What kinds of things are psychiatric disorders?'

Comparative Study on Knowledge About Autism Spectrum Disorder Among Paediatric and Psychiatric Nurses in Public Hospitals in Kumasi, Ghana.

PubMed

Sampson, Wireko-Gyebi; Sandra, Ashiagbor Emelia

2018-01-01

Despite the existence of autism spectrum disorder in Ghana, few studies have provided the necessary information on the phenomenon. These studies have mostly focused on speech and language therapy for children and modification of classroom environment for children with autism spectrum disorder. This approach has resulted in a paucity of knowledge on nurse's knowledge of autism spectrum disorder in Ghana. The study sought to assess the knowledge of paediatric and psychiatric on autism spectrum disorder. In this study, 130 paediatric and 93 psychiatric nurses sampled from five public hospitals in the Kumasi Metropolis participated in the survey. The Knowledge about Childhood Autism among Health Workers (KCAHW) questionnaire was employed to assess their knowledge of autism spectrum disorder. It emerged from the study that psychiatric nurses were more knowledgeable on autism spectrum disorder than paediatric nurses in general and specifically on each of the four domains on the KCAHW questionnaire. However, the level of knowledge on autism spectrum disorder among both groups of nurses remains low. Apart from the previous encounter, there were no significant differences between paediatric and psychiatric nurses' gender, age, marital status, working experience and their knowledge. In view of the findings, it will be appropriate for autism spectrum disorder to be included in the clinical training curriculum as well as the continuous professional education for both paediatric and psychiatric nurses. This will go a long way in helping paediatric and psychiatric nurses to increase their knowledge of autism spectrum disorder.

Executive functions and psychiatric symptoms in drug-refractory juvenile myoclonic epilepsy.

PubMed

Walsh, Jordana; Thomas, Rhys H; Church, Carla; Rees, Mark I; Marson, Anthony G; Baker, Gus A

2014-06-01

The pattern of executive dysfunction reported in juvenile myoclonic epilepsy (JME) resembles that of patients with cluster B personality disorders. This study examined whether executive dysfunction and maladaptive behavior reported in patients with JME are related. Sixty patients with drug-refractory JME were administered tests of intellect, memory, and executive dysfunction. Anxiety, depression, personality traits, impact of epilepsy, and perceived cognitive effects of antiepileptic drugs were measured. Half of the cohort exhibited moderate to severe anxiety symptoms. The patients performed most poorly on naming ability and inhibition switching. Duration of epilepsy exacerbated poor performance on inhibition switching. Females presented with pathological scores for neurotic and introvert traits and males for introvert traits. Abnormal personality traits and psychiatric disorders were associated with worse intellectual and executive functioning. People with extreme Eysenck Personality Scale - Brief Version (EPQ-BV) scores demonstrated the greatest level of executive impairment. Furthermore, the same degree of dysfunction was not seen in any individual with unremarkable EPQ-BV scores. This study indicates that specific patterns of executive dysfunction are related to maladaptive behavior in JME. Distinct behavioral patterns may be used to identify functional and anatomical differences between people with JME and for stratification to enable gene discovery. Copyright © 2014. Published by Elsevier Inc.

Personality traits and suicide attempts with and without psychiatric disorders: analysis of impulsivity and neuroticism.

PubMed

Bi, Bo; Liu, Wei; Zhou, Die; Fu, Xu; Qin, Xiaoxia; Wu, Jiali

2017-08-15

There is a critical need for empirical data concerning the association of personality traits and attempted suicide with and without psychiatric disorders in mainland China. The objective of the present study is to provide such data by determining the prevalence of psychiatric disorders and analyzing the levels of impulsivity and neuroticism among people who have attempted suicide, and to examine the association between these personality traits and suicide attempt in people with or without psychiatric disorders. We administered self-reported tests and clinical interviews to 196 people who have attempted suicide who were admitted to a hospital emergency room or our psychiatric settings after a suicide attempt. One hundred and fifty-six subjects (79.6%) met the criteria for Axis I disorders and eleven (6.6%) met the criteria Axis II personality disorders. Those who have attempted suicide who did not have psychiatric disorders exhibited a greater degree of background characteristics (e.g., high lethality, more interpersonal conflicts and more alcohol use), lower levels of suicidality (suicide risk, depressive symptoms) and differences of personality traits (e.g., more impulsive and less neuroticism) as compared to those who do have psychiatric disorders. Profile differences existed even after control for the stressful life event. Our findings suggest that some personality traits differ between people who have attempted suicide depending on whether or not they have psychiatric disorders. Based on these findings, investigating the impact of personality traits on suicidal behavior in therapeutic settings would provide critical data to improve patient treatment and outcomes.

A meta-analysis on the impact of psychiatric disorders and maltreatment on cognition.

PubMed

Masson, Marjolaine; East-Richard, Caroline; Cellard, Caroline

2016-02-01

Few studies have attempted to describe the range of cognitive impairments in individuals with psychiatric disorders who experienced maltreatment as children. The aims of this meta-analysis were to establish the impact of maltreatment and psychiatric disorders on cognition, and to examine the change in impact from childhood to adulthood. Twelve publications from 1970 to 2013 were included, with the following inclusion criteria: (a) individuals with a psychiatric disorder who experienced maltreatment, (b) use of at least 1 standardized neuropsychological measure, and (c) use of a control group without any psychiatric disorder or mistreatment. The majority of studies (10/12) were about posttraumatic stress disorder. Several effect sizes were calculated (Hedge's g) according to the cognitive domains. The results of the meta-analysis demonstrate that the combination of psychiatric disorders and childhood maltreatment has a negative impact on global cognitive performance, with a moderate effect size (g = -0.59). The most affected cognitive domains for individuals aged 7- to 18-years-old were visual episodic memory (g = -0.97), executive functioning (g = -0.90), and intelligence (g = -0.68). For individuals over the age of 18-years-old, the most affected cognitive domains were verbal episodic memory (g = -0.77), visuospatial/problem solving (g = -0.73), and attention (g = -0.72). The impact of maltreatment and psychiatric disorders was greater in children than in adults (slope = 0.008, p < .002). The results suggest that exposure to maltreatment and the presence of psychiatric disorders have a broad impact on cognition, with specific neuropsychological profile. PsycINFO Database Record (c) 2016 APA, all rights reserved.

Impulse control disorders are associated with multiple psychiatric symptoms in Parkinson's disease.

PubMed

Jaakkola, Elina; Kaasinen, Valtteri; Siri, Chiara; Martikainen, Kirsti; Cilia, Roberto; Niemelä, Solja; Joutsa, Juho

2014-01-01

Impulse control disorders can have serious adverse consequences to the life of a patient with Parkinson's disease. Although impulse control disorders are common, a possible psychiatric comorbidity has not been fully characterized. The aim of this study was to investigate the psychiatric symptoms exhibited by Parkinson's disease patients with impulse control disorders. The study was conducted as a postal survey to patients in the registry of the Finnish Parkinson Association. A total of 290 Parkinson's disease patients were evaluated for impulse control disorders using the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease. Psychiatric symptoms were systematically screened using the Symptom Checklist 90. We found that 108 of the evaluated patients had one or more impulse control disorders. Patients with impulse control disorders had markedly higher scores for symptoms of psychoticism (Bonferroni corrected p < 0.001), interpersonal sensitivity (p < 0.001), obsessive-compulsive disorder (p < 0.001), and depression (p = 0.01) when compared with patients without impulse control disorders. Impulse control disorders were shown to be independently associated with these symptoms. Patients with multiple impulse control disorders had higher scores for depression and obsessive-compulsive symptoms when compared with patients that exhibited only one impulse control disorder. COUNCLUSIONS: Our results confirm the previous observations that impulse control disorders in Parkinson's disease are linked with multiple psychiatric symptoms, including psychoticism, interpersonal sensitivity, obsessive-compulsive symptoms and depression. Clinicians treating these patients should acknowledge the concomitant psychiatric symptoms.

Risks of developing psychiatric disorders in pediatric patients with psoriasis.

PubMed

Kimball, Alexa B; Wu, Eric Q; Guérin, Annie; Yu, Andrew P; Tsaneva, Magda; Gupta, Shiraz R; Bao, Yanjun; Mulani, Parvez M

2012-10-01

Symptoms of psoriasis can be embarrassing and distressing, and may increase risk of developing psychiatric disorders in young people. We sought to compare incidences of psychiatric disorders between pediatric patients with psoriasis and psoriasis-free control subjects. Patients (<18 years) with continuous health plan enrollment 6 months before and after first psoriasis diagnosis (index date) were selected (Thomson Reuters MarketScan database, 2000-2006 [Thomson Reuters, New York, NY]). Patients with psoriasis (N = 7404) were matched 1:5 on age and sex to psoriasis-free control subjects (N = 37,020). Patients were followed from index date to first diagnosis of a psychiatric disorder (ie, alcohol/drug abuse, depression, anxiety disorder, bipolar disorder, suicidal ideation, eating disorder), end of data availability, or disenrollment. Patients with psychiatric diagnoses or psychotropic medication use before the index date were excluded. Cox proportional hazard models controlling for age, sex, and comorbidities were used to estimate the effect of psoriasis on risks of developing psychiatric disorders. Patients with psoriasis were significantly more at risk of developing psychiatric disorders versus control subjects (5.13% vs 4.07%; P = .0001; hazard ratio = 1.25; P = .0001), especially depression (3.01% vs 2.42%; P = .0036; hazard ratio = 1.25; P = .0053) and anxiety (1.81% vs 1.35%; P = .0048; hazard ratio = 1.32; P = .0045). Retrospective, observational studies of medical claims data are typically limited by overall quality and completeness of data and accuracy of coding for diagnoses and procedures. Pediatric patients with psoriasis had an increased risk of developing psychiatric disorders, including depression and anxiety, compared with psoriasis-free control subjects. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

[Somatic conditions in patients suffering from anxiety disorders].

PubMed

Pascual, Juan Carlos; Castaño, Juan; Espluga, Nuria; Díaz, Belén; García-Ribera, Carlos; Bulbena, Antonio

2008-03-08

Several studies have shown a higher prevalence of somatic illnesses in patients with anxiety disorders, especially cardiopathy, pneumopathy, digestive diseases and cephalea. The aim of this study was to investigate the comorbidity between anxiety disorders and medical illnesses in a group of patients with anxiety disorders compared with patients without psychiatric disorder attended at a primary care clinic and with psychiatric patients without anxiety pathology. Retrospective case-control study comparing 3 groups of patients paired by age and sex. The group of patients with anxiety disorders included 130 patients diagnosed by DSM-IV as panic disorders with/without agoraphobia and agoraphobia without panic attacks. There were 2 control groups: 150 patients without psychiatric disorder attended at primary care and 130 psychiatric patients without anxiety disorder attended at a psychiatric service. Patients with anxiety disorders showed higher risk of medical illnesses than patient without anxiety. Multivariate statistical logistic regression analysis showed that patients with anxiety presented 4.2-fold increase in the risk of cephalea, 3.9 of cardiopathy, 3.8 of osteomuscular disorder and 2-fold increase in the risk of digestive diseases. Patients with anxiety disorders presented higher risk of somatic illness. Similar physiopathology and genetic etiology could explain this association.

[Psychopathology of anxiety-phobic disorders that led to hospitalization in a psychiatric hospital].

PubMed

Chugunov, D A; Schmilovitch, A A

To study the psychopathology of anxiety-phobic disorders and motives of hospitalization of patients in a psychiatric hospital. One hundred and thirty-two patients were examined, 72 patients of the main group were admitted to general psychiatric departments, 60 patients of the control group in the sanatorium psychiatric departments. Clinical-psychopathological, follow-up, psychometric and statistical methods were used. Patients with hospital anxiety-phobic disorders had agoraphobia with panic disorder, social phobias, hypochondriacal phobias, specific phobias and multiple phobias. The main reasons for hospitalization were: the intensity of anxiety-phobic disorders, contrast content of phobias, multiplicity of anxiety-phobic disorders, ambulance calls, personality accentuations and rental aims.

Patterns of justice involvement among adults with schizophrenia and bipolar disorder: key risk factors.

PubMed

Robertson, Allison G; Swanson, Jeffrey W; Frisman, Linda K; Lin, Hsiuju; Swartz, Marvin S

2014-07-01

Adults with serious mental illness have a relatively high risk of criminal justice involvement. Some risk factors for justice involvement are known, but the specific interaction of these risk factors has not been examined. This study explored the interaction of gender, substance use disorder, and psychiatric diagnosis among patients with schizophrenia or bipolar disorder to identify subgroups at higher risk of justice involvement. Administrative service records of 25,133 adults with schizophrenia or bipolar disorder who were clients of Connecticut's public behavioral health system during 2005-2007 were merged with state records of criminal convictions, incarceration, and other measures of justice involvement. The main effects and the effects of interactions of gender, substance use disorder, and psychiatric diagnosis on risk of justice involvement ("offending") were estimated by using multivariable logistic regression. Men with bipolar disorder and co-occurring substance use disorder had the highest absolute risk of offending in every category of justice involvement. For both men and women, bipolar disorder was associated with an increased risk of offending versus schizophrenia, but the increase was significantly greater for women. Substance use disorder also increased risk of offending more among women than men, especially among those with schizophrenia. Men and women with bipolar disorder and substance use disorders have much higher risk of justice involvement than those with schizophrenia, especially those without a substance use disorder. Research is needed to validate these effects in other populations and specify risk factors for justice involvement among adults with mental illness.

Psychiatric symptoms and response quality to self-rated personality tests: Evidence from the PsyCoLaus study.

PubMed

Dupuis, Marc; Meier, Emanuele; Rudaz, Dominique; Strippoli, Marie-Pierre F; Castelao, Enrique; Preisig, Martin; Capel, Roland; Vandeleur, Caroline L

2017-06-01

Despite the fact that research has demonstrated consistent associations between self-rated measures of personality dimensions and mental disorders, little has been undertaken to investigate the relation between psychiatric symptoms and response patterns to self-rated tests. The aim of this study was to investigate the association between psychiatric symptoms and response quality using indices from our functional method. A sample of 1,784 participants from a Swiss population-based cohort completed a personality inventory (NEO-FFI) and a symptom checklist of 90 items (SCL-90-R). Different indices of response quality were calculated based on the responses given to the NEO-FFI. Associations among the responses to indices of response quality, sociodemographic characteristics and the SCL-90-R dimensions were then established. Psychiatric symptoms were associated with several important differences in response quality, questioning subjects' ability to provide valid information using self-rated instruments. As suggested by authors, psychiatric symptoms seem associated with differences in personality scores. Nonetheless, our study shows that symptoms are also related to differences in terms of response patterns as sources of differences in personality scores. This could constitute a bias for clinical assessment. Future studies could still determine whether certain subpopulations of subjects are more unable to provide valid information to self-rated questionnaires than others. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Sexual abuse and psychiatric disorder in England: results from the 2007 Adult Psychiatric Morbidity Survey.

PubMed

Jonas, S; Bebbington, P; McManus, S; Meltzer, H; Jenkins, R; Kuipers, E; Cooper, C; King, M; Brugha, T

2011-04-01

Evidence is accumulating that child sexual abuse (CSA) is associated with many psychiatric disorders in adulthood. This paper uses the detailed information available from the 2007 Adult Psychiatric Morbidity Survey of England (APMS 2007) to quantify links between CSA and a range of psychiatric conditions. The prevalence of psychiatric disorder was established in a random sample of the English household population (n=7403), which also provided sociodemographic and experiential information. We analyzed six types of common mental disorder, alcohol abuse and drug abuse, and people who screened positively for post-traumatic stress disorder (PTSD) and eating disorders. All were strongly and highly significantly associated with CSA, particularly if non-consensual sexual intercourse was involved, for which odds ratios (ORs) ranged from 3.7 to 12.1. These disorders were also related to adult sexual abuse (ASA), although the likelihood of reverse causality is then increased. Revictimization in adulthood was common, and increased the association of CSA with disorder. For several disorders, the relative odds were higher in females but formal tests for moderation by gender were significant only for common mental disorders and only in relation to non-consensual sexual intercourse. The population attributable fraction (PAF) was higher in females in all cases. The detailed and high-quality data in APMS 2007 provided important confirmation both of the strength of association of CSA with psychiatric disorder and of its relative non-specificity. Our results have major implications at the public health level and the individual level, in particular the need for better recognition and treatment of the sequelae of CSA.

Consequences of receipt of a psychiatric diagnosis for completion of college.

PubMed

Hunt, Justin; Eisenberg, Daniel; Kilbourne, Amy M

2010-04-01

The purpose of this study was to evaluate the independent associations between DSM-IV psychiatric disorders and the failure to complete college among college entrants. Data were from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). The sample included 15,800 adults, aged 22 years and older, who at least entered college. Diagnoses were made with the NESARC survey instrument, the Alcohol Use Disorder and Associated Disability Interview Schedule-DSM-IV Version. The large sample permitted analysis of multiple psychiatric disorders in the same multivariable logistic regression models. Given the frequent comorbidity of these disorders, this approach is an important step toward disentangling the independent roles of disorders in postsecondary educational outcomes. Evaluation of the independent associations between specific psychiatric disorders and postsecondary educational attainment showed that five diagnoses were positively and significantly associated with the failure to graduate from college. Four were axis I diagnoses: bipolar I disorder, marijuana use disorder, amphetamine use disorder, and cocaine use disorder. One was an axis II diagnosis: antisocial personality disorder. This study provides new data on DSM-IV diagnoses associated with the failure to complete postsecondary education. The findings suggest that psychiatric factors play a significant role in college academic performance, and the benefits of prevention, detection, and treatment of psychiatric illness may therefore include higher college graduation rates.

Psychotropic Medications and Substances of Abuse Interactions in Youth

ERIC Educational Resources Information Center

Kaminer, Yifrah; Goldberg, Pablo; Connor, Daniel F.

2010-01-01

The majority of youth with substance use disorders (SUDs) manifest one or more co-occurring psychiatric disorders. Consequently, many of these youths are being prescribed with psychotropic medications. As prescribing rates continue to increase for early-onset psychiatric disorders, potential risk for substance of abuse-psychiatric medication…

The Role of Sleep in Childhood Psychiatric Disorders

ERIC Educational Resources Information Center

Alfano, Candice A.; Gamble, Amanda L.

2009-01-01

Although sleep problems often comprise core features of psychiatric disorders, inadequate attention has been paid to the complex, reciprocal relationships involved in the early regulation of sleep, emotion, and behavior. In this paper, we review the pediatric literature examining sleep in children with primary psychiatric disorders as well as…

A Psychiatric Primer for Programs Serving People with Developmental Disabilities. Monograph #101.

ERIC Educational Resources Information Center

Dal Pozzo, Earlene; Bernstein, Gail S.

Intended for personnel in programs serving persons with developmental disabilities, the booklet provides basic information about the major psychiatric disorders and their treatment. Five sections cover: the major disorders; medications--uses and problems; assessment; cooordination of services; and psychiatric emergencies. Major disorders such as…

Self-Esteem of 8-14-Year-Old Children with Psychiatric Disorders: Disorder- and Gender-Specific Effects.

PubMed

Stadelmann, Stephanie; Grunewald, Madlen; Gibbels, Charlotte; Jaeger, Sonia; Matuschek, Tina; Weis, Steffi; Klein, Annette Maria; Hiemisch, Andreas; von Klitzing, Kai; Döhnert, Mirko

2017-02-01

In this study, we investigated the relation between global and domain-specific self-esteem and psychiatric disorders. A sample of 577 children aged 8-14 years was recruited via psychiatric hospitals and from the general population. Parents were given a diagnostic interview to assess children's psychiatric diagnoses (current/past). Parents and children completed questionnaires on child symptoms. Children completed a questionnaire on global and domain-specific self-esteem (scales: scholastic competence, social acceptance, athletic performance and physical appearance, global self-esteem). Self-esteem of children with current psychiatric disorders was lower than that of healthy controls (η p 2 between 0.01 and 0.08). Concerning scholastic competence, social acceptance and global self-esteem, children with past psychiatric disorders scored also lower than healthy controls. Different current psychiatric disorders showed specific but small effects on dimensions of self-esteem (β between -0.08 and 0.19). Moreover, we found a gender × group interaction, indicating that girls with depressive and adjustment disorders were specifically impaired in their global self-esteem and perception of their physical appearance. Findings might help clinicians to focus on particular domains of self-esteem during the diagnostic process and to define adequate treatment goals.

Psychosocial correlates of using faith healing services in Riyadh, Saudi Arabia: a comparative cross-sectional study.

PubMed

Alosaimi, Fahad D; Alshehri, Youssef; Alfraih, Ibrahim; Alghamdi, Ayedh; Aldahash, Saleh; Alkhuzayem, Haifa; Al-Beeshi, Haneen

2015-01-01

In this study, we compared the prevalence of psychiatric disorders and the characteristics of those who either use or do not use faith healers (FHs) services. We also assessed the independent factors of study subjects associated with using FHs. This cross-sectional study compared those who use FHs (n = 383) with a control group of those who do not use them (i.e., shopping mall visitors, n = 424) using a survey of sociodemographic characteristics and a validated Arabic version of the Mini International Neuropsychiatric Interview (MINI 6.0). Participants who ranked higher among FH users included males, people who were either married, divorced, or widowed, those with less education, and those with lower income. They were more likely to report past medical and psychiatric history. Those with diagnosable psychiatric disorders were more likely to visit FHs, especially if the diagnosis was of psychotic and bipolar disorders. The prevalence of psychiatric disorders was higher among FH users, and depressive and anxiety disorders were the most prevalent. The study showed that having past psychiatric history and a current psychiatric disorder are risk factors for using FHs. Also, a high percentage of FH users had a diagnosable psychiatric disorder. Further research should assess how to facilitate their access to the mental health system.

Treatment needs of prisoners with psychiatric disorders.

PubMed Central

Gunn, J; Maden, A; Swinton, M

1991-01-01

OBJECTIVE--To describe the prevalence of psychiatric disorder and the treatment needs of sentenced prisoners in England and Wales. DESIGN--Population survey based on a 5% sample of men serving prison sentences. SETTING--Sixteen prisons for adult males and nine institutions for male young offenders representative of all prisons in prison type, security levels, and length of sentences. SUBJECTS--406 young offenders and 1478 adult men, 404 and 1365 of whom agreed to be interviewed. MAIN OUTCOME MEASURES--History of psychiatric disorder, clinical diagnosis of psychiatrist, and required treatment. RESULTS--652 (37%) men had psychiatric disorders diagnosed, of whom 15 (0.8%) had organic disorders, 34 (2%) psychosis, 105 (6%) neurosis, 177 (10%) personality disorder, and 407 (23%) substance misuse. 52 (3%) were judged to require transfer to hospital for psychiatric treatment, 96 (5%) required treatment in a therapeutic community setting, and a further 176 (10%) required further psychiatric assessment or treatment within prison. CONCLUSIONS--By extrapolation the sentenced prison population includes over 700 men with psychosis, and around 1100 who would warrant transfer to hospital for psychiatric treatment. Provision of secure treatment facilities, particularly long term medium secure units, needs to be improved. Services for people with personality, sexual, and substance misuse disorders should be developed in both prisons and the health service. PMID:1912775

Psychiatric comorbidity and suicide risk in adolescents with chronic daily headache.

PubMed

Wang, Shuu-Jiun; Juang, Kai-Dih; Fuh, Jong-Ling; Lu, Shiang-Ru

2007-05-01

To investigate the prevalence and correlates of comorbid psychiatric disorders and suicidal risk in community-based adolescents with chronic daily headache (CDH). We identified and recruited 122 adolescents with CDH from a non-referral student sample (n = 7,900). CDH subtypes were classified according to the most updated criteria of the International Classification of Headache Disorders, 2nd edition (ICHD-2). An in-person psychiatric interview was performed with each subject with CDH to assess depressive and anxiety disorders and suicidal risk based on the Mini-International Neuropsychiatric Interview-Kid (MINI-Kid). Clinical correlates and impacts were investigated. A total of 121 subjects (31 male/90 female, mean age 13.8 years) finished the psychiatric interview. Fifty-seven subjects (47%) had > or =1 assessed psychiatric comorbidity with major depression (21%) and panic disorder (19%) as the two most common diagnoses. Current suicidal risk was assessed as high (score > or = 10) in 20% of subjects. Female gender and older age were associated with depressive disorders. Presence of migraine was associated with psychiatric comorbidities (OR = 3.5, p = 0.002). The associations with psychiatric disorders were stronger for migraine with aura than for migraine without aura. Migraine with aura also independently predicted a high suicidal risk (score > or = 10) (adjusted OR = 6.0, p = 0.028). In contrast, CDH subtypes, headache frequencies, or medication overuse were not correlated. Comorbid psychiatric disorders were not related to physician consultations or more days of sick leave. This community-based study showed high comorbidity of psychiatric disorders and suicidal risk in adolescents with chronic daily headache. The presence of migraine attacks, especially migraine with aura, was the major predictor for these associations.

Ghrelin-Derived Peptides: A Link between Appetite/Reward, GH Axis, and Psychiatric Disorders?

PubMed Central

Labarthe, Alexandra; Fiquet, Oriane; Hassouna, Rim; Zizzari, Philippe; Lanfumey, Laurence; Ramoz, Nicolas; Grouselle, Dominique; Epelbaum, Jacques; Tolle, Virginie

2014-01-01

Psychiatric disorders are often associated with metabolic and hormonal alterations, including obesity, diabetes, metabolic syndrome as well as modifications in several biological rhythms including appetite, stress, sleep–wake cycles, and secretion of their corresponding endocrine regulators. Among the gastrointestinal hormones that regulate appetite and adapt the metabolism in response to nutritional, hedonic, and emotional dysfunctions, at the interface between endocrine, metabolic, and psychiatric disorders, ghrelin plays a unique role as the only one increasing appetite. The secretion of ghrelin is altered in several psychiatric disorders (anorexia, schizophrenia) as well as in metabolic disorders (obesity) and in animal models in response to emotional triggers (psychological stress …) but the relationship between these modifications and the physiopathology of psychiatric disorders remains unclear. Recently, a large literature showed that this key metabolic/endocrine regulator is involved in stress and reward-oriented behaviors and regulates anxiety and mood. In addition, preproghrelin is a complex prohormone but the roles of the other ghrelin-derived peptides, thought to act as functional ghrelin antagonists, are largely unknown. Altered ghrelin secretion and/or signaling in psychiatric diseases are thought to participate in altered appetite, hedonic response and reward. Whether this can contribute to the mechanism responsible for the development of the disease or can help to minimize some symptoms associated with these psychiatric disorders is discussed in the present review. We will thus describe (1) the biological actions of ghrelin and ghrelin-derived peptides on food and drugs reward, anxiety and depression, and the physiological consequences of ghrelin invalidation on these parameters, (2) how ghrelin and ghrelin-derived peptides are regulated in animal models of psychiatric diseases and in human psychiatric disorders in relation with the GH axis. PMID:25386163

ASD Traits and Co-Occurring Psychopathology: The Moderating Role of Gender

ERIC Educational Resources Information Center

Kreiser, Nicole L.; White, Susan W.

2015-01-01

The higher prevalence of autism spectrum disorder (ASD) in males, relative to that seen in females, is a well-replicated phenomenon. A growing body of research has suggested that there may be gender differences in core ASD deficits and patterns of psychiatric comorbidity among adolescents and adults with ASD. The present study sought to determine…

Suicidal Attempt and Psychiatric Disorders in Iran

ERIC Educational Resources Information Center

Mohammadi, Mohammad-Reza; Ghanizadeh, Ahmad; Rahgozart, Mehdi; Noorbala, Ahmad Ali; Malekafzali, Hossein; Davidian, Haratoun; Naghavi, Hamidreza; Soori, Hamid; Yazdi, Seyed Abbas Bagheri

2005-01-01

This study is part of broader research aimed to determine the lifetime prevalence and pattern of comorbidity on self-reported suicidal attempts in the general population of Iran. Overall, 25,180 subjects were interviewed, face-to-face, at home; the lifetime prevalence was 1.4% (0.9% males and 2% females). The majority of attempters were 26-55…

Language Deficits in Children with Psychiatric Disorders: Educational Implications.

ERIC Educational Resources Information Center

Lutz, Margaret M.

The study was designed to determine if there was an identifiable pattern of language deficit in 10 children (6 to 12 years old) undergoing treatment in a hospital inpatient psychiatry ward for behavioral and emotional problems. Ss were administered the standard hearing and speech clinic test battery which included the Binet Memory for Sentences,…

[The role of psychological factors and psychiatric disorders in skin diseases].

PubMed

Kieć-Swierczyńska, Marta; Dudek, Bohdan; Krecisz, Beata; Swierczyńska-Machura, Dominika; Dudek, Wojciech; Garnczarek, Adrianna; Turczyn, Katarzyna

2006-01-01

In this paper, the relation between psychological factors and psychiatric disorders in patients with skin diseases is discussed. On the one hand psychological factors (stress, negative emotions) can influence the generation and aggravation of skin disorders (urticaria, atopic dermatitis, vitiligo), on the other hand psychological disorders can result in some skin diseases (psoriasis, atopic dermatitis). In the majority of cases the quality of life is poorly estimated by patients with skin problems. Psychodermatology is divided into three categories according to the relationship between skin diseases and mental disorders: 1) psychophysiologic disorders caused by skin diseases triggering different emotional states (stress), but not directly combined with mental disorders (psoriasis, eczema); 2) primary psychiatric disorders responsible for self-induced skin disorders (trichotillomania); and 3) secondary psychiatric disorders caused by disfiguring skin (ichthyosis, acne conglobata, vitiligo), which can lead to states of fear, depression or suicidal thoughts.

Risk of new psychiatric episodes in the year following divorce in midlife: cause or selection? A nationwide register-based study of 703,960 individuals.

PubMed

Björkenstam, Emma; Hallqvist, Johan; Dalman, Christina; Ljung, Rickard

2013-12-01

To examine if divorce is associated with an increased risk of psychiatric disorder. A register-based cohort study of all married or divorced individuals aged 45-54 in Sweden in 2006. After exclusion of 129,669 individuals with a history of psychiatric care in 1987-2005, we followed 703,960 persons for psychiatric disorder during 2007, measured as psychiatric inpatient care, outpatient care and use of psychotropic medication. Marital trajectories were taken into consideration. Data were analysed using Poisson regression. Divorced women and men had a higher risk for psychiatric inpatient care compared to married (ORwomen = 3.2, 95%CI = 1.6-6.3, ORmen = 3.3, 95%CI = 2.0-5.4). The longer the marriage, the lower the risk for psychiatric disorders. Lower educational level increased the risk for psychiatric inpatient care. In conclusion, our study supports both the selection hypothesis, linking healthy individuals to long and stable marriages, and the social causation hypothesis, linking the stress of recent divorce to increased psychiatric disorder for both women and men.

Access to Pharmacotherapy Amongst Women with Bipolar Disorder during Pregnancy: a Preliminary Study.

PubMed

Byatt, Nancy; Cox, Lucille; Moore Simas, Tiffany A; Biebel, Kathleen; Sankaran, Padma; Swartz, Holly A; Weinreb, Linda

2018-03-01

Bipolar disorder among pregnant women has deleterious effects on birth and child outcomes and is currently under-detected, not addressed effectively, or exacerbated through inappropriate treatment. The goal of this study was to identify perspectives of pregnant and postpartum women with bipolar disorder on barriers and facilitators to psychiatric treatment during pregnancy. In-depth interviews were conducted with pregnant and postpartum women who scored ≥ 10 on the Edinburgh Postnatal Depression Scale and met DSM-IV criteria for bipolar disorder I, II or not otherwise specified using the Mini International Neuropsychiatric Interview version 5.0. Interviews were transcribed, and resulting data were analyzed using a grounded theory approach to identify barriers and facilitators to bipolar disorder treatment access in pregnancy. Participant identified barriers included perception that psychiatric providers lack training and experience in the treatment of psychiatric illness during pregnancy, are reluctant to treat bipolar disorder among pregnant women, and believe that pharmacotherapy is not needed for psychiatric illness during pregnancy. Facilitators included participants' perception that providers' acknowledge risks associated with untreated or undertreated psychiatric illness during pregnancy and provide psycho-education about the risks, benefits and alternatives to pharmacotherapy. Psychiatric providers are critically important to the treatment of bipolar disorder and need knowledge and skills necessary to provide care during the perinatal period. Advancing psychiatric providers' knowledge/skills may improve access to pharmacotherapy for pregnant women with bipolar disorder.

Psychiatric comorbidity, psychological distress, and quality of life in gamma-hydroxybutyrate-dependent patients.

PubMed

Kamal, Rama M; Dijkstra, Boukje A G; de Weert-van Oene, Gerdien H; van Duren, Josja A M; de Jong, Cornelis A J

2017-01-01

Understanding the psychiatric state and psychological distress level of patients with gamma-hydroxybutyrate dependence is important to develop effective detoxification and relapse management methods. The aim of the current study was to assess the prevalence among gamma-hydroxybutyrate-dependent individuals of psychiatric comorbidity and psychological distress levels and their association with the individuals' pattern of misuse and quality of life. There were 98 patients tested with the Mini International Neuropsychiatric Interview-plus, the Brief Symptom Inventory, the Depression Anxiety Stress scale, and the EuroQoL-5D as a part of the Dutch gamma-hydroxybutyrate detoxification monitor in 7 addiction treatment centers. Participants were selected from those undergoing inpatient gamma-hydroxybutyrate detoxification treatment between March 2011 and September 2012. Males accounted for 68% of the participants and the average age was 28-years-old. A high rate of psychiatric comorbidity (79%) was detected, including anxiety (current 38%, lifetime 40%), mood (13%, 31%), and psychotic disorders (13%, 21%). The level of psychological distress was significantly higher than the standard outpatient reference group, especially in patients with current psychiatric comorbidity (Brief Symptom Inventory Global Severity Index mean 1.61 versus 1.09, p ≤ 0.01). Increased gamma-hydroxybutyrate misuse (higher dose and shorter interval between doses) was associated with the presence of lifetime psychosis, current mood disorders (r pb = 0.23, p = 0.025), and psychoticism as a symptom of psychological distress. Current anxiety, mood disorders and high psychological stress had a negative effect on participants' quality of life. Gamma-hydroxybutyrate dependence is characterized by serious psychiatric comorbidity and psychological distress, both of which are, in turn, associated with increased gamma-hydroxybutyrate use and a lower quality of life. This needs to be considered during detoxification to avoid complicated withdrawal. Providing treatment for patients' mental health issues is vital for ensuring treatment compliance, avoiding relapse and improving the patients' quality of life.

Psychological factors in the irritable bowel syndrome.

PubMed Central

Creed, F; Guthrie, E

1987-01-01

This paper reviews recent psychological studies of patients with the irritable bowel syndrome (IBS) or 'functional abdominal pain'. Many studies have used unreliable or invalid methods of assessment and some have confused personality with treatable psychiatric illness. Reliable and valid measures have indicated that 40-50% of patients with recently diagnosed functional abdominal pain have demonstrable psychiatric illness; these patients have a worse prognosis than those who are psychologically normal. When psychiatric disorder is diagnosed in a patient with IBS there are three possibilities: (1) The patient may have developed abdominal and psychiatric symptoms simultaneously in which case treatment of the latter may relieve the bowel symptoms. (2) Psychiatric disorder may precipitate increased concern about bowel symptoms, and consequent attendance at the gastroenterology clinic, of those with chronic mild symptoms. In this case it is illness behaviour, rather than abdominal symptoms, that is caused by the anxiety/depression. (3) Those with chronic neurotic symptoms as part of their personality must be screened for organic disease if they have a fresh onset of bowel symptoms; but they are at high risk of becoming persistent clinic attenders. Further research is needed to clarify when psychological abnormalities play a role in the aetiology of IBS and when they are coincidental, but lead to illness behaviour. The role of psychological factors in the aetiology of the irritable bowel syndrome (IBS) is far from clear, but a review of the literature suggests that some consistent patterns are emerging in spite of methodological problems. There have been three major defects with studies that have linked IBS with neurotic symptomatology. First, the measurement of psychological factors has generally been imprecise. Second, most studies have considered IBS patients as a single group, without making allowance for differing symptom patterns. Third, conclusions have been drawn about hospital samples and extrapolated to all IBS subjects, without taking account of factors which affect consulting behaviour. Most studies have been concerned with psychological factors so these will be considered in most detail. PMID:3315878

The mental health of UK Gulf war veterans: phase 2 of a two phase cohort study.

PubMed

Ismail, Khalida; Kent, Kate; Brugha, Traolach; Hotopf, Matthew; Hull, Lisa; Seed, Paul; Palmer, Ian; Reid, Steve; Unwin, Catherine; David, Anthony S; Wessely, Simon

2002-09-14

To examine the prevalence of psychiatric disorders in veterans of the Gulf war with or without unexplained physical disability (a proxy measure of ill health) and in similarly disabled veterans who had not been deployed to the Gulf war (non-Gulf veterans). Two phase cohort study. Current and ex-service UK military personnel. Phase 1 consisted of three randomly selected samples of Gulf veterans, veterans of the 1992-7 Bosnia peacekeeping mission, and UK military personnel not deployed to the Gulf war (Era veterans) who had completed a postal health questionnaire. Phase 2 consisted of randomly selected subsamples from phase 1 of Gulf veterans who reported physical disability (n=111) or who did not report disability (n=98) and of Bosnia (n=54) and Era (n=79) veterans who reported physical disability. Psychiatric disorders assessed by the schedule for clinical assessment in neuropsychiatry and classified by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. Only 24% (n=27) of the disabled Gulf veterans had a formal psychiatric disorder (depression, anxiety, or alcohol related disorder). The prevalence of psychiatric disorders in non-disabled Gulf veterans was 12%. Disability and psychiatric disorders were weakly associated in the Gulf group when confounding was adjusted for (adjusted odds ratio 2.4, 99% confidence interval 0.8 to 7.2, P=0.04). The prevalence of psychiatric disorders was similar in disabled non-Gulf veterans and disabled Gulf veterans ( 19% v 24%; 1.3, 0.5 to 3.4). All groups had rates for post-traumatic stress disorder of between 1% and 3%. Most disabled Gulf veterans do not have a formal psychiatric disorder. Post-traumatic stress disorder is not higher in Gulf veterans than in other veterans. Psychiatric disorders do not fully explain self reported ill health in Gulf veterans; alternative explanations for persistent ill health in Gulf veterans are needed.

Clinical and Functional Outcome of Childhood ADHD 33 Years Later

PubMed Central

Klein, Rachel G.; Mannuzza, Salvatore; Ramos Olazagasti, María A.; Roizen Belsky, Erica; Hutchison, Jesse A.; Lashua-Shriftman, Erin; Castellanos, F. Xavier

2012-01-01

Context Prospective studies of childhood attention deficit/hyperactivity disorder (ADHD) have not extended beyond early adulthood. Objective To test whether children diagnosed with ADHD at mean age 8 (probands) have worse educational, occupational, economic, social, marital outcomes; higher rates of ongoing ADHD, antisocial personality disorder (ASPD), substance disorders (SD); adult onset psychiatric disorders, psychiatric hospitalizations and incarcerations, than non-ADHD comparisons, at mean age 41. To test for: positive associations between probands’ ongoing ADHD and ASPD, and SD’s; and for worse social and occupational functioning in probands without ongoing psychiatric disorders, than comparisons. Design Prospective, 33 year follow-up study, with blind clinical assessments. Setting Research clinic. Participants 135 Caucasian males with ADHD in childhood, free of conduct disorder, and 136 male comparisons without childhood ADHD (65% and 76% of original cohort, respectively). Main Outcome Measures Occupational, economic, and educational attainment; marital history; occupational and social functioning; ongoing and lifetime psychiatric disorders; psychiatric hospitalizations, and incarcerations. Results Probands had significantly worse educational, occupational, economic, social outcomes, and more divorces than comparisons; higher rates of ongoing ADHD (22% vs 5%, p<.001), ASPD (16% vs 0%, p<.001)and SD (14% vs 5%, p<.01), but not more mood or anxiety disorders (p’s=.36 and .33). Ongoing ADHD was weakly related to ongoing SD (phi=.19, p=.04), and ASPD+SD (phi=.20, p=.04). Lifetime, probands had significantly more ASPD and SD’s, but not mood or anxiety disorders, and more psychiatric hospitalizations and incarcerations than comparisons. Relative to comparisons, psychiatric disorders with onsets at age 21 or beyond were not significantly elevated in probands. Probands without ongoing psychiatric disorders had worse social, but not occupational, functioning. Conclusions The multiple disadvantages predicted by childhood ADHD well into adulthood began in adolescence, without increased onsets of new disorders after age 20. Findings highlight the importance of extended monitoring and treatment of children with ADHD. PMID:23070149

Mental health trajectories from adolescence to adulthood: Language disorder and other childhood and adolescent risk factors.

PubMed

Bao, Lin; Brownlie, E B; Beitchman, Joseph H

2016-05-01

Longitudinal research on mental health development beyond adolescence among nonclinical populations is lacking. This study reports on psychiatric disorder trajectories from late adolescence to young adulthood in relation to childhood and adolescent risk factors. Participants were recruited for a prospective longitudinal study tracing a community sample of 5-year-old children with communication disorders and a matched control cohort to age 31. Psychiatric disorders were measured at ages 19, 25, and 31. Known predictors of psychopathology and two school-related factors specifically associated with language disorder (LD) were measured by self-reports and semistructured interviews. The LD cohort was uniquely characterized by a significantly decreasing disorder trajectory in early adulthood. Special education was associated with differential disorder trajectories between LD and control cohorts, whereas maltreatment history, specific learning disorder, family structure, and maternal psychological distress were associated with consistent trajectories between cohorts. From late adolescence to young adulthood, childhood LD was characterized by a developmentally limited course of psychiatric disorder; maltreatment was consistently characterized by an elevated risk of psychiatric disorder regardless of LD history, whereas special education was associated with significantly decreasing risk of psychiatric disorder only in the presence of LD.

The mental health of UK Gulf war veterans: phase 2 of a two phase cohort study

PubMed Central

Ismail, Khalida; Kent, Kate; Brugha, Traolach; Hotopf, Matthew; Hull, Lisa; Seed, Paul; Palmer, Ian; Reid, Steve; Unwin, Catherine; David, Anthony S; Wessely, Simon

2002-01-01

Objectives To examine the prevalence of psychiatric disorders in veterans of the Gulf war with or without unexplained physical disability (a proxy measure of ill health) and in similarly disabled veterans who had not been deployed to the Gulf war (non-Gulf veterans). Design Two phase cohort study. Setting Current and ex-service UK military personnel. Participants Phase 1 consisted of three randomly selected samples of Gulf veterans, veterans of the 1992-7 Bosnia peacekeeping mission, and UK military personnel not deployed to the Gulf war (Era veterans) who had completed a postal health questionnaire. Phase 2 consisted of randomly selected subsamples from phase 1 of Gulf veterans who reported physical disability (n=111) or who did not report disability (n=98) and of Bosnia (n=54) and Era (n=79) veterans who reported physical disability. Main outcome measure Psychiatric disorders assessed by the schedule for clinical assessment in neuropsychiatry and classified by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. Results Only 24% (n=27) of the disabled Gulf veterans had a formal psychiatric disorder (depression, anxiety, or alcohol related disorder). The prevalence of psychiatric disorders in non-disabled Gulf veterans was 12%. Disability and psychiatric disorders were weakly associated in the Gulf group when confounding was adjusted for (adjusted odds ratio 2.4, 99% confidence interval 0.8 to 7.2, P=0.04). The prevalence of psychiatric disorders was similar in disabled non-Gulf veterans and disabled Gulf veterans ( 19% v 24%; 1.3, 0.5 to 3.4). All groups had rates for post-traumatic stress disorder of between 1% and 3%. Conclusions Most disabled Gulf veterans do not have a formal psychiatric disorder. Post-traumatic stress disorder is not higher in Gulf veterans than in other veterans. Psychiatric disorders do not fully explain self reported ill health in Gulf veterans; alternative explanations for persistent ill health in Gulf veterans are needed. What is already known on this topicGulf veterans report medically unexplained symptoms more often than non-Gulf veteransThe clinical characteristics of ill health in Gulf veterans are not well known, and factors associated with ill health in Gulf veterans are poorly understoodWhat this study addsMost ill Gulf veterans do not have a formal psychiatric disorderThe rates for post-traumatic stress disorder are lowPsychiatric morbidity is not strongly associated with ill health in Gulf veteransThe rates for somatoform disorders are three times greater in disabled Gulf veterans than they are in disabled non-Gulf veterans PMID:12228134

Psychiatric disorders in youth in juvenile detention.

PubMed

Teplin, Linda A; Abram, Karen M; McClelland, Gary M; Dulcan, Mina K; Mericle, Amy A

2002-12-01

Given the growth of juvenile detainee populations, epidemiologic data on their psychiatric disorders are increasingly important. Yet, there are few empirical studies. Until we have better epidemiologic data, we cannot know how best to use the system's scarce mental health resources. Using the Diagnostic Interview Schedule for Children version 2.3, interviewers assessed a randomly selected, stratified sample of 1829 African American, non-Hispanic white, and Hispanic youth (1172 males, 657 females, ages 10-18 years) who were arrested and detained in Cook County, Illinois (which includes Chicago and surrounding suburbs). We present 6-month prevalence estimates by demographic subgroups (sex, race/ethnicity, and age) for the following disorders: affective disorders (major depressive episode, dysthymia, manic episode), anxiety (panic, separation anxiety, overanxious, generalized anxiety, and obsessive-compulsive disorders), psychosis, attention-deficit/hyperactivity disorder, disruptive behavior disorders (oppositional defiant disorder, conduct disorder), and substance use disorders (alcohol and other drugs). Nearly two thirds of males and nearly three quarters of females met diagnostic criteria for one or more psychiatric disorders. Excluding conduct disorder (common among detained youth), nearly 60% of males and more than two thirds of females met diagnostic criteria and had diagnosis-specific impairment for one or more psychiatric disorders. Half of males and almost half of females had a substance use disorder, and more than 40% of males and females met criteria for disruptive behavior disorders. Affective disorders were also prevalent, especially among females; more than 20% of females met criteria for a major depressive episode. Rates of many disorders were higher among females, non-Hispanic whites, and older adolescents. These results suggest substantial psychiatric morbidity among juvenile detainees. Youth with psychiatric disorders pose a challenge for the juvenile justice system and, after their release, for the larger mental health system.

Sleep Resilience, Comorbid Anxiety, and Treatment in a Muring Model of PTSD

DTIC Science & Technology

2012-12-01

INTRODUCTION PTSD is a prevalent psychiatric disorder characterized by intrusive thoughts and images during wake and sleep, hyperarousal, and...compared to CS-. (E) time in REM sleep was averaged in two hour bins across the 24 hour re-exposure period for animals that were re-exposed to the CS...compared to CS-. 9 (Figure 5E), a pattern of decreased REM during the dark period in the mtHC group (Figure 5F) paralleled the pattern of

Psychiatric diagnosis and differential risks of offending following discharge.

PubMed

Coid, Jeremy W; Yang, Min; Ullrich, Simone; Hickey, Nicole; Kahtan, Nadji; Freestone, Mark

2015-01-01

Psychiatric diagnosis is not considered a risk factor for offending following discharge. However, treatment interventions and aftercare are strongly influenced by clinical primary diagnosis. We compared differential risks of reoffending of patients falling into six primary diagnostic categories following discharge from Medium Secure Units in the UK: schizophrenia/schizoaffective disorder; delusional disorder; mania/hypomania; depressive disorder; organic brain syndrome; personality disorder. We followed up 1344 patients, on average 6.2 years (SD=2.1) at risk, discharged from 7 of 14 Regional Medium Secure services in England and Wales. Outcomes were period prevalence, incidence, and cumulative probability of criminal conviction. Established demographic and criminal history predictors of reoffending were observed across different diagnostic categories. Risks of all offending were increased for personality disorder, violence/acquisitive offending for delusional disorder, sexual offending for mania/hypomania and violence/acquisitive offending for organic brain syndrome. Patterns of risk over time differed markedly between categories of mental disorder. Most patients with personality disorder who offended violently did so within 4 years of discharge. A subgroup with delusional disorder demonstrated increased risk of violent offending 5 years after discharge. Differential risks of reoffending are observed between different diagnostic groups. Clinical diagnosis should be included together with established risk measures in risk management following discharge. Close supervision of patients with personality disorder should begin immediately after discharge when risks of reoffending are greatest. For delusional disorder further investigation is needed into the marked increase in risk of violence after 5 years. Copyright © 2015 Elsevier Ltd. All rights reserved.

Impact of psychiatric disorders on the quality of life of brazilian HCV-infected patients.

PubMed

Batista-Neves, Susana; Quarantini, Lucas C; Galvão-de Almeida, Amanda; Cardeal, Maurício; Lacerda, Acioly L; Paraná, Raymundo; Reis de-Oliveira, Irismar; Bressan, Rodrigo A; Miranda-Scippa, Angela

2009-02-01

The aim of our study was to determine the impact of psychiatric comorbidities on the health-related quality of life of HCV-infected patients. Assessment of clinical, socio-demographic and quality of life data of the patients followed up at a Hepatology unit was performed by using a standard questionnaire and the SF-36 instrument. Psychiatric diagnoses were confirmed by using the Mini International Neuropsychiatric Interview, Brazilian version 5.0.0 (MINI Plus). Evaluation using the MINI plus demonstrated that 46 (51%) patients did not have any psychiatric diagnosis, while 44 (49%) had at least one psychiatric diagnosis. Among patients with a psychiatric comorbidity, 26 (59.1%) had a current mental disorder, out of which 22 (84.6%) had not been previously diagnosed. Patients with psychiatric disorders had lower scores in all dimensions of the SF-36 when compared to those who had no psychiatric diagnosis. Scores of physical functioning and bodily pain domains were lower for those suffering from a current psychiatric disorder when compared to those who had had a psychiatric disorder in the past. Females had lower scores of bodily pain and mental health dimensions when compared to males. Scores for mental health dimension were also lower for patients with advanced fibrosis. The presence of a psychiatric comorbidity was the variable that was most associated with the different scores in the SF-36, compared to other variables such as age, gender, aminotransferase levels, and degree of fibrosis.

Detained Male Adolescent Offender's Emotional, Physical and Sexual Maltreatment Profiles and Their Associations to Psychiatric Disorders and Criminal Behaviors.

PubMed

Aebi, Marcel; Linhart, Susanne; Thun-Hohenstein, Leonhard; Bessler, Cornelia; Steinhausen, Hans-Christoph; Plattner, Belinda

2015-07-01

The objective of the present study was to analyse patterns of emotional, physical and sexual maltreatment in detained male juvenile offenders using latent class analysis (LCA). The association of maltreatment related LCA profiles with psychopathology and criminal behaviors was also studied. LCA based on the items of the Child Trauma Questionnaire (CTQ) assessing childhood emotional, physical, and sexual abuse was performed in a sample of 260 male adolescent offenders (mean age = 16.5 years, SD = 1.29 years). Chi square tests and general linear models were performed to assess the associations of CTQ profiles with categorical interview-based psychiatric disorders, dimensional Youth Self-Report problem scales, and officially registered offenses. LCA suggested a three class solution: (1) a no/mild trauma (NM; 76 %) (2) emotional and physical trauma (EP; 18 %) and (3) emotional, physical, and sexual trauma (EPS; 8 %). The classes EP and EPS were related to a variety of psychiatric disorders and self-reported mental health problems. Furthermore, EPS showed higher presence of a subsequent re-incarceration compared to NM. A majority of sexually abused juveniles also experienced emotional and physical abuse reflecting gravely disturbed family systems. Multiple abuse in childhood was associated with a broad variety of disorders including externalizing disorders and repeated criminal offending. Such findings indicate that trauma assessment is also relevant in externalizing youth. A comprehensive treatment approach for detained boys with multiple abuse experiences is required targeting both mental health needs and the reduction of criminal behaviors.

Psychiatric disorders and symptoms severity in preschool children with atopic eczema.

PubMed

Catal, F; Topal, E; Soylu, N; Ozel Ozcan, O; Celiksoy, M H; Babayiğit, A; Karakoç, H T E; Erge, D; Sancak, R

2016-01-01

To compare with a control group the frequency of psychiatric disorders and severity of psychiatric symptoms in preschool children with atopic eczema. The study included children between the ages of 3-5 who were diagnosed to have atopic eczema. The parents of the children with atopic eczema were interviewed in person and were asked to fill in "The Early Childhood Inventory-4" form. This form assesses the psychiatric disorders and symptoms severity in children between the ages of 3-5. The atopic eczema group included 80 patients (38 male, 42 female) with a mean age of 48.4 ± 15.7 months and the control group included 74 patients (41 male, 33 female) with a mean age of 49.9 ± 15.19 months. It was established that 68.8% of the group with atopic eczema received at least one psychiatric diagnosis. Between the psychiatric disorders, ADHD (Odds ratio: 2.57, 95% CI: 1.049-6.298, p=0.035), enuresis and encopresis (Odds ratio: 2.39, 95% CI: 1.121-5.097, p=0.022) and attachment disorder (Odds ratio: 2.03, 95% CI: 1.046-3.953, p=0.035) were found to be significantly higher when compared with the healthy control group. When the groups were compared in terms of psychiatric symptom severity scores calculated by using ECI-4, ADHD severity (p=0.043), conduct disorder severity (p=0.001), anxiety disorders severity (p<0.001), eating disorders severity (p=0.011) and tic disorder severity (p=0.01) were found to be higher in the atopic eczema group. Psychiatric illnesses are frequent in preschool children with atopic eczema. Copyright © 2015 SEICAP. Published by Elsevier Espana. All rights reserved.

Comparative Study on Knowledge About Autism Spectrum Disorder Among Paediatric and Psychiatric Nurses in Public Hospitals in Kumasi, Ghana

PubMed Central

Sampson, Wireko-Gyebi; Sandra, Ashiagbor Emelia

2018-01-01

Background: Despite the existence of autism spectrum disorder in Ghana, few studies have provided the necessary information on the phenomenon. These studies have mostly focused on speech and language therapy for children and modification of classroom environment for children with autism spectrum disorder. This approach has resulted in a paucity of knowledge on nurse’s knowledge of autism spectrum disorder in Ghana. Objective: The study sought to assess the knowledge of paediatric and psychiatric on autism spectrum disorder. Method: In this study, 130 paediatric and 93 psychiatric nurses sampled from five public hospitals in the Kumasi Metropolis participated in the survey. The Knowledge about Childhood Autism among Health Workers (KCAHW) questionnaire was employed to assess their knowledge of autism spectrum disorder. Results: It emerged from the study that psychiatric nurses were more knowledgeable on autism spectrum disorder than paediatric nurses in general and specifically on each of the four domains on the KCAHW questionnaire. However, the level of knowledge on autism spectrum disorder among both groups of nurses remains low. Apart from the previous encounter, there were no significant differences between paediatric and psychiatric nurses’ gender, age, marital status, working experience and their knowledge. Conclusion: In view of the findings, it will be appropriate for autism spectrum disorder to be included in the clinical training curriculum as well as the continuous professional education for both paediatric and psychiatric nurses. This will go a long way in helping paediatric and psychiatric nurses to increase their knowledge of autism spectrum disorder. PMID:29785200

Uncomplicated and comorbid obsessive-compulsive disorder in an epidemiologic sample.

PubMed

Hollander, E; Greenwald, S; Neville, D; Johnson, J; Hornig, C D; Weissman, M M

This study investigated lifetime prevalence rates, demographic characteristics, childhood conduct disorder and adult antisocial features, suicide attempts, and cognitive impairment in individuals with obsessive-compulsive disorder (OCD) uncomplicated by or comorbid with any other psychiatric disorder. The data are from the NIMH Epidemiologic Catchment Area (ECA) study, and the current analyses compared subjects with uncomplicated OCD (no history of any other lifetime psychiatric disorder), comorbid OCD (with any other lifetime disorder), other lifetime psychiatric disorders, and no lifetime psychiatric disorders across these variables. OCD in its uncomplicated and comorbid form had significantly higher rates of childhood conduct symptoms, adult antisocial personality disorder problems, and of suicide attempts than did no or other disorders. Comorbid OCD subjects had higher rates of mild cognitive impairment on the Mini-Mental Status Exam than did subjects with other disorders. These findings suggest that a subgroup of OCD patients may have impulsive features, including childhood conduct disorder symptoms and an increased rate of suicide attempts; wider clinical attention to these outcomes is needed.

Predictors of psychiatric readmission among patients with bipolar disorder at an academic safety-net hospital.

PubMed

Hamilton, Jane E; Passos, Ives C; de Azevedo Cardoso, Taiane; Jansen, Karen; Allen, Melissa; Begley, Charles E; Soares, Jair C; Kapczinski, Flavio

2016-06-01

Even with treatment, approximately one-third of patients with bipolar disorder relapse into depression or mania within 1 year. Unfavorable clinical outcomes for patients with bipolar disorder include increased rates of psychiatric hospitalization and functional impairment. However, only a few studies have examined predictors of psychiatric hospital readmission in a sample of patients with bipolar disorder. The purpose of this study was to examine predictors of psychiatric readmission within 30 days, 90 days and 1 year of discharge among patients with bipolar disorder using a conceptual model adapted from Andersen's Behavioral Model of Health Service Use. In this retrospective study, univariate and multivariate logistic regression analyses were conducted in a sample of 2443 adult patients with bipolar disorder who were consecutively admitted to a public psychiatric hospital in the United States from 1 January to 31 December 2013. In the multivariate models, several enabling and need factors were significantly associated with an increased risk of readmission across all time periods examined, including being uninsured, having ⩾3 psychiatric hospitalizations and having a lower Global Assessment of Functioning score. Additional factors associated with psychiatric readmission within 30 and 90 days of discharge included patient homelessness. Patient race/ethnicity, bipolar disorder type or a current manic episode did not significantly predict readmission across all time periods examined; however, patients who were male were more likely to readmit within 1 year. The 30-day and 1-year multivariate models showed the best model fit. Our study found enabling and need factors to be the strongest predictors of psychiatric readmission, suggesting that the prevention of psychiatric readmission for patients with bipolar disorder at safety-net hospitals may be best achieved by developing and implementing innovative transitional care initiatives that address the issues of multiple psychiatric hospitalizations, housing instability, insurance coverage and functional impairment. © The Royal Australian and New Zealand College of Psychiatrists 2015.

A study to compare the differences between genders in psychiatric comorbidities in individuals with psychoses.

PubMed

Das, Praveen; Sreedaran, Priya; Mv, Ashok

2018-02-01

Psychiatric comorbidities worsen the outcome and increase severity of suffering in psychotic disorders. Gender differences have also been found to impact the severity and outcome in psychoses. In this background, this study attempted to compare psychiatric comorbidity between genders. The aim was to compare psychiatric co-morbidity between men and women with psychotic disorders. A descriptive cross sectional study design was used. Data was collected through clinical interviews using standardized tools as well as the current case records. We used the MINI neuropsychiatric interview 5.0 to generate an ICD 10 diagnosis for primary psychotic illness and psychiatric comorbidity. PANSS was used to assess severity. Calgary Depression Scale for Schizophrenia, Hamilton Anxiety rating scale, Yale Brown Obsessive Compulsive Scale, Alcohol Use Disorders Identification Test and Fagerstrom Nicotine Tolerance Questionnaire were used to study comorbidity. 100 patients were included in the study. 61% of the population had a psychiatric comorbidity. 42% of the men had significantly more multiple psychiatric comorbidities as compared to 7% among women. Men had significantly more substance use than women. Age of onset of psychosis was not found to be different between men and women. In this study men had more psychiatric comorbidity than women, owing to greater levels of substance use disorders and anxiety disorders. This could be one of the possible reasons for differing outcomes between men and women with psychotic disorders thus indicating need for systematic future researching in psychiatric comorbidities in psychoses. Copyright © 2017 Elsevier B.V. All rights reserved.

Clinical correlates of childhood trauma and dissociative phenomena in patients with severe psychiatric disorders.

PubMed

Bozkurt Zincir, Selma; Yanartaş, Omer; Zincir, Serkan; Semiz, Umit Başar

2014-12-01

In this present study, we aim to investigate the possibility of a link between psychotic disorders and traumatic experiences in a group of female patients diagnosed with psychotic disorders by comparing childhood trauma exposure with a group of non-psychotic psychiatric disorder attending the same pschiatric clinic. Secondary purpose of this study is to examine the clinical correlates of trauma exposure, dissociative phenomena and psychiatric symptomatology between these two group of patients. Two psychiatric sample groups, those with psychotic disorders-mostly schizophrenic-(n = 54), and those with a non-psychotic severe psychiatric disorders (n = 24), were recruited. Data were collected for demographic, psychiatric and trauma histories and psychiatric symptomatology for all patients. In this study, high prevalance rates of childhood traumatic experiences and dissociative phenomena were found in both groups. Total scores of childhood trauma questionnaire in favor of the non-psychotic group were found to be close to significance (p = 0.052). DES scores of non-psychotic group were also higher although not statistically significant. 54.2 % of nonpsychotic cases had DES scores >20 on the other hand, that percentage of psychotic cases were found to be as 38.9 %. Furthermore, psychiatric patients who have suffered childhood traumatic experiences are far more likely to try to kill themselves than psychiatric patients who have not experienced such abuse. The high rates of childhood traumatic events in our present samples of both schizophrenia-spectrum patients and nonpsychotic patients confirm the need for clinicans to take trauma histories routinely.

Association Between Allergies and Psychiatric Disorders in Patients Undergoing Invasive Procedures.

PubMed

Aberle, Dwight; Wu, Stephanie E; Oklu, Rahmi; Erinjeri, Joseph; Deipolyi, Amy R

Associations between allergies and psychiatric disorders have been reported in the context of depression and suicide; psychiatric disorders may affect pain perception. To investigate the relationship of allergies with psychiatric disorders and pain perception in the context of invasive procedures, specifically during tunneled hemodialysis catheter placement. We identified 89 patients (51 men, 38 women), mean age 66 years (range: 23-96), who underwent tunneled hemodialysis catheter placement (1/2014-2/2015), recording numeric rating scale pain scores, medications, psychiatric history, allergies, and smoking status. Of 89 patients, 47 patients had no allergies, and 42 had ≥1 allergy. Patients with allergies were more likely to have a pre-existing psychiatric disorder compared to those without allergies, odds ratio 2.6 (95% CI: 1.0-6.8). Having allergies did not affect procedural sedation or postprocedural pain scores. Multiple logistic regression with age, sex, smoking, presence of allergies, psychiatric history, inpatient/outpatient status, procedure time, and procedural sedation administration as inputs and postprocedural pain as the outcome showed that the only independent predictor was receiving procedural sedation (P = 0.005). Findings corroborate anecdotal reports of allergies as a marker for psychiatric history. However, having allergies was not associated with increased pain or need for more sedation. Further studies could prospectively assess whether allergies and psychiatric disorders affect patient/doctor perceptions beyond pain during invasive procedures. Copyright © 2017 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Heterogeneity in 10-Year Course Trajectories of Moderate to Severe Major Depressive Disorder: A Danish National Register-Based Study.

PubMed

Musliner, Katherine L; Munk-Olsen, Trine; Laursen, Thomas M; Eaton, William W; Zandi, Peter P; Mortensen, Preben B

2016-04-01

Evidence suggests that long-term trajectories of major depressive disorder (MDD) are heterogeneous. The Danish Psychiatric Central Research Register (DPCRR) provides a rare opportunity to examine patterns and correlates of long-term trajectories in a large sample of patients with moderate to severe MDD. To characterize patterns and correlates of 10-year course trajectories of MDD in the DPCRR. A cohort containing 11 640 individuals born in Denmark in 1955 or later with their first recorded MDD diagnosis in the DPCRR between 1995 and 2002 was established. Patients were followed for 10 years from the date of their initial MDD diagnosis. Data were obtained from Danish civil and psychiatric national registers in June 2013 and were analyzed from April 4, 2014, to December 17, 2015. Correlates of trajectory class membership were sex, characteristics of the first recorded MDD episode (ie, age, severity, inpatient treatment, and record of suicide attempt or self-harm), and psychiatric diagnoses in parents (ie, depression, bipolar disorder, schizophrenia-spectrum disorders, substance abuse, and anxiety or somatoform disorders). The outcome variable was past-year contact at a psychiatric hospital with a main diagnosis of MDD during each of the 10 years following the initial MDD diagnosis. Trajectories were modeled using latent class growth analysis. The sample included 11 640 individuals (7493 [64.4%] women) aged 18 to 48 years (mean [SD], 31.4 [7.3]) at their first recorded MDD diagnosis. Four trajectory classes were identified: brief contact (77.0%) (characterized by low probability of contact after 2 years); prolonged initial contact (12.8%) (characterized by high decreasing probability of contact during the first 5 years); later reentry (7.1%) (characterized by moderate probability of contact during the second 5 years); and persistent contact (3.1%) (characterized by high or moderate probability of contact throughout). Female sex (odds ratio [OR] range, 1.82-2.22), inpatient treatment (OR range, 1.40-1.50), and severity at first recorded MDD episode (OR range: moderate, 1.61-1.84; severe, 1.93-2.23; and psychotic, 2.73-3.07) were associated with more severe trajectories. Parental anxiety (OR, 1.34 [95% CI, 1.10-1.63]) and depression (OR, 1.63 [95% CI, 1.28-2.09]) were associated with the prolonged initial contact and later reentry classes, respectively. Parental schizophrenia was associated with the persistent contact class (OR range, 2.55-3.04). Most people treated for moderate to severe MDD in Danish psychiatric hospitals do not receive additional MDD treatment after 2 years; however, a minority receive specialty treatment for up to a decade. Observable heterogeneity in the course may be indicative of underlying etiologic differences.

Understanding the Experiences of Students with Psychiatric Disabilities: A Foundation for Creating Conditions of Support and Success

ERIC Educational Resources Information Center

Belch, Holley A.

2011-01-01

One of the fastest-growing categories of disability in the college student population is psychiatric disabilities: bipolar disorder, anxiety disorders, and borderline personality disorders, among other. Appropriate treatment and support can provide students with psychiatric disabilities the opportunity to develop their talents and realize their…

Preschoolers' Observed Temperament and Psychiatric Disorders Assessed with a Parent Diagnostic Interview

ERIC Educational Resources Information Center

Dougherty, Lea R.; Bufferd, Sara J.; Carlson, Gabrielle A.; Dyson, Margaret; Olino, Thomas M.; Durbin, C. Emily; Klein, Daniel N.

2011-01-01

Evidence supports the role of temperament in the origins of psychiatric disorders. However, there are few data on associations between temperament and psychiatric disorders in early childhood. A community sample of 541 three-year-old preschoolers participated in a laboratory temperament assessment, and caregivers were administered a structured…

Minor Self-Harm and Psychiatric Disorder: A Population-Based Study

ERIC Educational Resources Information Center

Skegg, Keren; Nada-Raja, Shyamala; Moffit, Terrie E.

2004-01-01

Little is known about the extent to which minor self-harm in the general population is associated with psychiatric disorder. A population-based sample of 980 young adults was interviewed independently about past-year suicidal and self-harm behavior and thoughts, and psychiatric disorders. Self-harm included self-harmful behaviors such as…

Documentation of Psychiatric Disorders and Related Factors in a Large Sample Population of HIV-Positive Patients in California

PubMed Central

Parhami, Iman; Fong, Timothy W.; Siani, Aaron; Carlotti, Claudia; Khanlou, Homayoon

2013-01-01

This retrospective cohort study examined electronic medical records of HIV-positive patients in California (N=7,834) to find the prevalence of any psychiatric condition and the associations between several factors and the likelihood of these disorders. Approximately 53% of the patients in this study had a documented psychiatric condition, including 23% who had a mood disorder, 19% who had a substance-related disorder, and 16% who had an anxiety disorder. After controlling for potential confounders, significant positive associations (p<0.001) were found between female gender and the presence of any mood disorder (Adjusted Odds Ratio [95% Confidence Interval]=1.58[1.26–1.99]) or anxiety disorder (AOR=1.54[1.18–2.02]) and between homosexual orientation and the presence of any psychiatric condition (AOR=1.33[1.15–1.55]), mood disorder (AOR=1.71[1.42–2.07]), or anxiety disorder (AOR=1.41[1.22–1.88]). There were also significant negative associations between African American race and the presence of any psychiatric condition (AOR=0.68[0.60–0.77]), mood disorder (AOR=0.74[0.64–0.86]), anxiety disorder (AOR=0.43[0.36–0.52]), or substance-related disorder (AOR=0.78[0.67–0.91]) and between state/federal insurance and the presence of any psychiatric condition (AOR=0.70[0.62–0.79]), mood disorder (AOR=0.71[0.62–0.80]), or anxiety disorder (AOR=0.77[0.66–0.89]). PMID:23247363

A systematic review of the clinical efficacy of transcranial direct current stimulation (tDCS) in psychiatric disorders.

PubMed

Kekic, Maria; Boysen, Elena; Campbell, Iain C; Schmidt, Ulrike

2016-03-01

Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique, which can be used to selectively disrupt patterns of neural activity that are associated with symptoms of mental illness. tDCS has been implemented in numerous therapeutic trials across a range of patient populations, with a rapidly increasing number of studies being published each year. This systematic review aimed to evaluate the efficacy of tDCS in the treatment of psychiatric disorders. Four electronic databases were searched from inception until December 2015 by two independent reviewers, and 66 eligible studies were identified. Depression was the most extensively researched condition, followed by schizophrenia and substance use disorders. Data on obsessive compulsive disorder, generalised anxiety disorder, and anorexia nervosa were also obtained. The quality of included studies was appraised using a standardised assessment framework, which yielded a median score corresponding to "weak" on the three-point scale. This improved to "moderate" when case reports/series were excluded from the analysis. Overall, data suggested that tDCS interventions comprising multiple sessions can ameliorate symptoms of several major psychiatric disorders, both acutely and in the long-term. Nevertheless, the tDCS field is still in its infancy, and several methodological and ethical issues must be addressed before clinical efficacy can truly be determined. Studies probing the mechanisms of action of tDCS and those facilitating the definition of optimised stimulation protocols are warranted. Furthermore, evidence from large-scale, multi-centre randomised controlled trials is required if the transition of this therapy from the laboratory to the clinic is to be considered. Copyright © 2015 Elsevier Ltd. All rights reserved.

Patterns and Predictors of Tic Suppressibility in Youth With Tic Disorders

PubMed Central

Conelea, Christine A.; Wellen, Brianna; Woods, Douglas W.; Greene, Deanna J.; Black, Kevin J.; Specht, Matthew; Himle, Michael B.; Lee, Han-Joo; Capriotti, Matthew

2018-01-01

Tic suppression is the primary target of tic disorder treatment, but factors that influence voluntary tic inhibition are not well understood. Several studies using the Tic Suppression Task have demonstrated significant inter-individual variability in tic suppressibility but have individually been underpowered to address correlates of tic suppression. The present study explored patterns and clinical correlates of reward-enhanced tic suppression in youth with tic disorders using a large, pooled dataset. Individual-level data from nine studies using the Tic Suppression Task were pooled, yielding a sample of 99 youth with tic disorders. Analyses examined patterns of tic suppressibility and the relationship between tic suppressibility and demographic and clinical characteristics. A large majority of youth demonstrated a high degree of tic suppression, but heterogeneous patterns of tic suppressibility were also observed. Better tic suppressibility was related to older age and more frequent tics but unrelated to other clinical variables, including presence of psychiatric comorbidity, psychotropic medication status, tic and premonitory urge severity, and self-rated tic suppressibility. The mechanisms underlying the observed heterogeneity in reward-enhanced tic suppressibility warrant further investigation. The Tic Suppression Task is a promising method for testing mechanistic hypotheses related to tic suppression. PMID:29875706

Patterns and Predictors of Tic Suppressibility in Youth With Tic Disorders.

PubMed

Conelea, Christine A; Wellen, Brianna; Woods, Douglas W; Greene, Deanna J; Black, Kevin J; Specht, Matthew; Himle, Michael B; Lee, Han-Joo; Capriotti, Matthew

2018-01-01

Tic suppression is the primary target of tic disorder treatment, but factors that influence voluntary tic inhibition are not well understood. Several studies using the Tic Suppression Task have demonstrated significant inter-individual variability in tic suppressibility but have individually been underpowered to address correlates of tic suppression. The present study explored patterns and clinical correlates of reward-enhanced tic suppression in youth with tic disorders using a large, pooled dataset. Individual-level data from nine studies using the Tic Suppression Task were pooled, yielding a sample of 99 youth with tic disorders. Analyses examined patterns of tic suppressibility and the relationship between tic suppressibility and demographic and clinical characteristics. A large majority of youth demonstrated a high degree of tic suppression, but heterogeneous patterns of tic suppressibility were also observed. Better tic suppressibility was related to older age and more frequent tics but unrelated to other clinical variables, including presence of psychiatric comorbidity, psychotropic medication status, tic and premonitory urge severity, and self-rated tic suppressibility. The mechanisms underlying the observed heterogeneity in reward-enhanced tic suppressibility warrant further investigation. The Tic Suppression Task is a promising method for testing mechanistic hypotheses related to tic suppression.

The relation between emotional awareness and hallucinations and delusions in acute psychiatric inpatients.

PubMed

Serper, Mark; Berenbaum, Howard

2008-04-01

Although negative affect has been frequently implicated in the formation of cognitive and perceptual disturbances ranging from odd perceptions and beliefs to delusions and hallucinations it represents only one of the many aspects of emotional disturbances that may contribute to psychopathology. Surprisingly, no past research has examined in a psychiatric sample whether levels of cognitive-perceptual symptoms are associated with levels of emotional awareness (i.e., attention to emotion and clarity of emotion). In the present study we examined, in an acute psychiatric inpatient sample, the relations between emotional awareness and the severity of delusions and hallucinations. Two groups were included: 34 schizophrenia and schizophrenia spectrum disordered inpatients and 30 mood and substance use disordered inpatients. Patients were assessed on emotional awareness (attention to emotion and emotional clarity) and severity of psychiatric symptomatology. We found that lower levels of emotional clarity were associated with more severe hallucination ratings in both groups of patients. Among schizophrenia spectrum patients, lower levels of attention to emotion were also associated with more severe hallucination ratings. Among mood/substance disorder participants, higher levels of attention to emotion were associated with more severe delusion ratings, whereas the opposite pattern was found among schizophrenia spectrum participants. Consistent with the results of past research using college and community samples, we found that diminished emotional clarity is associated with elevated levels of hallucinations in both mood disorder/substance abuse and schizophrenia spectrum inpatients. We also found that greater attention to emotion was associated with more severe delusions, though only among the mood disorder/substance use group. The present research findings support the role of emotional awareness in hallucination formation and suggest that the factors that contribute to delusions in schizophrenia spectrum patients differ, in part, from the factors that contribute to delusion formation in other groups of individuals.

Psychiatric and psychosocial problems in adults with normal-intelligence autism spectrum disorders.

PubMed

Hofvander, Björn; Delorme, Richard; Chaste, Pauline; Nydén, Agneta; Wentz, Elisabet; Ståhlberg, Ola; Herbrecht, Evelyn; Stopin, Astrid; Anckarsäter, Henrik; Gillberg, Christopher; Råstam, Maria; Leboyer, Marion

2009-06-10

Individuals with autism spectrum disorders (ASDs) often display symptoms from other diagnostic categories. Studies of clinical and psychosocial outcome in adult patients with ASDs without concomitant intellectual disability are few. The objective of this paper is to describe the clinical psychiatric presentation and important outcome measures of a large group of normal-intelligence adult patients with ASDs. Autistic symptomatology according to the DSM-IV-criteria and the Gillberg & Gillberg research criteria, patterns of comorbid psychopathology and psychosocial outcome were assessed in 122 consecutively referred adults with normal intelligence ASDs. The subjects consisted of 5 patients with autistic disorder (AD), 67 with Asperger's disorder (AS) and 50 with pervasive developmental disorder not otherwise specified (PDD NOS). This study group consists of subjects pooled from two studies with highly similar protocols, all seen on an outpatient basis by one of three clinicians. Core autistic symptoms were highly prevalent in all ASD subgroups. Though AD subjects had the most pervasive problems, restrictions in non-verbal communication were common across all three subgroups and, contrary to current DSM criteria, so were verbal communication deficits. Lifetime psychiatric axis I comorbidity was very common, most notably mood and anxiety disorders, but also ADHD and psychotic disorders. The frequency of these diagnoses did not differ between the ASD subgroups or between males and females. Antisocial personality disorder and substance abuse were more common in the PDD NOS group. Of all subjects, few led an independent life and very few had ever had a long-term relationship. Female subjects more often reported having been bullied at school than male subjects. ASDs are clinical syndromes characterized by impaired social interaction and non-verbal communication in adulthood as well as in childhood. They also carry a high risk for co-existing mental health problems from a broad spectrum of disorders and for unfavourable psychosocial life circumstances. For the next revision of DSM, our findings especially stress the importance of careful examination of the exclusion criterion for adult patients with ASDs.

Sex differences in neural responses to disgusting visual stimuli: implications for disgust-related psychiatric disorders.

PubMed

Caseras, Xavier; Mataix-Cols, David; An, Suk Kyoon; Lawrence, Natalia S; Speckens, Anne; Giampietro, Vincent; Brammer, Michael J; Phillips, Mary L

2007-09-01

A majority of patients with disgust-related psychiatric disorders such as animal phobias and contamination-related obsessive-compulsive disorder are women. The aim of this functional magnetic resonance imaging (fMRI) study was to examine possible sex differences in neural responses to disgust-inducing stimuli that might help explain this female predominance. Thirty-four healthy adult volunteers (17 women, all right-handed) were scanned while viewing alternating blocks of disgusting and neutral pictures from the International Affective Picture System. Using a partially-silent fMRI sequence, the participants rated their level of discomfort after each block of pictures. Skin conductance responses (SCR) were measured throughout the experiment. All participants completed the Disgust Scale. Both women and men reported greater subjective discomfort and showed more SCR fluctuations during the disgusting picture blocks than during the neutral picture blocks. Women and men also demonstrated a similar pattern of brain response to disgusting compared with neutral pictures, showing activation in the anterior insula, ventrolateral and dorsolateral prefrontal cortices, and visual regions. Compared with men, women had significantly higher disgust sensitivity scores, experienced more subjective discomfort, and demonstrated greater activity in left ventrolateral prefrontal regions. However, these differences were no longer significant when disgust sensitivity scores were controlled for. In healthy adult volunteers, there are significant sex-related differences in brain responses to disgusting stimuli that are irrevocably linked to greater disgust sensitivity scores in women. The implications for disgust-related psychiatric disorders are discussed.

Pediatric Mania: The Controversy between Euphoria and Irritability

PubMed Central

Serra, Giulia; Uchida, Mai; Battaglia, Claudia; Casini, Maria Pia; De Chiara, Lavinia; Biederman, Joseph; Vicari, Stefano; Wozniak, Janet

2017-01-01

Abstract: Pediatric Bipolar Disorder (BD) is a highly morbid pediatric psychiatric disease, consistently associated with family psychiatric history of mood disorders and associated with high levels of morbidity and disability and with a great risk of suicide. While there is a general consensus on the symptomatology of depression in childhood, the phenomenology of pediatric mania is still highly debated and the course and long-term outcome of pediatric BD still need to be clarified. We reviewed the available studies on the phenomenology of pediatric mania with the aim of summarizing the prevalence, demographics, clinical correlates and course of these two types of pediatric mania. Eighteen studies reported the number of subjects presenting with either irritable or elated mood during mania. Irritability has been reported to be the most frequent clinical feature of pediatric mania reaching a sensitivity of 95–100% in several samples. Only half the studies reviewed reported on number of episodes or cycling patterns and the described course was mostly chronic and ultra-rapid whereas the classical episodic presentation was less common. Few long-term outcome studies have reported a diagnostic stability of mania from childhood to young adult age. Future research should focus on the heterogeneity of irritability aiming at differentiating distinct subtypes of pediatric psychiatric disorders with distinct phenomenology, course, outcome and biomarkers. Longitudinal studies of samples attending to mood presentation, irritable versus elated, and course, chronic versus episodic, may help clarify whether these are meaningful distinctions in the course, treatment and outcome of pediatric onset bipolar disorder. PMID:28503110

Pediatric Mania: The Controversy between Euphoria and Irritability.

PubMed

Serra, Giulia; Uchida, Mai; Battaglia, Claudia; Casini, Maria Pia; De Chiara, Lavinia; Biederman, Joseph; Vicari, Stefano; Wozniak, Janet

2017-04-01

Pediatric Bipolar Disorder (BD) is a highly morbid pediatric psychiatric disease, consistently associated with family psychiatric history of mood disorders and associated with high levels of morbidity and disability and with a great risk of suicide. While there is a general consensus on the symptomatology of depression in childhood, the phenomenology of pediatric mania is still highly debated and the course and long-term outcome of pediatric BD still need to be clarified. We reviewed the available studies on the phenomenology of pediatric mania with the aim of summarizing the prevalence, demographics, clinical correlates and course of these two types of pediatric mania. Eighteen studies reported the number of subjects presenting with either irritable or elated mood during mania. Irritability has been reported to be the most frequent clinical feature of pediatric mania reaching a sensitivity of 95-100% in several samples. Only half the studies reviewed reported on number of episodes or cycling patterns and the described course was mostly chronic and ultra-rapid whereas the classical episodic presentation was less common. Few long-term outcome studies have reported a diagnostic stability of mania from childhood to young adult age. Future research should focus on the heterogeneity of irritability aiming at differentiating distinct subtypes of pediatric psychiatric disorders with distinct phenomenology, course, outcome and biomarkers. Longitudinal studies of samples attending to mood presentation, irritable versus elated, and course, chronic versus episodic, may help clarify whether these are meaningful distinctions in the course, treatment and outcome of pediatric onset bipolar disorder.

Ethnicity and Psychiatric Disorders

PubMed Central

Hawes, Armani M.; Axinn, William G.; Ghimire, Dirgha J.

2016-01-01

Psychiatric disorders are one of the leading causes of disease-related disability in the world today. However, little is known about the ethnic variation of these disorders within populations. This is especially true in contexts outside of the United States and the European Diaspora. This study provides new evidence from South Asia on ethnic differences in Major Depressive Episode, Major Depressive Disorder, Panic Attack, Panic Disorder, Post-Traumatic Stress Disorder, and Intermittent Explosive Disorder. We use data from 400 adult interviews conducted in Nepal in a controlled comparison design as a case study. We use a series of multilevel logistic regression models to predict ethnic group differences in psychiatric disorders and episodes with measures from clinically validated World Mental Health survey instruments. Compared to the Brahmin/Chhetri group, we found historically excluded Dalits had statistically significantly higher odds of almost all psychiatric disorders and episodes. We also found that historically resilient Janajatis had statistically significantly lower odds of being diagnosed with PTSD than the majority Brahmin/Chhetri group. We also found no significant gender difference in MDD or MDE. Psychiatric disorders and episodes vary significantly by ethnicity within a rural Asian population, but gender differences are small. PMID:28824961

The Adolescent Community Reinforcement Approach (A-CRA) as a model paradigm for the management of adolescents with substance use disorders and co-occurring psychiatric disorders.

PubMed

Godley, Susan H; Smith, Jane Ellen; Passetti, Lora L; Subramaniam, Geetha

2014-01-01

Integrated treatment for youth with substance use disorders (SUDs) and co-occurring psychiatric disorders is recommended; however, there are few studies that have evaluated integrated treatment approaches. This paper includes a brief review of cognitive-behavioral and family therapies, since they have been demonstrated to be effective treatments for the disorders that commonly co-occur with substance use. It also describes how an integrated treatment paradigm has been implemented using one Empirically Supported Treatment, the Adolescent Community Reinforcement Approach (A-CRA). There is existing research that supports the use of several A-CRA procedures to treat substance use and commonly co-occurring psychiatric disorders. In the absence of further research, it is reasonable in the interim to train clinicians in treatments that incorporate components that have been found to be effective for both substance use and commonly co-occurring psychiatric disorders. These treatments can then be adapted as needed based on an individual youth's set of problems. Further research is needed to test treatments for various combinations of SUDs and psychiatric disorders (i.e., depression, trauma-related problems, conduct disorder/behavior problems, and attention-deficit/hyperactivity disorder [ADHD]).

[Developmental disorders in adulthood: concept, differential diagnosis, and treatment].

PubMed

Honda, Hideo

2014-01-01

The number of cases diagnosed with developmental disorders is rapidly increasing among those consulting psychiatry clinics for the first time in their adulthood. The author presents the concept of developmental disorders, discusses how they can be differentiated from other psychiatric disorders, and proposes some treatments. From now on, all psychiatrists should know the difference between developmental disorders and other psychiatric disorders, and diagnose them multi-axially, including the dimension of development. They should always keep in mind how developmental disorders lead to difficulties in everyday life, and treat developmental disorders in conjunction with adequate environmental modifications along with the treatment of other comorbid psychiatric disorders.

Parents' mental health and psychiatric expertise in child welfare family rehabilitation.

PubMed

Riihimäki, Kirsi

2015-02-01

Parents' mental health disorders are not well known within child welfare services. First, to assess the mental health disorders and treatment needs of parents participating in the child welfare-centred family rehabilitation; Second, to evaluate the work of psychiatric nurses and the effectiveness of consultations by psychiatrists in such cases. During 2010, a total of 141 parents participated in child welfare-centred family rehabilitation. The primary psychiatric disorders of parents not currently receiving psychiatric care were assessed, as was the appropriate treatment for them. The majority of parents in child welfare-centred family rehabilitation suffered from severe mental health disorders, often unrecognized and untreated. As much as 93% of parents were referred to mental health or substance abuse treatment, almost half of them to secondary care. The work of psychiatric nurses and consultations by psychiatrists were found to be useful. Most parents suffered from severe unrecognized and untreated mental health disorders. There is a high demand for adult-psychiatric expertise in child welfare.

Predictors of infant foster care in cases of maternal psychiatric disorders

PubMed Central

Glangeaud-Freudenthal, Nine M.-C.; Sutter-Dallay, Anne-Laure; Thieulin, Anne-Claire; Dagens, Véronique; Zimmermann, Marie-Agathe; Debourg, Alain; Amzallag, Corinne; Cazas, Odile; Cammas, Rafaële; Klopfert, Marie-Emmanuelle; Rainelli, Christine; Tielemans, Pascale; Mertens, Claudine; Maron, Michel; Nezelof, Sylvie; Poinso, François

2013-01-01

Purpose Our aim was to investigate the factors associated with mother-child separation at discharge, after joint hospitalization in psychiatric mother-baby units (MBUs) in France and Belgium. Because parents with postpartum psychiatric disorders are at risk of disturbed parent-infant interactions, their infants have an increased risk of an unstable early foundation. They may be particularly vulnerable to environmental stress and have a higher risk of developing some psychiatric disorders in adulthood. Methods: This prospective longitudinal study of 1018 women with postpartum psychiatric disorders, jointly admitted with their infant, to 16 French and Belgian psychiatric mother-baby units (MBUs), used multifactorial logistic regression models to assess the risk factors for mother-child separation at discharge from MBUs. Those factors include some infant characteristics associated with personal vulnerability, parents’ pathology and psychosocial context. Results Most children were discharged with their mothers, but 151 (15%) were separated from their mothers at discharge. Risk factors independently associated with separation were: i) neonatal or infant medical problems or complications; ii) maternal psychiatric disorder; iii) paternal psychiatric disorder; iv) maternal lack of good relationships with others; v) mother receipt of disability benefits; vi) low social class. Conclusions This study highlights the existence of factors other than maternal pathology that lead to decisions to separate mother and child for the child’s protection in a population of mentally ill mothers jointly hospitalized with the baby in the postpartum period. PMID:22706788

Predictors of infant foster care in cases of maternal psychiatric disorders.

PubMed

Glangeaud-Freudenthal, Nine M-C; Sutter-Dallay, Anne-Laure; Thieulin, Anne-Claire; Dagens, Véronique; Zimmermann, Marie-Agathe; Debourg, Alain; Amzallag, Corinne; Cazas, Odile; Cammas, Rafaële; Klopfert, Marie-Emmanuelle; Rainelli, Christine; Tielemans, Pascale; Mertens, Claudine; Maron, Michel; Nezelof, Sylvie; Poinso, François

2013-04-01

Our aim was to investigate the factors associated with mother-child separation at discharge, after joint hospitalization in psychiatric mother-baby units (MBUs) in France and Belgium. Because parents with postpartum psychiatric disorders are at risk of disturbed parent-infant interactions, their infants have an increased risk of an unstable early foundation. They may be particularly vulnerable to environmental stress and have a higher risk of developing some psychiatric disorders in adulthood. This prospective longitudinal study of 1,018 women with postpartum psychiatric disorders, jointly admitted with their infant to 16 French and Belgian psychiatric mother-baby units (MBUs), used multifactorial logistic regression models to assess the risk factors for mother-child separation at discharge from MBUs. Those factors include some infant characteristics associated with personal vulnerability, parents' pathology and psychosocial context. Most children were discharged with their mothers, but 151 (15 %) were separated from their mothers at discharge. Risk factors independently associated with separation were: (1) neonatal or infant medical problems or complications; (2) maternal psychiatric disorder; (3) paternal psychiatric disorder; (4) maternal lack of good relationship with others; (5) mother receipt of disability benefits; (6) low social class. This study highlights the existence of factors other than maternal pathology that lead to decisions to separate mother and child for the child's protection in a population of mentally ill mothers jointly hospitalized with the baby in the postpartum period.

Psychiatric outcome after severe cardio-respiratory failure treated with extracorporeal membrane oxygenation: a case-series.

PubMed

Risnes, Ivar; Heldal, Aasta; Wagner, Kari; Boye, Birgitte; Haraldsen, Ira; Leganger, Siv; Møkleby, Kjell; Svennevig, Jan Ludvig; Malt, Ulrik Fredrik

2013-01-01

Extracorporeal membrane oxygenation (ECMO) is increasingly used to save patients with severe cardiopulmonary failure at high risk of dying, but the long-term psychiatric outcome of the treatment has not been studied. Twenty-eight adults who survived ECMO were subjected to psychiatric assessment 5 years after ECMO by means of interviews (MINI-Neuropsychiatric Interview and Montgomery-Åsberg Depression Rating Scale) and psychometrics [Neuroticism and social conformity (EPQ-N+L); General Health Questionnaire (GHQ), Hospital Anxiety Depression Scale; Aggression Questionnaire, Toronto Alexithymia Scale, and Giessener somatic symptom checklist (GBB)]. Fifteen patients (54%) suffered lifetime psychiatric disorders prior to ECMO. After ECMO, 11 subjects (39%) developed new psychiatric disorders, mostly organic mental (18%), obsessive-compulsive disorders (OCD) 15%, and/or post-traumatic stress disorders (PTSD) 11%. These 11 patients reported higher scores on Montgomery-Åsberg Depression Rating Scale (MADRS), GHQ, EPQ-N, and GBB. Disregarding the presence of psychiatric disorders at follow-up, ECMO patients reported high levels of distress, physical aggression, anger, and alexithymic traits. Severe life-threatening cardiovascular or pulmonary failure with subsequent ECMO is associated with an increased prevalence of long-term psychiatric disorders and distress. Studies addressing the etiology and prevalence of psychiatric consequences after ECMO are needed. Copyright © 2013 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Discrimination and psychiatric disorder among Asian American immigrants: a national analysis by subgroups.

PubMed

Li, Miao

2014-12-01

Although considerable evidence suggests that discrimination negatively affects mental health for Asian American (AA) immigrants, few studies have disaggregated this heterogeneous community and/or differentiated effects of different forms of discrimination. Using the first nationally representative data on AA immigrants in US, this study examines whether perceived racial discrimination, perceived language discrimination, and vicarious racism experiences increase the risk of psychiatric disorder for different Asian immigrant groups in the past 12 months. Results from group specific logistic regressions show that both perceived racial and language discrimination have strong deleterious effects on mental health only for Filipinos, while Vietnamese and Chinese are more likely to be affected by vicarious racism experiences. No significant association was found between racial discrimination and the mental health outcome for Vietnamese and Chinese. Findings were discussed in the light of inter-racial contact pattern and acculturation status for each group.

Comparison of children with autism spectrum disorder with and without schizophrenia spectrum traits: gender, season of birth, and mental health risk factors.

PubMed

Gadow, Kenneth D; DeVincent, Carla J

2012-11-01

Children with autism spectrum disorder (ASD) with and without co-occurring schizophrenia spectrum traits (SST) were examined for differences in co-occurring psychiatric symptoms, background characteristics, and mental health risk factors. Participating mothers and teachers completed a DSM-IV-referenced rating scale and a background questionnaire (mothers only) describing 147 children (6-12 years) with ASD. There was a clear pattern of group differences in co-occurring psychiatric symptom severity (+SST > SST-) and background characteristics. Children with impairing SST had more mental health risk factors. Girls were more likely to be classified SST according to mothers' ratings. Children born in spring-summer were more likely to be classified non-SST by teachers' ratings. Findings provide tentative evidence that SST may be a useful marker of behavioral heterogeneity within the ASD clinical phenotype.

RARE VARIANTS IN THE NEUROTROPHIN SIGNALING PATHWAY IMPLICATED IN SCHIZOPHRENIA RISK

PubMed Central

Kranz, Thorsten M.; Goetz, Ray R.; Walsh-Messinger, Julie; Goetz, Deborah; Antonius, Daniel; Dolgalev, Igor; Heguy, Adriana; Seandel, Marco; Malaspina, Dolores; Chao, Moses V.

2015-01-01

Multiple lines of evidence corroborate impaired signaling pathways as relevant to the underpinnings of schizophrenia. There has been an interest in neurotrophins, since they are crucial mediators of neurodevelopment and in synaptic connectivity in the adult brain. Neurotrophins and their receptors demonstrate aberrant expression patterns in cortical areas for schizophrenia cases in comparison to control subjects. There is little known about the contribution of neurotrophin genes in psychiatric disorders. To begin to address this issue, we conducted high-coverage targeted exome capture in a subset of neurotrophin genes in 48 comprehensively characterized cases with schizophrenia-related psychosis. We herein report rare missense polymorphisms and novel missense mutations in neurotrophin receptor signaling pathway genes. Furthermore, we observed that several genes have a higher propensity to harbor missense coding variants than others. Based on this initial analysis we suggest that rare variants and missense mutations in neurotrophin genes might represent genetic contributions involved across psychiatric disorders. PMID:26215504

Antidepressant Prescription Pattern in the Presence of Medical Co-morbidity: REAP-AD 2013 Study.

PubMed

Grover, S; Avasthi, A; Tripathi, A; Tanra, A J; Chee, K Y; He, Y L; Chiu, H Fk; Kuga, H; Lee, M S; Chong, M Y; Udormatn, P; Kanba, S; Yang, S Y; Si, T M; Sim, K; Tan, C H; Shen, W W; Xiang, Y T; Sartorius, N; Shinfuku, N

2015-09-01

To evaluate the prescription pattern of antidepressants in patients with medical co-morbidity from major psychiatric centres in Asia. The Research on Asian Psychotropic Prescription Pattern for Antidepressants (REAP-AD 2013) collected data from 42 psychiatric centres in 10 Asian countries and regions. Antidepressant prescriptions of 2320 patients with various psychiatric disorders were evaluated. Of these, 370 patients who had specified medical co-morbidities formed the study cohort. Escitalopram (20%) and mirtazapine (20%) were the most commonly prescribed antidepressants in patients with medical co-morbidity followed by sertraline (16%), trazodone (15%), and paroxetine (12%). Overall, more than half (52%; 247/476) of prescriptions comprised selective serotonin reuptake inhibitors. Slightly less than two-thirds (63%; n = 233) of patients received at least 1 selective serotonin reuptake inhibitor. In addition, 79% of patients were prescribed only 1 antidepressant. The mean number of antidepressants used per patient was 1.25 (standard deviation, 0.56). There were subtle differences in the most preferred antidepressant across medical illnesses such as diabetes mellitus, liver dysfunction, acid peptic disease, and cerebrovascular disease. Differences were also seen in prescription patterns across different countries. Although selective serotonin reuptake inhibitors formed the bulk of antidepressant prescriptions in the presence of medical co-morbidity, mirtazapine was also commonly used in the presence of medical co-morbidities. Specified medical morbidities do influence the selection of antidepressants.

Psychiatric Co-Occurring Symptoms and Disorders in Young, Middle-Aged, and Older Adults with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Lever, Anne G.; Geurts, Hilde M.

2016-01-01

Although psychiatric problems are less prevalent in old age within the general population, it is largely unknown whether this extends to individuals with autism spectrum disorders (ASD). We examined psychiatric symptoms and disorders in young, middle-aged, and older adults with and without ASD (N[subscript max] = 344, age 19-79 years, IQ > 80).…

Thwarted interpersonal needs and suicide ideation: Comparing psychiatric inpatients with bipolar and non-bipolar mood disorders.

PubMed

Taylor, Nathanael J; Mitchell, Sean M; Roush, Jared F; Brown, Sarah L; Jahn, Danielle R; Cukrowicz, Kelly C

2016-12-30

Psychiatric inpatients are at heightened risk for suicide, and evidence suggests that psychiatric inpatients with bipolar mood disorders may be at greater risk for suicide ideation compared to those with non-bipolar mood disorders. There is a paucity of research directly comparing risk factors for suicide ideation in bipolar versus non-bipolar mood disorders in an inpatient sample. The current study sought to clarify the association between two constructs from the interpersonal theory of suicide (i.e., perceived burdensomeness and thwarted belongingness) in leading to suicide ideation among psychiatric inpatients with bipolar and non-bipolar mood disorders. Participants were (N=90) psychiatric inpatients with a bipolar (n = 20) or non-bipolar mood disorder (n=70; per their medical charts). Perceived burdensomeness, but not thwarted belongingness, was significantly associated with suicide ideation after adjusting for other covariates. This suggests perceived burdensomeness may play a key role in suicide ideation among psychiatric inpatients with any mood disorder and highlights the importance of assessment and intervention of perceived burdensomeness in this population. Contrary to our hypothesis, mood disorder group (i.e., bipolar versus non-bipolar) did not moderate the relations between perceived burdensomeness/thwarted belongingness and suicide ideation. Published by Elsevier Ireland Ltd.

Risk of psychiatric disorders following pelvic inflammatory disease: a nationwide population-based retrospective cohort study.

PubMed

Shen, Cheng-Che; Yang, Albert C; Hung, Jeng-Hsiu; Hu, Li-Yu; Chiang, Yung-Yen; Tsai, Shih-Jen

2016-01-01

Pelvic inflammatory disease (PID) a common infection in women that is associated with significant morbidity and is a major cause of infertility. A clear temporal causal relationship between PID and psychiatric disorders has not been well established. We used a nationwide population-based retrospective cohort study to explore the relationship between PID and the subsequent development of psychiatric disorders. We identified subjects who were newly diagnosed with PID between 1 January 2000 and 31 December 2002 in the Taiwan National Health Insurance Research Database. A comparison cohort was constructed for patients without PID. A total of 21 930 PID and 21 930 matched control patients were observed until diagnosed with psychiatric disorders, or until death, withdrawal from the NHI system, or until 31 December 2009. Adjusted hazard ratio (HR) of bipolar disorder, depressive disorder, anxiety disorder and sleep disorder in subjects with PID were significantly higher (HR: 2.671, 2.173, 2.006 and 2.251, respectively) than that of the controls during the follow-up. PID may increase the risk of subsequent newly diagnosed bipolar disorder, depressive disorder, anxiety disorder and sleep disorder, which will impair life quality. Our findings highlight that clinicians should pay particular attention to psychiatric comorbidities in PID patients.

Psychiatric disorders and family functioning in children and adolescents with functional abdominal pain syndrome.

PubMed

Ghanizadeh, Ahmad; Moaiedy, Farah; Imanieh, Mohammad Hadi; Askani, Hamid; Haghighat, Mahmood; Dehbozorgi, Gholamreza; Dehghani, Seyed Mohsen

2008-07-01

Functional abdominal pain syndrome (FAPS) is a functional gastrointestinal disorder. There is a heightened risk when conducting potentially dangerous and unnecessary medical investigations and procedures in children with FAPS. The aim of this study was to survey the rate of the psychiatric disorders and family functioning in children and adolescents with FAPS. The subjects were a consecutive new sample of 45 children and adolescents with FAPS, 45 with an organic abdominal pain, and 45 pain-free comparison subjects aged 5-18 years that were interviewed using the Farsi version of K-SADS. Family functioning and the severity of pain were also studied. About 51.1% of patients with FAPS suffered from at least one psychiatric disorder. Psychiatric disorders in the FAPS patients studied included general anxiety disorder (8.9%), obsessive-compulsive disorder (11.1%), attention deficit hyperactivity disorder (15.6%), separation anxiety disorder (24.4%), and major depressive disorder (15.6%). Except for generalized anxiety disorder and tic disorder, the other disorders were significantly more common in the FAPS group than in the two other control groups. Family functioning scores were not significantly different between groups. There is a high rate of psychiatric disorders in children and adolescents with FAPS in Iran, but our study found fewer incidences of disorders than previous reports have indicated. Family dysfunction difficulties in FAPS children are not more common than those in the control groups.

Associations between Polygenic Risk for Psychiatric Disorders and Substance Involvement.

PubMed

Carey, Caitlin E; Agrawal, Arpana; Bucholz, Kathleen K; Hartz, Sarah M; Lynskey, Michael T; Nelson, Elliot C; Bierut, Laura J; Bogdan, Ryan

2016-01-01

Despite evidence of substantial comorbidity between psychiatric disorders and substance involvement, the extent to which common genetic factors contribute to their co-occurrence remains understudied. In the current study, we tested for associations between polygenic risk for psychiatric disorders and substance involvement (i.e., ranging from ever-use to severe dependence) among 2573 non-Hispanic European-American participants from the Study of Addiction: Genetics and Environment. Polygenic risk scores (PRS) for cross-disorder psychopathology (CROSS) were generated based on the Psychiatric Genomics Consortium's Cross-Disorder meta-analysis and then tested for associations with a factor representing general liability to alcohol, cannabis, cocaine, nicotine, and opioid involvement (GENSUB). Follow-up analyses evaluated specific associations between each of the five psychiatric disorders which comprised CROSS-attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (AUT), bipolar disorder (BIP), major depressive disorder (MDD), and schizophrenia (SCZ)-and involvement with each component substance included in GENSUB. CROSS PRS explained 1.10% of variance in GENSUB in our sample (p < 0.001). After correction for multiple testing in our follow-up analyses of polygenic risk for each individual disorder predicting involvement with each component substance, associations remained between: (A) MDD PRS and non-problem cannabis use, (B) MDD PRS and severe cocaine dependence, (C) SCZ PRS and non-problem cannabis use and severe cannabis dependence, and (D) SCZ PRS and severe cocaine dependence. These results suggest that shared covariance from common genetic variation contributes to psychiatric and substance involvement comorbidity.

Significance of personality disorders in the face of drop-outs from psychiatric hospitalizations. The case of selected psychiatric units.

PubMed

Biała, Maja; Kiejna, Andrzej

2017-06-18

The World Health Organization's estimations indicate that about 50% of patients in well-developed countries may not adhere to long-term therapies. In the field of psychiatry, drop-outs from psychiatric treatment are particularly important. Personality disorders are a significant part of this sphere. The aim of this research was to empirically verify the hypothesis regarding the relation between comorbid personality disorders and drop-outs from treatment among patients of psychiatric wards. This study was a prospective cohort study. 110 patients, hospitalized in 3 different psychiatric wards, were included. Personality disorders were assessed with the Structured Clinical Interview For DSM-IV Personality Disorders (SCID-II). The research was financed by the Polish National Science Center (DEC-2011/01/N/NZ5/05364). The response rate was 89.1%. 72.56% of patients suffered from personality disorders (SCID-II) (among them the most prevalent were: personality disorder - not otherwise specified - 40.7% and borderline personality disorder - 12.38%; 22.95% of patients dropped out from treatment). However, occurrence of personality disorders was not relevant for those drop-outs. On the other hand, relationships at the level of certain criteria of borderline personality disorders and passive-aggressive personality have been revealed. These relationships became stronger when considered from the perspective of differences in the organization of treatment at individual wards. Some personality disorders may play an important role in drop-outs from psychiatric treatment. Presented results require further research.

Lessons learned from the study of masturbation and its comorbidity with psychiatric disorders in children: The first analytic study.

PubMed

Tashakori, Ashraf; Safavi, Atefeh; Neamatpour, Sorour

2017-04-01

The main source of information about children's masturbation is more on the basis of case reports. Due to the lack of consistent and accurate information. This study aimed to determine prevalence and underlying factors of masturbation and its comorbidity with psychiatric disorders in children. In this descriptive-analytical study, among the children referred to the Pediatrics Clinic of Psychiatric Ward, Golestan Hospital, Ahvaz, Southwest Iran, 98 children were selected by convenience sampling in 2014. Disorders were diagnosed by clinical interview based on the fourth edition of the Diagnostic and Statistical Manual for Psychiatric Disorders (DSM-IV) and the Child Symptom Inventory-4 (CSI-4). We also used a questionnaire, containing demographic information about the patient and their family and also other data. Data was analyzed using descriptive statistics and chi-square test with SPSS software version 16. Of the children who participated in this study (most of whom were boys), 31.6% suffered from masturbation. The phobias (p=0.002), separation anxiety disorder (p=0.044), generalized anxiety disorder (p=0.037), motor tics (p=0.033), stress disorder (p=0.005), oppositional defiant disorder (p=0.044), thumb sucking (p=0.000) and conduct disorder (p=0.001) were associated with masturbation. Masturbation was common in children referred to psychiatric clinic, and may be more associated with oppositional defiant disorder, or conduct disorder, some anxiety disorders, motor tics and other stereotypical behavior. Authors recommended more probing for psychiatric disorders in children with unusual sexual behavior.

Lessons learned from the study of masturbation and its comorbidity with psychiatric disorders in children: The first analytic study

PubMed Central

Tashakori, Ashraf; Safavi, Atefeh; Neamatpour, Sorour

2017-01-01

Background The main source of information about children’s masturbation is more on the basis of case reports. Due to the lack of consistent and accurate information. Objective This study aimed to determine prevalence and underlying factors of masturbation and its comorbidity with psychiatric disorders in children. Methods In this descriptive-analytical study, among the children referred to the Pediatrics Clinic of Psychiatric Ward, Golestan Hospital, Ahvaz, Southwest Iran, 98 children were selected by convenience sampling in 2014. Disorders were diagnosed by clinical interview based on the fourth edition of the Diagnostic and Statistical Manual for Psychiatric Disorders (DSM-IV) and the Child Symptom Inventory-4 (CSI-4). We also used a questionnaire, containing demographic information about the patient and their family and also other data. Data was analyzed using descriptive statistics and chi-square test with SPSS software version 16. Results Of the children who participated in this study (most of whom were boys), 31.6% suffered from masturbation. The phobias (p=0.002), separation anxiety disorder (p=0.044), generalized anxiety disorder (p=0.037), motor tics (p=0.033), stress disorder (p=0.005), oppositional defiant disorder (p=0.044), thumb sucking (p=0.000) and conduct disorder (p=0.001) were associated with masturbation. Conclusion Masturbation was common in children referred to psychiatric clinic, and may be more associated with oppositional defiant disorder, or conduct disorder, some anxiety disorders, motor tics and other stereotypical behavior. Authors recommended more probing for psychiatric disorders in children with unusual sexual behavior. PMID:28607641

Treatments for common psychiatric conditions among adults during acute, rehabilitation, and reintegration phases.

PubMed

Difede, Joann; Cukor, Judith; Lee, Francis; Yurt, Roger

2009-12-01

Common and pernicious adult psychiatric disorders consequent to burn injury include post-traumatic stress disorder (PTSD), major depressive disorder (MDD), and new-onset substance abuse disorder. Diagnosing and treating these disorders is complicated by the complex psychosocial issues associated with burns including grief, pain, role impairment, disfigurement, dysfunction, stigma, as well as financial and legal issues. Additionally, pre-morbid psychiatric and neurological illnesses are risk factors for burns, adding to the challenge of diagnosis and treatment. This article will focus on the diagnosis and treatment of PTSD and MDD consequent to burn trauma, as these are the major psychiatric outcomes, addressing the attendant psychosocial problems as threads in this post-trauma tapestry.

Sleep-related problems and minor psychiatric disorders among Brazilian shift workers.

PubMed

Olinto, Maria Teresa Anselmo; Garcez, Anderson; Henn, Ruth Liane; Macagnan, Jamile Block Araldi; Paniz, Vera Maria Vieira; Pattussi, Marcos Pascoal

2017-11-01

The aim of this study was to explore the association between sleep-related problems with the occurrence of minor psychiatric disorders in shift workers of southern Brazil. A cross-sectional study with 1202 workers (785 females) aged 18-50 years was carried out. Minor psychiatric disorders were assessed using the Self-Reporting Questionnaire (SRQ-20), and four sleep problems were collected and analyzed: sleep deprivation (≤ 5h), difficulty falling asleep, waking up during sleep, and sleep medication use. Results show that the overall prevalence of minor psychiatric disorders was 26.8%, but it was more prevalent among females than males (30.2% vs. 20.4%). Nightshift work was significantly associated with the occurrence of sleep-related problems. After adjusting for confounding factors, the number of sleep-related problems showed a positive linear trend with psychiatric disorders in both sexes. Having two or more sleep-related problems was associated with increased probability of psychiatric disorders approximately three-fold among males and two-fold among females, when compared with those without sleep problems. In conclusion, this study demonstrated that sleep-related problems have a strong and independent association with psychiatric disorders among shift workers. Furthermore, the prevalence of both conditions was higher among females than males; however, the strength of these associations was higher in males. Copyright © 2017 Elsevier B.V. All rights reserved.

Gender Differences in Compulsive Buying Disorder: Assessment of Demographic and Psychiatric Co-Morbidities

PubMed Central

Kim, Hyoun S.; Requião, Marinalva G.; Marasaldi, Renata F.; Filomensky, Tatiana Z.; Hodgins, David C.; Tavares, Hermano

2016-01-01

Compulsive buying is a common disorder found worldwide. Although recent research has shed light into the prevalence, etiology and clinical correlates of compulsive buying disorder, less is known about gender differences. To address this empirical gap, we assessed potential gender differences in demographic and psychiatric co-morbidities in a sample of 171 compulsive buyers (20 men and 151 women) voluntarily seeking treatment in São Paulo, Brazil. A structured clinical interview confirmed the diagnosis of compulsive buying. Of the 171 participants, 95.9% (n = 164) met criteria for at least one co-morbid psychiatric disorder. The results found that male and female compulsive buyers did not differ in problem severity as assessed by the Compulsive Buying Scale. However, several significant demographic and psychiatric differences were found in a multivariate binary logistic regression. Specifically, male compulsive buyers were more likely to report being non-heterosexual, and reported fewer years of formal education. In regards to psychiatric co-morbidities, male compulsive buyers were more likely to be diagnosed with sexual addiction, and intermittent explosive disorder. Conversely, men had lower scores on the shopping subscale of the Shorter PROMIS Questionnaire. The results suggest that male compulsive buyers are more likely to present with co-morbid psychiatric disorders. Treatment planning for compulsive buying disorder would do well to take gender into account to address for potential psychiatric co-morbidities. PMID:27907082

Gender Differences in Compulsive Buying Disorder: Assessment of Demographic and Psychiatric Co-Morbidities.

PubMed

Nicoli de Mattos, Cristiana; Kim, Hyoun S; Requião, Marinalva G; Marasaldi, Renata F; Filomensky, Tatiana Z; Hodgins, David C; Tavares, Hermano

2016-01-01

Compulsive buying is a common disorder found worldwide. Although recent research has shed light into the prevalence, etiology and clinical correlates of compulsive buying disorder, less is known about gender differences. To address this empirical gap, we assessed potential gender differences in demographic and psychiatric co-morbidities in a sample of 171 compulsive buyers (20 men and 151 women) voluntarily seeking treatment in São Paulo, Brazil. A structured clinical interview confirmed the diagnosis of compulsive buying. Of the 171 participants, 95.9% (n = 164) met criteria for at least one co-morbid psychiatric disorder. The results found that male and female compulsive buyers did not differ in problem severity as assessed by the Compulsive Buying Scale. However, several significant demographic and psychiatric differences were found in a multivariate binary logistic regression. Specifically, male compulsive buyers were more likely to report being non-heterosexual, and reported fewer years of formal education. In regards to psychiatric co-morbidities, male compulsive buyers were more likely to be diagnosed with sexual addiction, and intermittent explosive disorder. Conversely, men had lower scores on the shopping subscale of the Shorter PROMIS Questionnaire. The results suggest that male compulsive buyers are more likely to present with co-morbid psychiatric disorders. Treatment planning for compulsive buying disorder would do well to take gender into account to address for potential psychiatric co-morbidities.

Preliminary Outcomes from an Integrated Pediatric Mental Health Outpatient Clinic.

PubMed

Maslow, Gary R; Banny, Adrienne; Pollock, McLean; Stefureac, Kristen; Rosa, Kendra; Walter, Barbara Keith; Hobbs Knutson, Katherine; Lucas, Joseph; Heilbron, Nicole

2017-10-01

An estimated 1 in 5 children in the United States meet criteria for a diagnosable mental disorder, yet fewer than 20% receive mental health services. Unmet need for psychiatric treatment may contribute to patterns of increasing use of the emergency department. This article describes an integrated pediatric evaluation center designed to prevent the need for treatment in emergency settings by increasing access to timely and appropriate care for emergent and critical mental health needs. Preliminary results showed that the center provided rapid access to assessment and treatment services for children and adolescents presenting with a wide range of psychiatric concerns. Copyright © 2017 Elsevier Inc. All rights reserved.

Boys with Asperger Syndrome Grow Up: Psychiatric and Neurodevelopmental Disorders 20 Years After Initial Diagnosis.

PubMed

Gillberg, I Carina; Helles, Adam; Billstedt, Eva; Gillberg, Christopher

2016-01-01

We examined comorbid psychiatric and neurodevelopmental disorders in fifty adult males (mean age 30 years) with Asperger syndrome (AS) diagnosed in childhood and followed up prospectively for almost two decades (13-26 years). Only three of the 50 men had never met criteria for an additional psychiatric/neurodevelopmental diagnosis and more than half had ongoing comorbidity (most commonly either ADHD or depression or both). Any psychiatric comorbidity increased the risk of poorer outcome. The minority of the AS group who no longer met criteria for a full diagnosis of an autism spectrum disorder were usually free of current psychiatric comorbidity. The high rate of psychiatric/neurodevelopmental comorbidities underscores the need for a full psychiatric/neurodevelopmental assessment at follow-up of males with AS.

The role of comorbid psychiatric conditions in health status in epilepsy.

PubMed

Zeber, John E; Copeland, Laurel A; Amuan, Megan; Cramer, Joyce A; Pugh, Mary Jo V

2007-06-01

Comorbid psychiatric conditions are highly prevalent in patients with epilepsy, yet the long-term implications across multiple mental health conditions are poorly understood. We examined the association between psychiatric diagnoses and self-reported health status in veterans with epilepsy. ANCOVA models were used to derive adjusted SF-36V scores for individuals with epilepsy alone (N=7379) or with additional psychiatric conditions (N=6320): depression, schizophrenia, bipolar disorder, anxiety disorder, substance abuse, and posttraumatic stress disorder (PTSD). Compared with patients with epilepsy alone, scores of veterans with comorbid psychiatric diagnoses averaged 21% lower across all domains. Role Limitation scales exhibited the greatest decrement across domains. A PTSD diagnosis consistently corresponded to lower scores, followed by depression. Schizophrenia contributed the least detriment to perceived health status. Comorbid psychiatric conditions impart significant emotional and physical burdens, requiring timely recognition and treatment of these disorders. Patients with epilepsy are uniquely at risk for high physical-psychiatric comorbidity profiles, with concomitant losses in perceived health status.

Annual Research Review: Transgenic Mouse Models of Childhood-Onset Psychiatric Disorders

ERIC Educational Resources Information Center

Robertson, Holly R.; Feng, Guoping

2011-01-01

Childhood-onset psychiatric disorders, such as attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), mood disorders, obsessive compulsive spectrum disorders (OCSD), and schizophrenia (SZ), affect many school-age children, leading to a lower quality of life, including difficulties in school and personal relationships that…

Risk of Psychiatric Disorders following Irritable Bowel Syndrome: A Nationwide Population-Based Cohort Study.

PubMed

Lee, Yao-Tung; Hu, Li-Yu; Shen, Cheng-Che; Huang, Min-Wei; Tsai, Shih-Jen; Yang, Albert C; Hu, Chang-Kuo; Perng, Chin-Lin; Huang, Yi-Shin; Hung, Jeng-Hsiu

2015-01-01

Irritable bowel syndrome (IBS) is the most common functional gastrointestinal (GI) disorder observed in patients who visit general practitioners for GI-related complaints. A high prevalence of psychiatric comorbidities, particularly anxiety and depressive disorders, has been reported in patients with IBS. However, a clear temporal relationship between IBS and psychiatric disorders has not been well established. We explored the relationship between IBS and the subsequent development of psychiatric disorders including schizophrenia, bipolar disorder, depressive disorder, anxiety disorder, and sleep disorder. We selected patients who were diagnosed with IBS caused by gastroenteritis, according to the data in the Taiwan National Health Insurance Research Database. A comparison cohort was formed of patients without IBS who were matched according to age and sex. The incidence rate and the hazard ratios (HRs) of subsequent new-onset psychiatric disorders were calculated for both cohorts, based on psychiatrist diagnoses. The IBS cohort consisted of 4689 patients, and the comparison cohort comprised 18756 matched control patients without IBS. The risks of depressive disorder (HR = 2.71, 95% confidence interval [CI] = 2.30-3.19), anxiety disorder (HR = 2.89, 95% CI = 2.42-3.46), sleep disorder (HR = 2.47, 95% CI = 2.02-3.02), and bipolar disorder (HR = 2.44, 95% CI = 1.34-4.46) were higher in the IBS cohort than in the comparison cohort. In addition, the incidence of newly diagnosed depressive disorder, anxiety disorder, and sleep disorder remained significantly increased in all of the stratified follow-up durations (0-1, 1-5, ≥5 y). IBS may increase the risk of subsequent depressive disorder, anxiety disorder, sleep disorder, and bipolar disorder. The risk ratios are highest for these disorders within 1 year of IBS diagnosis, but the risk remains statistically significant for more than 5 years. Clinicians should pay particular attention to psychiatric comorbidities in IBS patients.

When social anxiety disorder co-exists with risk-prone, approach behavior: Investigating a neglected, meaningful subset of people in the National Comorbidity Survey-Replication

PubMed Central

Kashdan, Todd B.; McKnight, Patrick E.; Richey, J. Anthony; Hofmann, Stefan G.

2009-01-01

Little is known about people with social anxiety disorder (SAD) who are not behaviorally inhibited. To advance knowledge on phenomenology, functional impairment, and treatment seeking, we investigated whether engaging in risk-prone behaviors accounts for heterogeneous outcomes in people with SAD. Using the National Comorbidity Survey-Replication (NCS-R) dataset, our analyses focused on people with current (N = 679) or lifetime (N = 1143) SAD diagnoses. Using latent class analysis on NCS-R risk-prone behavior items, results supported two SAD classes: (1) a pattern of behavioral inhibition and risk aversion and (2) an atypical pattern of high anger and aggression, and moderate/high sexual impulsivity and substance use problems. An atypical pattern of risk-prone behaviors was associated with greater functional impairment, less education and income, younger age, and particular psychiatric comorbidities. Results could not be subsumed by the severity, type, or number of social fears, or comorbid anxiety or mood disorders. Conclusions about the nature, course, and treatment of SAD may be compromised by not attending to heterogeneity in behavior patterns. PMID:19345933

Over-expression of XIST, the Master Gene for X Chromosome Inactivation, in Females With Major Affective Disorders

PubMed Central

Ji, Baohu; Higa, Kerin K.; Kelsoe, John R.; Zhou, Xianjin

2015-01-01

Background Psychiatric disorders are common mental disorders without a pathological biomarker. Classic genetic studies found that an extra X chromosome frequently causes psychiatric symptoms in patients with either Klinefelter syndrome (XXY) or Triple X syndrome (XXX). Over-dosage of some X-linked escapee genes was suggested to cause psychiatric disorders. However, relevance of these rare genetic diseases to the pathogenesis of psychiatric disorders in the general population of psychiatric patients is unknown. Methods XIST and several X-linked genes were studied in 36 lymphoblastoid cell lines from healthy females and 60 lymphoblastoid cell lines from female patients with either bipolar disorder or recurrent major depression. XIST and KDM5C expression was also quantified in 48 RNA samples from postmortem human brains of healthy female controls and female psychiatric patients. Findings We found that the XIST gene, a master in control of X chromosome inactivation (XCI), is significantly over-expressed (p = 1 × 10− 7, corrected after multiple comparisons) in the lymphoblastoid cells of female patients with either bipolar disorder or major depression. The X-linked escapee gene KDM5C also displays significant up-regulation (p = 5.3 × 10− 7, corrected after multiple comparisons) in the patients' cells. Expression of XIST and KDM5C is highly correlated (Pearson's coefficient, r = 0.78, p = 1.3 × 10− 13). Studies on human postmortem brains supported over-expression of the XIST gene in female psychiatric patients. Interpretations We propose that over-expression of XIST may cause or result from subtle alteration of XCI, which up-regulates the expression of some X-linked escapee genes including KDM5C. Over-expression of X-linked genes could be a common mechanism for the development of psychiatric disorders between patients with those rare genetic diseases and the general population of female psychiatric patients with XIST over-expression. Our studies suggest that XIST and KDM5C expression could be used as a biological marker for diagnosis of psychiatric disorders in a significantly large subset of female patients. Research in context Due to lack of biological markers, diagnosis and treatment of psychiatric disorders are subjective. There is utmost urgency to identify biomarkers for clinics, research, and drug development. We found that XIST and KDM5C gene expression may be used as a biological marker for diagnosis of major affective disorders in a significantly large subset of female patients from the general population. Our studies show that over-expression of XIST and some X-linked escapee genes may be a common mechanism for development of psychiatric disorders between the patients with rare genetic diseases (XXY or XXX) and the general population of female psychiatric patients. PMID:26425698

Complex Psychiatric Comorbidity of Treatment-Seeking Youth With Autism Spectrum Disorder and Anxiety Symptoms

PubMed Central

HEPBURN, SUSAN L.; STERN, JESSICA A.; BLAKELEY-SMITH, AUDREY; KIMEL, LILA K.; REAVEN, JUDITH A.

2015-01-01

Anxiety disorders and other co-occurring psychiatric disorders significantly impact adaptive functioning for many children with autism spectrum disorder (ASD). This descriptive study examines the complexity of psychiatric comorbidity in treatment-seeking youth with ASD and anxiety symptoms. Forty-two parents of 8- to 14-year-old children with ASD and anxiety symptoms completed a structured psychiatric interview (K-SADS) and provided information about the child’s past and current psychological functioning as part of a screening process to enter an anxiety intervention program. Overall, comorbidity was very complex, with children obtaining an average of 4 psychiatric diagnoses (including anxiety disorders) on a structured clinical interview (range = 0–9). Onset and course differed by psychiatric disorder. Complexity of comorbidity did not differ significantly by age, sex, or autism severity. Despite clinical significance of the symptoms reported, few children were currently (or ever) engaged in mental health treatment or group psychosocial intervention. Although the specificity of the current sample limits the generalizability of these results, findings suggest that treatment-seeking children with ASD and anxiety often present with additional psychiatric symptoms, which supports a transdiagnostic approach to research and intervention in this area. Accurate assessment of comorbidity may provide valuable information for families and clinicians regarding individualized treatment approaches. PMID:25960821

Evolutionary Perspectives on Genetic and Environmental Risk Factors for Psychiatric Disorders.

PubMed

Keller, Matthew C

2018-05-07

Evolutionary medicine uses evolutionary theory to help elucidate why humans are vulnerable to disease and disorders. I discuss two different types of evolutionary explanations that have been used to help understand human psychiatric disorders. First, a consistent finding is that psychiatric disorders are moderately to highly heritable, and many, such as schizophrenia, are also highly disabling and appear to decrease Darwinian fitness. Models used in evolutionary genetics to understand why genetic variation exists in fitness-related traits can be used to understand why risk alleles for psychiatric disorders persist in the population. The usual explanation for species-typical adaptations-natural selection-is less useful for understanding individual differences in genetic risk to disorders. Rather, two other types of models, mutation-selection-drift and balancing selection, offer frameworks for understanding why genetic variation in risk to psychiatric (and other) disorders exists, and each makes predictions that are now testable using whole-genome data. Second, species-typical capacities to mount reactions to negative events are likely to have been crafted by natural selection to minimize fitness loss. The pain reaction to tissue damage is almost certainly such an example, but it has been argued that the capacity to experience depressive symptoms such as sadness, anhedonia, crying, and fatigue in the face of adverse life situations may have been crafted by natural selection as well. I review the rationale and strength of evidence for this hypothesis. Evolutionary hypotheses of psychiatric disorders are important not only for offering explanations for why psychiatric disorders exist, but also for generating new, testable hypotheses and understanding how best to design studies and analyze data.

A descriptive study of psychiatric disorders and psychosocial burden in rehabilitation patients with musculoskeletal diseases.

PubMed

Härter, Martin; Reuter, Katrin; Weisser, Bettina; Schretzmann, Beate; Aschenbrenner, Astrid; Bengel, Jürgen

2002-04-01

To investigate current, 12-month, and lifetime prevalence rates, and associated psychosocial burden of psychiatric disorders in rehabilitation inpatients with musculoskeletal diseases. Two-stage epidemiologic survey. Four orthopedic rehabilitation inpatient clinics in southwest Germany. A total of 910 inpatients with different musculoskeletal diseases participated in the survey. According to their General Health Questionnaire-12 scores, 205 patients were selected randomly for standardized interviews. Not applicable. Psychosocial burden (Hospital Anxiety and Depression Scale, Lübeck Alcoholism Screening Test) and quality of life (Medical Outcomes Study 36-Item Short-Form Health Survey), assessment of diagnosis and somatic parameters through standardized medical records. Clinical interview (Munich Composite International Diagnostic Interview) in the second-stage examination to obtain Diagnostic and Statistical Manual of Mental Disorders (4th edition) diagnoses of psychiatric disorders. Prevalence rates of psychiatric disorders are 31.1% for the 4-week period, 47.1% for the 12-month period, and 64.6% for the lifetime period. The most prevalent current disorders are anxiety (15%), affective (10.7%), and substance-related disorders (9.2%). Half of the comorbid ill patients have 2 or more simultaneous psychiatric disorders and report elevated levels of psychosocial burden (eg, intense pain, low quality of life, more days of sick leave). Patients undergoing musculoskeletal rehabilitation should be assessed carefully for comorbid psychiatric illnesses. Further research should be undertaken to evaluate the effectiveness of psychosocial interventions for comorbid psychiatric disorders on life quality, therapeutic compliance, and outcome of rehabilitation treatment. Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Psychiatric Symptoms in Children Diagnosed with an Autism Spectrum Disorder: An Examination of Gender Differences

ERIC Educational Resources Information Center

Worley, Julie A.; Matson, Johnny L.

2011-01-01

In addition to the triad of impairments experienced by children and adolescents diagnosed with Autism Spectrum Disorders (ASD), they often present with symptoms of psychiatric disorders. To date, very few studies have examined gender differences in regards to psychiatric symptoms in children and adolescents diagnosed with an ASD. Thus, the current…

N-acetylcysteine in the treatment of psychiatric disorders: current status and future prospects.

PubMed

Minarini, Alessandro; Ferrari, Silvia; Galletti, Martina; Giambalvo, Nina; Perrone, Daniela; Rioli, Giulia; Galeazzi, Gian Maria

2017-03-01

N-acetylcysteine (NAC) is widely known for its role as a mucolytic and as an antidote to paracetamol overdose. There is increasing interest in the use of NAC in the treatment of several psychiatric disorders. The rationale for the administration of NAC in psychiatric conditions is based on its role as a precursor to the antioxidant glutathione, and its action as a modulating agent of glutamatergic, dopaminergic, neurotropic and inflammatory pathways. Areas covered: This study reviews the available data regarding the use of NAC in different psychiatric disorders including substance use disorders, autism, obsessive-compulsive spectrum disorders, schizophrenia, depression, bipolar disorder. Promising results were found in trials testing the use of NAC, mainly as an add-on treatment, in cannabis use disorder in young people, depression in bipolar disorder, negative symptoms in schizophrenia, and excoriation (skin-picking) disorder. Despite initial optimism, recent findings regarding NAC efficacy in autism have been disappointing. Expert opinion: These preliminary positive results require further confirmation in larger samples and with longer follow-ups. Given its high tolerability and wide availability, NAC represents an important target to investigate in the field of new adjunctive treatments for psychiatric conditions.

Psychiatric disorders in individuals diagnosed with infantile autism as children: a case control study.

PubMed

Mouridsen, Svend Erik; Rich, Bente; Isager, Torben; Nedergaard, Niels Jørgen

2008-01-01

The objective of this study was to compare the prevalence and types of psychiatric disorders in a clinical sample of 118 individuals diagnosed as children with infantile autism (IA) with psychiatric disorders in 336 matched controls from the general population using data from the nationwide Danish Psychiatric Central Register. The average observation time was 32.5 years, and mean age at follow-up was 40.6 years (range 25-55 years). Of the 118 individuals with IA, 57 (48.3%) had been in contact with psychiatric hospitals (inpatient hospitalization or outpatient visits) during the follow-up period, compared with 20/336 (6.0%) in the control group (p < 0.0001). This observation should alert general psychiatrists to the possibility of additional treatable psychiatric disorders occurring in individuals with IA. Of the 118 individuals in the IA group, 20 individuals (17%) had been given a comorbid psychiatric diagnosis during the observation period, compared with 9 individuals (2.7%) in the control group. Of the subjects with IA, 3.4% had received a diagnosis of schizophrenia (F20) at least once since the index admission in childhood, 0.8% had been diagnosed with delusional disorder (F22), 0.8% with acute psychotic disorder (F23), and 1.6% with unspecified non-organic psychosis (F29). In the control group, 0.9% had been diagnosed with schizophrenia (p = 0.08). In the group with IA, 3.4% had received a diagnosis in the broad category of affective disorders compared with 1.2% in the control group (p = 0.21). Issues associated with using registers in the ascertainment of co-occurring psychiatric disorders in IA are discussed.

Non-violent and violent forms of childhood abuse in the prediction of suicide attempts: Direct or indirect effects through psychiatric disorders?

PubMed

Sachs-Ericsson, Natalie J; Stanley, Ian H; Sheffler, Julia L; Selby, Edward; Joiner, Thomas E

2017-06-01

Childhood abuse is linked to suicide. Potential pathways include the increased risk for the development of psychiatric disorders and the contribution of abuse to suicide capability. The current study compared the effects of childhood non-violent and violent abuse in the prediction of suicide attempts, and examined the potential mediated effects of psychiatric disorders. Data from the National Comorbidity Surveys were obtained. At baseline, assessments of childhood non-violent abuse (e.g., parental verbal abuse) and violent abuse (e.g., parental physical abuse, relative rape) were obtained. We also assessed for other adverse childhood experiences, baseline suicidal behaviors, and psychiatric disorders. At the ten-year follow-up, we assessed for psychiatric disorders and suicide attempts that had occurred over time. Both non-violent and violent abuse predicted attempts, though participants experiencing violent abuse had significantly higher rates. Bootstrapped mediation analyses determined that the influence of non-violent abuse on suicide attempts was indirect, and exerted its influence through the psychiatric disorders that occurred during the ten-year follow-up. The study relied on retrospective reports of childhood abuse. Further, we could not clearly determine the temporal order of the psychiatric disorders and suicide attempts occurring over follow-up. Different mechanisms may underlie the pathway between violent and non-violent abuse and suicide attempts. Verbal abuse may lead to negative cognitive styles and psychiatric disorders associated with suicidality; violent abuse may contribute to the capacity for suicide. Interventions may need to be specifically tailored to meet the distinct needs of individuals who have experienced past childhood abuse. Copyright © 2017 Elsevier B.V. All rights reserved.

Reliability and validity of the adolescent health profile-types.

PubMed

Riley, A W; Forrest, C B; Starfield, B; Green, B; Kang, M; Ensminger, M

1998-08-01

The purpose of this study was to demonstrate the preliminary reliability and validity of a set 13 profiles of adolescent health that describe distinct patterns of health and health service requirements on four domains of health. Reliability and validity were tested in four ethnically diverse population samples of urban and rural youths aged 11 to 17-years-old in public schools (N = 4,066). The reliability of the classification procedure and construct validity were examined in terms of the predicted and actual distributions of age, gender, race, socioeconomic status, and family type. School achievement, medical conditions, and the proportion of youths with a psychiatric disorder also were examined as tests of construct validity. The classification method was shown to produce consistent results across the four populations in terms of proportions of youths assigned with specific sociodemographic characteristics. Variations in health described by specific profiles showed expected relations to sociodemographic characteristics, family structure, school achievement, medical disorders, and psychiatric disorders. This taxonomy of health profile-types appears to effectively describe a set of patterns that characterize adolescent health. The profile-types provide a unique and practical method for identifying subgroups having distinct needs for health services, with potential utility for health policy and planning. Such integrative reporting methods are critical for more effective utilization of health status instruments in health resource planning and policy development.

Cumulative Socioeconomic Status Risk, Allostatic Load, and Adjustment: A Prospective Latent Profile Analysis with Contextual and Genetic Protective Factors

ERIC Educational Resources Information Center

Brody, Gene H.; Yu, Tianyi; Chen, Yi-Fu; Kogan, Steven M.; Evans, Gary W.; Beach, Steven R. H.; Windle, Michael; Simons, Ronald L.; Gerrard, Meg; Gibbons, Frederick X.; Philibert, Robert A.

2013-01-01

The health disparities literature has identified a common pattern among middle-aged African Americans that includes high rates of chronic disease along with low rates of psychiatric disorders despite exposure to high levels of cumulative socioeconomic status (SES) risk. The current study was designed to test hypotheses about the developmental…

Alcoholism, Psychopathology and Sensation-Seeking: Differences Between Male Dui First Offenders and Recidivists

DTIC Science & Technology

1994-01-01

scales from the Drug Use Screening Inventory: Behavior Pattern Domain and Psychiatric Disorder Domain. The following scales from the Zuckerman ...1992). Validation of the adolescent Drug Use Screening Inventory: Preliminary findings. -Py hogyof Addictive Behaviors.6(4), 233-36. Tennen, H... Drug Use Screening Inventory - Revised (Behavior and Psychiatry Scales) ..................................... 58 Measures of Sensation-seeking and

A review on eye movement studies in childhood and adolescent psychiatry.

PubMed

Rommelse, Nanda N J; Van der Stigchel, Stefan; Sergeant, Joseph A

2008-12-01

The neural substrates of eye movement measures are largely known. Therefore, measurement of eye movements in psychiatric disorders may provide insight into the underlying neuropathology of these disorders. Visually guided saccades, antisaccades, memory guided saccades, and smooth pursuit eye movements will be reviewed in various childhood psychiatric disorders. The four aims of this review are (1) to give a thorough overview of eye movement studies in a wide array of psychiatric disorders occurring during childhood and adolescence (attention-deficit/hyperactivity disorder, oppositional deviant disorder and conduct disorder, autism spectrum disorders, reading disorder, childhood-onset schizophrenia, Tourette's syndrome, obsessive compulsive disorder, and anxiety and depression), (2) to discuss the specificity and overlap of eye movement findings across disorders and paradigms, (3) to discuss the developmental aspects of eye movement abnormalities in childhood and adolescence psychiatric disorders, and (4) to present suggestions for future research. In order to make this review of interest to a broad audience, attention will be given to the clinical manifestation of the disorders and the theoretical background of the eye movement paradigms.

Schizophrenia and Leigh syndrome, a simple comorbidity or the same etiopathogeny: about a case.

PubMed

Mnif, Leila; Sellami, Rim; Masmoudi, Jawaher

2015-01-01

Leigh syndrome is a mitochondrial encephalomyopathy that occurs due to "cytochrome c oxidase deficiency". Few psychiatric disorders have been defined that are associated with Leigh syndrome. The objective of this work is to study relations between mitochondrial dysfunction and psychiatric disorders. It was a 20 year old male patient, who received Modopar, for severe extra pyramidal symptoms caused by Leigh syndrome. He developed, four months ago, acute psychotic symptoms such as audio-visual hallucinations, persecution and mystic delirium. The cerebral MRI has shown signal abnormalities in central grey nucleus. The EEG recording and blood test were normal. The hypothesis of drug induced psychiatric disorders (Modopar) was possible. The evolution under atypical antipsychotic was only partial. In this case, the cerebrospinal fluid and lactate levels mean that mitochondria were not an overall explanation for these psychiatric disorders but may at least play a partial role. Psychiatric disorders may just be acomorbidity.

Mind-Body Practices and the Adolescent Brain: Clinical Neuroimaging Studies.

PubMed

Sharma, Anup; Newberg, Andrew B

Mind-Body practices constitute a large and diverse group of practices that can substantially affect neurophysiology in both healthy individuals and those with various psychiatric disorders. In spite of the growing literature on the clinical and physiological effects of mind-body practices, very little is known about their impact on central nervous system (CNS) structure and function in adolescents with psychiatric disorders. This overview highlights findings in a select group of mind-body practices including yoga postures, yoga breathing techniques and meditation practices. Mind-body practices offer novel therapeutic approaches for adolescents with psychiatric disorders. Findings from these studies provide insights into the design and implementation of neuroimaging studies for adolescents with psychiatric disorders. Clinical neuroimaging studies will be critical in understanding how different practices affect disease pathogenesis and symptomatology in adolescents. Neuroimaging of mind-body practices on adolescents with psychiatric disorders will certainly be an open and exciting area of investigation.

The role of psychosocial factors and psychiatric disorders in functional dyspepsia.

PubMed

Van Oudenhove, Lukas; Aziz, Qasim

2013-03-01

In this Review, after a brief historical introduction, we first provide an overview of epidemiological studies that demonstrate an association between functional dyspepsia and psychological traits, states or psychiatric disorders. These studies suggest an important intrinsic role for psychosocial factors and psychiatric disorders, especially anxiety and depression, in the aetiopathogenesis of functional dyspepsia, in addition to their putative influence on health-care-seeking behaviour. Second, we describe pathophysiological evidence on how psychosocial factors and psychiatric disorders might exert their role in functional dyspepsia. Novel insights from functional brain imaging studies regarding the integration of gut-brain signals, processed in homeostatic-interoceptive brain regions, with input from the exteroceptive system, the reward system and affective and cognitive circuits, help to clarify the important role of psychological processes and psychiatric morbidity. We therefore propose an integrated model of functional dyspepsia as a disorder of gut-brain signalling, supporting a biopsychosocial approach to the diagnosis and management of this disorder.

Autistic-Like Traits in Adult Patients with Mood Disorders and Schizophrenia

PubMed Central

Matsuo, Junko; Kamio, Yoko; Takahashi, Hidetoshi; Ota, Miho; Teraishi, Toshiya; Hori, Hiroaki; Nagashima, Anna; Takei, Reiko; Higuchi, Teruhiko; Motohashi, Nobutaka; Kunugi, Hiroshi

2015-01-01

Autism spectrum disorder often co-occurs with other psychiatric disorders. Although a high prevalence of autistic-like traits/symptoms has been identified in the pediatric psychiatric population of normal intelligence, there are no reports from adult psychiatric population. This study examined whether there is a greater prevalence of autistic-like traits/symptoms in patients with adult-onset psychiatric disorders such as major depressive disorder (MDD), bipolar disorder, or schizophrenia, and whether such an association is independent of symptom severity. The subjects were 290 adults of normal intelligence between 25 and 59 years of age (MDD, n=125; bipolar disorder, n=56; schizophrenia, n=44; healthy controls, n=65). Autistic-like traits/symptoms were measured using the Social Responsiveness Scale for Adults. Symptom severity was measured using the Positive and Negative Symptoms Scale, the Hamilton Depression Rating Scale, and/or the Young Mania Rating Scale. Almost half of the clinical subjects, except those with remitted MDD, exhibited autistic-like traits/symptoms at levels typical for sub-threshold or threshold autism spectrum disorder. Furthermore, the proportion of psychiatric patients that demonstrated high autistic-like traits/symptoms was significantly greater than that of healthy controls, and not different between that of remitted or unremitted subjects with bipolar disorder or schizophrenia. On the other hand, remitted subjects with MDD did not differ from healthy controls with regard to the prevalence or degree of high autistic-like traits/symptoms. A substantial proportion of adults with bipolar disorder and schizophrenia showed high autistic-like traits/symptoms independent of symptom severity, suggesting a shared pathophysiology among autism spectrum disorder and these psychiatric disorders. Conversely, autistic-like traits among subjects with MDD were associated with the depressive symptom severity. These findings suggest the importance of evaluating autistic-like traits/symptoms underlying adult-onset psychiatric disorders for the best-suited treatment. Further studies with a prospective design and larger samples are needed. PMID:25838109

Autistic-like traits in adult patients with mood disorders and schizophrenia.

PubMed

Matsuo, Junko; Kamio, Yoko; Takahashi, Hidetoshi; Ota, Miho; Teraishi, Toshiya; Hori, Hiroaki; Nagashima, Anna; Takei, Reiko; Higuchi, Teruhiko; Motohashi, Nobutaka; Kunugi, Hiroshi

2015-01-01

Autism spectrum disorder often co-occurs with other psychiatric disorders. Although a high prevalence of autistic-like traits/symptoms has been identified in the pediatric psychiatric population of normal intelligence, there are no reports from adult psychiatric population. This study examined whether there is a greater prevalence of autistic-like traits/symptoms in patients with adult-onset psychiatric disorders such as major depressive disorder (MDD), bipolar disorder, or schizophrenia, and whether such an association is independent of symptom severity. The subjects were 290 adults of normal intelligence between 25 and 59 years of age (MDD, n=125; bipolar disorder, n=56; schizophrenia, n=44; healthy controls, n=65). Autistic-like traits/symptoms were measured using the Social Responsiveness Scale for Adults. Symptom severity was measured using the Positive and Negative Symptoms Scale, the Hamilton Depression Rating Scale, and/or the Young Mania Rating Scale. Almost half of the clinical subjects, except those with remitted MDD, exhibited autistic-like traits/symptoms at levels typical for sub-threshold or threshold autism spectrum disorder. Furthermore, the proportion of psychiatric patients that demonstrated high autistic-like traits/symptoms was significantly greater than that of healthy controls, and not different between that of remitted or unremitted subjects with bipolar disorder or schizophrenia. On the other hand, remitted subjects with MDD did not differ from healthy controls with regard to the prevalence or degree of high autistic-like traits/symptoms. A substantial proportion of adults with bipolar disorder and schizophrenia showed high autistic-like traits/symptoms independent of symptom severity, suggesting a shared pathophysiology among autism spectrum disorder and these psychiatric disorders. Conversely, autistic-like traits among subjects with MDD were associated with the depressive symptom severity. These findings suggest the importance of evaluating autistic-like traits/symptoms underlying adult-onset psychiatric disorders for the best-suited treatment. Further studies with a prospective design and larger samples are needed.

Bullying behavior in relation to psychiatric disorders and physical health among adolescents: a clinical cohort of 508 underage inpatient adolescents in Northern Finland.

PubMed

Luukkonen, Anu-Helmi; Räsänen, Pirkko; Hakko, Helinä; Riala, Kaisa

2010-06-30

The aim was to investigate the association of bullying behavior with psychiatric disorders and physical health in a sample of adolescent psychiatric patients, as there have to our knowledge been no previous studies using actual psychiatric diagnoses examining this relationship in boys and girls. We studied 508 Finnish adolescents (age 12-17) admitted to psychiatric inpatient care between April 2001 and March 2006 from the geographically large area of Northern Finland. The Schedule for Affective Disorder and Schizophrenia for School-Age Children, Present and Lifetime (K-SADS-PL) was used to obtain psychiatric diagnoses of adolescents according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and information on bullying behavior. Logistic regression analyses showed that having an externalizing disorder increased the likelihood of being a bully or a bully-victim (i.e. a person who is both a bully and a victim of bullying) among both the boys (odds ratio, OR=14.4, P=0.001) and the girls (OR=10.0, P<0.001). In addition, having an internalizing disorder increased the likelihood of being a victim of bullying among the boys (OR=3.4, P=0.008), but not the girls. Chronic somatic diseases were also significantly associated with being bullied among the boys (OR=2.5, P=0.041). Our results suggest that adolescents who are involved in bullying behavior should be evaluated psychiatrically, as this might be an early marker of psychiatric disorders.

Co-aggregation of major psychiatric disorders in individuals with first-degree relatives with schizophrenia: a nationwide population-based study.

PubMed

Cheng, C-M; Chang, W-H; Chen, M-H; Tsai, C-F; Su, T-P; Li, C-T; Tsai, S-J; Hsu, J-W; Huang, K-L; Lin, W-C; Chen, T-J; Bai, Y-M

2017-11-07

A previous genetic study has suggested that schizophrenia, bipolar disorder, major depressive disorder, autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) share common disease-associated genes. However, whether individuals with first-degree relatives (FDRs) with schizophrenia have a higher risk of these major psychiatric disorders requires further investigation. This study used Taiwan's National Health Insurance Research Database and identified 151 650 patients with schizophrenia and 227 967 individuals with FDRs with schizophrenia. The relative risks (RRs) of schizophrenia and other major psychiatric disorders were assessed in individuals with FDRs with schizophrenia. The individuals with FDRs with schizophrenia exhibited higher RRs (95% confidence interval) of major psychiatric disorders, namely schizophrenia (4.76, 4.65-4.88), bipolar disorder (3.23, 3.12-3.35), major depressive disorder (2.05, 2.00-2.10), ASD (2.55, 2.35-2.77) and ADHD (1.31, 1.25-1.37) than were found in the total population. Several sensitivity analyses were conducted to confirm these results. A dose-dependent relationship was observed between the risks of major psychiatric disorders and the numbers of FDRs with schizophrenia. The increased risks of major psychiatric disorders were consistent in different family relationships, namely among parents, offspring, siblings and twins. Our study supports the familial dose-dependent co-aggregation of schizophrenia, bipolar disorder, major depressive disorder, ASD and ADHD, and our results may prompt governmental public health departments and psychiatrists to focus on the mental health of individuals with FDRs with schizophrenia.Molecular Psychiatry advance online publication, 7 November 2017; doi:10.1038/mp.2017.217.

Stability of sleep disorders from preschool to first grade and their bidirectional relationship with psychiatric symptoms.

PubMed

Steinsbekk, Silje; Wichstrøm, Lars

2015-05-01

To examine the prevalence and stability of DSM-4-defined sleep disorders from preschool to first grade and to explore the bidirectional relationship between sleep disorders and symptoms of psychiatric disorders. All children born in 2003 or 2004 in Trondheim, Norway, who attended regular community health checkups for 4-year-olds, were invited to participate (97.2% attendance; 82.0% consent rate, n = 2475) in this study. The authors recruited a screen-stratified subsample of 1250 children and interviewed 994 parents (79.6%) using a structured diagnostic interview (the Preschool Age Psychiatric Assessment). Two years later, 795 of the parents completed the interview. There was stability in insomnia (adjusted odds ratio [OR] = 4.03, confidence interval [CI] = 2.83-5.75) and sleepwalking (adjusted OR = 19.28, CI = 4.53-82.10), whereas none of the children with hypersomnia or nightmare disorder at age 4 had the same disorder 2 years later. Insomnia increased the risk for developing symptoms of conduct disorder, major depressive disorder (MDD), and social phobia when the initial levels of insomnia were adjusted for. Symptoms of attention-deficit hyperactivity disorder, oppositional defiant disorder, and MDD at age 4 were statistically linked to insomnia at age 6. Sleepwalking predicted later separation anxiety disorder, whereas hypersomnia was unrelated to symptoms of psychiatric disorders. Insomnia is a prevalent and stable disorder in children and is bidirectionally related to psychiatric symptoms.

The Epidemiology of Chronic Major Depressive Disorder and Dysthymic Disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions

PubMed Central

Blanco, Carlos; Okuda, Mayumi; Markowitz, John C.; Liu, Shang-Min; Grant, Bridget F.; Hasin, Deborah S.

2011-01-01

Objective To examine the prevalence of chronic major depressive disorder (CMDD) and dysthymic disorder (DD), their sociodemographic correlates, patterns of 12-month and lifetime psychiatric comorbidity, lifetime risk factors, psychosocial functioning, and mental health service utilization. Method Face-to-face interviews were conducted in the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions (n = 43,093). Results The 12-month and lifetime prevalence were greater for CMDD (1.5% and 3.1%) than for DD (0.5% and 0.9%). Individuals with CMDD and DD shared most sociodemographic correlates and lifetime risk factors for MDD. Individuals with CMDD and DD had almost identically high rates of Axis I and Axis II comorbid disorders. However, individuals with CMDD received higher rates of all treatment modalities than individuals with DD. Conclusion Individuals with CMDD and DD share many sociodemographic correlates, comorbidity patterns, risk factors, and course. Individuals with chronic depressive disorders, especially those with DD, continue to face substantial unmet treatment needs. PMID:21190638

Biomarkers in mood disorders research: developing new and improved therapeutics

PubMed Central

Niciu, Mark J.; Mathews, Daniel C.; Ionescu, Dawn F.; Richards, Erica M.; Furey, Maura L.; Yuan, Peixiong; Nugent, Allison C.; Henter, Ioline D.; Machado-Vieira, Rodrigo; Zarate, Carlos A.

2015-01-01

Background Recently, surrogate neurobiological biomarkers that correlate with target engagement and therapeutic response have been developed and tested in early phase studies of mood disorders. Objective The identification of biomarkers could help develop personalized psychiatric treatments that may impact public health. Methods These biomarkers, which are associated with clinical response post-treatment, can be directly validated using multimodal approaches including genetic tools, proteomics/metabolomics, peripheral measures, neuroimaging, biostatistical predictors, and clinical predictors. Results To date, early phase biomarker studies have sought to identify measures that can serve as “biosignatures”, or biological patterns of clinical response. These studies have also sought to identify clinical predictors and surrogate outcomes associated with pathophysiological domains consistently described in the National Institute of Mental Health’s (NIMH) new Research Domain Criteria (RDoC). Using the N-methyl-D-aspartate (NMDA) antagonist ketamine as an example, we identified changes in several domains (clinical, cognitive, and neurophysiological) that predicted ketamine’s rapid and sustained antidepressant effects in individuals with treatment-resistant major depressive disorder (MDD) or bipolar depression. Discussion These approaches may ultimately provide clues into the neurobiology of psychiatric disorders and may have enormous impact Backon the development of novel therapeutics. PMID:26082563

Factors Associated With Antidepressant Dosing in Asia: Findings From the Research on Asian Psychotropic Prescription Study.

PubMed

Rajaratnam, Kamini; Xiang, Yu-Tao; Tripathi, Adarsh; Chiu, Helen Fung Kum; Si, Tian-Mei; Chee, Kok-Yoon; Avasthi, Ajit; Grover, Sandeep; Chong, Mian-Yoon; Kuga, Hironori; Kanba, Shigenobu; He, Yan-Ling; Lee, Min-Soo; Yang, Shu-Yu; Udomratn, Pichet; Kallivayalil, Roy Abraham; Tanra, Andi J; Maramis, Margarita; Shen, Winston Wu-Dien; Sartorius, Norman; Kua, Ee-Heok; Tan, Chay-Hoon; Mahendran, Rathi; Shinfuku, Naotaka; Sum, Min Yi; Baldessarini, Ross J; Sim, Kang

2016-12-01

In this study, we sought to examine factors associated with dosing of antidepressants (ADs) in Asia. Based on reported data and clinical experience, we hypothesized that doses of ADs would be associated with demographic and clinical factors and would increase over time. This cross-sectional, pharmacoepidemiological study analyzed data collected within the Research Study on Asian Psychotropic Prescription Pattern for Antidepressants from 4164 participants in 10 Asian countries, using univariate and multivariate methods. The AD doses varied by twofold among countries (highest in PR China and RO Korea, lowest in Singapore and Indonesia), and averaged 124 (120-129) mg/d imipramine-equivalents. Average daily doses increased by 12% between 2004 and 2013. Doses were significantly higher among hospitalized patients and ranked by diagnosis: major depression > anxiety disorders > bipolar disorder, but were not associated with private/public or psychiatric/general-medical settings, nor with age, sex, or cotreatment with a mood stabilizer. In multivariate modeling, AD-dose remained significantly associated with major depressive disorder and being hospitalized. Doses of ADs have increased somewhat in Asia and were higher when used for major depression or anxiety disorders than for bipolar depression and for hospitalized psychiatric patients.

Examining the nature of the comorbidity between pediatric attention deficit/hyperactivity disorder and post-traumatic stress disorder.

PubMed

Biederman, J; Petty, C R; Spencer, T J; Woodworth, K Y; Bhide, P; Zhu, J; Faraone, S V

2013-07-01

This study sought to address the link between attention deficit/hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD) in youth by providing a comprehensive comparison of clinical correlates of ADHD subjects with and without PTSD across multiple non-overlapping domains of functioning and familial patterns of transmission. Participants were 271 youths with ADHD and 230 controls without ADHD of both sexes along with their siblings. Participants completed a large battery of measures designed to assess psychiatric comorbidity, psychosocial, educational, and cognitive parameters. Post-traumatic stress disorder was significantly higher in ADHD probands vs. controls (5.2% vs. 1.7%, χ(2) (1) = 4.36, P = 0.04). Irrespective of the comorbidity with PTSD, ADHD subjects had similar ages at onset of ADHD, similar type and mean number of ADHD symptoms, and similar ADHD-associated impairments. PTSD in ADHD probands was significantly associated with a higher risk of psychiatric hospitalization, school impairment, poorer social functioning and higher prevalences of mood, conduct disorder, and anxiety disorders. The mean onset of PTSD (12.6 years) was significantly later than that of ADHD and comorbid disorders (all P < 0.05). Siblings of ADHD and ADHD + PTSD probands had higher prevalences of ADHD vs. siblings of controls (35% vs. 18%, z = 4.00, P < 0.001 and 67% vs. 18%, z = 4.02, P < 0.001 respectively) and siblings of ADHD+PTSD probands had a significantly higher prevalence of PTSD compared with the siblings of ADHD and control probands (20% vs. 3% and 3%, z = 2.99, P = 0.003 and z = 2.07, P = 0.04 respectively). Findings indicate that the comorbidity with PTSD in ADHD leads to greater clinical severity as regards psychiatric comorbidity and psychosocial dysfunction. ADHD is equally familial in the presence of PTSD in the proband indicating that their co-occurrence is not owing to diagnostic error. © 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Managing complex patients on a medical psychiatric unit: an observational study of university hospital costs associated with medical service use, length of stay, and psychiatric intervention.

PubMed

Leue, Carsten; Driessen, Ger; Strik, Jacqueline J; Drukker, Marjan; Stockbrügger, Reinhold W; Kuijpers, Petra M; Masclee, Ad A; van Os, Jim

2010-03-01

Although there is a suggestion that the medical psychiatric unit (MPU) may reduce length of hospital stay (LOS), little is known about costs in terms of medical service use and psychiatric interventions in MPU care. A record linkage study was conducted, linking cost data of hospital medical service use, LOS, and hospital psychiatric interventions to patients admitted to the MPU of the Maastricht University Medical Centre (MUMC) between 1998 and 2004. The data set was analyzed to enable comparison between cost changes of the same complex patient population following either MPU index admission or index admissions to reference MUMC medical wards. Comparisons revealed lower costs of medical service use in favor of the MPU (-euro104; 95% CI -euro174 to -euro35; P<.01). However, cost of psychiatric intervention and cost of LOS were higher after MPU admission (respectively, +euro165; 95% CI +euro25 to +euro305; P<.05; and +euro202; 95% CI +euro170 to +euro235; P<.001). Total costs were higher after MPU admission compared to medical ward admission (+euro263; 95% CI +euro68 to +euro458; P<.05). These differences were not moderated by somatic diagnosis or previous pattern of admissions. The findings suggest that patients at the interface of psychiatric and somatic morbidity are diagnosed and treated adequately at the MPU, leading to a decrease in medical service use and an appropriate increase in exposure to psychiatric interventions. These results are specifically generalizable to MPUs with a focus on psychosomatic conditions, for instance, somatoform disorders or affective disorders with comorbid somatic diseases. However, failure to show cost savings in terms of LOS compared to medical wards outweighs cost-benefit derived from lower medical service use, suggesting that MPU activities may gain in cost-effectiveness if shifted more to outpatient psychosomatic care solutions. Copyright 2010 Elsevier Inc. All rights reserved.

Antiepileptic drug prescribing patterns in Iraq and Afghanistan war veterans with epilepsy.

PubMed

Rohde, Natalie N; Baca, Christine B; Van Cott, Anne C; Parko, Karen L; Amuan, Megan E; Pugh, Mary Jo

2015-05-01

We examined patterns of antiepileptic drug (AED) use in a cohort of Iraq/Afghanistan war veterans (IAVs) who were previously identified as having epilepsy. We hypothesized that clinicians would be more likely to prescribe newer AEDs and would select specific AEDs to treat seizures based on patient characteristics including gender and comorbidities. From the cohort of IAVs previously identified with epilepsy between fiscal years 2009 and 2010, we selected those who received AEDs from the Veterans Health Administration in FY2010. Regimens were classified as monotherapy or polytherapy, and specific AED use was examine overall and by gender. Multivariable logistic regression examined associations of age; gender; race/ethnicity; medical, psychiatric, and neurological comorbidities; and receipt of neurology specialty care associated with the six most commonly used AEDs. Among 256,284 IAVs, 2123 met inclusion criteria (mean age: 33years; 89% men). Seventy-two percent (n=1526) received monotherapy, most commonly valproate (N=425) and levetiracetam (n=347). Sixty-one percent of those on monotherapy received a newer AED (levetiracetam, topiramate, lamotrigine, zonisamide, oxcarbazepine). Although fewer women than men received valproate, nearly 90% (N=45) were of reproductive age (≤45years). Antiepileptic drug prescribing patterns were associated with posttraumatic stress disorder, bipolar disorder, cerebrovascular disease, dementia/cognitive impairment, headache, and receipt of neurological specialty care (all p<0.01). In this cohort of veterans with epilepsy, most received AED monotherapy and newer AEDs. Prescribing patterns were different for men and women. The patterns observed between AEDs and neurological/psychiatric comorbidities suggest that clinicians are practicing rational prescribing. Copyright © 2015. Published by Elsevier Inc.

Emotional availability in mothers with borderline personality disorder and mothers with remitted major depression is differently associated with psychopathology among school-aged children.

PubMed

Kluczniok, Dorothea; Boedeker, Katja; Hindi Attar, Catherine; Jaite, Charlotte; Bierbaum, Anna-Lena; Fuehrer, Daniel; Paetz, Luisa; Dittrich, Katja; Herpertz, Sabine C; Brunner, Romuald; Winter, Sibylle; Heinz, Andreas; Roepke, Stefan; Heim, Christine; Bermpohl, Felix

2018-04-15

Both, maternal borderline personality disorder (BPD) and maternal major depressive disorder (MDD) are often associated with adverse consequences for children, including increased risk for child behavior problems. Reduced maternal emotional availability might play a critical role in transmitting maternal psychopathology on the child. Our aim was to investigate the association between emotional availability and maternal BPD and MDD in remission (rMDD), and if this interrelatedness mediates the association between maternal mental disorders and child behavior problems. The interaction of 178 mother-child dyads was assessed during a play situation using the Emotional Availability Scales. Children were between 5 and 12 years old. Regression analyses were used to investigate the impact of maternal BPD and maternal rMDD on emotional availability. Ordinary least squares regression analyses using bootstrapping were conducted to investigate the mediating effect of emotional availability on the association between maternal mental disorders and child behavior problems. Mothers with BPD showed increased hostility during mother-child interaction, whereas history of MDD was associated with reduced sensitivity. Maternal hostility was a mediator between maternal BPD and number of child psychiatric disorders, as well as externalizing and internalizing behavior. Maternal sensitivity mediated the association between maternal rMDD and number of child psychiatric disorders, as well as internalizing child behavior. Our data suggest that mothers with BPD show a qualitatively different pattern of emotional availability compared to mothers with rMDD. These patterns might reflect two separate pathways of transgenerational transmission of aspects of maternal mental disorders, where intervention and training programs could start: maternal rMDD impacts on child behavior problems via reduced sensitivity, and maternal BPD via increased hostility, which could both be addressed with specific therapeutic interventions. Copyright © 2018 Elsevier B.V. All rights reserved.

Comorbid Psychiatric Diagnoses in Preschoolers with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Hayashida, Kristen; Anderson, Bryan; Paparella, Tanya; Freeman, Stephanny F. N.; Forness, Steven R.

2010-01-01

Although comorbid or co-occurring psychiatric diagnoses such as attention deficit hyperactivity disorder, anxiety disorders, depression, and oppositional defiant or conduct disorders have been well studied in children or adolescents with autism spectrum disorders (ASDs), very little research is available on preschool samples. The current study…

Cross-sectional study to evaluate the longitudinal development of child and adolescent psychiatric diagnoses of inpatients in Vorarlberg, Austria.

PubMed

Schwarz, Karoline; Fuchs, Martin; Veraar, Maria; Menz, Wolfgang; Kemmler, Georg; Simma, Burkhard

2016-02-01

Clinical experience has repeatedly shown evidence for continuity between mental disorders in children and adolescents and mental disorders in adulthood. Up to now, Austria has had no epidemiologic data on psychiatric diseases in children and adolescents and their development into adulthood. How often do children and adolescents with psychiatric diseases have psychiatric diseases in adulthood? Is there any association between psychiatric diagnoses in childhood/adolescence and adulthood? Electronic medical records provided us with data on 2210 children and adolescents who were admitted to any hospital in the State of Vorarlberg, Austria, between 1997 and 2012 because of psychiatric diseases. In this cross-sectional study, diagnoses were coded according to ICD-10 and ICD-9 criteria. The three main reasons for admission of children and adolescents were substance abuse, emotional disorders and conduct disorders. Of the admitted children and adolescents, 9.8 % were readmitted to a psychiatric institution in adulthood. The main reason for readmission in adulthood appears to be disorders due to psychoactive substances (42.1 %). Of young patients with psychoactive substance use, 9.7 % were rehospitalized in adulthood, 70.8 % of them showed a diagnosis in the same category (F1) on admission. Children and adolescents admitted for schizophrenia, schizotypal, and delusional disorders (F2) were significantly more likely to be readmitted in adulthood (40.9 %) compared to any other child psychiatric diagnosis. This study once again shows the continuity of psychiatric disorders from childhood and adolescence to adulthood. It also gives further information about the transmission of diagnoses when patients reached the age of 18 years and their outcome. Until now, there is hardly any information about the outcome of children and adolescents with psychiatric diagnoses in Austria. We want to bring up more knowledge on that issue. Research findings may improve prevention and clinical assessment of children and adolescents with mental health problems.

Long term mental health outcomes of Finnish children evacuated to Swedish families during the second world war and their non-evacuated siblings: cohort study.

PubMed

Santavirta, Torsten; Santavirta, Nina; Betancourt, Theresa S; Gilman, Stephen E

2015-01-05

To compare the risks of admission to hospital for any type of psychiatric disorder and for four specific psychiatric disorders among adults who as children were evacuated to Swedish foster families during the second world war and their non-evacuated siblings, and to evaluate whether these risks differ between the sexes. Cohort study. National child evacuation scheme in Finland during the second world war. Children born in Finland between 1933 and 1944 who were later included in a 10% sample of the 1950 Finnish census ascertained in 1997 (n = 45,463; women: n = 22,021; men: n = 23,442). Evacuees in the sample were identified from war time government records. Adults admitted to hospital for psychiatric disorders recorded between 1971 and 2011 in the Finnish hospital discharge register. We used Cox proportional hazards models to estimate the association between evacuation to temporary foster care in Sweden during the second world war and admission to hospital for a psychiatric disorder between ages 38 and 78 years. Fixed effects methods were employed to control for all unobserved social and genetic characteristics shared among siblings. Among men and women combined, the risk of admission to hospital for a psychiatric disorder did not differ between Finnish adults evacuated to Swedish foster families and their non-evacuated siblings (hazard ratio 0.89, 95% confidence interval 0.64 to 1.26). Evidence suggested a lower risk of admission for any mental disorder (0.67, 0.44 to 1.03) among evacuated men, whereas for women there was no association between evacuation and the overall risk of admission for a psychiatric disorder (1.21, 0.80 to 1.83). When admissions for individual psychiatric disorders were analyzed, evacuated girls were significantly more likely than their non-evacuated sisters to be admitted to hospital for a mood disorder as an adult (2.19, 1.10 to 4.33). The Finnish evacuation policy was not associated with an increased overall risk of admission to hospital for a psychiatric disorder in adulthood among former evacuees. In fact, evacuation was associated with a marginally reduced risk of admission for any psychiatric disorder among men. Among women who had been evacuated, however, the risk of being admitted to hospital for a mood disorder was increased. © Santavirta et al 2014.

Psychiatric disorders among American Indian and white youth in Appalachia: the Great Smoky Mountains Study.

PubMed

Costello, E J; Farmer, E M; Angold, A; Burns, B J; Erkanli, A

1997-05-01

This study examined prevalence of psychiatric disorders, social and family risk factors for disorders, and met and unmet needs for mental health care among Appalachian youth. All 9-, 11-, and 13-year-old American Indian children in an 11-county area of the southern Appalachians were recruited, together with a representative sample of the surrounding population of White children. Three-month prevalences of psychiatric disorders were similar (American Indian, 16.7%; White, 19.2%). Substance use was more common in American Indian children (9.0% vs 3.8% in White children), as was comorbidity of substance use and psychiatric disorder (2.5% vs 0.9%). American Indian poverty, family adversity (e.g., parental unemployment, welfare dependency), and family deviance (parental violence, substance abuse, and crime) rates were higher, but the rate of family mental illness, excluding substance abuse, was lower. Child psychiatric disorder and mental health service use were associated with family mental illness in both ethnic groups but were associated with poverty and family deviance only in White children. Despite lower financial barriers, American Indian children used fewer mental health services. This study suggests that poverty and crime play different roles in different communities in the etiology of child psychiatric disorder.

Perceived body weight, eating and exercise problems of different groups of women.

PubMed

Coker, Elise; Telfer, James; Abraham, Suzanne

2012-10-01

To compare prevalence of problems with body weight, eating and exercise (past or present) of female psychiatric inpatients with routine care, gynaecological and obstetric female outpatients, and eating disorder inpatients. One thousand and thirty-eight females aged 18-55 years from routine care (n=99), gynaecological (n=263) and obstetric (n=271) outpatient clinics, and eating disorder (n=223) and general psychiatric units (n=182) participated. Participants self-reported past or current problems with weight, eating and exercise using a short survey. A sub-sample of women completed the Eating and Exercise Examination (EEE) which includes the Quality of Life for Eating Disorders (QOL ED). The prevalence of self-reported problems controlling weight (52%), disordered eating and eating disorders (43%) for the psychiatric patients was significantly greater than for the routine care and gynaecological and obstetrics outpatients. The psychiatric group had a significantly higher mean body mass index (BMI) of 27.3 kg/m(2) (standard deviation (SD)=6.7) and prevalence of self-reported obesity (28%) than the other groups. Treatment of women with psychiatric problems should include assessment and concurrent attention to body weight, eating disorder and exercise problems in association with appropriate medical, psychiatric, psychological and medication treatment of their presenting disorder.

Novel psychoactive substance consumption is more represented in bipolar disorder than in psychotic disorders: A multicenter-observational study.

PubMed

Acciavatti, Tiziano; Lupi, Matteo; Santacroce, Rita; Aguglia, Andrea; Attademo, Luigi; Bandini, Laura; Ciambrone, Paola; Lisi, Giulia; Migliarese, Giovanni; Pinna, Federica; Quattrone, Diego; Ribolsi, Michele; Signorelli, Maria Salvina; Calò, Salvatore; Schifano, Fabrizio; di Giannantonio, Massimo; Martinotti, Giovanni

2017-05-01

Comorbidities between psychiatric diseases and use of traditional substances of abuse are common. Nevertheless, there are few data regarding the use of novel psychoactive substances (NPS) among psychiatric patients. Aim of this multicentre survey is to investigate the consumption of a number of psychoactive substances in a young psychiatric sample. Between December 2013 and September 2015, a questionnaire was administered in 10 Italian psychiatric care facilities to a sample of 671 patients, aged 18-26 (mean age 22.24; SD 2.87). About 8.2% of the sample declared to have used NPS at least once, and 2.2% had consumed NPS in the previous 3 months. The three psychiatric diagnoses most frequently associated with NPS use were bipolar disorder (23.1%), personality disorders (11.8%), and schizophrenia and related disorders (11.6%). In univariate regression analysis, bipolar disorder was positively associated with NPS consumption, an association that did not reach statistical significance in the multivariate analysis. The use of NPS in a young psychiatric population appears to be frequent, and probably still underestimated. Bipolar disorder shows an association with NPS use. Careful and constant monitoring and an accurate evaluation of possible clinical effects related to NPS use are necessary. Copyright © 2017 John Wiley & Sons, Ltd.

Responses to discrimination and psychiatric disorders among Black, Hispanic, female, and lesbian, gay, and bisexual individuals.

PubMed

McLaughlin, Katie A; Hatzenbuehler, Mark L; Keyes, Katherine M

2010-08-01

We examined associations between perceived discrimination due to race/ethnicity, sexual orientation, or gender; responses to discrimination experiences; and psychiatric disorders. The sample included respondents in the 2004-2005 National Epidemiologic Survey on Alcohol and Related Conditions (n = 34 653). We analyzed the associations between self-reported past-year discrimination and past-year psychiatric disorders as assessed with structured diagnostic interviews among Black (n = 6587); Hispanic (n = 6359); lesbian, gay, and bisexual (LGB; n = 577); and female (n = 20 089) respondents. Black respondents reported the highest levels of past-year discrimination, followed by LGB, Hispanic, and female respondents. Across groups, discrimination was associated with 12-month mood (odds ratio [ORs] = 2.1-3.1), anxiety (ORs = 1.8-3.3), and substance use (ORs = 1.6-3.5) disorders. Respondents who reported not accepting discrimination and not discussing it with others had higher odds of psychiatric disorders (ORs = 2.9-3.9) than did those who did not accept discrimination but did discuss it with others. Black respondents and women who accepted discrimination and did not talk about it with others had elevated rates of mood and anxiety disorders, respectively. Psychiatric disorders are more prevalent among individuals reporting past-year discrimination experiences. Certain responses to discrimination, particularly not disclosing it, are associated with psychiatric morbidity.

The Prevalence and Characteristics of Psychiatric Disorders among Adolescent Bedouin with Mild to Moderate Intellectual Disability

ERIC Educational Resources Information Center

Manor-Binyamini, Iris

2010-01-01

The aim of this study was to examine the prevalence and types of psychiatric disorders among Bedouin adolescents with mild to moderate intellectual disability. This is the first study ever conducted on this topic within the Bedouin community in the Negev in Israel. The issue of psychiatric disorders among adolescents with intellectual disability…

Longitudinal Predictors of Psychiatric Disorders in Very Low Birth Weight Adults

ERIC Educational Resources Information Center

Westrupp, E. M.; Northam, E.; Doyle, L. W.; Callanan, C.; Anderson, P. J.

2012-01-01

The purpose of this study was to determine risk and protective factors for adult psychiatric disorders in very low birth weight (VLBW, birth weight less than 1,501 g) survivors. 79 of 154 (51%) VLBW subjects recruited at birth were assessed in early adulthood (24-27 years). Participants were screened for a psychiatric disorder; those elevated were…

A brief note on the history of psychosurgery in Japan.

PubMed

Nudeshima, Jiro; Taira, Takaomi

2017-09-01

In Japan, there has been no neurosurgical treatment for psychiatric disorders since the 1970s. Even deep brain stimulation (DBS) has not been studied or used for psychiatric disorders. Neurosurgery for psychiatric disorders has been thwarted by social taboos for many years, and psychiatrists today seem to simply ignore modern developments and therapies offered by neurosurgery such as DBS. As a result, most patients and their families do not know such "last-resort" options exist. Historically, as in other countries, frontal lobotomies were widely performed in Japan in the 1940s and 1950s, and some Japanese neurosurgeons used stereotactic methods for the treatment of psychiatric disorders until the 1960s. However, in the 1960s and 1970s such surgical treatments began to receive condemnation based on political judgment, rather than on medical and scientific evaluation. Protest campaigns at the time hinged on the prevailing political beliefs, forming a part of the new "left" movement against leading authorities across a wide range of societal institutions including medical schools. Finally, the Japanese Society for Psychiatry and Neurology banned the surgical treatment for psychiatric disorders in 1975. Even today, Japan's dark history continues to exert an enormous negative influence on neurosurgery for psychiatric disorders.

Parental psychological symptoms and familial risk factors of children and adolescents who exhibit school refusal.

PubMed

Bahali, K; Tahiroglu, A Y; Avci, A; Seydaoglu, G

2011-12-01

To assess the levels of psychological symptoms in the parents of children with school refusal and determine the familial risk factors in its development. This study was performed on 55 pairs of parents who had children exhibiting school refusal and were compared with a control group. A socio-demographic data form, the Beck Depression Inventory, the State-Trait Anxiety Inventory, and the Symptom Checklist-90 revised were applied to these parents. Parents of the school refusal group had higher anxiety and depression scores than the controls. Among the risk factors for school refusal, physical punishment by the parents, a history of organic disease in the parents or children, and a history of psychiatric disorders in the parents or other relatives were found to be significant. Depending on genetic and environmental factors, parents with psychiatric disorders appeared to be associated with development of psychiatric disorders in their children. Moreover, psychiatric disorders in parents negatively affected the treatment of their children and adolescents who exhibited school refusal. It is therefore vital to treat psychiatric disorders of parents with the children having psychiatric disorders, and thus increase parent participation in their children's therapeutic process.

Asperger Syndrome in India: Findings from a Case-Series with Respect to Clinical Profile and Comorbidity

PubMed Central

Sreedaran, Priya; Ashok, M. V.

2015-01-01

Asperger syndrome (AS) is an autism spectrum disorder with a high rate of psychiatric comorbidity. We describe the clinical profile and psychiatric comorbidity in a series of affected individuals referred to an Indian general hospital psychiatry setting. Gilliam Asperger's disorder scale was used to evaluate the clinical characteristics while Mini-International Neuropsychiatric Interview (MINI)-KID and MINI-PLUS were used to assess psychiatric comorbidity. The profile of subjects with AS in our case-series appears similar to that published elsewhere with high rates of psychiatric comorbidity. Mental health professionals should evaluate for psychiatric comorbidity in individuals with autism spectrum disorders. PMID:25969609

Asperger syndrome in India: findings from a case-series with respect to clinical profile and comorbidity.

PubMed

Sreedaran, Priya; Ashok, M V

2015-01-01

Asperger syndrome (AS) is an autism spectrum disorder with a high rate of psychiatric comorbidity. We describe the clinical profile and psychiatric comorbidity in a series of affected individuals referred to an Indian general hospital psychiatry setting. Gilliam Asperger's disorder scale was used to evaluate the clinical characteristics while Mini-International Neuropsychiatric Interview (MINI)-KID and MINI-PLUS were used to assess psychiatric comorbidity. The profile of subjects with AS in our case-series appears similar to that published elsewhere with high rates of psychiatric comorbidity. Mental health professionals should evaluate for psychiatric comorbidity in individuals with autism spectrum disorders.

Slater revisited: 6 year follow up study of patients with medically unexplained motor symptoms.

PubMed

Crimlisk, H L; Bhatia, K; Cope, H; David, A; Marsden, C D; Ron, M A

1998-02-21

To investigate psychiatric and neurological morbidity, diagnostic stability, and indicators of prognosis in patients previously identified as having medically unexplained motor symptoms. Follow up study. National Hospital for Neurology and Neurosurgery, London--a secondary and tertiary referral hospital for neurological disorders. 73 patients with medically unexplained motor symptoms admitted consecutively in 1989-91. 35 (48%) patients had absence of motor function (for example, hemiplegia) and 38 (52%) had abnormal motor activity (for example, tremor, dystonia, or ataxia). Neurological clinical diagnosis at face to face reassessment by a neurologist and a psychiatric diagnosis after a standardised assessment interview--the schedule for affective disorders and schizophrenia--conducted by a psychiatrist. Good follow up data were available for 64 subjects (88%). Only three subjects had new organic neurological disorders at follow up that fully or partly explained their previous symptoms. 44/59 (75%) subjects had had psychiatric disorders; in 33 (75%) patients, the psychiatric diagnosis coincided with their unexplained motor symptoms. 31/59 (45%) patients had a personality disorder. Three subjects had developed new psychiatric illnesses at follow up, but in only one did the diagnosis account for the previous motor symptoms. Resolution of physical symptoms was associated with short length of symptoms, comorbid psychiatric disorder, and a change in marital status during follow up. Unlike Slater's study of 1965, a low incidence of physical or psychiatric diagnoses which explained these patients' symptoms or disability was found. However, a high level of psychiatric comorbidity existed.

Arrest types and co-occurring disorders in persons with schizophrenia or related psychoses.

PubMed

McCabe, Patrick J; Christopher, Paul P; Druhn, Nicholas; Roy-Bujnowski, Kristen M; Grudzinskas, Albert J; Fisher, William H

2012-07-01

This study examined the patterns of criminal arrest and co-occurring psychiatric disorders among individuals with schizophrenia or related psychosis that were receiving public mental health services and had an arrest history. Within a 10-year period, 65% of subjects were arrested for crimes against public order, 50% for serious violent crimes, and 45% for property crimes. The presence of any co-occurring disorder increased the risk of arrest for all offense categories. For nearly all offense types, antisocial personality disorder and substance use disorders conferred the greatest increase in risk for arrest. Among anxiety disorders, post-traumatic stress disorder was associated with a greater risk of arrest for serious violent crimes but not other offense types. Criminal risk assessments and clinical management in this population should focus on co-occurring antisocial personality disorder and substance use disorders in addition to other clinical and non-clinical factors.

A comparison of DSM-II and DSM-III in the diagnosis of childhood psychiatric disorders. II. Interrater agreement.

PubMed

Mattison, R; Cantwell, D P; Russell, A T; Will, L

1979-10-01

A case-history format was utilized to compare interrater agreement on childhood and adolescent psychiatric disorders, using DSM-II and DSM-III. The average interrater agreement was 57% for DSM-II and 54% for axis I (clinical psychiatric syndrome) of DSM-III. There was high agreement in both systems on cases of psychosis, conduct disorder, hyperactivity, and mental retardation, with DSM-III appearing slightly better. There was noteworthy interrater disagreement in both systems for "anxiety" disorders, complex cases, and in the subtyping of depression. Overall, the reliability of DSM-III appears to be good and is comparable with that of DSM-II and other classification systems of childhood psychiatric disorders.

Refining psychiatric genetics: from ‘mouse psychiatry’ to understanding complex human disorders

PubMed Central

LaPorte, Justin L.; Ren-Patterson, Renee F.; Murphy, Dennis L.; Kalueff, Allan V.

2009-01-01

Investigating the pathogenesis of psychiatric disorders is a complicated and rigorous task for psychiatric geneticists, as the disorders often involve combinations of genetic, behavioral, personality, and environmental factors. To nurture further progress in this field, a new set of conceptual tools is needed in addition to the currently accepted approaches. Concepts that consider cross-species trait genetics and the interplay between the domains of disorders, as well as the full spectrum of potential symptoms and their place along the pathogenetic continuum, are particularly important to address these needs. Here, we outline recent concepts and approaches that can help refine the field and enable more precise dissection of the genetic mechanisms contributing to psychiatric disorders. PMID:18690099

Prevalence of social phobia and its comorbidity with psychiatric disorders in Iran.

PubMed

Mohammadi, Mohammad-Reza; Ghanizadeh, Ahmad; Mohammadi, Mohammad; Mesgarpour, Bita

2006-01-01

This study explored the prevalence of social phobia (SP) in the general population of Iran, the sociodemographic characteristics of subjects with SP, and its comorbidity with the other lifetime psychiatric disorders. Our study was part of the nationwide study on the prevalence of psychiatric disorders in Iran. Overall, 25,180 Iranian subjects, age 18 years and over, from urban and rural areas of Iran were selected by a clustered random sampling method and interviewed face-to-face by 250 trained clinical psychologists using DSM-IV diagnostic criteria. Out of 12,398,235 households, 7,795 households in the form of 1,559 clusters of five households were selected. The statistical framework was based on the household lists available from the Department of Health in the provinces. The response rate was 90%. The lifetime prevalence of SP was 0.82%. The rate was 0.4% in males and 1.3% in females. The rate was higher in younger age groups and widows/widowers. It was not related to educational level and residential area. Specific phobia (66.7%), obsessive-compulsive disorder (17.4%), major depressive disorder (15%), and panic disorder (12.1%) were the most common lifetime psychiatric disorders among subjects with SP. The rate of SP in Iran is more similar to that in other Asian countries, and it is lower than that in Western countries. The rate of other psychiatric disorders among subjects with SP is more than that in the general population, and the most common psychiatric disorders were the other anxiety disorders and major depressive disorder.

Incremental predictive validity of the Addiction Severity Index psychiatric composite score in a consecutive cohort of patients in residential treatment for drug use disorders.

PubMed

Thylstrup, Birgitte; Bloomfield, Kim; Hesse, Morten

2018-01-01

The Addiction Severity Index (ASI) is a widely used assessment instrument for substance abuse treatment that includes scales reflecting current status in seven potential problem areas, including psychiatric severity. The aim of this study was to assess the ability of the psychiatric composite score to predict suicide and psychiatric care after residential treatment for drug use disorders after adjusting for history of psychiatric care. All patients treated for drug use disorders in residential treatment centers in Denmark during the years 2000-2010 with complete ASI data were followed through national registers of psychiatric care and causes of death (N=5825). Competing risks regression analyses were used to assess the incremental predictive validity of the psychiatric composite score, controlling for previous psychiatric care, length of intake, and other ASI composite scores, up to 12years after discharge. A total of 1769 patients received psychiatric care after being discharged from residential treatment (30.3%), and 27 (0.5%) committed suicide. After adjusting for all covariates, psychiatric composite score was associated with a higher risk of receiving psychiatric care after residential treatment (subhazard ratio [SHR]=3.44, p<0.001), and of committing suicide (SHR=11.45, p<0.001). The ASI psychiatric composite score has significant predictive validity and promises to be useful in identifying patients with drug use disorders who could benefit from additional mental health treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

Shared genetic and environmental influences on early temperament and preschool psychiatric disorders in Hispanic twins

PubMed Central

Silberg, Judy L.; Gillespie, Nathan; Moore, Ashlee A.; Eaves, Lindon J.; Bates, John; Aggen, Steven; Pfister, Elizabeth; Canino, Glorisa

2015-01-01

Objective Despite an increasing recognition that psychiatric disorders can be diagnosed as early as preschool, little is known how early genetic and environmental risk factors contribute to the development of psychiatric disorders during this very early period of development. Method We assessed infant temperament at age 1, and attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and separation anxiety disorder (SAD) at ages 3 through 5 years in a sample of Hispanic twins. Genetic, shared, and non-shared environmental effects were estimated for each temperamental construct and psychiatric disorder using the statistical program MX. Multivariate genetic models were fitted to determine whether the same or different sets of genes and environments account for the co-occurrence between early temperament and preschool psychiatric disorders. Results Additive genetic factors accounted for 61% of the variance in ADHD, 21% in ODD, and 28% in SAD. Shared environmental factors accounted for 34% of the variance in ODD and 15% of SAD. The genetic influence on difficult temperament was significantly associated with preschool ADHD, SAD, and ODD. The association between ODD and SAD was due to both genetic and family environmental factors. The temperamental trait of resistance to control was entirely accounted for by the shared family environment. Conclusions There are different genetic and family environmental pathways between infant temperament and psychiatric diagnoses in this sample of Puerto Rican preschool age children. PMID:25728588

Shared genetic and environmental influences on early temperament and preschool psychiatric disorders in Hispanic twins.

PubMed

Silberg, Judy L; Gillespie, Nathan; Moore, Ashlee A; Eaves, Lindon J; Bates, John; Aggen, Steven; Pfister, Elizabeth; Canino, Glorisa

2015-04-01

Despite an increasing recognition that psychiatric disorders can be diagnosed as early as preschool, little is known how early genetic and environmental risk factors contribute to the development of psychiatric disorders during this very early period of development. We assessed infant temperament at age 1, and attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and separation anxiety disorder (SAD) at ages 3 through 5 years in a sample of Hispanic twins. Genetic, shared, and non-shared environmental effects were estimated for each temperamental construct and psychiatric disorder using the statistical program MX. Multivariate genetic models were fitted to determine whether the same or different sets of genes and environments account for the co-occurrence between early temperament and preschool psychiatric disorders. Additive genetic factors accounted for 61% of the variance in ADHD, 21% in ODD, and 28% in SAD. Shared environmental factors accounted for 34% of the variance in ODD and 15% of SAD. The genetic influence on difficult temperament was significantly associated with preschool ADHD, SAD, and ODD. The association between ODD and SAD was due to both genetic and family environmental factors. The temperamental trait of resistance to control was entirely accounted for by the shared family environment. There are different genetic and family environmental pathways between infant temperament and psychiatric diagnoses in this sample of Puerto Rican preschool age children.

Parent Report of Community Psychiatric Comorbid Diagnoses in Autism Spectrum Disorders

PubMed Central

Rosenberg, Rebecca E.; Kaufmann, Walter E.; Law, J. Kiely; Law, Paul A.

2011-01-01

We used a national online registry to examine variation in cumulative prevalence of community diagnosis of psychiatric comorbidity in 4343 children with autism spectrum disorders (ASD). Adjusted multivariate logistic regression models compared influence of individual, family, and geographic factors on cumulative prevalence of parent-reported anxiety disorder, depression, bipolar disorder, and attention deficit/hyperactivity disorder or attention deficit disorder. Adjusted odds of community-assigned lifetime psychiatric comorbidity were significantly higher with each additional year of life, with increasing autism severity, and with Asperger syndrome and pervasive developmental disorder—not otherwise specified compared with autistic disorder. Overall, in this largest study of parent-reported community diagnoses of psychiatric comorbidity, gender, autistic regression, autism severity, and type of ASD all emerged as significant factors correlating with cumulative prevalence. These findings could suggest both underlying trends in actual comorbidity as well as variation in community interpretation and application of comorbid diagnoses in ASD. PMID:22937248

Closed Loop Deep Brain Stimulation for PTSD, Addiction, and Disorders of Affective Facial Interpretation: Review and Discussion of Potential Biomarkers and Stimulation Paradigms

PubMed Central

Bina, Robert W.; Langevin, Jean-Phillipe

2018-01-01

The treatment of psychiatric diseases with Deep Brain Stimulation (DBS) is becoming more of a reality as studies proliferate the indications and targets for therapies. Opinions on the initial failures of DBS trials for some psychiatric diseases point to a certain lack of finesse in using an Open Loop DBS (OLDBS) system in these dynamic, cyclical pathologies. OLDBS delivers monomorphic input into dysfunctional brain circuits with modulation of that input via human interface at discrete time points with no interim modulation or adaptation to the changing circuit dynamics. Closed Loop DBS (CLDBS) promises dynamic, intrinsic circuit modulation based on individual physiologic biomarkers of dysfunction. Discussed here are several psychiatric diseases which may be amenable to CLDBS paradigms as the neurophysiologic dysfunction is stochastic and not static. Post-Traumatic Stress Disorder (PTSD) has several peripheral and central physiologic and neurologic changes preceding stereotyped hyper-activation behavioral responses. Biomarkers for CLDBS potentially include skin conductance changes indicating changes in the sympathetic nervous system, changes in serum and central neurotransmitter concentrations, and limbic circuit activation. Chemical dependency and addiction have been demonstrated to be improved with both ablation and DBS of the Nucleus Accumbens and as a serendipitous side effect of movement disorder treatment. Potential peripheral biomarkers are similar to those proposed for PTSD with possible use of environmental and geolocation based cues, peripheral signs of physiologic arousal, and individual changes in central circuit patterns. Non-substance addiction disorders have also been serendipitously treated in patients with OLDBS for movement disorders. As more is learned about these behavioral addictions, DBS targets and effectors will be identified. Finally, discussed is the use of facial recognition software to modulate activation of inappropriate responses for psychiatric diseases in which misinterpretation of social cues feature prominently. These include Autism Spectrum Disorder, PTSD, and Schizophrenia—all of which have a common feature of dysfunctional interpretation of facial affective clues. Technological advances and improvements in circuit-based, individual-specific, real-time adaptable modulation, forecast functional neurosurgery treatments for heretofore treatment-resistant behavioral diseases. PMID:29780303

Lower prevalence of psychiatric conditions when negative age stereotypes are resisted

PubMed Central

Levy, Becca R.; Pilver, Corey E.; Pietrzak, Robert H.

2015-01-01

Older military veterans are at greater risk for psychiatric disorders than same-aged non-veterans. However, little is known about factors that may protect older veterans from developing these disorders. We considered whether an association exists between the potentially stress-reducing factor of resistance to negative age stereotypes and lower prevalence of the following outcomes among older veterans: suicidal ideation, anxiety, and posttraumatic stress disorder (PTSD). Participants consisted of 2031 veterans, aged 55 or older, who were drawn from the National Health and Resilience in Veterans Study, a nationally representative survey of American veterans. The prevalence of all three outcomes was found to be significantly lower among participants who fully resisted negative age stereotypes, compared to those who fully accepted them: suicidal ideation, 5.0% vs. 30.1%; anxiety, 3.6% vs. 34.9%; and PTSD, 2.0% vs. 18.5%, respectively. The associations followed a graded linear pattern and persisted after adjustment for relevant covariates, including age, combat experience, personality, and physical health. These findings suggest that developing resistance to negative age stereotypes could provide older individuals with a path to greater mental health. PMID:25189737

Differential diagnosis between dementia and psychiatric disorders: Diagnostic criteria and supplementary exams. Recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology

PubMed Central

Bottino, Cássio M.C.; de Pádua, Analuiza Camozzato; Smid, Jerusa; Areza-Fegyveres, Renata; Novaretti, Tânia; Bahia, Valeria S.

2011-01-01

In 2005, the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology published recommendations for the diagnosis of Alzheimer's disease These recommendations were updated following a review of evidence retrieved from national and international studies held on PUBMED, SCIELO and LILACS medical databases. The main aims of this review article are as follows: 1) to present the evidence found on Brazilian (LILACS, SCIELO) and International (MEDLINE) databases from articles published up to May 2011, on the differential diagnosis of these psychiatric disorders and dementia, with special focus on Dementia due to Alzheimer's and vascular dementia, including a review of supplementary exams which may facilitate the diagnostic process; and 2) to propose recommendations for use by clinicians and researchers involved in diagnosing patients with dementia. Differential diagnosis between dementia and other neuropsychiatric disorders should always include assessments for depression, delirium, and use of psychoactive substances, as well as investigate the use of benzodiazepines, anti-epileptics and pattern of alcohol consumption. PMID:29213755

Misophonia: Diagnostic Criteria for a New Psychiatric Disorder

PubMed Central

Schröder, Arjan; Vulink, Nienke; Denys, Damiaan

2013-01-01

Background Some patients report a preoccupation with a specific aversive human sound that triggers impulsive aggression. This condition is relatively unknown and has hitherto never been described, although the phenomenon has anecdotally been named misophonia. Methodology and Principal Findings 42 patients who reported misophonia were recruited by our hospital website. All patients were interviewed by an experienced psychiatrist and were screened with an adapted version of the Y-BOCS, HAM-D, HAM-A, SCL-90 and SCID II. The misophonia patients shared a similar pattern of symptoms in which an auditory or visual stimulus provoked an immediate aversive physical reaction with anger, disgust and impulsive aggression. The intensity of these emotions caused subsequent obsessions with the cue, avoidance and social dysfunctioning with intense suffering. The symptoms cannot be classified in the current nosological DSM-IV TR or ICD-10 systems. Conclusions We suggest that misophonia should be classified as a discrete psychiatric disorder. Diagnostic criteria could help to officially recognize the patients and the disorder, improve its identification by professional health carers, and encourage scientific research. PMID:23372758

Differential diagnosis between dementia and psychiatric disorders: Diagnostic criteria and supplementary exams. Recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology.

PubMed

Bottino, Cássio M C; de Pádua, Analuiza Camozzato; Smid, Jerusa; Areza-Fegyveres, Renata; Novaretti, Tânia; Bahia, Valeria S

2011-01-01

In 2005, the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology published recommendations for the diagnosis of Alzheimer's disease These recommendations were updated following a review of evidence retrieved from national and international studies held on PUBMED, SCIELO and LILACS medical databases. The main aims of this review article are as follows: 1) to present the evidence found on Brazilian (LILACS, SCIELO) and International (MEDLINE) databases from articles published up to May 2011, on the differential diagnosis of these psychiatric disorders and dementia, with special focus on Dementia due to Alzheimer's and vascular dementia, including a review of supplementary exams which may facilitate the diagnostic process; and2) to propose recommendations for use by clinicians and researchers involved in diagnosing patients with dementia. Differential diagnosis between dementia and other neuropsychiatric disorders should always include assessments for depression, delirium , and use of psychoactive substances, as well as investigate the use of benzodiazepines, anti-epileptics and pattern of alcohol consumption.

Immigrants and borderline personality disorder at a psychiatric emergency service.

PubMed

Pascual, J C; Malagón, A; Córcoles, D; Ginés, J M; Soler, J; García-Ribera, C; Pérez, V; Bulbena, A

2008-12-01

Several studies have suggested that immigrants have higher rates of psychiatric emergency service use and a higher risk of mental disorders such as schizophrenia than indigenous populations. To compare the likelihood that immigrants (immigrant group) v. indigenous population (indigenous group) will be diagnosed with borderline personality disorder in a psychiatric emergency service and to determine differences according to area of origin. A total of 11 578 consecutive admissions over a 4-year period at a tertiary psychiatric emergency service were reviewed. The collected data included socio-demographic and clinical variables and the Severity of Psychiatric Illness rating score. Psychiatric diagnosis was limited to information available in the emergency room given that a structured interview is not usually feasible in this setting. The diagnosis of borderline personality disorder was based on DSM-IV criteria. Immigrants were divided into five groups according to region of origin: North Africa, sub-Saharan Africa, South America, Asia and Western countries. Multivariate statistical logistic regression analysis showed that all subgroups of immigrants had a lower likelihood of being diagnosed with borderline personality disorder than the indigenous population independently of age and gender. Furthermore, the rates of borderline personality disorder diagnosis were considerably lower in Asian and sub-Saharan subgroups than in South American, North African, Western or native subgroups. Our results showed that in the psychiatric emergency service borderline personality disorder was diagnosed less frequently in the immigrant group v. the indigenous group. Our results do not support the concept of migration as a risk factor for borderline personality disorder.

Work and common psychiatric disorders

PubMed Central

Henderson, M; Harvey, SB; Øverland, S; Mykletun, A; Hotopf, M

2011-01-01

Psychiatric disorders are now the most common reason for long-term sickness absence. The associated loss in productivity and the payment of disability benefits places a substantial burden on the economies of many developed countries. The occupational dysfunction associated with psychiatric disorders can also lead to poverty and social isolation. As a result the area of work and psychiatric disorders is a high priority for policymakers. There are two main agendas: for many researchers and clinicians the focus is on the need to overcome stigma and ensure people with severe psychiatric disorders have meaningful work; however the public health agenda predominantly relates to the more common disorders such as depression and anxiety, which contribute a greater burden of disability benefits and pensions. In this review we attempt to address this second agenda. The relatively sparse evidence available reveals a complex field with significant interplay between medical, psychological social and cultural factors. Sick leave can be a ‘process’ as well as an ‘event’. In this review we propose a staged model where different risk and protective factors contribute to the onset of psychiatric disorders in the working population, the onset of short-term sickness absence, and the transition from short- to long-term absence. We also examine strategies to manage psychiatric disorder in the workforce with a view towards returning the employee to work. Our aim in this review is to highlight the complexity of the area, to stimulate debate and to identify important gaps in knowledge where further research might benefit both patients and wider society. PMID:21558098

Psilocybin-Assisted Therapy: A Review of a Novel Treatment for Psychiatric Disorders.

PubMed

Thomas, Kelan; Malcolm, Benjamin; Lastra, Dan

2017-01-01

Recent research suggests that functional connectivity changes may be involved in the pathophysiology of psychiatric disorders. Hyperconnectivity in the default mode network has been associated with psychopathology, but psychedelic serotonin agonists like psilocybin may profoundly disrupt these dysfunctional neural network circuits and provide a novel treatment for psychiatric disorders. We have reviewed the current literature to investigate the efficacy and safety of psilocybin-assisted therapy for the treatment of psychiatric disorders. There were seven clinical trials that investigated psilocybin-assisted therapy as a treatment for psychiatric disorders related to anxiety, depression, and substance use. All trials demonstrated reductions in psychiatric rating scale scores or increased response and remission rates. There were large effect sizes related to improved depression and anxiety symptoms. Psilocybin may also potentially reduce alcohol or tobacco use and increase abstinence rates in addiction, but the benefits of these two trials were less clear due to open-label study designs without statistical analysis. Psilocybin-assisted therapy efficacy and safety appear promising, but more robust clinical trials will be required to support FDA approval and identify the potential role in clinical psychiatry.

Psychiatric Disorders and Labor Market Outcomes: Evidence from the National Latino and Asian American Study

PubMed Central

Chatterji, Pinka; Alegria, Margarita; Lu, Mingshan; Takeuchi, David

2009-01-01

This paper investigates to what extent psychiatric disorders and mental distress affect labor market outcomes in two rapidly growing populations that have not been studied to date – ethnic minorities of Latino and Asian descent, most of whom are immigrants. Using data from the National Latino and Asian American Study (NLAAS), we examine the labor market effects of having any psychiatric disorder in the past 12 months as well as the effects of experiencing psychiatric distress in the past 12 months. The labor market outcomes analyzed are current employment status, the number of weeks worked in the past year among those who are employed, and having at least one work absence in the past month among those who are employed. Our results show that among Latinos, psychiatric disorders and mental distress are associated with large, detrimental effects on employment and absenteeism, similar to effects found in analyses of mostly white, American born populations. Among Asians, we find more mixed evidence that psychiatric disorders and mental distress detract from labor market outcomes. PMID:17294497

Psychiatric comorbidities in patients with systemic lupus erythematosus: a systematic review of the last 10 years.

PubMed

Asano, Nadja Maria Jorge; Coriolano, Maria das Graças Wanderley de Sales; Asano, Breno Jorge; Lins, Otávio Gomes

2013-01-01

To analyze the frequency of psychiatric comorbidities in patients with systemic lupus erythematosus (SLE) using the systematic review method. A systematic literature search was performed between April and July 2011 in the following databases: BIREME, PubMed and CAPES thesis database. This search prioritized studies published over the last ten years (2001-2011), involving the presence of psychiatric comorbidities in patients with SLE. Out of 314 articles published in scientific journals (PubMed) and 29 (BIREME), previously identified ones, 13 articles on psychiatric disorders and SLE were selected so they could be submitted to the systematic review methodological approach. The articles indicated high frequency of psychiatric comorbidities, especially mood and anxiety disorders. There is no consensus between the disease activity and psychiatric disorders. Patients with active SLE showed a higher risk of developing mood disorders than patients with inactive SLE. Patients with SLE had a higher suicide risk than the general population. More thorough studies to evaluate the psychological and genetic role, specific and non-specific autoimmune inflammatory mechanisms in mood and anxiety disorders are needed.

PsyGeNET: a knowledge platform on psychiatric disorders and their genes.

PubMed

Gutiérrez-Sacristán, Alba; Grosdidier, Solène; Valverde, Olga; Torrens, Marta; Bravo, Àlex; Piñero, Janet; Sanz, Ferran; Furlong, Laura I

2015-09-15

PsyGeNET (Psychiatric disorders and Genes association NETwork) is a knowledge platform for the exploratory analysis of psychiatric diseases and their associated genes. PsyGeNET is composed of a database and a web interface supporting data search, visualization, filtering and sharing. PsyGeNET integrates information from DisGeNET and data extracted from the literature by text mining, which has been curated by domain experts. It currently contains 2642 associations between 1271 genes and 37 psychiatric disease concepts. In its first release, PsyGeNET is focused on three psychiatric disorders: major depression, alcohol and cocaine use disorders. PsyGeNET represents a comprehensive, open access resource for the analysis of the molecular mechanisms underpinning psychiatric disorders and their comorbidities. The PysGeNET platform is freely available at http://www.psygenet.org/. The PsyGeNET database is made available under the Open Database License (http://opendatacommons.org/licenses/odbl/1.0/). lfurlong@imim.es Supplementary data are available at Bioinformatics online. © The Author 2015. Published by Oxford University Press.

Prevalence of mental disorder in remand prisoners: consecutive case study.

PubMed Central

Birmingham, L.; Mason, D.; Grubin, D.

1996-01-01

OBJECTIVE: To define the prevalence of mental disorder and need for psychiatric treatment in new remand prisoners and to determine to what extent these are recognised and addressed in prison. DESIGN: Study of consecutive male remand prisoners at reception using a semistructured psychiatric interview. SETTING: Large remand prison for men (HMP Durham). SUBJECTS: 669 men aged 21 years and over on remand, awaiting trial. MAIN OUTCOME MEASURES: Prevalence of mental disorder at reception, prisoners need for psychiatric treatment, identification of mental disorder by prison reception screening, and numbers placed appropriately in the prison hospital. RESULTS: 148 (26%) men had one or more current mental disorders (excluding substance misuse) including 24 who were acutely psychotic. The prison reception screening identified 34 of the men with mental disorder and six of those with acute psychosis. 168 men required psychiatric treatment, 50 of whom required urgent intervention; 16 required immediate transfer to psychiatric hospital. Of these 50, 17 were placed on the hospital wing because of mental disorder recognised at prison screening. CONCLUSION: Not only is the prevalence of mental disorder, in particular severe mental illness, high in this population, but the numbers identified at reception are low and subsequent management in prison is poor. PMID:8978227

Interventions for comorbid problem gambling and psychiatric disorders: Advancing a developing field of research.

PubMed

Dowling, N A; Merkouris, S S; Lorains, F K

2016-07-01

Despite significant psychiatric comorbidity in problem gambling, there is little evidence on which to base treatment recommendations for subpopulations of problem gamblers with comorbid psychiatric disorders. This mini-review draws on two separate systematic searches to identify possible interventions for comorbid problem gambling and psychiatric disorders, highlight the gaps in the currently available evidence base, and stimulate further research in this area. In this mini-review, only 21 studies that have conducted post-hoc analyses to explore the influence of psychiatric disorders or problem gambling subtypes on gambling outcomes from different types of treatment were identified. The findings of these studies suggest that most gambling treatments are not contraindicated by psychiatric disorders. Moreover, only 6 randomized studies comparing the efficacy of interventions targeted towards specific comorbidity subgroups with a control/comparison group were identified. The results of these studies provide preliminary evidence for modified dialectical behavior therapy for comorbid substance use, the addition of naltrexone to cognitive-behavioral therapy (CBT) for comorbid alcohol use problems, and the addition of N-acetylcysteine to tobacco support programs and imaginal desensitisation/motivational interviewing for comorbid nicotine dependence. They also suggest that lithium for comorbid bipolar disorder, escitalopram for comorbid anxiety disorders, and the addition of CBT to standard drug treatment for comorbid schizophrenia may be effective. Future research evaluating interventions sequenced according to disorder severity or the functional relationship between the gambling behavior and comorbid symptomatology, identifying psychiatric disorders as moderators of the efficacy of problem gambling interventions, and evaluating interventions matched to client comorbidity could advance this immature field of study. Copyright © 2016 Elsevier Ltd. All rights reserved.

Crime and Psychiatric Disorders Among Youth in the US Population: An Analysis of National Comorbidity Survey-Adolescent Supplement

PubMed Central

Coker, Kendell L.; Smith, Philip H.; Westphal, Alexander; Zonana, Howard V.; McKee, Sherry A.

2014-01-01

Objective Current knowledge regarding psychiatric disorders and crime in youth is limited to juvenile justice and community samples. This study examined relationships between psychiatric disorders and self-reported crime involvement in a sample of youth representative of the US population. Method The National Comorbidity Survey-Adolescent Supplement (N=10,123; ages 13–17; 2001–2004) was used to examine the relationship between lifetime DSM-IV-based diagnoses, reported crime (property, violent, other), and arrest history. Logistic regression compared the odds of reported crime involvement with specific psychiatric disorders to those without any diagnoses, and examined the odds of crime by psychiatric comorbidity. Results Prevalence of crime was 18.4%. Youth with lifetime psychiatric disorders, compared to no disorders, had significantly greater odds of crime, including violent crime. For violent crime resulting in arrest, conduct disorder (CD; OR=57.5; 95% CI=30.4,108.8), alcohol use disorders (OR=19.5; 95% CI=8.8,43.2), and drug use disorders (OR=16.1; 95% CI=9.3,27.7) had the greatest odds with similar findings for violent crime with no arrest. Psychiatric comorbidity increased the odds of crime. Youth with 3 or more diagnoses (16.0% of population) accounted for 54.1% of those reporting arrest for violent crime. Youth with at least 1 diagnosis committed 85.8% of crime, which was reduced to 67.9% by removing those with CD. Importantly, 88.2% of youth with mental illness report never committing any crime. Conclusion Our findings highlight the importance of improving access to mental health services for youthful offenders in community settings given the substantial associations found between mental illness and crime in this nationally representative epidemiological sample. PMID:25062596

Comorbidity of Psychiatric and Personality Disorders in First Suicide Attempters

PubMed Central

Rao, K. Nagaraja; Kulkarni, Ranganath R.; Begum, Shamshad

2013-01-01

Background: Attempted suicide is a common clinical problem in a general hospital setting. It has a serious clinical and socio-economical impact too. Aims: To study the psychosocial, psychiatric, and personality profile of the first suicide attempters in a general hospital. Settings and Design: Cross-sectional, hospital-based, descriptive study. Materials and Methods: All the consecutive cases of first suicide attempt (n=100) treated in a general hospital were studied to know the clinical profile. Variables related to socio-demographic characteristics, family background, suicide characteristics, psychiatric morbidity, and comorbidity were analyzed. Risk-Rescue rating was applied to know the medical seriousness of the suicide attempt. Presumptive stressful life event scale was utilized to calculate life events score. Structured clinical interview (MINI Plus) and semi-structured clinical interview (IPDE) were used for axis-I and axis-II (personality) diagnoses. The results were analyzed using appropriate statistical measures. Results: Family history of psychiatric illnesses (31%) and suicide (11%) were noted. Insecticides and pesticides were the most common agents (71%) employed to attempt suicide. Interpersonal difficulties (46%) were the most frequent stressor. Overall medical seriousness of the suicide attempt was of moderate lethality. 93% of the suicide attempters had at least one axis-I and/or axis-II psychiatric disorder. Most common diagnostic categories were mood disorders, adjustment disorders, and substance-related disorders, with axis-I disorders (89%), personality disorders (52%), and comorbidity of psychiatric disorders (51.6%). Conclusion: Individuals who made first suicide attempt were young adults, had lower educational achievement; overall seriousness of the suicide attempt was of moderate lethality, high prevalence of psychiatric morbidity, personality disorders, and comorbidity, and had sought medical help from general practitioners. PMID:23833346

Transcranial Direct Current Stimulation in Child and Adolescent Psychiatry.

PubMed

Muszkat, Débora; Polanczyk, Guilherme Vanoni; Dias, Taciana G Costa; Brunoni, André Russowsky

2016-09-01

Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that consists of applying a weak electric current over the scalp to modulate cortical excitability. tDCS has been extensively investigated in adults with psychiatric disorders. The aim of this study was to review the current literature regarding the use of tDCS in children and adolescents with psychiatric disorders. We searched MEDLINE and EMBASE databases for studies evaluating the safety and efficacy of tDCS in children and adolescents from age 0 to 18 years with psychiatric disorders. We found six studies that evaluated patients with different psychiatric disorders, with diverse study designs and stimulation parameters, including three small randomized clinical trials (RCTs), one evaluating childhood-onset schizophrenia, one RCT with patients with autism spectrum disorders (ASD), and one study in attention-deficit/hyperactivity disorder (ADHD); three open-label studies, two evaluating patients with ASD, and one study of feasibility of the technique in children and adolescents with language disorders and diverse psychiatric disorders, including ASD, intellectual disability, and ADHD. We also found three studies of dosage considerations in the general pediatric population. The technique was well tolerated, with no reports of serious side effects. Preliminary research suggests that tDCS may be well tolerated and safe for children and adolescents with psychiatric and neurodevelopmental disorders. Nevertheless, because the literature regarding tDCS in child and adolescent psychiatry is scarce and there exist limited numbers of randomized controlled trials, it is not possible to draw definite conclusions. Future studies should investigate the technique with regard to specific psychiatric conditions in comparison with standard treatments. In addition, long-term efficacy and safety should be monitored.

Obsessive-compulsive disorder in the postpartum period: diagnosis, differential diagnosis and management.

PubMed

Sharma, Verinder; Sommerdyk, Christina

2015-07-01

Childbirth can trigger or exacerbate a variety of psychiatric disorders but the extant literature has focused primarily on mood disorders. Obsessive-compulsive disorder (OCD) after childbirth can occur alone or in combination with other psychiatric disorders such as major depressive disorder. Due to the general lack of awareness of the relationship between childbirth and OCD among clinicians as well as patients, the disorder may be underdiagnosed or misdiagnosed as major depressive disorder. This article describes the prevalence, clinical features, common psychiatric comorbidities, differential diagnosis and potential consequences of underdiagnosis or misdiagnosis. Using case vignettes strategies for its detection and clinical management are suggested. Finally, areas in need of further research are proposed.

Repetitive negative thinking and suicide: a burgeoning literature with need for further exploration.

PubMed

Law, Keyne C; Tucker, Raymond P

2017-08-24

Extant research has found a significant overlap between various repetitive negative thinking (RNT) patterns, such as rumination and worry, across different affective disorders implicating that the process of repetitive negative thinking is likely trans-diagnostic. Furthermore, RNT patterns at the core of psychiatric disorders associated with suicide (e.g., rumination and worry) have been found to be associated with suicide even after accounting for the disorder. A synthesis of existing literature on repetitive negative thoughts suggest that following negative emotional experiences, RNTs may lead to a sense of entrapment and hopelessness that may contribute to the onset of suicidal ideation and then facilitate the transition from thinking about suicide to making a suicide attempt by increasing an individual's capability for suicide through repetitive exposure to violent thoughts and imagery associated with suicide. Copyright © 2017 Elsevier Ltd. All rights reserved.

Associations between self-rated mental health and psychiatric disorders among older adults: do racial/ethnic differences exist?

PubMed

Kim, Giyeon; DeCoster, Jamie; Chiriboga, David A; Jang, Yuri; Allen, Rebecca S; Parmelee, Patricia

2011-05-01

[corrected] This study examined racial/ethnic differences in the association between self-rated mental health (SRMH) and psychiatric disorders among community-dwelling older adults in the United States. Cross-sectional analyses of nationally representative data from the Collaborative Psychiatric Epidemiology Surveys (2001-2003). In-person household interviews. Older adults aged 60 and older (N = 1,840), including non-Hispanic Whites (N = 351), Blacks (N = 826), Hispanics (N = 406), and Asians (N = 257). SRMH was measured with a single item, "How would you rate your own mental health?" Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), diagnoses for mood and anxiety disorders were measured with the World Health Organization's World Mental Health version of the Composite International Diagnostic Interview. Results from logistic regression analyses showed significant main effects of both SRMH and race/ethnicity on the presence of mood and anxiety disorders: people who have poor SRMH and are non-Hispanic Whites were more likely to have mood and anxiety disorders. There were also significant interaction effects between SRMH and race/ethnicity, such that the relation of SRMH with diagnoses of psychiatric disorders was strongest in non-Hispanic Whites. Racial/ethnic variations were found in the relationship between self-perception of mental health and DSM-IV psychiatric disorders. The findings suggest the need to develop race/ethnicity-specific strategies to screen psychiatric disorders in diverse elderly populations. Future studies are needed to investigate possible reasons for the racial/ethnic group differences.

Preschool psychiatric disorders: homotypic and heterotypic continuity through middle childhood and early adolescence.

PubMed

Finsaas, Megan C; Bufferd, Sara J; Dougherty, Lea R; Carlson, Gabrielle A; Klein, Daniel N

2018-01-16

Many preschool-age children meet criteria for psychiatric disorders, and rates approach those observed in later childhood and adolescence. However, there is a paucity of longitudinal research examining the outcomes of preschool diagnoses. Families with a 3-year-old child (N = 559) were recruited from the community. Primary caregivers were interviewed using the Preschool Age Psychiatric Assessment when children were 3 years old (n = 541), and, along with children, using the Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime Version when children were 9 and 12 years old. Rates of disruptive behavior disorders (DBD) decreased from preschool to middle childhood and early adolescence, whereas rates of attention-deficit/hyperactivity disorder (ADHD) increased. Rates of any psychiatric disorder and depression increased from preschool to early adolescence only. Preschoolers with a diagnosis were over twice as likely to have a diagnosis during later periods. Homotypic continuity was present for anxiety disorders from preschool to middle childhood, for ADHD from preschool to early adolescence, and for DBD through both later time points. There was heterotypic continuity between preschool anxiety and early adolescent depression, and between preschool ADHD and early adolescent DBD. Dimensional symptom scores showed homotypic continuity for all diagnostic categories and showed a number of heterotypic associations as well. Results provide moderate support for the predictive validity of psychiatric disorders in preschoolers. Psychopathology in preschool is a significant risk factor for future psychiatric disorders during middle childhood and early adolescence.

[Recognition of psychiatric disorders with a religious content by members of the clergy of different denominations in the Netherlands].

PubMed

Noort, A; Braam, A W; van Gool, A R; Verhagen, P J; Beekman, A T F

2012-01-01

Clergy members (CMS) frequently provide support and counselling for people with psychological and psychiatric disorders. There is evidence in the literature that CMS consider themselves to be inadequately trained to recognise psychiatric disorders. To investigate to what extent CMS are able to recognise psychiatric symptoms. CMS were recruited in the south-west of the Netherlands among various denominations (Roman Catholic, strict (orthodox) Protestant, moderate Protestant and Evangelical; n = 143) by means of a regional sampling method. The participating CMS (n = 143) and a control group consisting of mental health care professionals MPHS; n = 73) evaluated four vignettes of psychiatric problems with a religious content: two were about a psychiatric disorder (a psychotic state and a psychotic depression/melancholic state), and two concerned non-psychiatric states (a spiritual/religious experience and a mourning reaction with a religious dilemma). For each vignette the respondents scored the suitability of psychiatric medication, the desirability of mental health care, the severity of the disorder and whether there was a religious or spiritual aetiology. Some CMS were able to recognise psychiatric problems almost as well as the MHPS, but among the CMS the degree of recognition varied according to the denomination. Recognition was relatively poor among Evangelical CMS, but was best among the strict Protestant CMS. Evangelical pastors and strict Protestant CMS tended to interpret the non-psychiatric states as pathological. The findings of this study emphasise the need for collaboration between MHPS and CMS and stress the importance of consultation.

PSYCHIATRIC COMORBIDITY DOES NOT ONLY DEPEND ON DIAGNOSTIC THRESHOLDS: AN ILLUSTRATION WITH MAJOR DEPRESSIVE DISORDER AND GENERALIZED ANXIETY DISORDER.

PubMed

van Loo, Hanna M; Schoevers, Robert A; Kendler, Kenneth S; de Jonge, Peter; Romeijn, Jan-Willem

2016-02-01

High rates of psychiatric comorbidity are subject of debate: To what extent do they depend on classification choices such as diagnostic thresholds? This paper investigates the influence of different thresholds on rates of comorbidity between major depressive disorder (MDD) and generalized anxiety disorder (GAD). Point prevalence of comorbidity between MDD and GAD was measured in 74,092 subjects from the general population (LifeLines) according to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) criteria. Comorbidity rates were compared for different thresholds by varying the number of necessary criteria from ≥ 1 to all nine symptoms for MDD, and from ≥ 1 to all seven symptoms for GAD. According to DSM thresholds, 0.86% had MDD only, 2.96% GAD only, and 1.14% both MDD and GAD (odds ratio (OR) 42.6). Lower thresholds for MDD led to higher rates of comorbidity (1.44% for ≥ 4 of nine MDD symptoms, OR 34.4), whereas lower thresholds for GAD hardly influenced comorbidity (1.16% for ≥ 3 of seven GAD symptoms, OR 38.8). Specific patterns in the distribution of symptoms within the population explained this finding: 37.3% of subjects with core criteria of MDD and GAD reported subthreshold MDD symptoms, whereas only 7.6% reported subthreshold GAD symptoms. Lower thresholds for MDD increased comorbidity with GAD, but not vice versa, owing to specific symptom patterns in the population. Generally, comorbidity rates result from both empirical symptom distributions and classification choices and cannot be reduced to either of these exclusively. This insight invites further research into the formation of disease concepts that allow for reliable predictions and targeted therapeutic interventions. © 2015 Wiley Periodicals, Inc.

Cognitive functioning in psychiatric disorders following deep brain stimulation.

PubMed

Bergfeld, Isidoor O; Mantione, Mariska; Hoogendoorn, Mechteld L C; Denys, Damiaan

2013-07-01

Deep brain stimulation (DBS) is routinely used as a treatment for treatment-refractory Parkinson's disease and has recently been proposed for psychiatric disorders such as Tourette syndrome (TS), obsessive-compulsive disorder (OCD) and major depressive disorder (MDD). Although cognitive deterioration has repeatedly been shown in patients with Parkinson's disease following DBS, the impact of DBS on cognitive functioning in psychiatric patients has not yet been reviewed. Reviewing the available literature on cognitive functioning following DBS in psychiatric patients. A systematic literature search in PubMed, EMBASE and Web of Science, last updated in September 2012, found 1470 papers. Abstracts were scrutinized and 26 studies examining cognitive functioning of psychiatric patients following DBS were included on basis of predetermined inclusion criteria. Twenty-six studies reported cognitive functioning of 130 psychiatric patients following DBS (37 TS patients, 56 OCD patients, 28 MDD patients, 6 patients with Alzheimer's disease, and 3 patients with other disorders). None of the studies reported substantial cognitive decline following DBS. On the contrary, 13 studies reported cognitive improvement following DBS. Preliminary results suggest that DBS in psychiatric disorders does not lead to cognitive decline. In selected cases cognitive functioning was improved following DBS. However, cognitive improvement cannot be conclusively attributed to DBS since studies are hampered by serious limitations. We discuss the outcomes in light of these limitations and offer suggestions for future work. Copyright © 2013 Elsevier Inc. All rights reserved.

Annual research review: Child and adolescent mental health interventions: a review of progress in economic studies across different disorders.

PubMed

Beecham, Jennifer

2014-06-01

Resources for supporting children and adolescents with psychiatric disorders continue to be scarce. Economics research can identify current patterns of expenditure, and help inform allocation of treatment and support resources between competing needs or uses. The aim was to identify the costs of supporting children and adolescents, the economic impacts of childhood psychiatric disorders in adulthood and any new evidence on the cost-effectiveness of interventions. An electronic search of databases (including PubMed, Medline and Psychinfo) identified peer-reviewed journal articles published between 2005 and 2012. Sixty-seven papers provided data on support and treatment costs now or in the future, or cost-effectiveness analyses of services. Half the articles came from the United States. Most articles focussed on autism spectrum disorder (ASD; 23 articles), attention deficit hyperactivity disorder (ADHD; n = 15), conduct disorder (CD; n = 7), and anxiety or depression (n = 8). Only 14 studies used a cost perspective wider than health care; most included education costs (n = 11), but only five included costs to the justice system. The number of studies estimating costs to the family has increased, particularly for children with autism spectrum disorder (ASD). In the United Kingdom, support costs for children and adolescents with conduct disorder (CD) appear to be lower than for those with attention deficit hyperactivity disorder (ADHD), although for the United States, the opposite may be true. Support costs for children and adolescents with ASD may be higher than both CD and ADHD. However, there were many differences between the samples and the methods employed making comparisons between studies difficult. Outcomes in adulthood include negative impacts on (mental) health, quality of life, public sector services, employment status and income. The evidence base is improving for child and adolescent psychiatric disorders, although only one full cost-effectiveness analysis was identified since the previous review published in 2012. However, we still do not know enough about the economic implications of support and treatment for specific disorders. © 2014 The Authors. Journal of Child Psychology and Psychiatry. © 2014 Association for Child and Adolescent Mental Health.

Annual Research Review: Child and adolescent mental health interventions: a review of progress in economic studies across different disorders

PubMed Central

Beecham, Jennifer

2014-01-01

Background Resources for supporting children and adolescents with psychiatric disorders continue to be scarce. Economics research can identify current patterns of expenditure, and help inform allocation of treatment and support resources between competing needs or uses. Scope and methods The aim was to identify the costs of supporting children and adolescents, the economic impacts of childhood psychiatric disorders in adulthood and any new evidence on the cost-effectiveness of interventions. An electronic search of databases (including PubMed, Medline and Psychinfo) identified peer-reviewed journal articles published between 2005 and 2012. Findings Sixty-seven papers provided data on support and treatment costs now or in the future, or cost-effectiveness analyses of services. Half the articles came from the United States. Most articles focussed on autism spectrum disorder (ASD; 23 articles), attention deficit hyperactivity disorder (ADHD; n = 15), conduct disorder (CD; n = 7), and anxiety or depression (n = 8). Conclusion Only 14 studies used a cost perspective wider than health care; most included education costs (n = 11), but only five included costs to the justice system. The number of studies estimating costs to the family has increased, particularly for children with autism spectrum disorder (ASD). In the United Kingdom, support costs for children and adolescents with conduct disorder (CD) appear to be lower than for those with attention deficit hyperactivity disorder (ADHD), although for the United States, the opposite may be true. Support costs for children and adolescents with ASD may be higher than both CD and ADHD. However, there were many differences between the samples and the methods employed making comparisons between studies difficult. Outcomes in adulthood include negative impacts on (mental) health, quality of life, public sector services, employment status and income. The evidence base is improving for child and adolescent psychiatric disorders, although only one full cost-effectiveness analysis was identified since the previous review published in 2012. However, we still do not know enough about the economic implications of support and treatment for specific disorders. PMID:24580503

Influence of Psychiatric Comorbidity on Recovery and Recurrence in Generalized Anxiety Disorder, Social Phobia, and Panic Disorder: A 12-Year Prospective Study

PubMed Central

Bruce, Steven E.; Yonkers, Kimberly A.; Otto, Michael W.; Eisen, Jane L.; Weisberg, Risa B.; Pagano, Maria; Shea, M. Tracie; Keller, Martin B.

2012-01-01

Objective The authors sought to observe the long-term clinical course of anxiety disorders over 12 years and to examine the influence of comorbid psychiatric disorders on recovery from or recurrence of panic disorder, generalized anxiety disorder, and social phobia. Method Data were drawn from the Harvard/Brown Anxiety Disorders Research Program, a prospective, naturalistic, longitudinal, multicenter study of adults with a current or past history of anxiety disorders. Probabilities of recovery and recurrence were calculated by using standard survival analysis methods. Proportional hazards regression analyses with time-varying covariates were conducted to determine risk ratios for possible comorbid psychiatric predictors of recovery and recurrence. Results Survival analyses revealed an overall chronic course for the majority of the anxiety disorders. Social phobia had the smallest probability of recovery after 12 years of follow-up. Moreover, patients who had prospectively observed recovery from their intake anxiety disorder had a high probability of recurrence over the follow-up period. The overall clinical course was worsened by several comorbid psychiatric conditions, including major depression and alcohol and other substance use disorders, and by comorbidity of generalized anxiety disorder and panic disorder with agoraphobia. Conclusions These data depict the anxiety disorders as insidious, with a chronic clinical course, low rates of recovery, and relatively high probabilities of recurrence. The presence of particular comorbid psychiatric disorders significantly lowered the likelihood of recovery from anxiety disorders and increased the likelihood of their recurrence. The findings add to the understanding of the nosology and treatment of these disorders. PMID:15930067

[Interview with the editor-in-chief of Nature--a decade for psychiatrie disorders. Interview by Shinsuke Koike, Atsushi Nishida, Syudo Yamasaki and Shuntaro Ando].

PubMed

Campbell, Philip

2012-01-01

Nature is the most frequently cited interdisciplinary science journal globally; however, it has recently begun publishing impressive reviews and special topics in the fields of mental health and psychiatric disorders. An editorial entitled, "A decade for psychiatric disorders" was published on the first page of the first 2010 issue of Nature. This editorial was a significantly symbolic publication; not only did it have an impressive title, but also consisted of precise and appropriate content in accordance with the present conditions and future perspectives of psychiatric disorders. This was of further significance as it was published on the first page of the first 2010 issue. In this report, we review an interview with the author of the editorial and the editor-in-chief of Nature, Dr. Philip Campbell. He explained to us the reason for Nature increasingly publishing articles in the fields of mental health and psychiatric disorders, and the reason for this editorial being published in this impressive space. He opined that, although the pathophysiology of psychiatric disorders has been gradually revealed through scientific progress in most research fields, a big gap remains between cancer and psychiatric disorders with regard to health policy and research conditions. The entire editorial team of Nature believed that they could contribute in some way to bridge this gap. He was of the opinion that the media should be apprised with appropriate information on psychiatric disorders by mental health researchers in order to dispel the stigma associated with these disorders and create awareness of the importance of mental health among the public. He drew our attention to the recent brilliant progress in neuroscience research and the future perspectives of mental health research; this trend was notably observed in recent articles in Nature. The concluding sentence in "A decade for psychiatric disorders" is, "Yet the exposure of many psychiatrists to contemporary biology is shallow at best. That, too, will need to change over the next decade." Therefore, psychiatrists have to pay close attention not only to the problem of stigma, but also to the scientific progress in psychiatric disorders, and, thus, need to change their thoughts and attitudes.

Childhood Predictors of Psychiatric Disorders among Boys: A Prospective Community-Based Follow-Up Study from Age 8 Years to Early Adulthood.

ERIC Educational Resources Information Center

Sourander, Andre; Multimaki, Petteri; Nikolakaros, Georgios; Haavisto, Antti; Ristkari, Terja; Helenius, Hans; Parkkola, Kai; Piha, Jorma; Tamminen, Tuula; Moilanen, Irma; Kumpulainen, Kirsti; Almqvist, Fredrik

2005-01-01

Objective: To study early childhood predictors for early adulthood psychiatric disorders. Method: The sample included 2,712 Finnish boys born in 1981. Information about the 8-year-old boys' problem behavior was obtained from parents, teachers, and children. The 10-15-year follow-up information about psychiatric disorders in early adulthood was…

Effects of the Good Behavior Game on the Behavioral, Emotional, and Social Problems of Children with Psychiatric Disorders in Special Education Settings

ERIC Educational Resources Information Center

Breeman, Linda D.; van Lier, Pol A. C.; Wubbels, Theo; Verhulst, Frank C.; van der Ende, Jan; Maras, Athanasios; Struiksma, A. J. Chris; Hopman, Juliette A. B.; Tick, Nouchka T.

2016-01-01

Teaching children with psychiatric disorders can be a challenging task. The purpose of this study was to examine the impact of the Good Behavior Game (GBG) in children with psychiatric disorders, and their teachers, in special education. Teachers were trained by licensed school consultants to implement positive behavior support strategies to…

Deep brain stimulation for psychiatric disorders: where we are now.

PubMed

Cleary, Daniel R; Ozpinar, Alp; Raslan, Ahmed M; Ko, Andrew L

2015-06-01

Fossil records showing trephination in the Stone Age provide evidence that humans have sought to influence the mind through physical means since before the historical record. Attempts to treat psychiatric disease via neurosurgical means in the 20th century provided some intriguing initial results. However, the indiscriminate application of these treatments, lack of rigorous evaluation of the results, and the side effects of ablative, irreversible procedures resulted in a backlash against brain surgery for psychiatric disorders that continues to this day. With the advent of psychotropic medications, interest in invasive procedures for organic brain disease waned. Diagnosis and classification of psychiatric diseases has improved, due to a better understanding of psychiatric patho-physiology and the development of disease and treatment biomarkers. Meanwhile, a significant percentage of patients remain refractory to multiple modes of treatment, and psychiatric disease remains the number one cause of disability in the world. These data, along with the safe and efficacious application of deep brain stimulation (DBS) for movement disorders, in principle a reversible process, is rekindling interest in the surgical treatment of psychiatric disorders with stimulation of deep brain sites involved in emotional and behavioral circuitry. This review presents a brief history of psychosurgery and summarizes the development of DBS for psychiatric disease, reviewing the available evidence for the current application of DBS for disorders of the mind.

The relationship between attachment styles and childhood trauma: a transgenerational perspective - a controlled study of patients with psychiatric disorders.

PubMed

Özcan, Neslihan K; Boyacioğlu, Nur E; Enginkaya, Semra; Bilgin, Hülya; Tomruk, Nesrin B

2016-08-01

This study had two aims. The first aim was to compare attachment styles and traumatic childhood experiences of women with psychiatric disorders and their children to a control group. The second aim was to determine the relationship between attachment styles and traumatic childhood experiences both in mothers and their children. According to attachment theories, trauma in an early relationship initiates a developmental cascade in which insecure attachments may occur. A cross-sectional, descriptive study which, employed a case-control design, was performed between May 2013-March 2014. This study was conducted in 63 women with psychiatric disorders and their children. The control group consisted of 63 women without any psychiatric disorders and their children. Data were collected using questionnaire forms, including the Adult Attachment Style Scale and the Childhood Trauma Questionnaire for both mothers and children. Descriptive statistics, a Pearson correlation and comparative statistics were used to analyse data. The childhood trauma scores of both the women with psychiatric disorders and their children were higher than the control group scores. Compared to the control group, the mothers with psychiatric disorders and their children were found to have less secure attachment styles. It was determined that the mothers and children with insecure attachment were more likely to have been abused. These results point to a relationship between trauma in childhood and attachment style. They also suggest that this relationship may undergo intergenerational transfer. This study contributes to the existing literature on the relationship between childhood traumas and attachment. Psychiatric nurses should focus not only on psychiatric disorders but also on the difficulties a patient faces regarding being a parent. © 2016 John Wiley & Sons Ltd.

Attention-deficit/hyperactivity disorder symptoms and suicidal behavior in adult psychiatric outpatients.

PubMed

Stickley, Andrew; Tachimori, Hisateru; Inoue, Yosuke; Shinkai, Takahiro; Yoshimura, Reiji; Nakamura, Jun; Morita, Gihei; Nishii, Shigeki; Tokutsu, Yuki; Otsuka, Yuka; Egashira, Kazuteru; Inoue, Miyuki; Kubo, Takamitsu; Tesen, Hirofumi; Takashima, Naoyuki; Tominaga, Hirotaka; Koyanagi, Ai; Kamio, Yoko

2018-05-29

To examine the association between attention-deficit/hyperactivity disorder (ADHD) symptoms and suicidal behavior in psychiatric outpatients and whether this association differs among patients with different psychiatric disorders. Cross-sectional data came from the Japan Prevalence Study of Adult ADHD at Psychiatric Outpatient Care (the J-PAAP study) which included psychiatric outpatients aged 18-65 years recruited from one university hospital and three general psychiatric outpatient clinics in Kitakyushu City, Fukuoka, Japan in April 2014 to January 2015 (N=864). The Adult ADHD Self-Report Scale (ASRS) Screener was used to collect information on ADHD symptoms. Reports of current and lifetime suicidal behavior were also obtained. A multivariable Poisson regression analysis was used to examine the association between ADHD symptoms and suicidal behavior. After adjusting for covariates there was a strong association between possible ADHD (ASRS ≥ 14) and suicidal behavior with prevalence ratios ranging from 1.17 (lifetime suicidal ideation) to 1.59 (lifetime suicide attempt) and 2.36 (current suicidal ideation). When ASRS strata were used, there was a dose-response association between increasing ADHD symptoms and suicidal ideation and suicide attempts. Analyses of individual ICD-10 psychiatric disorders showed that associations varied across disorders and that for anxiety disorder ADHD symptoms were significantly linked to all forms of suicidal behavior. ADHD symptom severity is associated with an increased risk for suicidal behavior in general psychiatric outpatients. As ADHD symptoms are common among adult psychiatric outpatients, detecting and treating ADHD in this population may be important for preventing suicidal behavior. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

The Association between Psychiatric Comorbidities and Outcomes for Inpatients with Traumatic Brain Injury.

PubMed

Brandel, Michael G; Hirshman, Brian R; McCutcheon, Brandon A; Tringale, Kathryn; Carroll, Kate; Richtand, Neil M; Perry, William; Chen, Clark C; Carter, Bob S

2017-03-01

It is well established that traumatic brain injury (TBI) is associated with the development of psychiatric disorders. However, the impact of psychiatric disorders on TBI outcome is less well understood. We examined the outcomes of patients who experienced a traumatic subdural hemorrhage and whether a comorbid psychiatric disorder was associated with a change in outcome. A retrospective observational study was performed in the California Office of Statewide Health Planning and Development (OSHPD) and the Nationwide Inpatient Sample (NIS). Patients hospitalized for acute subdural hemorrhage were identified using International Classification of Diseases, Ninth Revision (ICD-9) diagnosis codes. Patients with coexisting psychiatric diagnoses were identified. Outcomes studied included mortality and adverse discharge disposition. In OSPHD, diagnoses of depression (OR = 0.64, p < 0.001), bipolar disorder (OR = 0.45, p < 0.05), and anxiety (OR = 0.37, p < 0.001) were associated with reduced mortality during hospitalization for TBI, with a trend toward psychosis (OR = 0.56, p = 0.08). Schizophrenia had no effect. Diagnoses of psychosis (OR = 2.12, p < 0.001) and schizophrenia (OR = 2.60, p < 0.001) were associated with increased adverse discharge. Depression and bipolar disorder had no effect, and anxiety was associated with reduced adverse discharge (OR = 0.73, p = 0.01). Results were confirmed using the NIS. Analysis revealed novel associations between coexisting psychiatric diagnoses and TBI outcomes, with some subgroups having decreased mortality and increased adverse discharge. Potential mechanisms include pharmacological effects of frequently prescribed psychiatric medications, the pathophysiology of individual psychiatric disorders, or under-coding of psychiatric illness in the most severely injured patients. Because pharmacological mechanisms, if validated, might lead to improved outcome in TBI patients, further studies may provide significant public health benefit.

Psychiatric Disorders and Substance Use in Homeless Youth: A Preliminary Comparison of San Francisco and Chicago

PubMed Central

Quimby, Ernika G.; Edidin, Jennifer P.; Ganim, Zoe; Gustafson, Erika; Hunter, Scott J.; Karnik, Niranjan S.

2012-01-01

Youth homelessness is a growing problem in the United States. The experience of homelessness appears to have numerous adverse consequences, including psychiatric and substance use disorders. This study compared the frequencies of psychiatric disorders, including substance use, between homeless youth (18–24 years-old) in San Francisco (N = 31) and Chicago (N = 56). Subjects were administered the Mini International Neuropsychiatric Interview (M.I.N.I.) to assess DSM-IV-TR diagnoses and substance use disorders. Eighty-seven percent of the San Francisco youth, and 81% of the Chicago youth met criteria for at least one M.I.N.I. psychiatric diagnosis. Nearly two-thirds of the youth in both samples met criteria for a mood disorder. Approximately one-third met criteria for an anxiety disorder. Thirty-two percent of the San Francisco sample and 18% of the Chicago met criteria for Antisocial Personality Disorder. Approximately 84% of the San Francisco youth and 48% of the Chicago youth met criteria for a substance-related disorder, and more substances were used by San Francisco youth. In conclusion, the high rate of psychiatric disorders in homeless youth provides clear evidence that the mental health needs of this population are significant. Implications are discussed. PMID:25379220

Increases in multiple psychiatric disorders in parents and grandparents of patients with bipolar disorder from the USA compared with The Netherlands and Germany.

PubMed

Post, Robert M; Leverich, Gabriele S; Kupka, Ralph; Keck, Paul E; McElroy, Susan L; Altshuler, Lori L; Frye, Mark A; Rowe, Michael; Grunze, Heinz; Suppes, Trisha; Nolen, Willem A

2015-10-01

We previously found that compared with Europe more parents of the USA patients were positive for a mood disorder, and that this was associated with early onset bipolar disorder. Here we examine family history of psychiatric illness in more detail across several generations. A total of 968 outpatients (average age 41) with bipolar disorder from four sites in the USA and three in the Netherlands and Germany (abbreviated as Europe) gave informed consent and provided detailed demographic and family history information on a patient questionnaire. Family history of psychiatric illness (bipolar disorder, unipolar depression, suicide attempt, alcohol abuse, substance abuse, and other illness) was collected for each parent, four grandparents, siblings, and children. Parents of the probands with bipolar disorder from the USA compared with Europe had a significantly higher incidence of both unipolar and bipolar mood disorders, as well as each of the other psychiatric conditions listed above. With a few exceptions, this burden of psychiatric disorders was also significantly greater in the grandparents, siblings, and children of the USA versus European patients. The increased complexity of psychiatric illness and its occurrence over several generations in the families of patients with bipolar disorder from the USA versus Europe could be contributing to the higher incidence of childhood onsets and greater virulence of illness in the USA compared with Europe. These data are convergent with others suggesting increased both genetic and environmental risk in the USA, but require replication in epidemiologically-derived populations with data based on interviews of the family members.

Identifying novel interventional strategies for psychiatric disorders: integrating genomics, 'enviromics' and gene-environment interactions in valid preclinical models.

PubMed

McOmish, Caitlin E; Burrows, Emma L; Hannan, Anthony J

2014-10-01

Psychiatric disorders affect a substantial proportion of the population worldwide. This high prevalence, combined with the chronicity of the disorders and the major social and economic impacts, creates a significant burden. As a result, an important priority is the development of novel and effective interventional strategies for reducing incidence rates and improving outcomes. This review explores the progress that has been made to date in establishing valid animal models of psychiatric disorders, while beginning to unravel the complex factors that may be contributing to the limitations of current methodological approaches. We propose some approaches for optimizing the validity of animal models and developing effective interventions. We use schizophrenia and autism spectrum disorders as examples of disorders for which development of valid preclinical models, and fully effective therapeutics, have proven particularly challenging. However, the conclusions have relevance to various other psychiatric conditions, including depression, anxiety and bipolar disorders. We address the key aspects of construct, face and predictive validity in animal models, incorporating genetic and environmental factors. Our understanding of psychiatric disorders is accelerating exponentially, revealing extraordinary levels of genetic complexity, heterogeneity and pleiotropy. The environmental factors contributing to individual, and multiple, disorders also exhibit breathtaking complexity, requiring systematic analysis to experimentally explore the environmental mediators and modulators which constitute the 'envirome' of each psychiatric disorder. Ultimately, genetic and environmental factors need to be integrated via animal models incorporating the spatiotemporal complexity of gene-environment interactions and experience-dependent plasticity, thus better recapitulating the dynamic nature of brain development, function and dysfunction. © 2014 The British Pharmacological Society.

Asperger Syndrome: Associated Psychiatric and Medical Conditions.

ERIC Educational Resources Information Center

Ghaziuddin, Mohammad

2002-01-01

This article explores the association of medical and psychiatric conditions with Asperger syndrome, based mainly on publications from the last two decades. It examines comorbidity of Asperger syndrome with mood disorders, schizophrenia, obsessive-compulsive disorder, attention deficit/hyperactivity disorder, tic disorders, violence and aggression,…

Psychiatric Aspects of Dementia

PubMed Central

Onyike, Chiadi U.

2016-01-01

Purpose of Review: The psychiatric aspects of dementia are increasingly recognized as significant contributors to distress, disability, and care burden, and, thus, are of increasing interest to practicing neurologists. This article examines how psychiatric disorders are entwined with dementia and describes the predictive, diagnostic, and therapeutic implications of the psychiatric symptoms of dementia. Recent Findings: Psychiatric disorders, particularly depression and schizophrenia, are associated with higher risk for late-life dementia. Psychiatric phenomena also define phenotypes such as frontotemporal dementia and dementia with Lewy bodies, cause distress, and amplify dementia-related disabilities. Management requires a multidisciplinary team, a problem-solving stance, programs of care, and pharmacologic management. Recent innovations include model programs that provide structured problem-solving interventions and tailored in-home care. Summary: There is new appreciation of the complexity of the relationship between psychiatric disorders and dementia as well as the significance of this relationship for treatment, community services, and research. PMID:27042910

A Case of Sporadic Creutzfeldt-Jakob Disease Presenting as Conversion Disorder.

PubMed

Yegya-Raman, Nikhil; Aziz, Rehan; Schneider, Daniel; Tobia, Anthony; Leitch, Megan; Nwobi, Onyi

2017-01-01

Background . Creutzfeldt-Jakob disease is a rare disorder of the central nervous system. Its initial diagnosis may be obscured by its variable presentation. This case report illustrates the complexity of diagnosing this disease early in the clinical course, especially when the initial symptoms may be psychiatric. It offers a brief review of the literature and reinforces a role for consultation psychiatry services. Methods . PUBMED/MEDLINE was searched using the terms "Creutzfeldt-Jakob disease", "psychiatric symptoms", "conversion disorder", "somatic symptom disorder", "functional movement disorder", and "functional neurologic disorder". Case . The patient was a 64-year-old woman with no prior psychiatric history who was initially diagnosed with conversion disorder and unspecified anxiety disorder but soon thereafter was discovered to have Creutzfeldt-Jakob disease. Discussion . This case highlights the central role of psychiatric symptoms in early presentations of Creutzfeldt-Jakob disease. Still, few other cases in the literature report functional neurological symptoms as an initial sign. The consultation psychiatrist must remain alert to changing clinical symptoms, especially with uncharacteristic disease presentations.

Current comorbidity among consecutive adolescent psychiatric outpatients with DSM-IV mood disorders.

PubMed

Karlsson, Linnea; Pelkonen, Mirjami; Ruuttu, Titta; Kiviruusu, Olli; Heilä, Hannele; Holi, Matti; Kettunen, Kirsi; Tuisku, Virpi; Tuulio-Henriksson, Annamari; Törrönen, Johanna; Marttunen, Mauri

2006-06-01

To compare selected characteristics (age, sex, age of onset for depression, impairment, severity of depression, somatic comorbidity, and treatment status) of adolescents with currently comorbid and non-comorbid depression. A sample of 218 consecutive adolescent (13-19 years) psychiatric outpatients with depressive disorders, and 200 age- and sex-matched school-attending controls were interviewed for DSM-IV Axis I and Axis II diagnoses. Current comorbidity, most commonly with anxiety disorders, was equally frequent (>70%) in outpatients and depressed controls. Younger age (OR 0.20; 95% CI 0.08, 0.51) and male gender (OR 0.02; 95% CI 0.09, 0.55) were associated with concurrent disruptive disorders. Current comorbidity with substance use disorders (SUD) was independent of age (OR 1.13; 95% CI 0.51, 2.49) and sex (OR 0.51; 95% CI 0.22, 1.17). Personality disorders associated with older age (OR 2.06; 95% CI 1.10, 3.86). In multivariable logistic regression analysis, impairment (GAF

Lack of leadership confidence relates to problem drinking in women: gender identity, heavy episodic drinking and alcohol use disorders in Swedish women.

PubMed

Hensing, Gunnel; Spak, Fredrik

2009-01-01

The aim of this study was to analyse in women the association between four dimensions of gender identity, heavy episodic drinking (HED) and alcohol use disorders (AUD), taking into account age, personality, psychiatric co-morbidity and level of education. An initial screening of alcohol consumption was followed by a structured psychiatric interview in a sample of women drawn from the Gothenburg population and women attending primary care, maternity and hospital services (n = 930). Gender identity was assessed using the Masculinity-Femininity Questionnaire (M/F-Q) (items grouped into four dimensions: leadership, caring, self-assertiveness and emotionality). The Karolinska Scale of Personality was administered. Clinical psychiatric diagnoses according to DSM were made in face-to-face interviews. HED was defined as consumption of at least 60 g of ethanol on a single day at least once a month. Women who scored low on the leadership dimension were twice as likely to have AUD [age-adjusted odds1.98 (95% confidence interval 1.30-3.01)] compared to those with medium scores. These odds ratios were significant after adjustment for personality [2.21 (1.35-3.63)], psychiatric disorders [2.09 (1.25-3.47)] and level of education [1.95 (1.17-3.26)]. Low scores on the leadership dimension were associated with HED [1.55 (0.98-2.44)] after adjustment for age, personality, psychiatric disorders and level of education. High scores on leadership were not significantly associated with AUD or HED after these adjustments. The odds ratios for those who scored low on caring were non-significant throughout the analyses of associations with both AUD and HED. A similar pattern was found for the self-assertiveness dimension. Low emotionality was associated with decreased odds for AUD [0.42 (0.25-0.70)] and HED [0.66 (0.44-0.99)], and increased odds for AUD [2.14 (1.38-3.31)] and HED [2.33 (1.58-3.44)], after adjusting for age. These associations became non-significant after adjustment for personality and remained so after psychiatric disorders and level of education were added to the models. Of the four gender identity dimensions, only low scores on leadership remained significantly associated with AUD and HED after adjustment for age and personality. Clinical work could focus on the development of leadership abilities in women scoring low on these items to improve the ability.