88,310 research outputs found

    Post-Intensive Care Unit Psychiatric Comorbidity and Quality of Life

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    The prevalence of psychiatric symptoms ranges from 17% to 44% in intensive care unit (ICU) survivors. The relationship between the comorbidity of psychiatric symptoms and quality of life (QoL) in ICU survivors has not been carefully examined. This study examined the relationship between psychiatric comorbidities and QoL in 58 survivors of ICU delirium. Patients completed 3 psychiatric screens at 3 months after discharge from the hospital, including the Patient Health Questionnaire-9 (PHQ-9) for depression, the Generalized Anxiety Disorder-7 (GAD-7) questionnaire for anxiety, and the Post-Traumatic Stress Syndrome (PTSS-10) questionnaire for posttraumatic stress disorder. Patients with 3 positive screens (PHQ-9 ≥ 10; GAD-7 ≥ 10; and PTSS-10 > 35) comprised the high psychiatric comorbidity group. Patients with 1 to 2 positive screens were labeled the low to moderate (low-moderate) psychiatric comorbidity group. Patients with 3 negative screens were labeled the no psychiatric morbidity group. Thirty-one percent of patients met the criteria for high psychiatric comorbidity. After adjusting for age, gender, Charlson Comorbidity Index, discharge status, and prior history of depression and anxiety, patients who had high psychiatric comorbidity were more likely to have a poorer QoL compared with the low-moderate comorbidity and no morbidity groups, as measured by a lower EuroQol 5 dimensions questionnaire 3-level Index (no, 0.69 ± 0.25; low-moderate, 0.70 ± 0.19; high, 0.48 ± 0.24; P = 0.017). Future studies should confirm these findings and examine whether survivors of ICU delirium with high psychiatric comorbidity have different treatment needs from survivors with lower psychiatric comorbidity

    Comorbidity and Quality of Life in Adults with Hair Pulling Disorder

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    Hair pulling disorder (HPD; trichotillomania) is thought to be associated with significant psychiatric comorbidity and functional impairment. However, few methodologically rigorous studies of HPD have been conducted, rendering such conclusions tenuous. The following study examined comorbidity and psychosocial functioning in a well-characterized sample of adults with HPD (N=85) who met DSM-IV criteria, had at least moderate hair pulling severity, and participated in a clinical trial. Results revealed that 38.8% of individuals with HPD had another current psychiatric diagnosis and 78.8% had another lifetime (present and/or past) psychiatric diagnosis. Specifically, HPD showed substantial overlap with depressive, anxiety, addictive, and other body-focused repetitive behavior disorders. The relationships between certain comorbidity patterns, hair pulling severity, current mood and anxiety symptoms, and quality of life were also examined. Results showed that current depressive symptoms were the only predictor of quality of life deficits. Implications of these findings for the conceptualization and treatment of HPD are discussed

    Psychiatric comorbidity and psychosocial stressors among people initiating HIV care in Cameroon

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    BACKGROUND: Psychiatric comorbidity, the presence of two or more mental health disorders, has been associated with suboptimal HIV treatment outcomes. Little is known about the prevalence of psychiatric comorbidity among people with HIV (PWH) in sub-Saharan Africa. METHODS: We conducted interviews with PWH initiating HIV care in Cameroon between June 2019 and March 2020. Depression, anxiety, post-traumatic stress disorder (PTSD), and harmful drinking were dichotomized to represent those with and without symptoms of each. Psychiatric comorbidity was defined as having symptoms of two or more disorders assessed. Moderate or severe household hunger, high anticipatory HIV-related stigma, low social support, and high number of potentially traumatic events were hypothesized as correlates of psychiatric comorbidity. Bivariable log binomial regression models were used to estimate unadjusted associations between psychosocial stressors and psychiatric comorbidity. RESULTS: Among 424 participants interviewed, the prevalence of psychiatric comorbidity was 16%. Among those with symptoms of at least one mental health or substance use disorder (n = 161), the prevalence of psychiatric comorbidity was 42%. The prevalence of psychiatric comorbidity was 33%, 67%, 76%, and 81% among those with symptoms of harmful drinking, depression, anxiety, and PTSD, respectively. Among individuals with symptoms of a mental health or substance use disorder, a high number of potentially traumatic events (prevalence ratio (PR) 1.71 [95% CI 1.21, 2.42]) and high anticipatory HIV-related stigma (PR 1.45 [95% CI 1.01, 2.09]) were associated with greater prevalence of psychiatric comorbidity. CONCLUSION: Psychiatric comorbidity was common among this group of PWH in Cameroon. The effectiveness and implementation of transdiagnostic or multi-focus mental health treatment approaches in HIV care settings should be examined

    국가 대표 코호트 자료를 이용한 자폐스펙트럼장애의 정신병리 공병 위험

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    학위논문 (석사) -- 서울대학교 대학원 : 사회과학대학 심리학과, 2021. 2. 곽금주.Those with Autism Spectrum Disorder (ASD) have various adversities from childhood to adulthood. For instance, they are exposed to child abuse, bullying by peers, and have a lower quality of life (QoL) compared to the general population. Another major adversity related to ASD is the risk of psychiatric comorbidity. However, research on the psychiatric comorbidity of ASD is scarce and previous studies had various limitations (e.g., only included clinical samples without comparing with general population, studied a single type of psychiatric disorder, included limited age groups, etc.). Therefore, a more comprehensive understanding regarding the risk of psychiatric comorbidity in ASD is needed. The current study conducted an explorative study to investigate the risk of psychiatric comorbidity in ASD using a nationally representative cohort. Also, the risk of psychiatric comorbidity was analyzed by intellectual functioning level and diagnosis timing. Results indicate that those with ASD had significantly higher risk of having comorbid psychiatric disorder compared to the general public. Also, Late-Diagnosed ASD showed higher risk of having certain psychiatric disorders (i.e., depression, OCD, PTSD, ADHD) compared to Early-Diagnosed ASD. Those with High-Functioning ASD had a lower odd of having schizophrenia spectrum and other psychotic disorders and Attention-deficit/hyperactivity disorder and had a higher odd of having depression compared to Low-Functioning ASD. These results imply that those with ASD have a higher risk of psychiatric comorbidity compared to the general population and delayed diagnosis is associated with increased risk for psychiatric comorbidity. Moreover, the risk for psychiatric comorbidity by functioning level varied. Based on the results of this study, screening for psychiatric comorbidity of ASD is needed. Especially, delayed diagnosis seems to be associated with higher risk of psychiatric comorbidity. Therefore, efforts to increase recognition of ASD are needed. Also, intellectual functioning needs to be considered when screening psychiatric comorbidity in ASD.자폐스펙트럼장애를 가진 환자들은 아동기부터 성인기까지 다양한 어려움을 겪는다. 예컨대, 아동 폭력, 또래 괴롭힘, 낮은 삶의 질, 등의 어려움을 겪는다. 더불어, 자폐스펙트럼장애를 가진 자녀의 부모 또한 극심한 스트레스를 호소한다. 이러한 자폐스펙트럼장애 환자들이 직면해야 하는 다른 문제는 정신질환 공병(psychiatric comorbidity) 위험이다. 이미 자폐스펙트럼장애만으로도 어려움을 겪지만, 다른 정신질환 (예컨대, 우울장애, ADHD, 등)을 동반하게 되면, 삶의 질은 더 낮아지며 자살 위험 또한 높아지게 되는 것으로 보고되고 있다. 그러나 이런 연구결과들에도 불구하고, 자폐스펙트럼장애와 정신질환 공병에 대한 연구는 드물며 국가단위의 데이터를 사용한 연구는 극히 드물다. 더불어, 대부분의 연구들은 한 연구에서 한 가지 정신질환을 살펴보았으며, 다양한 연령대가 포함된 데이터를 사용하지 않았다는 제한점이 있다. 본 연구는 국가를 대표할 수 있는 자료를 사용하여, 자폐스펙트럼장애의 정신질환 공병 위험을 살펴보는 탐색적인 연구를 진행하였으며, 관련 요인 (지적 수준 및 진단 시기)에 따라 그 위험에 차이가 있는지를 추가적으로 살펴보았다. 연구 결과, 자폐스펙트럼장애를 가진 환자들은 일반인에 비해 조현병, 양극성장애, 우울장애, 불안장애, 강박장애, 외상후스트레스장애, 주의력결핍 과잉행동장애를 동반할 위험이 일반인에 비해 높은 것으로 나타났다. 고기능 (high-functioning) 자폐스펙트럼장애 환자들은 저기능 (low-functioning) 자폐스펙트럼 환자들에 비해 조현병 및 주의력결핍 과잉행동장애를 가질 위험이 낮았으며, 우울장애를 가질 위험은 더 높았다. 더불어, 진단시기에 따른 정신동반 위험을 살펴보았을 때, 늦은 진단을 받은 자폐스펙트럼장애 환자들이 이른 진단을 받은 자폐스펙트럼장애 환자들에 비해 우울장애, 강박장애, 외상후스트레스장애, 주의력결핍 과잉행동장애를 동반할 위험이 높은 것으로 나타났다. 이러한 결과는 자폐스펙트럼장애 환자들이 일반인에 비해 다른 정신질환을 동반할 위험이 높다는 것을 보여주며, 특히 진단을 늦게 받는 것은 다른 정신질환 동반을 높이는 것으로 보여진다. 또한, 기능 수준(지적 수준)에 따른 정신질환 동반 위험은 질환에 따라 상이한 결과가 나타난 것으로 보아, 지적 수준에 따라 동반할 위험이 높은 정신질환이 다르다는 것을 시사한다. 그러나, 기능 수준에 따른 정신질환 동반 위험은 보다 많은 연구가 필요할 것으로 보인다. 본 연구 결과를 토대로, 자폐스펙트럼장애 환자들을 대상으로 정신질환 공병에 대한 평가가 필요하다는 것을 알 수 있다. 특히, 진단 시기가 늦을 경우, 정신질환 동반 위험이 높아지는 것으로 나타났으므로 이른 진단을 받을 수 있도록 자폐스펙트럼장애에 대한 인식이 높아질 수 있도록 노력해야 하며, 지적 수준에 따른 개입이 다르게 진행되어야 할 것으로 보인다.Introduction 1 Psychiatric Comorbidity of ASD 5 Psychiatric Comorbidity of ASD and Functionoing Level 11 Psychiatric Comorbidity of ASD and Diagnosis Timing 14 Methods 18 Data 18 Participant Selection 20 Measures 22 Statistical Analysis 24 Results 26 ASD vs. Non-ASD 26 High-functioniong vs. Low-Functioning ASD 33 Late-Diagnosed vs. Early Diagnosed ASD 39 Discussion 45 ASD and Psychiatric Comorbidity 45 Psychiatric Comorbidity of ASD and Functioning Level 48 Psychiatric Comorbidity of ASD and Diagnosis Timing 51 Implications and Limitations 53 References 56 국문초록 78 Appendix 80Maste

    Early clinical predictors and correlates of long-term morbidity in bipolar disorder

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    OBJECTIVES: Identifying factors predictive of long-term morbidity should improve clinical planning limiting disability and mortality associated with bipolar disorder (BD). METHODS: We analyzed factors associated with total, depressive and mania-related long-term morbidity and their ratio D/M, as %-time ill between a first-lifetime major affective episode and last follow-up of 207 BD subjects. Bivariate comparisons were followed by multivariable linear regression modeling. RESULTS: Total % of months ill during follow-up was greater in 96 BD-II (40.2%) than 111 BD-I subjects (28.4%; P=0.001). Time in depression averaged 26.1% in BD-II and 14.3% in BD-I, whereas mania-related morbidity was similar in both, averaging 13.9%. Their ratio D/M was 3.7-fold greater in BD-II than BD-I (5.74 vs. 1.96; P<0.0001). Predictive factors independently associated with total %-time ill were: [a] BD-II diagnosis, [b] longer prodrome from antecedents to first affective episode, and [c] any psychiatric comorbidity. Associated with %-time depressed were: [a] BD-II diagnosis, [b] any antecedent psychiatric syndrome, [c] psychiatric comorbidity, and [d] agitated/psychotic depressive first affective episode. Associated with %-time in mania-like illness were: [a] fewer years ill and [b] (hypo)manic first affective episode. The long-term D/M morbidity ratio was associated with: [a] anxious temperament, [b] depressive first episode, and [c] BD-II diagnosis. CONCLUSIONS: Long-term depressive greatly exceeded mania-like morbidity in BD patients. BD-II subjects spent 42% more time ill overall, with a 3.7-times greater D/M morbidity ratio, than BD-I. More time depressed was predicted by agitated/psychotic initial depressive episodes, psychiatric comorbidity, and BD-II diagnosis. Longer prodrome and any antecedent psychiatric syndrome were respectively associated with total and depressive morbidity

    Psychiatric Comorbidity in People with Epilepsy

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    Background and Objective: People with epilepsy often experience psychiatric comorbidity. This study aims to investigate the relationship among seizure regulation, psychiatric comorbidity, and antiepileptic drug use in a group of individuals with epilepsy in Pakistan. Methods: This is an observational study conducted at Pakistan Institute of Medical Sciences, over a period of six months (1st June – 31st Dec 2022). One-hundred-twenty people (sample size) with epilepsy above the age of 18 with confirmed diagnosis of epilepsy were included in the study who completed a questionnaire that assessed their seizure control, psychiatric comorbidity, and antiepileptic drug use. Data was analyzed using SPSS version 25 Results: The majority of participants (80.8%) reported effective seizure control , while 19.2% reported ineffective seizure control . Regarding psychiatric comorbidity, 84.2% of the participants reported some form of psychiatric comorbidity, with depression being the most commonly reported (31.7%). In terms of antiepileptic drug use, 69.2% of the participants reported being on monotherapy, 28.3% reported being on polytherapy, and 2.5% reported not being on any medication. Conclusion: People with epilepsy have a significant likelihood of experiencing psychiatric comorbidity which highlights the need for screening and therapy

    Psychiatric Comorbidity and Greater Hospitalization Risk, Longer Length of Stay, and Higher Hospitalization Costs in Older Adults with Heart Failure

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    OBJECTIVES: To explore associations between psychiatric comorbidity and rehospitalization risk, length of hospitalization, and costs. DESIGN: Cross‐sectional study of 1‐year hospital administrative data. SETTING: Claims‐based study of older adults hospitalized in the United States. PARTICIPANTS: Twenty‐one thousand four hundred twenty‐nine patients from a 5% national random sample of U.S. Medicare beneficiaries aged 65 and older, with at least one acute care hospitalization in 1999 with a Diagnostic‐Related Group of congestive heart failure. MEASUREMENTS: The number of hospitalizations, mean length of hospital stay, and total hospitalization costs in calendar year 1999. RESULTS: Overall, 15.8% of patients hospitalized for heart failure (HF) had a coded psychiatric comorbidity; the most commonly coded comorbid psychiatric disorder was depression (8.5% of the sample). Most forms of psychiatric comorbidity were associated with greater inpatient utilization, including risk of additional hospitalizations, days of stay, and hospitalization charges. Additional hospitalization costs associated with psychiatric comorbidity ranged up to $7,763, and additional days length of stay ranged up to 1.4 days. CONCLUSION: Psychiatric comorbidity appears in a significant minority of patients hospitalized for HF and may affect their clinical and economic outcomes. The associations between psychiatric comorbidity and use of inpatient care are likely to be an underestimate, because psychiatric illness is known to be underdetected in older adults and in hospitalized medical patients

    Psychiatric Comorbidity and Complex Regional Pain Syndrome Through the Lens of the Biopsychosocial Model: A Comparative Study.

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    To compare the prevalence of psychiatric comorbidity between patients with complex regional pain syndrome (CRPS) of the hand and non-CRPS patients and to assess the association between biopsychosocial (BPS) complexity profiles and psychiatric comorbidity in a comparative study. We included a total of 103 patients with CRPS of the hand and 290 patients with chronic hand impairments but without CRPS. Psychiatric comorbidities were diagnosed by a psychiatrist, and BPS complexity was measured by means of the INTERMED. The odds ratios (OR) of having psychiatric comorbidities according to BPS complexity were calculated with multiple logistic regression (adjusted for age, sex, and pain). Prevalence of psychiatric comorbidity was 29% in CRPS patients, which was not significantly higher than in non-CRPS patients (21%, relative risk=1.38, 95% CI: 0.95 to 2.01 p=0.10). The median total scores of the INTERMED were the same in both groups (23 points). INTERMED total scores (0-60 points) were related to an increased risk of having psychiatric comorbidity in CRPS patients (OR=1.46; 95% CI: 1.23-1.73) and in non-CRPS patients (OR=1.21; 95% CI: 1.13-1.30). The four INTERMED subscales (biological, psychological, social, and health care) were correlated with a higher risk of having psychiatric comorbidity in both groups. The differences in the OR of having psychiatric comorbidity in relation to INTERMED total and subscale scores were not statistically different between the two groups. The total scores, as well as all four dimensions of BPS complexity measured by the INTERMED, were associated with psychiatric comorbidity, with comparable magnitudes of association between the CRPS and non-CRPS groups. The INTERMED was useful in screening for psychological vulnerability in the two groups

    Psychiatric comorbidity and psychosocial impairment among patients with vertigo and dizziness

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    Background: Vertigo and dizziness are often not fully explained by an organic illness, but instead are related to psychiatric disorders. This study aimed to evaluate psychiatric comorbidity and assess psychosocial impairment in a large sample of patients with a wide range of unselected organic and non-organic (ie, medically unexplained) vertigo/dizziness syndromes. Methods: This cross-sectional study involved a sample of 547 patients recruited from a specialised interdisciplinary treatment centre for vertigo/dizziness. Diagnostic evaluation included standardised neurological examinations, structured clinical interview for major mental disorders (SCID-I) and self-report questionnaires regarding dizziness, depression, anxiety, somatisation and quality of life. Results: Neurological diagnostic workup revealed organic and non-organic vertigo/dizziness in 80.8% and 19.2% of patients, respectively. In 48.8% of patients, SCID-I led to the diagnosis of a current psychiatric disorder, most frequently anxiety/phobic, somatoform and affective disorders. In the organic vertigo/dizziness group, 42.5% of patients, particularly those with vestibular paroxysmia or vestibular migraine, had a current psychiatric comorbidity. Patients with psychiatric comorbidity reported more vertigo-related handicaps, more depressive, anxiety and somatisation symptoms, and lower psychological quality of life compared with patients without psychiatric comorbidity. Conclusions: Almost half of patients with vertigo/dizziness suffer from a psychiatric comorbidity. These patients show more severe psychosocial impairment compared with patients without psychiatric disorders. The worst combination, in terms of vertigo-related handicaps, is having non-organic vertigo/dizziness and psychiatric comorbidity. This phenomenon should be considered when diagnosing and treating vertigo/dizziness in the early stages of the disease

    Pediatric ADHD and Screening for Comorbidities

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    Psychiatric disorders are very common in the general pediatric population. Attention Deficit Hyperactivity Disorder (ADHD) is a common psychiatric diagnosis in childhood but can mimic and be found comorbidity with other psychiatric disorders. It is necessary for primary care providers to perform a thorough initial workup for ADHD and possible comorbidity psychiatric disorders to ensure proper diagnosis and treatment of pediatric patients
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