The predictors of health care seeking behavior in obsessive-compulsive disorder

A majority of individuals with obsessive-compulsive disorder (OCD) do not seek health care. To better understand why not, health care-seekers (HCS) with OCD (n = 25) were compared with non-health care-seekers (NHCS) with OCD (n = 23) regarding their sociodemographic variables, symptom severity, types of obsessions and compulsions, 'insight degree, comorbid diagnosis, and quality-of-life (QOL) level. There was no significant difference for sociodemographic characteristics between the groups. NHCS scored significantly lower on a measure of illness severity than HCS. The NHCS group had significantly poorer insight degree than the HCS group. Aggressive and religious obsessions were significantly less identified in the NHCS group compared to the HCS group. NHCS were significantly less likely to have comorbid diagnosis than HCS. The NHCS group reported significantly worse levels of QOL in psychological health and level of independence domains. To identify the predictors of health care seeking behavior, probable variables were entered in a logistic regression model. Insight degree and level of independence emerged as the predictors of health care seeking. Our results suggest that health care seeking behavior in OCD is associated with the individuals' ability to recognize their symptoms as a disorder and subjective interpretation regarding the impact of OCD on their level of independence. Results of the present study extend findings of two recent studies that have investigated factors related to health care seeking in OCD. (C) 2004 Elsevier Inc. All rights reserved

Obsessive-compulsive disorder in the community : 12-month prevalence, comorbidity and impairment

Although subthreshold conditions are associated with impairment in numerous disorders, research on obsessive-compulsive disorder (OCD) below the diagnostic threshold of DSM-IV in the general population is limited. Estimate the DSM-IV 12-month prevalence, comorbidity and impairment of OCD, subthreshold OCD (i.e., fulfilling some but not all core DSM-IV criteria), and obsessive-compulsive symptoms (OCS) (i.e., endorsement of OCS without fulfilling any core DSM-IV criteria) in a general population sample. Data from the German National Health Interview and Examination Survey - Mental Health Supplement (N = 4181, age 18-65 years), based on the standardized diagnostic interview Munich Composite International Diagnostic Interview. The 12-month prevalence of OCD was 0.7%, subthreshold OCD was 4.5%, and OCS was 8.3%. Subjects in all three groups showed higher comorbidity (odds ratios [ORs] € ≥ 3.3), compared to those without OCS. OCD, subthreshold OCD and OCS were all associated with increased odds of substance abuse/dependence-, mood-, anxiety- and somatoform disorders, with especially strong associations with possible psychotic disorder (ORs € ≥ 4.1) and bipolar disorders (ORs € ≥ 4.7). Participants in all three groups showed higher impairment (ORs € ≥ 3.1) and health-care utilization (ORs € ≥ 2.4), compared to those without OCS, even after controlling for covariates. Individuals with subthreshold OCD and OCS, not currently captured by DSM-IV OCD criteria, nevertheless show substantial comorbidity, impairment and health-care utilization

Repetitive and frightening dreams and suicidal behavior in patients with major depression

The purpose of the present study was to examine the association between repetitive and frightening dreams and suicidal tendency in patients with major depression. Depressed patients who reported frequent nightmare (N = 29) and depressed patients who reported dreaming but never nightmares (N = 34) were evaluated using the Schedule for Affective Disorders and Schizophrenia (SADS) suicide subscale to rate the severity of active suicidality. The patients with frequent nightmares, particularly women, had higher mean SADS suicide subscale scores and were more likely to be classified as suicidal than the others. The findings demonstrate that frequent nightmares are associated with suicidal tendency in patients with major depression. Theoretical and clinical implications for the function of dreaming are discussed. Copyright (C) 1998 by W.B. Saunders Company

Twelve-month prevalence of obsessive-compulsive disorder in Konya, Turkey

We conducted a household survey of 3,012 adults aged 18 and over in order to estimate the prevalence of DSM-IV obsessive-compulsive disorder (OCD) in urban areas in Konya, Turkey. Trained psychiatry interns administered the 2.1 version of the OCD section of the Composite International Diagnostic Interview (CIDI). The 12-month period prevalence rate of OCD was 3.0%. The mean age of onset of OCD was 25.9 12.5 (range, 7 to 63) years. The prevalence rate of OCD was slightly higher among females (males 2.5%, females 3.3%), but the difference was not statistically significant. The relative risk for divorced, separated, or widowed subjects was approximately 4.2 times higher for OCD than others (2.7% v 10.5%). The 1-year prevalence of OCD inversely related to age group in male subjects, but increased with age in female subjects. The prevalence rate of OCD was not different by the level of education, except it was statistically higher among subjects who were literate but had no schooling, of which the causal relationship was high prevalence rate of OCD among female literate-but no schooling subjects. Subjects with few (one or two) and more siblings (seven or more) had a significantly higher prevalence rate of OCD than subjects with moderate numbers of siblings (three to six). No significant difference was found according to employment, fertility, birth order, and income of the subjects. About 30% of subjects with OCD had only obsessions, whereas 68.5% had both obsessions and compulsions. Only one subject (1.1%) with OCD met compulsion criteria without obsessions. The prevalence rate of OCD we found in Konya, Turkey was similar to the prevalence rates of most epidemiological studies. (C) 2004 Elsevier Inc. All rights reserved

Comparison of vitamin B12, vitamin D and folic acid blood levels in patients with schizophrenia, drug addiction and controls

PMID = 3107624

Assessment of anxiety in subclinical thyroid disorders

It is well known that manifest thyroid dysfunction causes mood disorders. In the literature there are few studies related with subclinical thyroid dysfunction and anxiety. We aimed to determine if there exists a relation between the anxiety and subclinical thyroid dysfunction. This study was carried out in the Meram Medical Faculty of Selcuk University, Department of Endocrinology and Metabolism. Eighty-five outpatients were enrolled into the study. In the presence of normal fT(3) and fT(4) patients were grouped as subclinical hyperthyroid with TSH lower than 0.1 mU/L (n = 24), subclinical hypothyroid with TSH higher than 4.5 mU/L (n = 32) and euthyroid subjects (n = 29). Beck's Anxiety Inventory (BAI) was administered to all patients. There was no any statistically significant difference between euthyroid and study groups in terms of age, gender, weight and height (p<0.05). One-way ANOVA showed that both of the subclinical hypothyroid and subclinical hyperthyroid groups had significantly higher anxiety scores than cuthyroid group (F: 11.4, p<0.001). Manifest hypothyroidism and hyperthyroidism, as causes of mental and neurological dysfunction have been known for a long time, but the relation between subclinical thyroid dysfunction and anxiety is less well studied. We have found that subclinical thyroid dysfunction increases the anxiety of patients whether hyperthyroid or hypothyroid. Overlap of symptoms common to both thyroid dysfunction and anxiety is an important limitation in this study. Mood changes especially anxiety due to subclinical thyroid dysfunction may have an important impact on the patient's quality of life. Negative effect on quality of life may be an indication of treatment in these patients. It is the first study evaluating anxiety in subclinical hypothyroidism in the literature

Nightmares and serum cholesterol level: A preliminary report

Objective: To examine whether there is a relation between nightmares and serum lipid levels. Methods: Fifteen subjects who met DSM-IV criteria for the diagnosis of nightmare disorder and 15 healthy control subjects participated in the study. We used an enzymatic colorimetric method for cholesterol and triglyceride determination. We measured high-density lipoprotien (HDL) cholesterol using the direct HDL-cliolesterot method. Low-density lipoprotein (LDL) was calculated according to the Friedewald formula. Results: Patients with nightmare disorder had. lower serum triglyceride, lower total cholesterol, and lower LDL levels than healthy control Subjects. Conclusion: These findings suggest that nightmares are associated with low serum lipid levels

Radiographic correlation of symptomatic and asymptomatic flexible flatfoot in young male adults

The purpose was to evaluate the value of radiology to distinguish between symptomatic and asymptomatic flexible flatfeet in young male adults. Among young male army recruits, 56 feet of 28 recruits were diagnosed as otherwise normal, flexible flatfoot with invisible longitudinal arch on stance and either symptomatic or asymptomatic unilaterally or bilaterally. The talus-first metatarsal and calcaneal pitch angles were measured on weight-bearing lateral radiographs, and the results were evaluated statistically. The talus-first metatarsal angle showed statistical significance in both non-parametric and logistic regression tests, but the calcaneal pitch angle showed statistical significance only in non-parametric test between symptomatic and asymptomatic flatfoot groups. Although the single gender and number of samples limit the applicability of our study, these results caused us to make an interpretation that increased talus-first metatarsal angle might be an important risk factor of being symptomatic in otherwise normal flexible flatfoot