The prevalence of anxiety and its association with the quality of life and illness severity among bipolar affective disorder patients in a developing country

The objective of the study was to determine the prevalence of anxiety symptoms and describe the association with illness severity, quality of life (QOL) and current medications among patients with BPAD who are currently in remission. A descriptive cross-sectional study conducted among outpatient clinic patients at the University Professorial Unit of University of Ruhuna, Sri Lanka. The study population consisted of patients diagnosed with BPAD and who are currently in remission. Anxiety symptoms among BPAD patients were assessed using the DASS-21 anxiety subscale and QOL was assessed using WHOQoL-BREF. Medications and severity of illness related information were gathered from both the patent and from their medical records. The study population consisted of 145 patients. The prevalence of anxiety among patients with BPAD who are currently in remission was 48.3 % (95 %CI 40.0–56.6). Multiple logistic regression revealed that being anxious was independently associated with currently not being married (aOR 2.92) and currently not being employed (aOR 2.1). Presence of anxiety significantly reduced the QOL in all the domains. Having anxiety was significantly associated with having one or more relapses within the past three years (aOR 4.1), one or more hospital admissions within the past three years (aOR 6.1), needing more psychoactive medications to maintain a euthymic state (aOR 7.7), and one or more suicidal attempts in the past (aOR 6.5). Anxiety was highly prevalent among patients with BPAD. Those with anxiety experienced significantly lower QOL and were found to be having significantly high adverse outcomes from the disease.</p

Smoking, Alcohol Consumption, and Illegal Substance Abuse among Adolescents in Sri Lanka: Results from Sri Lankan Global School-Based Health Survey 2016

Background. Adolescence is defined by the World Health Organization (WHO) as “the transition period from childhood to adulthood”. Increases in autonomy during this period, willingness to experiment, and peer influence create an environment of taking high-risk decisions influencing adolescent health, such as substance abuse and smoking. The current study was conducted to estimate the prevalence of smoking, alcohol consumption, and illegal substance abuse and their determinants on in-school adolescents using data from the Global School-based Student Health Survey, Sri Lanka in 2016. Methods. A cross-sectional survey was conducted among 3,650 students using a self-administered questionnaire in government schools. Weighted prevalence was calculated, and logistic regression analysis was conducted to determine the correlates. Results. The prevalence of current alcohol, smoking, smokeless tobacco consumption, and substance abuse, 30 days before the survey, was 3.4% (95% CI 2.6 - 4.3), 3.6% (95% CI 2.5-5.0), 2.3% (95% CI 1.5-3.7), and 2.7% (95% CI - 1.7-4.2%). Male sex and involvement in physical fighting were independently associated with increased risk in all four substance categories assessed. Multivariate analysis using multiple logistic regression revealed that only the male sex and involvement in physical fighting were correlates for four substance categories assessed when confounding effects of other variables were accounted for. Being in the 16-17 age category, parents’ tobacco use and seeing actors consuming alcohol on TV increased the risk of alcohol consumption, smoking, and smokeless tobacco. Having ever attempted suicide was positively associated with increased risk for alcohol consumption, smoking, and illegal substance abuse. Conclusion. Alcohol use, smoking, smokeless tobacco use, and illegal substance abuse by students remain a concern in Sri Lanka and implementing life skills-based interventions at schools is recommended

Prevalence of Chronic Complications, Their Risk Factors, and the Cardiovascular Risk Factors among Patients with Type 2 Diabetes Attending the Diabetic Clinic at a Tertiary Care Hospital in Sri Lanka

Diabetes incurs heavy burden to patients and the healthcare system. Assessment of disease burden is important in taking necessary precautions and management decisions. We aimed to determine the prevalence of macro- and microvascular complications, their risk factors, and coronary artery disease (CAD) risk factors among patients with type 2 diabetes mellitus (T2DM). A descriptive cross-sectional single-centre study was carried out among 3000 patients with T2DM attending the diabetic clinic at the National Hospital of Sri Lanka from January to July 2016. The study population had 72.7% females and 27.3% males. Mean age and disease duration were 58.3 ± 10.3 and 10.8 ± 7 years, respectively. Prevalence of CAD, stroke, and peripheral vascular disease were 10.6%, 1.1%, and 4.7% while diabetic retinopathy, neuropathy, nephropathy, diabetic foot, and lower extremity amputation (LEA) were 26.1%, 62.6%, 50.8%, 2.6%, and 1.3%, respectively. Prevalence of overweight/obesity, hypertension, dyslipidemia, and smoking were 80%, 77.6%, 76.7%, and 11%, respectively. Increased age, disease duration, and HBA1c were risk factors for microvascular disease and diabetic foot while age was the only risk factor for macrovascular complications. Occurrence of CAD, peripheral neuropathy, diabetic foot, and LEA was significantly higher among males than when compared to females. This study highlights the major burden of chronic complications and high prevalence of CAD risk factors in this population