To Screen or Not to Screen: Conceptual Issues in Screening for Psychiatric Disorders in Psychiatric Patients with a Focus on the Performance of the Psychiatric Diagnostic Screening Questionnaire

Background: Normal personality development, gone awry due to genetic or environmental factors, results in personality disorders (PD). These often coexist with other psychiatric disorders, affecting their outcome adversely. Considering the heterogeneity of data, more research is warranted. Methods: This was a cross-sectional study on personality traits in psychiatric patients of a tertiary hospital, over 1 year. Five hundred and twenty-five subjects, aged 18–45 years, with substance, psychotic, mood, or neurotic disorders were selected by convenience sampling. They were evaluated for illness-related variables using psychiatric pro forma; diagnostic confirmation and severity assessment were done using ICD-10 criteria and suitable scales. Personality assessment was done using the International Personality Disorder Examination after achieving remission. Results: Prevalence of PD traits and PDs was 56.3% and 4.2%, respectively. While mood disorders were the diagnostic group with the highest prevalence of PD traits, it was neurotic disorders for PDs. Patients with PD traits had a past psychiatric history and upper middle socioeconomic status (SES); patients with PDs were urban and unmarried. Both had a lower age of onset of psychiatric illness. Psychotic patients with PD traits had higher and lower PANSS positive and negative scores, respectively. The severity of personality pathology was highest for mixed cluster and among neurotic patients. Clusterwise prevalence was cluster C > B > mixed > A (47.1%, 25.2%, 16.7%, and 11.4%). Among subtypes, anankastic (18.1%) and mixed (16.7%) had the highest prevalence. Those in the cluster A group were the least educated and with lower SES than others. Conclusions: PD traits were present among 56.3% of the patients, and they had many significant sociodemographic and illness-related differences from those without PD traits. Cluster C had the highest prevalence. Among patients with psychotic disorders, those with PD traits had higher severity of psychotic symptoms.

Download Full-text

Metabolic syndrome in psychiatry: advances in understanding and management

Advances in Psychiatric Treatment ◽

10.1192/apt.bp.113.011619 ◽

2014 ◽

Vol 20 (2) ◽

pp. 101-112 ◽

Cited By ~ 13

Author(s):

Cyrus S. H. Ho ◽

Melvyn W. B. Zhang ◽

Anselm Mak ◽

Roger C. M. Ho

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Psychiatric Disorders ◽

Psychiatric Patients ◽

Learning Objectives ◽

List Type ◽

Type Number ◽

Unhealthy Lifestyle ◽

Definition Of ◽

The Relationship

SummaryMetabolic syndrome comprises a number of cardiovascular risk factors that increase morbidity and mortality. The increase in incidence of the syndrome among psychiatric patients has been unanimously demonstrated in recent studies and it has become one of the greatest challenges in psychiatric practice. Besides the use of psychotropic drugs, factors such as genetic polymorphisms, inflammation, endocrinopathies and unhealthy lifestyle contribute to the association between metabolic syndrome and a number of psychiatric disorders. In this article, we review the current diagnostic criteria for metabolic syndrome and propose clinically useful guidelines for psychiatrists to identify and monitor patients who may have the syndrome. We also outline the relationship between metabolic syndrome and individual psychiatric disorders, and discuss advances in pharmacological treatment for the syndrome, such as metformin.LEARNING OBJECTIVES•Be familiar with the definition of metabolic syndrome and its parameters of measurement.•Appreciate how individual psychiatric disorders contribute to metabolic syndrome and vice versa.•Develop a framework for the prevention, screening and management of metabolic syndrome in psychiatric patients.

Download Full-text

Assessment of drug attitude, medication adherence and quality of life among psychiatric patients in South Indian population: a cross sectional study

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20185159 ◽

2018 ◽

Vol 8 (1) ◽

pp. 61

Author(s):

Suganya Ganesan ◽

Nitya Selvaraj ◽

Vinoth Krishna Dass ◽

Nalinidevi Jayabalan ◽

Meher Ali Rajamohammad ◽

...

Keyword(s):

Quality Of Life ◽

Medication Adherence ◽

Psychiatric Disorders ◽

Psychiatric Patients ◽

Cross Sectional Study ◽

Sectional Study ◽

Medication Nonadherence ◽

Cross Sectional ◽

Drug Attitude

Background: In spite of many progresses in treatment of psychiatric disorders, medication nonadherence plays an important role in worsening of clinical condition and affects quality of life among psychiatric patients. There are numerous factors contributing for medication nonadherence among patients with mental illness. So, this study was conducted to assess psychiatric patients’ adherence of medication and to improve their quality of life with psychiatric disorder. The objectives of the study were to analyze impact of pharmacophilia and pharmacophobia on medication adherence among patients with psychiatric disorders at a tertiary care hospital and to assess quality of life among pharmacophilic and pharmacophobic patients.Methods: A cross-sectional study was conducted in outpatient psychiatric department for a period of two months. After obtaining informed voluntary consent, patient’s socio-demographic details, diagnosis, and treatment were recorded from prescription slip. Patients above 18yr age with psychiatric diagnosis as per International Classification of Diseases 10 (ICD-10) and receiving at least one psychotropic medication for >1 month were enrolled in study and assessed using: Drug attitude inventory classification (DAI-10); Medication Rating Scale (MARS); Quality of life enjoyment and satisfaction Questionnaire-Short Form (Q-LES-Q-SF).Results: Among 130 patients, 116 were pharmacophilic and 14 were pharmacophobic as per DAI-10 scale. 81.9% of pharmacophilic were adherent to prescribed medication assessed using MARS scale only 14.3% were pharmacophobic. The quality of life was better in pharmacophilic compared to pharmacophobic group (p=0.002) using Q-LES-Q-SF.Conclusions: This study concluded that pharmacophilic patients have higher adherence and good quality of life index compared to pharmacophobic. Proper counselling of pharmacophobic patients by psychiatrists could improve adherence and QOL.

Download Full-text

Health habits, attitudes and behavior towards oral health of psychiatric patients

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1004136j ◽

2010 ◽

Vol 138 (3-4) ◽

pp. 136-142 ◽

Cited By ~ 2

Author(s):

Svetlana Jovanovic ◽

Ivanka Gajic ◽

Jelena Mandic ◽

Bojan Mandic

Keyword(s):

Oral Health ◽

Psychiatric Disorders ◽

Social Economic ◽

Psychiatric Patients ◽

Demographic Characteristics ◽

Medical Documentation ◽

Oral Diseases ◽

And Behavior ◽

Attitudes And Behavior ◽

Healthy Persons

Introduction. People with psychiatric disorders are at high risk of oral diseases due to the impact of their primary psychiatric condition and the side-effects of antipsychotic medications. Objective. The aim of this study was to identify habits, attitudes and behavior towards oral health of hospitalized psychiatric patients with psychotic disorders, including mood disorders with psychotic characteristics, as well as to identify factors that could influence those habits, attitudes and behavior. Methods. The experimental group consisted of 186 hospitalized patients with psychiatric disorders (87 males and 99 females), aged from 18 to 59 years (mean age 46.0?8.0 years). The control group consisted of 186 healthy persons matched for age and gender. Data were obtained by using specially designed questionnaires with questions about the subjects' social, economic and demographic characteristics, as well as their habits, attitudes and behaviour concerning their oral health, in a form of a standardized interview. Other medical data were collected from medical documentation of disease history. Statistical analysis was performed by Student's t-test, Chi-square test, ANOVA, Logistic Regression and simultaneous multiple regression. Results. Psychiatric patients have worse habits, attitudes and behavior concerning their oral health in comparison with healthy persons (p<0.001): they wash their teeth more rarely and in a shorter time, have less knowledge of oral diseases and their effect on general health, and visit their dentist more rarely. The obtained results depend on social, economic and demographic characteristics and on the underlying illness of patients. Conclusion. Health educational work concerning oral health of patients should be included in psychiatric treatment, as a part of an existing therapy with the aim of improving the general quality of their life.

Download Full-text

Correlation of adverse childhood experiences with psychiatric disorders and aggressiveness in adulthood

Vojnosanitetski pregled ◽

10.2298/vsp1008653s ◽

2010 ◽

Vol 67 (8) ◽

pp. 653-658 ◽

Cited By ~ 2

Author(s):

Ljiljana Samardzic ◽

Gordana Nikolic ◽

Grozdanko Grbesa ◽

Maja Simonovic ◽

Tatjana Milenkovic

Keyword(s):

Psychiatric Disorders ◽

Adverse Childhood Experiences ◽

Psychotic Disorders ◽

Psychiatric Patients ◽

Statistical Significance ◽

Healthy Individuals ◽

Childhood Experiences ◽

Positive Correlation ◽

Adverse Childhood ◽

Significant Difference

Background/Aim. Consequences of individual adverse childhood experiences for adult mental health have been precisely studied during past decades. The focus of past research was mainly on childhood maltreatment and neglect. The aim of this paper was to determine association between multiple adverse childhood experiences and psychiatric disorders, as well as their correlation to the degree and type of aggressiveness in adult psychiatric patients. Methods. One hundred and thirteen psychiatric outpatients were divided into three diagnostic groups: psychotics, non-psychotics and alcoholics and compared with fourty healthy individuals. Adverse childhood experiences data were gathered retrospectively, using the Adverse childhood experiences questionnaire and explanatory interview. Aggressiveness was assessed using Buss-Perry Aggression Questionnaire. The Student's t test, ANOVA and correlational analysis were used for evaluation of statistical significance of differences among the groups. A value p < 0.05 was considered statistically significant. Results. Our results showed that the mean number of adverse childhood experiences in each group of psychiatric patients, as well as in the whole group of patients, was statistically significantly higher than in the group of healthy individuals (p < 0.001); there was a statistically significant difference in score of physical aggressiveness between the patients exposed to adverse childhood experiences and those who were not exposed to them (p < 0.05); scores of physical aggressiveness were in positive correlation with the number of adverse childhood experiences (p < 0.05). The highest mean score of adverse childhood experiences was evidenced in the group of patients with psychotic disorders. Conclusion. Multiple adverse childhood experiences are significantly associated with psychotic disorders, nonpsychotic disorders and alcohol dependence in adulthood and their presence is important morbidity risk factor for psychiatric disorders. They are in positive correlation with physical aggressiveness of the patients from these diagnostic groups.

Download Full-text

Oral lesions in patients with psychiatric disorders

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1010564j ◽

2010 ◽

Vol 138 (9-10) ◽

pp. 564-569 ◽

Cited By ~ 5

Author(s):

Svetlana Jovanovic ◽

Ivanka Gajic ◽

Bojan Mandic ◽

Jelena Mandic ◽

Vlada Radivojevic

Keyword(s):

Psychiatric Disorders ◽

Facial Pain ◽

Psychiatric Patients ◽

Medical Documentation ◽

Oral Lesions ◽

Age And Gender ◽

Taste Changes ◽

Swallowing Difficulties ◽

And Gender ◽

Healthy Persons

Introduction. Oral diseases in psychiatric patients are usually a result of bad oral hygiene and psychopharmaceutical side-effects. Objective. The aim of this study was to detect oral lesions in patients hospitalized in psychiatric institutions with the confirmed diagnosis of psychiatric illness and mood disorder with psychotic characteristics, as well as to discover the factors that can influence these oral lesions. Methods. Cross-section study consisted of 186 hospitalized patients with psychiatric disorders in the experimental group, out of whom 87 were males and 99 females. Patients were aged from 18 to 59 years, mean age 46.0?8.0 years. The control group consisted of 186 healthy persons matched for age and gender. Data on oral lesions were obtained within history and clinical examination of the oral cavity. Other medical data were collected from medical documentation. Statistical analysis was performed by Student?s t-test, chi-square test and logistic regression. Results. Dry mouth was registered in 78.5% of patients. The difference in tongue and lip lesions, burning and stinging symptoms, bruxism, facial pain, low saliva rates, halitosis, taste changes and swallowing difficulties between the patients and healthy persons was highly statistically significant (p<0.001). Age and gender, as well as the factors of main disease, influence burning and stinging, bruxism, low saliva rates, swallowing difficulties, taste changes and facial pain of the psychiatric patients. Conclusion. Results imply that psychiatric patients are more frequently involved with oral lesions than healthy persons. It is necessary to organize specific preventive and educational oral health programmes with these patients, as well as with doctors who treat the basic illness.

Download Full-text

Multiple sclerosis and psychiatric disorders: Comorbidity and sibling risk in a nationwide Swedish cohort

Multiple Sclerosis Journal ◽

10.1177/1352458514540970 ◽

2014 ◽

Vol 20 (14) ◽

pp. 1881-1891 ◽

Cited By ~ 32

Author(s):

Viktoria Johansson ◽

Cecilia Lundholm ◽

Jan Hillert ◽

Thomas Masterman ◽

Paul Lichtenstein ◽

...

Keyword(s):

Multiple Sclerosis ◽

Bipolar Disorder ◽

Psychiatric Disorders ◽

Psychiatric Patients ◽

Familial Risk ◽

Positive Association ◽

Protective Mechanisms ◽

Genetic Liability ◽

Sibling Comparison ◽

National Patient

Background: Psychiatric disorders are known to be prevalent in multiple sclerosis (MS). Objective: The objective of this paper is to study comorbidity between MS and bipolar disorder, schizophrenia and depression in a nationwide cohort and to determine whether shared genetic liability underlies the putative association. Methods: We identified ICD-diagnosed patients with MS ( n = 16,467), bipolar disorder ( n = 30,761), schizophrenia ( n = 22,781) and depression ( n = 172,479) in the Swedish National Patient Register and identified their siblings in the Multi-Generation Register. The risk of MS was compared in psychiatric patients and in matched unexposed individuals. Shared familial risk between MS and psychiatric disorders was estimated by sibling comparison. Results: The risk of MS was increased in patients with bipolar disorder (hazard ratio (HR) 1.8, 95% confidence interval (CI) 1.6–2.2, p < 0.0001) and depression (HR 1.9, 95% CI 1.7–2.0, p < 0.0001). MS risk in schizophrenia was decreased (HR 0.6, 95% CI 0.4–0.9, p = 0.005). The association between having a sibling with a psychiatric disorder and developing MS was not significant. Conclusion: We found a strong positive association between MS and bipolar disorder and depression that could not be explained by genetic liability. The unexpected negative association between MS and schizophrenia might be spurious or indicate possible protective mechanisms that warrant further exploration.

Download Full-text

Clinical and demographic characteristics of psychiatric patients seropositive for Borrelia burgdorferi

European Psychiatry ◽

10.1016/j.eurpsy.2004.09.021 ◽

2006 ◽

Vol 21 (2) ◽

pp. 118-122 ◽

Cited By ~ 8

Author(s):

T. Hájek ◽

J. Libiger ◽

D. Janovská ◽

P. Hájek ◽

M. Alda ◽

...

Keyword(s):

Borrelia Burgdorferi ◽

Psychiatric Disorders ◽

Psychiatric Patients ◽

Psychiatric Morbidity ◽

Demographic Variables ◽

Healthy Controls ◽

Diagnostic Categories ◽

Potential Association ◽

History Of ◽

The Central Nervous System

AbstractPurpose.Borrelia burgdorferi (Bb) infection can affect the central nervous system and possibly lead to psychiatric disorders. We compared clinical and demographic variables in Bb seropositive and seronegative psychiatric patients and healthy controls.Method.Nine hundred and twenty-six consecutive psychiatric patients were screened for antibodies to Bb and compared with 884 simultaneously recruited healthy subjects.Results.Contrary to healthy controls, seropositive psychiatric patients were significantly younger than seronegative ones. None of the studied psychiatric diagnostic categories exhibited stronger association with seropositivity. There were no differences between seropositive and seronegative psychiatric patients in hospitalization length, proportion of previously hospitalized patients and proportion of subjects with family history of psychiatric disorders.Conclusion.These findings elaborate on potential association between Bb infection and psychiatric morbidity, but fail to identify any specific clinical ‘signature’ of Bb infection.

Download Full-text

Breathing-Related Sleep Disorders

Management of Sleep Disorders in Psychiatry ◽

10.1093/med/9780190929671.003.0015 ◽

2020 ◽

pp. 215-238

Author(s):

Ahmed S. BaHammam ◽

Sulaiman Alhifzi ◽

Salih Aleissi

Keyword(s):

Risk Factors ◽

Sleep Apnea ◽

Sleep Disorders ◽

Psychiatric Disorders ◽

Clinical Skills ◽

Psychiatric Patients ◽

Central Sleep Apnea ◽

Metabolic Dysfunction ◽

Obstructive Sleep ◽

Risk Patients

Breathing-related sleep disorders (BRSD) encompass obstructive sleep apnea (OSA), central sleep apnea, and hypoventilation disorders. Risk factors for BRSD include obesity, metabolic dysfunction, smoking, use of respiratory depressant medications (like opiates and benzodiazepines), and alcohol consumption, all of which are highly prevalent among patients with psychiatric disorders. BRSDs are associated with substantial morbidity, disturbed quality of life, and worse prognosis of comorbid psychiatric disorders. Therefore, it is essential for psychiatric care providers to have the clinical skills to recognize BRSDs. Recent studies suggest that the prevalence rates of OSA in psychiatric patients are higher than the general population. Moreover, BRSD’s share common symptoms and risk-factors with psychiatric disorders. A comprehensive clinical approach including a thorough sleep history and examination along with the use of validated screening questionnaires like the STOP-BANG questionnaire, particularly for at-risk patients, is effective in identifying BRSD.

Download Full-text