Using additive and relative hazards to quantify colorectal survival inequalities for patients with a severe psychiatric illness

2020 ◽  
Author(s):  
Alyson L. Mahar ◽  
Laura E. Davis ◽  
Paul Kurdyak ◽  
Timothy P. Hanna ◽  
Natalie G. Coburn ◽  
...  
Keyword(s):  
Psychiatric Illness ◽  
Survival Inequalities

scholarly journals Using Additive and Relative Hazards to Quantify Colorectal Survival Inequalities for Patients with A Severe Psychiatric Illness

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Alyson L Mahar ◽  
Laura E Davis ◽  
Paul Kurdyak ◽  
Timothy P Hanna ◽  
Natalie G Coburn ◽  
...  
Keyword(s):  
Psychiatric Illness ◽  
Proportional Hazards ◽  
Primary Tumour ◽  
Risk Difference ◽  
Cox Proportional Hazards ◽  
Administrative Databases ◽  
Risk Of Death ◽  
Increased Risk ◽  
Absolute Effect ◽  
Survival Inequalities

IntroductionDespite recommendations, most studies examining health inequalities fail to report both absolute and relative summary measures. We examine colorectal cancer (CRC) survival for patients with and without severe psychiatric illness (SPI) to demonstrate the use and importance of relative and absolute effects. Objectives and ApproachWe conducted a retrospective cohort study of CRC patients diagnosed between 01/04/2007 and 31/12/2012, using linked administrative databases. SPI was defined as diagnoses of major depression, bipolar disorder, schizophrenia, and other psychotic illnesses six months to five years preceding cancer diagnosis and categorized as inpatient, outpatient or none. Associations between SPI history and risk of death were examined using Cox Proportional Hazards regression to obtain hazard ratios and Aalen’s semi-parametric additive hazards regression to obtain absolute differences. Both models controlled for age, sex, primary tumour location, and rurality. ResultsThe final cohort included 24,507 CRC patients, 482 patients had an outpatient SPI history and 258 patients had an inpatient SPI history. 58.1% of patients with inpatient SPI history died, and 47.1% of patients with outpatient SPI history died. Patients with an outpatient SPI history had a 40% (HR 1.40, 95% CI: 1.22-1.59) increased risk of death and patients with an inpatient SPI history had a 91% increased risk of death (HR 1.91, 95% CI: 1.63-2.25), relative to no history of a mental illness. An outpatient SPI history was associated with an additional 33 deaths per 1000 person years, and an inpatient SPI was associated with an additional 82 deaths per 1000 person years after controlling for confounders. Conclusion / ImplicationsWe demonstrated that reporting of both relative and absolute effects is possible and calculating risk difference is relatively simple using Aalen models. We encourage future studies examining inequalities with time-to-event data to use this method and report both relative and absolute effect measures.

Review of Psychiatric Illness in Physicians.

1983 ◽  
Vol 28 (3) ◽  
pp. 243-243
Author(s):  
Samuel Pieper
Keyword(s):  
Psychiatric Illness

ASSESSMENT OF CORRELATION BETWEEN LEUKODERMA AND PSYCHIATRIC ILLNESS

2019 ◽  
Vol 3 (8) ◽  
Author(s):  
Dr. Mukesh Batra
Keyword(s):  
Psychiatric Illness ◽  
Study Participant ◽  
Simple Random Sampling ◽  
Anxiety Symptoms ◽  
Control Group ◽  
P Value ◽  
Common Symptom ◽  
Cross Sectional ◽  
Duration Of Disease ◽  
Illness Anxiety

Background: Leukoderma is an acquired disease of pigmentation which is presented by depigmented areas of different shape and sizes on the skin. In various researches it was reported that these defects in melanocytes occurred due to autoimmune pathway or the complex causation of oxidative stress and genetics. Material & Methods: In the present cross‑sectional prospective study 100 patients who were diagnosed with Leukoderma and controls who were not having depigmentation of skin and without any known clinical disease were enrolled for present study by simple random sampling. Written informed consent was taken from each study participant. Clearance from institutional ethical committee was also taken prior to the study. Results: The prevalence of psychiatric illness among leukoderma group was 22% and among 78% patients we did not found any psychiatric illness. The most common symptom was depression which was present among 22% of patients with Leukoderma and 18% patients with Leukoderma had anxiety symptoms. Among the control group depression was present in 5 % subjects and anxiety symptoms were present in 7% of subjects. The mean WHO-Quality of life scores was low among Leukoderma group in relation to the control group (p value <0.05). On correlation with psychiatric illness, observations were statistically non-significant (p > 0.05) with HAMA-A and HAMA- D. The observations were statistically significant (p < 0.05) with GHQ total and BSA score. Conclusion:  Higher prevalence of psychitric morbidity among patients with leukoderma and it was found associated with duration of disease and BSA scores. The most common symptom was depression which was followed by anxiety symptoms. Key words: Leukoderma, psychiatric illness, anxiety, depression.

Modified Frontal Leucotomy: A Review of 106 Cases

1964 ◽  
Vol 110 (465) ◽  
pp. 211-221 ◽  
Author(s):  
J. L. T. Birley
Keyword(s):  
Side Effects ◽  
Critical Review ◽  
Psychiatric Illness ◽  
Empirical Therapy ◽  
Psychological Literature ◽  
Standard Operation ◽  
Functional Psychoses

Frontal leucotomy has been used in the treatment of psychiatric illness for over twenty years. Its popularity has undergone the usual fluctuations of a newly-introduced form of empirical therapy, and at present there are many different opinions about its value (Lancet, 1962; Pippard, 1962). For a critical review of the clinical and psychological literature, see Willett (1960). The standard operation has fallen out of favour, not because it was thought to be ineffective, but because it had undesirable side-effects on the personality. Various “modified” operations have, therefore, been introduced. Using one of these—the “orbital undercutting” technique—Knight (1960) has reported excellent results in 129 cases of long-standing depression. Robin (1958, 1959), however, has reported no difference between the outcome for 198 patients who had a standard leucotomy for functional psychoses, fifty-two of them affective, and an equal number of carefully but retrospectively matched controls.

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