Correlation Between Chronic Somatic Co-morbidities and Prognosis of Major Depressive Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. s240-s240
Author(s):  
N. Lucev ◽  
A. Vuk ◽  
I. Simunovic Filipcic ◽  
I. Filipcic
Keyword(s):  
Poor Prognosis ◽  
Treatment Success ◽  
Cross Sectional ◽  
Duration Of Illness ◽  
Co Morbidity ◽  
Wide Range ◽  
Somatic Comorbidities ◽  
Somatic Disorders ◽  
Competing Interest ◽  
Somatic Diseases

IntroductionDepression and somatic disorders are closely interrelated. Depressed mood is recognized to contribute to the development and progression of wide range of somatic diseases, while at the same time somatic diseases may increase the risk of depression. Co-morbidity research still represents huge research and clinical challenge to contemporary psychiatry and medicine.ObjectivesTo check whether the correlation of NSC and poor prognosis of MDD treatment is merely the consequence of age and duration of illness.MethodsWe investigated a cross-sectional sample consisting of 290 psychiatric diagnosed with MDD. Outcome was the number of psychiatric rehospitalizations (NPR) since the first diagnosis of MDD treatment success. Predictor was NSC. Covariates controlled were sex, age, BMI, marital status, number of household members, education, work status, duration of MDD, CGI-severity of MDD at diagnosis, treatment with antidepressants and anti-psychotics.ResultsAfter adjustment for all confounders, mediation analysis revealed insignificant indirect effects of NSC on NPR through patient's age (P = 0.296) and duration of MDD (P = 0.180). Direct effect of NSC was significant and clinically relevant (P < 0.001). Effect of NSC was significantly moderated by duration of MDD (P = 0.019). NSC and NPR were not significantly associated if MDD lasted for less than a year. The more MDD lasted the stronger was correlation of NSC and NPR.ConclusionCorrelation of NSC and poor prognosis of MDD is not a mere consequence of patient's age and duration of illness. To treat MDD effectively we have to treat simultaneously somatic comorbidities.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Chronic Somatic and Psychiatric Co-morbidities are Associated with Psychiatric Treatment Success; A Nested Cross-sectional Study

2017 ◽  
Vol 41 (S1) ◽  
pp. S135-S135
Author(s):  
I. Filipcic ◽  
I. Simunovic Filipcic ◽  
M. Rojnic Kuzman ◽  
G. Vladimir ◽  
P. Svrdlin ◽  
...  
Keyword(s):  
Psychiatric Treatment ◽  
Psychiatric Patients ◽  
Treatment Success ◽  
Cross Sectional Study ◽  
Interdisciplinary Treatment ◽  
Cross Sectional ◽  
Psychiatric Comorbidities ◽  
Causal Pathways ◽  
Somatic Comorbidities ◽  
Competing Interest

IntroductionA rich body of literature dealt with somatic comorbidities of psychiatric illnesses. However, relatively few explored the association of somatic and psychiatric comorbidities with psychiatric treatment success.ObjectiveObjective of this analysis was to explore chronic somatic and psychiatric comorbidities association with the average number of psychiatric re-hospitalisations annually.MethodsThis cross-sectional analysis was done on the baseline data of prospective cohort study “Somatic comorbidities in psychiatric patients” started during 2016 at Psychiatric hospital Sveti Ivan, Zagreb, Croatia. We included 798 patients. Outcome was the average number of psychiatric re-hospitalisations annually since the diagnosis. Predictors were number of chronic somatic and psychiatric comorbidities. Covariates that we controlled were sex, age, BMI, marital status, number of household members, education, work status, duration of primary psychiatric illness, CGI–severity at diagnosis, treatment with antidepressants and antipsychotics.ResultsInteraction of somatic and psychiatric comorbidities was the strongest predictor of the average number of psychiatric re-hospitalisations annually (P < 0.001). Mean number of re-hospitalisations annually adjusted for all covariates, was increasing from 0.60 in patients with no chronic comorbidities, up to 1.10 in patients with ≥ 2 somatic and ≥ 2 psychiatric comorbidities.ConclusionSomatic and psychiatric comorbidities are independently associated with the psychiatric treatment success. Further studies should look at possible causal pathways between them, and interdisciplinary treatment of psychiatric patients is urgently needed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The Dietary Status of Adults With ADHD

2017 ◽  
Vol 41 (S1) ◽  
pp. s245-s245 ◽  
Author(s):  
J.N. Kjaer ◽  
L. Jakobsen ◽  
M. Lasgaard ◽  
P. Munk-Jørgensen
Keyword(s):  
Dietary Pattern ◽  
Representative Sample ◽  
Fruits And Vegetables ◽  
University Hospital ◽  
Sample Population ◽  
Co Morbidity ◽  
Public Health Survey ◽  
Competing Interest ◽  
Somatic Diseases ◽  
Physical Activity Scale

ObjectiveThe aim was to investigate the dietary status of adults with ADHD. Furthermore, we compared the group with a representative sample of a healthy adult Danish population.MethodData were collected from the ADHD database operated by the ADHD outpatient clinic at Aarhus university hospital. We used data from newly referred patients in a seven months period from April 2014 through October 2014. The collected data include weight, height, blood pressure, somatic or psychiatric co-morbidity, blood sample, physical activity scale. Concerning the diagnosis of ADHD: DIVA, ASRS, BRIEF-V. Inter99 was used to assess the dietary status. The representative sample was obtained as a part of a public health survey from 2010 called “how are you” conducted in the same region of Denmark as the location of the psychiatric hospital. Preliminary results, one hundred and forty-three patients were included in the study, 52% males. The mean age was 30.9 years. A larger proportion of ADHD patients fall in the category “unhealthy dietary pattern” compared to the representative sample population (26% vs. 12%), while the proportion in the “healthy dietary pattern” category is markedly lower (14% vs. 24%). The differences seem to be explained by lower than recommended intakes of fruits and vegetables.ConclusionOur findings suggest a general shift towards more unhealthy dietary patterns among patients with ADHD. This exposes them to higher risk of somatic diseases, notably diabetes mellitus and cardiovascular disease. Lifestyle interventions could be a necessary part of standard treatment for patients with ADHD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Eating problems and body image among Finnish adolescents

2017 ◽  
Vol 41 (S1) ◽  
pp. S560-S560
Author(s):  
A. Sourander ◽  
J. Maezono
Keyword(s):  
Body Image ◽  
Behavioral Problems ◽  
Population Based ◽  
Emotional And Behavioral Problems ◽  
Eating Problems ◽  
Cross Sectional ◽  
Peer Problems ◽  
9Th Grade ◽  
Wide Range ◽  
Competing Interest

ObjectiveTo study prevalence of self-reported body image and eating distress symptoms among Finnish adolescents, and to study associations between psychopathology, body image and eating distress.DesignCross-sectional population-based, survey subjects, 7th to 9th grade students aged 13–15: 3154 in Finland in 2014.MethodsData were collected by student self-reported questionnaire including scale designed for evaluating attitudes and behaviors towards body shape and eating, and Strengths and Difficulties Questionnaire (SDQ) for assessing emotional and behavioral problems.ResultsThe female adolescents reported much more dissatisfaction and concerns with their bodies than the males, high levels of distress with body emotional, behavioral and peer problems measured with SDQ. Body image and eating problems were higher in Finnish than Japanese females with peer problems.ConclusionThe finding was in accordance with previous studies that found that body image and eating distress are associated with to gender and wide range of psychiatric problems.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Misuse of trihexyphenidyl: Factors associated to the prescription

2016 ◽  
Vol 33 (S1) ◽  
pp. S613-S613
Author(s):  
K. Hajji ◽  
M. ilyes ◽  
F. Soumaya ◽  
Y. Samira ◽  
N. mohamed
Keyword(s):  
Anticholinergic Drug ◽  
Cross Sectional ◽  
Residual Symptoms ◽  
Factors Associated ◽  
Abnormal Movements ◽  
Episodic Evolution ◽  
Somatic Comorbidities ◽  
Competing Interest ◽  
Determinant Factor

IntroductionTrihexyphenidyl (THP) is an anti-Parkison and anticholinergic drug. It is essentially prescribed by psychiatrists in order to treat abnormal movements and Parkinsonism induced by antipsychotics. However, in unusual practice, the THP is widely used by patients.AimsTo assess different factors associated to the prescription of trihexyphenidyl in patients treated with neuroleptics.MethodsA cross-sectional, descriptive, comparative and analytical study among 153 patients followed in outpatients clinics and treated by antipsychotics.ResultsDuring a six-month period, 153 patients were interested by the study. In total, 79.73% of them were receiving a treatment by THP. Mean age was 47.79 years old. Almost patients were married (44.1%), having a primary level education (46.7%) and jobless (66.7%). Mean factors associated to THP prescription were: hospitalization in a psychiatry unit (P = 0.025), good evolution of mental disorder during hospitalization (P = 0.008), regular follow-up (P = 0.005), episodic evolution and existence of residual symptoms (P = 0.001), personality disorder (P = 0.025) and somatic comorbidities (P = 0.001). Prescription was crucial in order to indicate necessity of THP. Doses of neuroleptics were a determinant factor (P = 0.0001). Forty-one percent of patients were receiving more than one treatment (P = 0.0001). In most cases, prescription consists of classic antipsychotics (67.60%).ConclusionPrescription of THP should be argued, considering different factors associated to the prescription, in order to prevent misuse of the drug.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Somatic comorbidities are associated with poorer treatment outcome in schizophrenia spectrum disorders, independently of psychiatric comorbidities and other clinical factors

2017 ◽  
Vol 41 (S1) ◽  
pp. S384-S384
Author(s):  
I. Simunovic Filipcic ◽  
F. Igor ◽  
B. Marijana ◽  
K. Matic ◽  
I. Ena ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Cross Sectional Study ◽  
Integrative Approach ◽  
Schizophrenia Spectrum Disorders ◽  
Cross Sectional ◽  
Psychiatric Comorbidities ◽  
Schizophrenia Spectrum ◽  
Somatic Comorbidities ◽  
Schizophrenic Patients ◽  
Competing Interest

IntroductionIncreased somatic morbidities in schizophrenic patients and their association with HRQoL are well documented. Less is known about their association with schizophrenia treatment outcome.ObjectiveTo explore whether the number of somatic comorbidities is associated with poorer psychosis treatment outcome independently of psychiatric comorbidities and other clinical and socio-demographic parameters.AimTo improve understanding of association of somatic morbidities on treatment outcome of schizophrenic patients.MethodsThis nested-cross-sectional study was done during 2016 at Psychiatric hospital Sveti Ivan, Zagreb-Croatia on the sample of 301 patients diagnosed with schizophrenia spectrum disorder. Outcomes were the number of psychiatric rehospitalizations since primary psychiatric diagnosis and the composite of significant improvement measured by CGI-S and the best self-rated health defined as 4th quartile of EQ-5D-5L VAS. Predictors were number of somatic and psychiatric comorbidities. By logistic regression, we controlled socio-demographic and clinical confounders.ResultsHaving two or more somatic comorbidities was significantly associated with the failure to achieve the composite of improvement. The number of somatic comorbidities was significantly associated with increase in psychiatric hospitalizations, even after the adjustment for psychiatric comorbidities and large number of clinical and socio-demographic variables.ConclusionsChronic somatic comorbidities are associated with poorer psychosis treatment outcome independently of psychiatric comorbidities and other factors. Therefore, to treat psychosis effectively it may be essential to treat chronic somatic comorbidities promptly and adequately. The integrative approach should be the imperative in clinical practice.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Resilience and risk, metal health and well-being: How do these concepts relate?

2017 ◽  
Vol 41 (S1) ◽  
pp. S463-S463
Author(s):  
F. Schultze-Lutter ◽  
S. Ochsenbein ◽  
S.J. Schmidt
Keyword(s):  
Mental Health ◽  
Well Being ◽  
The Other ◽  
Cross Sectional ◽  
Wide Range ◽  
Proxy Measure ◽  
Competing Interest ◽  
Universal Definition ◽  
Definition Of ◽  
Relationship Of

IntroductionResilience and well-being have become commonplace and increasingly used terms in a wide range of scientific as well as mental health political contexts.ObjectivesThere is much confusion about the relationship of the two constructs: while some use well-being as a proxy measure of resilience, others treat one concept as a component of the other or see interchangeably one as the prerequisite of the other.AimsTo study the definition of these two concepts in relation to each other.MethodsLiterature review.ResultsBoth ‘resilience’ as well as ‘well-being’, have so far defied universal definition and common understanding of their respective measurement. Part of the confusion around these two concepts is the overlap in their components, in particular with regard to resilience and psychological well-being, and the lack of research on these concepts both by themselves, in relation to each other and in relation to other concepts like mental health, risk or protective (or promotive) factors.ConclusionOur critical and comparative inspection of both concepts highlights the need for more conceptual cross-sectional as well as longitudinal studies:– to uncover the composition of these constructs and to reach agreement on their definition and measurement;– to detect their potential neurobiological underpinnings;– to reveal how they relate to each other;– to determine the potential role of developmental and cultural peculiarities.Thus, the use of the terms resilience and well-being should always be accompanied by a brief explanation of their respective meanings and theoretical framework.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Mood lability and psychopathology in youth

2008 ◽  
Vol 39 (8) ◽  
pp. 1237-1245 ◽  
Author(s):  
A. Stringaris ◽  
R. Goodman
Keyword(s):  
Children And Adolescents ◽  
Community Sample ◽  
Externalizing Disorders ◽  
Self Report ◽  
Cross Sectional ◽  
Co Morbidity ◽  
Wide Range ◽  
Significant Impairment ◽  
Mood Lability ◽  
Internalizing And Externalizing

BackgroundMood lability is a concept widely used. However, data on its prevalence and morbid associations are scarce. We sought to establish the occurrence and importance of mood lability in a large community sample of children and adolescents by testing a priori hypotheses.MethodCross-sectional data were taken from a national mental health survey including 5326 subjects aged 8–19 years in the UK. The outcomes were prevalence and characteristics of mood lability and its associations with psychopathology and overall impairment.ResultsMood lability occurred in more than 5% of the population of children and adolescents, both by parent and self-report. Mood lability was strongly associated with a wide range of psychopathology and was linked to significant impairment even in the absence of psychiatric disorders. Mood lability was particularly strongly associated with co-morbidity between internalizing and externalizing disorders, even when adjusting for the association with individual disorders. The pattern of results did not change after excluding youth with bipolar disorder or with episodes of elated mood.ConclusionsClinically significant mood lability is relatively common in the community. Our findings indicate that mood lability is not a mere consequence of other psychopathology in that it is associated with significant impairment even in the absence of psychiatric diagnoses. Moreover, the pattern of association of mood lability with co-morbidity suggests that it could be a risk factor shared by both internalizing and externalizing disorders. Our data point to the need for greater awareness of mood lability and its implications for treatment.

Interest of admission clinical and paraclinical examinations for the detection of organic comorbidities in psychiatry

2016 ◽  
Vol 33 (S1) ◽  
pp. S385-S385
Author(s):  
M. Turki ◽  
N. Halouani ◽  
N. Hamza ◽  
R. Naoui ◽  
I. Gassara ◽  
...  
Keyword(s):  
Mental Illnesses ◽  
Clinical Observations ◽  
Somatic Disorder ◽  
Admission Data ◽  
Somatic Comorbidities ◽  
Patients At Risk ◽  
Biological Tests ◽  
Skin Abnormalities ◽  
Somatic Disorders ◽  
Competing Interest

IntroductionSomatic comorbidities in patients with mental disorders have become an important issue. They complicate therapeutic management and aggravate the prognosis.ObjectivesOutline the nature of somatic disorders observed in psychiatry and assess the different interactions between psychiatric pathologies and organic diseases.MethodsWe conducted a descriptive retrospective study including 60 patients hospitalized in a psychiatry department during 2 years (2013 and 2014). We included patients having presented a somatic disorder at their admission. Data collection was based on psychiatric and clinical observations.ResultsAt the admission, somatic examination was abnormal in 53.3% of cases: skin abnormalities 28.3%; blood pressure abnormalities 8.3%. An abnormality of the initial biological tests has been reported in 51.7% of patients: leukocytosis 18.3%; liver test abnormalities 13.3%; hematologic abnormalities 8.3%. The electro-cardiograph was pathologic in 35% of cases. These anomalies have required advices from medical and surgical services: cardiology 33.3%; endocrinology 10%, orthopedics 10%. The relationship between somatic and psychiatric pathology was: a comorbidity: 55%; a side effect of psychotropic drug: 5%; an organic origin of the psychiatric disorder: 6.6% and a somatic disorder secondary to the psychiatric pathology: 10%. In the course of this investigation, 6.6% of patients were transferred urgently to a specialist department, the psychotropic treatment was stopped in 10% of cases, and a therapeutic adjustment was necessary in 6.6% of cases.ConclusionOur study confirms the importance of somatic assessment of patients with mental illnesses. This must be a systematic practice in order to detect in time patients at risk of somatic complications.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Wallop of Symptoms and Co-morbidities on COVID-19 Outcome

2021 ◽  
Vol 15 (1) ◽  
pp. 46-51
Author(s):  
Heba H. Abo ElNaga ◽  
Hesham A. AbdelHalim ◽  
Mohamed Abdellatif ◽  
Haroun BG ◽  
Basem Elnagdy ◽  
...  
Keyword(s):  
Clinical Picture ◽  
Online Survey ◽  
Severe Disease ◽  
Time Lag ◽  
Cross Sectional ◽  
Duration Of Symptoms ◽  
Co Morbidity ◽  
Wide Range ◽  
Severity Of The Disease ◽  
Prevalent Symptom

Background: Fever, cough, fatigue, and myalgia are usually the original clinical picture of the COVID-19 pandemic, which appears non-specific and not exclusive. Objectives: To illustrate the clinical picture pattern and assess the prevalence of underlying co-morbidities and their correlation with the severity of COVID-19 infected patients. Methods: A cross-sectional online survey included 580 participants who were either suspected or confirmed with COVID-19 infection. Results: The severity of the disease significantly correlates with both age (p=.01) and the time lag of the diagnosis of COVID-19 (p=.03). Hypertension (p=.015) and diabetes mellitus (p<.01) were significantly associated with the duration of symptoms. A wide range of ages (21-60 years) seemed to be the only risk factor for the severity. When symptoms were tested, dyspnea appeared to be the most prevalent symptom, predicting a more severe disease (OR= .066, 95% CI: .022- .200), followed by diarrhea (OR= .285, 95% CI: .122-.663), then fever (OR= .339, 95% CI: .139-.824). During the examination of co-morbidities influences on the severity, the only major co-morbidity that predicted a more severe disease was IHD (OR= .218, 95% CI: .073- .648), p= .006. Conclusion: Special consideration is required for patients with COVID-19 with an associated longer gap between symptoms and diagnosis and associated co-morbidities including hypertension, diabetes, and established chronic kidney disease (CKD), for which this study proved its profound influence on the severity of the illness and duration of symptoms.

Factors Related to Disability Pensions – A Cross-Sectional Analysis From A University Hospital In Istanbul

2016 ◽  
Vol 33 (S1) ◽  
pp. S486-S486
Author(s):  
E. Sönmez ◽  
D. Tunca ◽  
Y. Akvardar
Keyword(s):  
Intellectual Disability ◽  
Psychiatric Diagnosis ◽  
Disability Pension ◽  
University Hospital ◽  
Cultural Perceptions ◽  
Cross Sectional ◽  
Perceptions Of Disability ◽  
Competing Interest ◽  
Somatic Diseases ◽  
Sectional Analysis

IntroductionMental disorders are one of the leading reasons for disability-related retirement and payment of associated long-term benefits in many countries.ObjectivesTo explore the characteristics of psychiatric outpatients who apply for disability pensions and to investigate the factors associated with making an application.MethodsA four-month cross-sectional evaluation of disability pension and retirement applications to the psychiatry outpatient clinic in a university hospital in Istanbul.ResultsThe majority of 144 patients were male (n = 102, 70.8%), based in Istanbul, married, living with their families and had no occupation at the time of inquiry. Excluding applications for individuals with a diagnosis of intellectual disability (n = 44), most applicants were primary school graduates (n = 31, 32.3%). For the whole group, the median age of application was 34. 60%, (n = 87) had an established psychiatric diagnosis before the application, with average duration since diagnosis of approximately 8 years. The most frequent diagnoses were intellectual disability, followed by schizophrenia and depression. More than half of the patients were treated only outpatiently, with no hospitalization (n = 55, 58%). Thirty-two of them (22.4%) had a comorbid psychiatric diagnosis and 58 (40.3%) had at least one comorbid medical diagnosis.ConclusionsThere are some similarities between our findings and findings from other countries, such as low educational level and frequent comorbid somatic diseases among patients applying for disability pension. In contrast with the literature and as an indicator of social inequality, most patients applied for disability pension were male. The results are reflecting the specificities of different health systems and cultural perceptions of disability.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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