Differences in the prevalence of insomnia and their predictive value in patients with deliberate drug self-poisoning

2011 ◽  
Vol 26 (S2) ◽  
pp. 1622-1622
Author(s):  
N. Kokras ◽  
A. Kouzoupis ◽  
T. Paparrigopoulos ◽  
G.N. Papadimitriou

IntroductionEvidence suggests a relationship between sleep disturbances and suicidal ideation. The temporal appearance of insomnia has been proposed as a warning sign of imminent suicidal acts. However, there is little information on the temporal relation of insomnia with acts of deliberate self-poisoning (DSP) in particular.ObjectivesThis study aimed to identify the insomnia prevalence in DSP patients and test its predictive value in relation to current psychiatric diagnosis and history of previous DSP acts.MethodsSeventy consecutive patients with DSP admitted from February to September 2010 into three general hospitals had a psychiatric consultation and their sleeping pattern during the week before the DSP act was assessed using the Athens Insomnia Scale.ResultsPatients, with a mean age of 34 ± 2 years, predominantly women (70%), were diagnosed with personality disorders (68%), depression (22%) and psychosis (10%). The overall insomnia prevalence was 69%. A chi-square analysis showed that patients with an Axis I diagnosis were significantly more likely to present insomnia than patients with an Axis II diagnosis. Interestingly, when the number of previous DSP acts was included into the analysis, patients with an Axis I diagnosis with and without previous DSP acts had an equal prevalence of insomnia. On the contrary, in patients with an Axis II diagnosis and previous DSP acts, insomnia was three times more prevalent than in those with no previous DSP acts.ConclusionsThese results suggest that insomnia may be a valid proximal warning sign, particularly in patients with personality disorders and previous DSP acts.

2003 ◽  
Vol 18 (7) ◽  
pp. 350-355 ◽  
Author(s):  
Åsa Westrin ◽  
Karin Frii ◽  
Lil Träskman-Bendz

AbstractPrevious research on hypothalamic-pituitary adrenal (HPA) axis-activity in suicide attempter research has shown conflicting outcomes. The design of the present study was to test the influence of personality disorders and concominant axis I diagnoses on the dexamethasone suppression diagnostic test by use of multiple regression analyses. The sample consisted of 184 patients with a recent suicide attempt and 42 healthy controls. As expected, the lowest pre- and postdexamethasone cortisol levels were found in patients with personality disorders axis II, cluster B as compared to the other patients. The results remained significant when analysed for covariance with DSM-III-R axis I diagnoses, age or sex. Whether these low cortisol levels are due to previous experience of extreme stressful events or long-lasting burden, or whether they may be a consequence of biogenetic or psychological predisposal of interest, remains to be elucidated. Axis I comorbidity needs to be further examined.


2010 ◽  
Vol 12 (1) ◽  
pp. 103-114 ◽  

Genetic epidemiologic studies indicate that all ten personality disorders (PDs) classified on the DSM-IV axis II are modestly to moderately heritable. Shared environmental and nonadditive genetic factors are of minor or no importance. No sex differences have been identified, Multivariate studies suggest that the extensive comorbidity between the PDs can be explained by three common genetic and environmental risk factors. The genetic factors do not reflect the DSM-IV cluster structure, but rather: i) broad vulnerability to PD pathology or negative emotionality; ii) high impulsivity/low agreeableness; and iii) introversion. Common genetic and environmental liability factors contribute to comorbidity between pairs or clusters of axis I and axis II disorders. Molecular genetic studies of PDs, mostly candidate gene association studies, indicate that genes linked to neurotransmitter pathways, especially in the serotonergic and dopaminergic systems, are involved. Future studies, using newer methods like genome-wide association, might take advantage of the use of endophenotypes.


2021 ◽  
Author(s):  
Analise Peleggi ◽  
Jessica Bohonowych ◽  
Theresa Strong ◽  
Lauren Schwartz ◽  
Soo-Jeong Kim

Abstract BACKGROUND: Prader–Willi syndrome (PWS) is a rare, genetic, neurodevelopmental syndrome associated with hyperphagia and early onset obesity, growth and sex hormone insufficiencies, mild-to-moderate intellectual disability, and behavioral challenges such as compulsivity, anxiety, skin picking, social skills deficits and temper outbursts. Given high rates of psychiatric comorbidity and potential risk factors for suicide in PWS, this study sought a first estimate of the prevalence of suicidal ideation (SI) and attempts (SA) in the PWS population and any characteristics associated with suicidality in this population. METHODS: Using the Global Prader-Willi Syndrome Registry, we included all participants who had answered a question about SI. We examined the most recent data from the surveys about social, economic, and demographic factors, genetic subtype, and psychiatric symptoms and treatments. A chi-square analysis was used to compare registry participants who reported SI to those without reported SI. RESULTS: From 750 included survey respondents, 94 (12.5%) endorsed some history of SI. Of these, 25 (26.6%) also reported a history of SA, with an average age of 16.25 years at their first attempt. Those with a history of SI were predominantly male and adult age, and had higher rates of aggression and psychiatric comorbidities, therapies, and medications. CONCLUSIONS: This study indicates that the rate of SI and SA in PWS is comparable to the general population, and that suicide attempts in PWS typically begin in middle-teenage years. Despite unique challenges, individuals with PWS and their caregivers should be included in screens and psychoeducation for suicide and mental health concerns.


2019 ◽  
Vol 11 (2) ◽  
pp. 80
Author(s):  
Ribka Wowor

Abstract: Prehypertension is a warning sign, early in age which denotes the risk of hypertension later on in life. Clinical and academic challenges of medical students may have adverse effect on their lifestyle, predisposing vulnerable subjects to elevated blood pressure. This study was aimed to determine the association between dietary habits and prehypertension among Indonesian young adults in Manado. This was an analytical study with a cross-sectional study. Subjects were 111 medical students (undergraduate and postgraduate) aged between 20-30 years, of either sex. A pre-tested questionnaire was used to elicit the details on physical activity, family history of hypertension, tobacco use, and dietary habits. According to JNC-7 guidelines, a systolic blood pressure (SBP) of 120 to 139 mmHg and/or diastolic blood pressure (DBP) of 80 to 89 mmHg is considered as prehypertension. Of the 111 subjects, 22.5% showed blood pressure levels within the range of prehypertension. Chi-square analysis revealed that junk food consumption (OR=3,152; 95% CI=1,253-7,925; P=0,023), and soft drink consumption (OR=4,747; 95% CI=1,797-12,539; P=0,002) were the risk factors of prehypertension. Conclusion: Dietary habits were associated with the prehypertension among young adults in Manado.Keywords: dietary habits, prehypertension, young adultsAbstrak: Prehipertensi merupakan tanda peringatan dini akan resiko terjadinya hipertensi di kemudian hari. Mahasiswa kedokteran memiliki kesibukan studi terutama pada masa kepaniteraan klinik di Rumah Sakit. Tuntutan dalam pendidikan dan pelayanan sekaligus di RS berdampak terhadap pola aktivitas mereka sehari-hari sehingga dapat memengaruhi tekanan darah. Penelitian ini bertujuan untuk mengetahui hubungan antara diet (konsumsi makanan dan minuman) dengan kejadian prehipertensi pada mahasiswa kedokteran Univrsitas Sam Ratulangi. Jenis penelitian ialah analitik dengan desain potong lintang. Hasil penelitian mendapatkan 111 mahasiswa kedokteran peserta P3D dan PPDS (calon spesialis) berusia antara 20-30 tahun sebagai subyek penelitian. Dilakukan pemeriksaan tekanan darah dan berat badan. Penentuan kebiasaan makan ditetapkan berdasarkan hasil pengisian kuesioner. Definisi prehipertensi berdasarkan kriteria JNC 7 yaitu tekanan darah sistolik lebih dari 120 mmHg tapi kurang dari 140 mmHg, dan atau tekanan darah diastolik lebih dari 80 mmHg tapi kurang dari 90 mmHg. Uji Chi-square dilakukan untuk melihat hubungan antara konsumsi junk food dan soft drink dengan kejadian prehipertensi dan didapatkan adanya hubungan antara konsumsi junk food (OR=3,152; 95% CI=1,253-7,925; P=0,023), dan soft drink (OR=4,747; 95% CI=1,797-12,539; P=0,002) dengan kejadian prehipertensi pada subyek dewasa muda. Simpulan: Diet (konsumsi junk food dan soft drink) berhubungan dengan kejadian prehipertensi pada subyek dewasa muda di Manado.Kata kunci: diet, prehipertensi, dewasa muda


2016 ◽  
Vol 209 (4) ◽  
pp. 319-326 ◽  
Author(s):  
Yongsheng Tong ◽  
Michael R. Phillips ◽  
Kenneth R. Conner

BackgroundThere are meagre data on Axis II personality disorders and suicidal behaviour in China.AimsTo describe the prevalence of Axis II personality disorders in suicides and suicide attempts in China and to estimate risk for these outcomes associated with personality disorders.MethodPeople who died by suicide (n = 151), people who attempted suicide (n = 118) and living community controls (n = 140) were randomly sampled from four Chinese counties and studied using the Structured Clinical Interviews for DSM-IV-TR Axis I Disorders (SCID-I) and Axis II Personality Disorders (SCID-II). We also determined the prevalence of subthreshold versions of ten DSM-IV personality disorders.ResultsAxis II personality disorders were present in 7% of the suicide group, 6% of the suicide attempt group and 1% of the control group. Threshold and subthreshold personality disorders had adjusted odds ratios (point estimates) in the range of 2.7–8.0 for suicide and for suicide attempts.ConclusionsAxis II personality disorders may confer increased risk for suicidal behaviour in China, but their low prevalence in the community and among people with suicidal behaviour suggests that other personality constructs such as select dimensional traits may be a more fruitful avenue for understanding and preventing suicide in China.


2007 ◽  
Vol 38 (1) ◽  
pp. 135-146 ◽  
Author(s):  
J. Hill ◽  
P. Pilkonis ◽  
J. Morse ◽  
U. Feske ◽  
S. Reynolds ◽  
...  

BackgroundSocial dysfunction in personality disorder is commonly ascribed to abnormal temperamental traits but may also reflect deficits in social processing. In this study, we examined whether borderline and avoidant personality disorders (BPD, APD) may be differentiated by deficits in different social domains and whether disorganization of social domain functioning uniquely characterizes BPD.MethodPatients were recruited from psychiatric clinics in Pittsburgh, USA, to provide a sample with BPD, APD and a no-personality disorder (no-PD) comparison group. Standardized assessments of Axis I and Axis II disorders and social domain dysfunction were conducted, including a new scale of ‘domain disorganization’ (DD).ResultsPervasive social dysfunction was associated with a 16-fold increase in the odds of an Axis II disorder. Both APD and BPD were associated with elevated social dysfunction. Romantic relationship dysfunction was associated specifically with BPD symptoms and diagnosis. DD was associated specifically with a categorical BPD diagnosis and with a dimensional BPD symptom count.ConclusionsA focus on the inherently interpersonal properties of personality disorders suggests specific mechanisms (within and across interpersonal domains) that may help to account for the origins and maintenance of some disorders. In particular, BPD reflects disturbances in romantic relationships, consistent with a role for attachment processes, and in the organization of functioning across social domains.


2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Muhammad Anshory ◽  
Cesarius Singgih Wahono ◽  
Handono Kalim ◽  
Harun Al Rasyid

Background: WHO-ILAR COPCORD Program is a program that aimed to obtain data on joints pain and musculoskeletal diseases in developing countries, one aspect which has not been studied is the ability of COPCORD questionnaire as a screening tool which standardized for  screening  joint pain and musculoskeletal diseases. Objective of this study is to assess the validity of modified COPCORD questionnaire Indonesian version in screening joint pain and musculoskeletal disease compared to examination by rheumatologists.Methods: The initial phase of the research is determining essential points, translation to Indonesian, and back translation. The second stage is testing questionnaires in communities which 100 respondents involved. Dependent variable is the diagnosis of rheumatic diseases and independent variables are pain in less and more than 7 days, high degree pain in less and more than 7 days, history of NSAIDs/Steroids/DMARDs use, and disabilities. Validation test was assessed by calculating the sensitivity, specificity, PPV, NPV, LR+, and ROC curve. Bivariate analysis using Chi Square analysis, and multivariate analysis using logistic regression.Results: The sensitivity test results is best obtained on the question history of NSAIDs/steroids/DMARDs use (100%)  and specificity is best obtained on the question about disability (98%). ROC curve analysis which the results >85% obtained on the question of pain >7 days (90%), high degree pain >7 days (93%), and history of NSAIDs/steroids/DMARDs use (92%).  LR+ to diagnose rheumatic diseases found in all questions. Chi square analysis showed that all questions were significant with p <0.05 and odds ratio (OR) obtained most on high degree pain more than 7 days (OR: 180.167; 95% CI: 38.196-849.834).Conclusion: The modified COPCORD questionnaire Indonesian version has been adapted and can be a good tool in the screening of joint pain and musculoskeletal diseases compared to examination by rheumatologists. Keyword: Validation, Questionnaire, COPCORD


2018 ◽  
pp. 48-56
Author(s):  
Yohan Yuanta ◽  
Didik Gunawan Tamtomo ◽  
Diffah Hanim

ABSTRAK Kondisi riwayat ASI di Indonesia saat ini cukup memprihatinkan. Rendahnya pemberian ASI secara Eksklusif dipengaruhi oleh beberapa faktor, yakni ketidaktahuan ibu tentang pentingnya ASI, cara menyusui dengan benar, serta pemasaran susu formula. Pola asuh pada tahun pertama kehidupan sangatlah penting untuk perkembangan anak. Pola asuh balita yang kurang baik di Indonesia salah satunya ditunjukkan dengan masih rendahnya dukungan ibu dalam memonitor pertumbuhan dan perkembangan anak balita. Penelitian bertujuan untuk menganalisis hubungan riwayat pemberian ASI dan pola asuh terhadap kejadian gizi kurang. Penelitian dilaksanakan di Kecamatan Wongsorejo, kabupaten Banyuwangi Jawa Timur. Penelitian ini menggunakan metode kuantitatif dengan rancangan kasus kontrol. Variabel dependen gizi kurang dan variabel independen riwayat pemberian ASI dan pola asuh Ibu. Jumlah subjek sebanyak 174 balita yang diambil secara Fixed Disease Sampling, melalui wawancara langsung dan observasi. Analisis bivariate menggunakan uji C-Square dan analisis multivariat menggunakan uji regresi logistic biner. Hasil penelitian menunjukkan sebagian besar riwayat pemberian ASI pada balita adalah ASI eksklusif pada kasus (83.9%) dan kontrol (97.7%). Hasil analisis menunjukkan bahwa riwayat pemberian ASI (OR=0.123; p<0.05), pola asuh pemberian makan (p<0.05) dan pola asuh kesehatan (p<0.05) berhubungan secara signifikan dengan kejadian gizi kurang. Terdapat hubungan antara riwayat pemberian ASI dan pola asuh ibu dengan kejadian gizi kurang.   Kata Kunci: pola asuh ibu, pola pemberian makan, riwayat ASI.       ABSTRACT The current history of breast milk in Indonesia was quite alarming. The lack of exclusive breastfeeding was influenced by several factors, namely mother’s ignorance about the importance of breastfeeding, how to breastfeed properly, and the marketing of formula milk. The pattern of care in the first year of life was very important for the development of children. Poor toddler pattern in Indonesia was one of them shown by the low support of mother in monitoring growth and development of children under five. This study aimed to analyze association of breastfeeding history and parenting mother to the incidence of malnutrition and was conducted in Wongsorejo, Banyuwangi, East java. This study used the quantitative case-control design. Dependent variable in this study was malnutrition and independent variable were history of breastfeeding and parenting mother. The number of samples were 174 under five children taken by a Fixed Disease Sampling. The data was gained through in-depth interview and observation.History of Breast Feeding and Parenting Mother was taken by interview and used a quesstionarry. Bivariate analysis used chi-square analysis and multivariate analysis used binarry regression. Most of the breastfeeding history among under five children was exclusive breastfeeding with case (83.9%) and control (97.7%). Correlation analysis showed that history brestfeeding (OR=0.123; p<0.05), feeding practices of parenting mother (p<0.05) and health parenting mother (p<0.05) were related positively to malnutrition. There is a relationship of breastfeeding history and parenting mother to malnutrition among under five children.   Keywords: Family’s Economic Level; Food Intake; mild psychomotor Development; Nutritional Status; Toddlers.


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