Obesity and psychopathology. A study of psychiatric comorbidity among patients attending a specialist obesity unit

2009 ◽  
Vol 18 (2) ◽  
pp. 119-127 ◽  
Author(s):  
Bernardo Carpiniello ◽  
Federica Pinna ◽  
Gianluca Pillai ◽  
Valentina Nonnoi ◽  
Enrica Pisano ◽  
...  
Keyword(s):  
Mental Health ◽  
Major Depression ◽  
Mood Disorders ◽  
Clinical Sample ◽  
Psychiatric Evaluation ◽  
Routine Practice ◽  
Obese Patients ◽  
High Prevalence ◽  
Axis I ◽  
Treatment Of Obesity

SummaryAims – The study aims to evaluate the frequency of association between Axis I and II disorders according to DSMIVTR criteria and obesity, and use of mental health services in a clinical sample of patients attending a centre for the diagnosis and treatment of Obesity. Methods – 150 consecutive patients (32 Males, 118 females, mean age 44.614.3 yrs; mean BMI 35.46.2) were interviewed by means of SCID I and SCID II. Results – Lifetime Prevalence of Axis I disorders was 58% (males 50%; females 61%); the highest prevalence rate was found for Anxiety Disorders (approx 35%), whilst 30% of subjects were affected by Mood disorders, chiefly Major Depression (20%), and 18% by Eating Disorders. 28% of obese patients presented a Personality Disorder, 23% of patients being affected both by an Axis I and Axis II disorder. Mood Disorders, in particular Major Depression, were significantly prevalent among female obese. 50% of females and approx 37% males included in the sample had contacted mental health units for treatment. Conclusion – Data obtained in the present study confirm the high prevalence rates of mental disorders in obese patients seeking treatment. Specialist units should therefore include thorough psychiatric evaluation of patients as a routine practice.Declaration of Interest: The study was supported by a research grant by University of Cagliari (ex 60% funding, financial year 2006); the authors declare no conflict of interest.

scholarly journals Improving Implementation of eMental Health for Mood Disorders in Routine Practice: Systematic Review of Barriers and Facilitating Factors

2018 ◽  
Vol 5 (1) ◽  
pp. e20 ◽  
Author(s):  
Christiaan Vis ◽  
Mayke Mol ◽  
Annet Kleiboer ◽  
Leah Bührmann ◽  
Tracy Finch ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Mood Disorders ◽  
Routine Care ◽  
System Level ◽  
Routine Practice

Background Electronic mental health interventions (eMental health or eMH) can be used to increase accessibility of mental health services for mood disorders, with indications of comparable clinical outcomes as face-to-face psychotherapy. However, the actual use of eMH in routine mental health care lags behind expectations. Identifying the factors that might promote or inhibit implementation of eMH in routine care may help to overcome this gap between effectiveness studies and routine care. Objective This paper reports the results of a systematic review of the scientific literature identifying those determinants of practices relevant to implementing eMH for mood disorders in routine practice. Methods A broad search strategy was developed with high sensitivity to four key terms: implementation, mental health care practice, mood disorder, and eMH. The reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework was applied to guide the review and structure the results. Thematic analysis was applied to identify the most important determinants that facilitate or hinder implementation of eMH in routine practice. Results A total of 13,147 articles were screened, of which 48 studies were included in the review. Most studies addressed aspects of the reach (n=33) of eMH, followed by intervention adoption (n=19), implementation of eMH (n=6), and maintenance (n=4) of eMH in routine care. More than half of the studies investigated the provision of mental health services through videoconferencing technologies (n=26), followed by Internet-based interventions (n=20). The majority (n=44) of the studies were of a descriptive nature. Across all RE-AIM domains, we identified 37 determinants clustered in six main themes: acceptance, appropriateness, engagement, resources, work processes, and leadership. The determinants of practices are expressed at different levels, including patients, mental health staff, organizations, and health care system level. Depending on the context, these determinants hinder or facilitate successful implementation of eMH. Conclusions Of the 37 determinants, three were reported most frequently: (1) the acceptance of eMH concerning expectations and preferences of patients and professionals about receiving and providing eMH in routine care, (2) the appropriateness of eMH in addressing patients’ mental health disorders, and (3) the availability, reliability, and interoperability with other existing technologies such as the electronic health records are important factors for mental health care professionals to remain engaged in providing eMH to their patients in routine care. On the basis of the taxonomy of determinants of practices developed in this review, implementation-enhancing interventions can be designed and applied to achieve better implementation outcomes. Suggestions for future research and implementation practice are provided.

Mental illness among the homeless: prevalence study in a Dublin homeless hostel

2012 ◽  
Vol 29 (1) ◽  
pp. 22-26 ◽  
Author(s):  
Bernice Prinsloo ◽  
Catherine Parr ◽  
Joanne Fenton
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Training ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Addiction Services ◽  
High Prevalence ◽  
Current Axis ◽  
Axis I ◽  
Staff Research

Objective: To determine the prevalence of mental illness among the residents of a homeless hostel in inner city Dublin.Method: A cross-sectional survey was carried out among hostel residents, as previous studies have indicated that homeless hostel-dwelling men in Dublin constitute the largest single grouping of homeless Irish people. All agreeable residents were interviewed by the authors over an eight-week period using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) Clinical Version. For each disorder, the current (30-day) and past prevalence was determined.Results: A total of 38 residents were interviewed, resulting in a response rate of 39.2% for the study. A total of 81.6% of residents had a current Axis I diagnosis; this number increased to 89.5% when combining current and past diagnoses. Only four residents had no diagnosis. There was considerable comorbidity between disorders, with a significant number of residents experiencing both mental illness and substance use problems. When considering lifetime diagnoses, 31.6% had a single diagnosis only; 57.9% had two/more diagnoses. Twelve residents (31.6%) had been admitted to a psychiatric hospital during their lifetime. The most prevalent disorders during the past month were Alcohol Dependence (23.7%), Opioid Dependence and Major Depressive Disorder (both 18.4%), Opioid Abuse and Alcohol-Induced Depression (both 7.9%). Only 23.7% of interviewed residents were attending psychiatric or addiction services. A significant number of residents who did not wish to participate in the study were identified by hostel staff as having a confirmed psychiatric diagnosis.Conclusion: The survey demonstrated a very high prevalence of mental disorders among homeless hostel residents. The high prevalence of dual diagnosis highlights the need for greater collaboration between psychiatric services and addiction services. The outcome also points to the importance of providing mental health training to emergency shelter/hostel staff. Research into the mental health status of the homeless should be undertaken regularly if services are to be planned to meet the needs of this vulnerable group.

scholarly journals Impact of Mental Health Background and Nutrition Intake on Medium-Term Weight Loss in Japanese Patients Undergoing Laparoscopic Sleeve Gastrectomy

Obesity Facts ◽  
2020 ◽  
Vol 13 (4) ◽  
pp. 371-383
Author(s):  
Atsuhito Saiki ◽  
Rieko Kanai ◽  
Shoko Nakamura ◽  
Sho Tanaka ◽  
Rena Oka ◽  
...  
Keyword(s):  
Mental Health ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Mental Disorders ◽  
Mood Disorders ◽  
Japanese Patients ◽  
Average Group ◽  
High Prevalence ◽  
Nutrition Intake

<b><i>Objectives:</i></b> Bariatric surgery is the most effective weight loss therapy, and recently laparoscopic sleeve gastrectomy (LSG) is gaining popularity worldwide. On the other hand, patients undergoing bariatric surgery have a high prevalence of mental disorders. A Japanese nationwide survey reported high prevalence of mental disorders in patients with low percent total weight loss (%TWL) and also in those with high %TWL. The aim of this study was to investigate the relationship of 1-year %TWL with background mental health status, 3-year outcomes, and nutrition intake in Japanese patients after LSG. <b><i>Methods:</i></b> This study was a single-center retrospective database analysis. A total of 89 Japanese patients who underwent LSG and were followed for 3 years were enrolled (mean age 41.9 years, baseline body mass index 44.9, baseline glycosylated hemoglobin, HbA<sub>1c</sub>, 7.0%). The patients were divided into 3 groups according to 1-year %TWL as follows: ≤19.9% (insufficient group), 20.0–34.9% (average group) and ≥35.0% (excessive group). Psychosocial and nutritional status as well as physical data were collected from all patients. <b><i>Results:</i></b> The prevalence of mental disorders was 51.7%, and 1-year %TWL was 28.1% in all patients. No significant differences were observed in the changes in body weight and HbA<sub>1c</sub> between patients with and those without mental disorders. The prevalence of mental disorders was particularly high in the insufficient and excessive groups. In the insufficient group, mood disorders and mental retardation/developmental disorders were frequent, and snacking and eating out habits were often observed. In the excessive group, the frequencies of mood disorders and binge eating were high, and a decrease in skeletal muscle mass due to low protein intake was observed. Furthermore, weight regain was shown 12 months after LSG in both groups. In the average group, there were fewer problems in weight loss outcomes, mental health, nutrition intake and body composition. <b><i>Conclusions:</i></b> Psychosocial and nutritional problems were often found not only in patients with insufficient weight loss, but also in those with seemingly “excellent” weight reduction. To improve long-term weight loss outcome and future health, a multidisciplinary approach focusing on mental health and nutrition is essential for patients undergoing bariatric surgery.

A personality disorders prevalence study among inpatients with mood disorders, psychoactive substance use disorders and anxiety disorders

2000 ◽  
Vol 9 (1) ◽  
pp. 36-44 ◽  
Author(s):  
Maria Grazia Marinangeli ◽  
Giancarlo Butti ◽  
Antonella Scinto ◽  
Loredana Di Cicco ◽  
Artemis Kalyvoka ◽  
...  
Keyword(s):  
Personality Disorders ◽  
Mood Disorders ◽  
Clinical Sample ◽  
Psychiatric Inpatients ◽  
Self Report ◽  
Exact Nature ◽  
Obsessive Compulsive ◽  
Axis Ii ◽  
Axis I Disorders ◽  
Axis I

SummaryObjective- The aim of this study was to asses type and prevalence of Personality Disorders (PDs) and their patterns of comorbidity with Axis I disorders in a sample of psychiatric inpatients.Setting- The sample consisted of 300 subjects admitted to a psychiatric unit on a voluntary bases for an index episode. The study was conducted over a period of 12 months, from 1.11.1997 to 31.10.1998.Main outcome measures- The Italian version of SCID-II-PQ (Structured Clinical Interview for DSM-III-R personality disorders, with Personality Questionnaire-PQ- a self report questionnaire).Results- More than half the patients had at least one personality disorder. The mean of disorders per patient was 2.83±1.93 (±SD). The most prevalent Axis II disorders were Borderline PD (30.7%), Obsessive-compulsive PD (30.7%) and Avoidant PD (25.3%). Women were significantly more likely than men to meet criteria for Dependent PD and Avoidant PD. Man showed significantly more frequently than women Antisocial PD. Significant associations (p<0.05) were found for comorbidity of Mood Disorders and Avoidant PD, and for Psicoactive Use Disorders and Antisocial PD.Conclusions- Our study confirms the high prevalence of PDs in psychiatric inpatients and showes some interesting associations between Axis I and Axis II disorders. These results can't be generalized to outpatients because our clinical sample involved mainly severely ill inpatients, but they raise questions about the exact nature of PDs and of the relationship with Axis I disorders. Further research involving outpatients and general population is needed to examine factors that could affect development and course of Personality Disorders.

scholarly journals Improving Implementation of eMental Health for Mood Disorders in Routine Practice: Systematic Review of Barriers and Facilitating Factors (Preprint)

2018 ◽  
Author(s):  
Christiaan Vis ◽  
Mayke Mol ◽  
Annet Kleiboer ◽  
Leah Bührmann ◽  
Tracy Finch ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Mood Disorders ◽  
Routine Care ◽  
System Level ◽  
Routine Practice

BACKGROUND Electronic mental health interventions (eMental health or eMH) can be used to increase accessibility of mental health services for mood disorders, with indications of comparable clinical outcomes as face-to-face psychotherapy. However, the actual use of eMH in routine mental health care lags behind expectations. Identifying the factors that might promote or inhibit implementation of eMH in routine care may help to overcome this gap between effectiveness studies and routine care. OBJECTIVE This paper reports the results of a systematic review of the scientific literature identifying those determinants of practices relevant to implementing eMH for mood disorders in routine practice. METHODS A broad search strategy was developed with high sensitivity to four key terms: implementation, mental health care practice, mood disorder, and eMH. The reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework was applied to guide the review and structure the results. Thematic analysis was applied to identify the most important determinants that facilitate or hinder implementation of eMH in routine practice. RESULTS A total of 13,147 articles were screened, of which 48 studies were included in the review. Most studies addressed aspects of the reach (n=33) of eMH, followed by intervention adoption (n=19), implementation of eMH (n=6), and maintenance (n=4) of eMH in routine care. More than half of the studies investigated the provision of mental health services through videoconferencing technologies (n=26), followed by Internet-based interventions (n=20). The majority (n=44) of the studies were of a descriptive nature. Across all RE-AIM domains, we identified 37 determinants clustered in six main themes: acceptance, appropriateness, engagement, resources, work processes, and leadership. The determinants of practices are expressed at different levels, including patients, mental health staff, organizations, and health care system level. Depending on the context, these determinants hinder or facilitate successful implementation of eMH. CONCLUSIONS Of the 37 determinants, three were reported most frequently: (1) the acceptance of eMH concerning expectations and preferences of patients and professionals about receiving and providing eMH in routine care, (2) the appropriateness of eMH in addressing patients’ mental health disorders, and (3) the availability, reliability, and interoperability with other existing technologies such as the electronic health records are important factors for mental health care professionals to remain engaged in providing eMH to their patients in routine care. On the basis of the taxonomy of determinants of practices developed in this review, implementation-enhancing interventions can be designed and applied to achieve better implementation outcomes. Suggestions for future research and implementation practice are provided.

Nosological validity of dysthymia. Part II: familial, comorbidity, biological and psychological data

1998 ◽  
Vol 13 (4) ◽  
pp. 181-187 ◽  
Author(s):  
L Waintraub ◽  
JD Guelfi
Keyword(s):  
Major Depression ◽  
Personality Disorder ◽  
Mood Disorders ◽  
Complex Nature ◽  
Axis Ii ◽  
Psychological Correlates ◽  
Familial Relationship ◽  
Axis I ◽  
Depressive Personality ◽  
The Relationship

SummaryIf some recent studies seem to reveal a more specific familial relationship for dysthymia in addition to a previously known familial relationship to mood disorders, and if results concerning the relationship between dysthymia and depressive personality as well as the search for possible biological and psychological correlates support the nosological validity of dysthymia, comorbidity studies raise difficult questions. Both comorbidity studies with Axis I and Axis II disorders challenge the validity of dysthymia, but as well they question the categorical model presently in use more than the validity of a definite category.However, there are now enough data confirming some of the hypotheses implied by the nosological construct of dysthymia inside this model for this category not to be discarded. For instance, dysthymia is definitely not a personality disorder, and appears also distinct from major depression. The problem of the complex nature of the relationship between dysthymia and major depression still remains unsolved.

scholarly journals The depression paradigm and beyond

2020 ◽  
Vol 24 (1) ◽  
pp. 81-112
Author(s):  
Ilpo Helén
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Health Care ◽  
Major Depression ◽  
Mood Disorders ◽  
Depressive Disorders ◽  
Primary Target ◽  
Present Understanding ◽  
Object Of Knowledge

This paper is an analysis of three elements of which depression as the primary target of current Western psychiatry and mental health care is made: the quest of psychiatrists to identify a depressive disease proper; the category of ‘major depression’ as defined by the diagnostic manuals; and the epidemiological view emphasising risk factors of depression. These elements are pivotal to the present understanding and experience of what depression is since they delineate the space of reasoning in which claims about depression are presented, problematised, and disputed. The paper presents how these elements have historically evolved and coalesced, and how depression has been formed and transformed as an object of knowledge and treatment in psychiatry and how the claims about depressive disorders acquire objectivity in the current mental health discussions. The paper also demonstrates how the quest of depression as a neurophysiological disease, consolidation of Major Depression as the diagnostic core of mood disorders, and the central role of the epidemiological notion of risk are both interlocked and discordant with each other in the current depression paradigm. In addition, tendencies of subversion of the depression paradigm are discussed.

Smartphone Sensor Data for Identifying and Monitoring Symptoms of Mood Disorders: A longitudinal observational study (Preprint)

2021 ◽  
Author(s):  
Taylor Austin Braund ◽  
May The Zin ◽  
Tjeerd W. Boonstra ◽  
Quincy J. J. Wong ◽  
Mark E. Larsen ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Circadian Rhythm ◽  
Observational Study ◽  
Mood Disorders ◽  
Clinical Sample ◽  
Sensor Data ◽  
Gps Data ◽  
Positioning Systems ◽  
Smartphone Sensor

BACKGROUND Mood disorders are burdensome illnesses that often go undetected and untreated. Sensor technologies within smartphones may provide an opportunity for identifying the early changes in circadian rhythm and social support/connectedness that signify the onset of a depressive or manic episode. OBJECTIVE Using smartphone sensor data, this study investigated the relationship between circadian rhythm, determined by Global Positioning Systems (GPS) data, and symptoms of mental health among a clinical sample of adults diagnosed with Major Depressive Disorder (MDD) or Bipolar Disorder (BD). METHODS A total of 121 participants were recruited from a clinical setting to take part in a ten-week observational study. Self-report questionnaires for mental health outcomes, social support, social connectedness, and quality of life were assessed at six timepoints throughout the study period. Participants consented to passively sharing their smartphone GPS data for the duration of the study. Circadian rhythm (i.e., regularity of location changes in a 24-hour rhythm) was extracted from GPS mobility patterns at baseline. RESULTS While we found no association between circadian rhythm and mental health functioning at baseline, there was a positive association between circadian rhythm and the size of participants social support network at baseline (r = .22, p = .030, R2 = .049). In participants with BD, circadian rhythm was associated with change in anxiety from baseline, whereby higher circadian rhythm was associated with an increase in anxiety and lower circadian rhythm was associated with a decrease in anxiety at timepoint five. CONCLUSIONS Circadian rhythm, extracted from smartphone GPS data, was associated with social support and predicted changes in anxiety in a clinical sample of adults with mood disorders. Larger studies are required for further validations. However, smartphone sensing may have the potential to monitor early symptoms of mood disorders.

Test-Retest Reliability of a Self-Report Questionnaire for DSM-IV and ICD-10 Personality Disorders

2000 ◽  
Vol 16 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Hans Ottosson ◽  
Martin Grann ◽  
Gunnar Kullgren
Keyword(s):  
Personality Disorder ◽  
Anxiety Disorders ◽  
Personality Disorders ◽  
Clinical Sample ◽  
Self Report ◽  
Anxiety State ◽  
Short Term ◽  
Retest Reliability ◽  
Axis I ◽  
Test Retest Reliability

Summary: Short-term stability or test-retest reliability of self-reported personality traits is likely to be biased if the respondent is affected by a depressive or anxiety state. However, in some studies, DSM-oriented self-reported instruments have proved to be reasonably stable in the short term, regardless of co-occurring depressive or anxiety disorders. In the present study, we examined the short-term test-retest reliability of a new self-report questionnaire for personality disorder diagnosis (DIP-Q) on a clinical sample of 30 individuals, having either a depressive, an anxiety, or no axis-I disorder. Test-retest scorings from subjects with depressive disorders were mostly unstable, with a significant change in fulfilled criteria between entry and retest for three out of ten personality disorders: borderline, avoidant and obsessive-compulsive personality disorder. Scorings from subjects with anxiety disorders were unstable only for cluster C and dependent personality disorder items. In the absence of co-morbid depressive or anxiety disorders, mean dimensional scores of DIP-Q showed no significant differences between entry and retest. Overall, the effect from state on trait scorings was moderate, and it is concluded that test-retest reliability for DIP-Q is acceptable.

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