Mortality Associated with Incident Mental Health Disorders After Stroke

2007 ◽  
Vol 41 (3) ◽  
pp. 274-281 ◽  
Author(s):  
Osvaldo P. Almeida ◽  
Jianguo Xiao

Objective: Sparse information is currently available about the incidence of the major psychiatric syndromes following a stroke and their long-term contribution to morbidity and mortality. This study was designed to determine: (1) the incidence of first ever mental health disorder in amongst stroke patients; (2) the 10-year mortality associated with incident post-stroke mental health disorders. Methods: Design: Retrospective cohort study. Setting: Entire Western Australian community. Participants: First-ever stroke in 1990. Subjects with a prior recorded history of any mental health disorder were excluded from the study. Main outcomes of interest: Incident mental health diagnoses and 10-year mortality. Results: 1,129 hospital stroke contacts were recorded in 1990, with 21 people dying on the same day of contact. Between 1990-2002 36.6% of the survivors received a mental health diagnosis (6.1 per 1,000 person-years): alcohol-related disorders (16.2%), dementia (12.1%), delirium (7.6%), psychotic disorders (6.7%), and depression (5.5%). Mental health disorder onset was usually within 6 months of the stroke. Patients with an incident psychotic disorder were twice as likely to die during the subsequent 10 years as post-stroke controls with no mental health disorder (risk ratio = 2.03, 95%CI = 1.39-2.95). Being a widow (HR = 1.61, 95%CI = 1.13-2.30) or having been born in ‘other countries’ as opposed to Australia (HR = 1.56, 95%CI = 1.15-2.11) was also associated with increased death hazard. Conclusions: Approximately 1 in 3 patients develop a mental health disorder after stroke, although incidence estimates are relatively low. Post-stroke psychosis is associated with greater 10-year mortality, but the mechanisms underlying such an association are yet to be determined.

2021 ◽  
pp. 003329412110268
Author(s):  
Juliana Alvares Duarte Bonini Campos ◽  
Lucas Arrais Campos ◽  
Bianca Gonzalez Martins ◽  
Filomena Valadão Dias ◽  
Rodrigo Ruano ◽  
...  

Objective To identify people with history of mental health disorders before the COVID-19 pandemic in the Brazilian population and estimate the prevalence of mood swings and the subjective distress of the pandemic among individuals with or without mental health disorders. Methods Through an online survey, participants were asked about presence or absence of mental health disorders. In addition, they answered the Brunel Mood Scale and the Impact of Event Scale. The mean percentile of mood swing indicators and psychological impact scores were estimated, and data were analyzed by logistic regression. Results 13,248 people participated (70.5% women, mean age 35.4 years, 31.2% with history of mental health disorder). Women and younger people were more likely to be diagnosed with mental health disorder. All participants had significant changes in mood due to the pandemic. Anger, depressed mood, mental confusion, and fatigue were higher among individuals with bipolar disorder or with combined disorders. Individuals with mental health disorders had a greater subjective distress, especially the group with bipolar disorder (OR = 4.89 [3.64–6.56]) and combined disorders (OR = 6.89 [5.21–9.10]). Conclusion Individuals previously diagnosed with mental health disorders at some point in life are more vulnerable to psychological impact from the pandemic.


Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sophie D. Bennett ◽  
◽  
J. Helen Cross ◽  
Anna E. Coughtrey ◽  
Isobel Heyman ◽  
...  

Abstract Background Mental health disorders in the context of long-term conditions in children and young people are currently overlooked and undertreated. Evidence-based psychological treatments for common childhood mental health disorders (anxiety, depression and disruptive behaviour disorders) have not been systematically evaluated in young people with epilepsy despite their high prevalence in this population. The aim of this multi-site randomised controlled trial is to determine the clinical and cost-effectiveness of adding a modular psychological intervention to usual care for the mental health disorders in comparison to assessment-enhanced usual care alone. Methods In total, 334 participants aged 3–18 years attending epilepsy services will be screened for mental health disorders with the Strengths and Difficulties Questionnaire (SDQ) and the diagnostic Development and Wellbeing Assessment (DAWBA). Those identified as having a mental health disorder and consenting to the trial will be randomised to either receive up to 22 sessions of the modular psychological intervention (MATCH-ADTC) delivered over the telephone over 6 months by non-mental health professionals in addition to usual care or to assessment-enhanced usual care alone. Outcomes will be measured at baseline, 6 months and 12 months post-randomisation. It is hypothesised that MATCH-ADTC plus usual care will be superior to assessment-enhanced usual care in improving emotional and behavioural symptoms. The primary outcome is the SDQ reported by parents at 6 months. Secondary outcomes include parent-reported mental health measures such as the Revised Children’s Anxiety and Depression Scale, quality of life measures such as the Paediatric Quality of Life Inventory and physical health measures such as the Hague Seizure Severity Scale. Outcome assessors will be blinded to group assignment. Qualitative process evaluations and a health economic evaluation will also be completed. Discussion This trial aims to determine whether a systematic and integrated approach to the identification and treatment of mental health disorders in children and young people with epilepsy is clinically and cost-effective. The findings will contribute to policies and practice with regard to addressing mental health needs in children and young people with other long-term conditions. Trial registration ISRCTN ISRCTN57823197. Registered on 25 February 2019.


2021 ◽  
pp. 112067212110676
Author(s):  
Ahmad Abdel-Aty ◽  
Ninani Kombo

Chronic inflammatory diseases can cause significant psychosocial stress in affected patients. Few studies have examined the psychological effects of ocular inflammatory disease and no studies have examined the psychological effects of scleritis. In this study we evaluate the prevalence of mental health disorders in scleritis patients and we conduct a comprehensive review of the literature on the mental health effects of ocular inflammatory diseases. 162 patients (195 eyes) presenting to a tertiary care center with scleritis were identified. At least one comorbid mental health disorder was diagnosed in 35 patients (21.6%), most commonly major depression in 11.7%, generalized anxiety disorder in 9.3%, and substance use disorder in 6.2%. There were no significant differences in the length of an episode of scleritis or in the probability of symptom resolution between patients with a mental health disorder and other patients. In a review of the literature, 30 manuscripts met the inclusion criteria. The majority of manuscripts (83.3%) were focused on uveitis patients. Eight of these studies were focused on patients with uveitis in the context of systemic disease. The most commonly reported mental health disorders reported were anxiety and depression. An average of 31.3% of patients with ocular inflammatory disease had depression and 35.0% had anxiety. Similar to other chronic illnesses, ocular inflammatory disease may be a significant psychosocial stressor. Future studies will further elucidate the relationship between these diseases and mental health.


2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Richard Idro ◽  
Angelina Kakooza-Mwesige ◽  
Benjamin Asea ◽  
Keron Ssebyala ◽  
Paul Bangirana ◽  
...  

2021 ◽  
Vol Volume 14 ◽  
pp. 2841-2849
Author(s):  
Mojtaba Vaismoradi ◽  
Shazia Jamshed ◽  
Stefan Lorenzl ◽  
Piret Paal

Pain Medicine ◽  
2019 ◽  
Vol 21 (3) ◽  
pp. 488-500
Author(s):  
Penny L Brennan ◽  
Sonya SooHoo

Abstract Objective To determine the key classes of nursing home residents’ nine-month pain trajectories, the influence of residents’ mental health disorders on membership in these classes, and nine-month health-related outcomes associated with pain trajectory class membership. Methods Four times over a nine-month period, the MDS 3.0 resident assessment instrument was used to record the demographic characteristics, mental health disorder diagnoses, pain characteristics, and health and functioning outcomes of 2,539 Department of Veterans Affairs Community Living Center (VA CLC) residents. Growth mixture modeling was used to estimate the key classes of residents’ nine-month pain trajectories, the influence of residents’ mental health disorders on their pain trajectory class membership, and the associations of class membership with residents’ health and functioning outcomes at nine-month follow-up. Results Four-class solutions best described nursing home residents’ nine-month trajectories of pain frequency, severity, and interference. Residents with dementia and severe mental illness diagnoses were less likely, and those with depressive disorder, PTSD, and substance use disorder diagnoses more likely, to belong to adverse nine-month pain trajectory classes. Membership in adverse pain frequency and pain severity trajectory classes, and in trajectory classes characterized by initially high but steeply declining pain interference, portended more depressive symptoms but better cognitive and physical functioning at nine-month follow-up. Conclusions Nursing home residents’ mental health disorder diagnoses help predict their subsequent pain frequency, severity, and interference trajectories. This may be clinically useful information for improving pain assessment and treatment approaches for nursing home residents.


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