Medical Illness in Psychiatric Patients

Objective: Because psychiatric screening methods are usually developed using psychiatric samples but not medical samples, they often include distress indicators that overlap with medical illness. This potentially inflates psychopathology estimates for medically ill patient groups. The objective of this study was to determine whether somatic distress indicator base rates are elevated in diabetes patients. Method: The occurrence of Symptom Checklist 90-R (SLC-90-R) somatic symptoms was studied in fifty-six diabetes mellitus patients (27 insulin dependent, 29 non-insulin dependent) with non-elevated SLC-90-R profiles, as compared to both community nonpatient and psychiatric patient norms. Results: Of the fifteen SCL-90-R items rated by endocrinologists as most likely to be diabetes-related, nine were endorsed more frequently by diabetes patients than by nonpatients: faintness/dizziness (endorsed by 36% of diabetics), reduced libido (endorsed by 41%), anenergia (68%), memory problems (66%), trembling (18%), numbness (55%), weakness (39%), overeating (59%), and somatic concerns (41%). Anergia and faintness/dizziness were endorsed more frequently by psychiatric patients than diabetes patients, whereas numbness was endorsed more often by diabetes patients. Conclusions: Conservatism is warranted when applying these somatic indicators of distress to diabetes patients. Further studies are needed to determine whether such illness overlap biases case classification.

Download Full-text

Appraisal and discernment of prevalent drug-drug interactions in patients with psychiatric disorders

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20212931 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1005

Author(s):

Axa Jacob ◽

Cristin Simon Thomas ◽

Anay Deore ◽

Prasanna Deshpande

Keyword(s):

Drug Interactions ◽

Hospital Admissions ◽

Psychiatric Patients ◽

Medical Complications ◽

Medical Illness ◽

Inclusion Criteria ◽

Potential Ddis ◽

Careful Monitoring ◽

Mechanistic Approach ◽

High Prevalence

Background: Drug-drug interactions (DDIs) contribute majorly to hospital admissions, treatment failures, avoidable medical complications and subsequent healthcare costs. Thus, we employ a mechanistic approach to prospectively investigate the incidence of potential DDIs in the psychiatric patients in a clinical setting.Methods: In this prospective, observational, multi centred study conducted for a span of 6 months, psychiatric inpatients (≥18 years) prescribed with 2 or more medications daily for any medical illness were included. The secured prescriptions of the inpatients selected in accordance to the inclusion criteria were then assessed for DDIs using Micromedex(TM) as a standard.Results: Of the total 400 enrolled participants, 383 (95%) of them showed at least one pDDI regardless of the severity. An average of 7.33 interactions per patient was also deduced. A high prevalence of pDDIs totalling to 2900 was recorded in our study with an average of 7.33 interactions per patient. Most of the interactions were of major (56.52%) and moderate severity (39.07) followed by contraindicated (2.55) and minor (1.83). Cardiovascular system (41.77%) had the highest potential to be affected due to the pDDIs identified. Trihexyphenidyl, haloperidol, promethazine, amisulpride, risperidone, divalproex, trifluoperazine, olanzapine and clozapine where among the most commonly encountered drugs in these interactions.Conclusions: A high prevalence of pDDIs totalling to 2900 was recorded in our study with an average of 7.33 interactions per patient. A significant association of the pDDIs with variables such as age, gender, diagnosis and total number of drugs used was identified. More studies are required to explore the overall pattern of DDIs in psychiatric patients along with their levels and correlation with different risk factors. Careful monitoring and documentation are necessary to prevent further complications thereby improving the therapeutic outcome.

Download Full-text

The Frequency and Factors Related to Aggressive Behavior in Psychiatric Patients Controlled by a Variety of Restraint Methods

Iranian Journal of Psychiatry and Behavioral Sciences ◽

10.5812/ijpbs.98881 ◽

2022 ◽

Vol In Press (In Press) ◽

Author(s):

Ali Kheradmand ◽

Anita Hosseini ◽

Abdollah Farhadinasab

Keyword(s):

Aggressive Behavior ◽

Psychiatric Patients ◽

Nonparametric Test ◽

Demographic Variables ◽

P Value ◽

Medical Illness ◽

Factors Affecting ◽

History Of ◽

Overt Aggression Scale ◽

The Relationship

Background: Aggressive behavior of patients in psychiatric wards is one of the main challenges faced by healthcare workers. Despite the abundance of research on the frequency of aggressive behavior, not enough attention has been paid to its severity. Furthermore, limited studies have evaluated the restraint methods used to manage aggressive behaviors. Objectives: The current descriptive study aimed to compare the relationship between demographic characteristics, diagnosis of psychiatric illness, medical illness, and hospitalization characteristics with features of aggressive behavior in patients experiencing different types of restraint during hospitalization. Methods: We evaluated subjects admitted to the adult psychiatric wards of Imam Hossein and Taleghani hospitals in Tehran, Iran, in 2018. The patients were controlled by various restraint methods during hospitalization. All the patients were evaluated for the severity of aggression, which was determined utilizing the Persian version of the Modified Overt Aggression Scale (MOAS). All the data along with demographic and clinical characteristics obtained from medical records were analyzed using the Mann-Whitney and Kruskal-Wallis nonparametric test (P-value = 0.05) and Spearman correlation coefficient to describe the factors affecting the aggressive behavior of patients. Results: In this study, the prevalence of aggressive behavior was 11.7%. Among the demographic variables, gender (P-value = 0.003), education level (P-value = 0.05), and the history of aggressive behavior (P-value = 0.001) were significantly associated with the MOAS. Furthermore, as the hospitalization duration increased, the frequency of aggressive behavior decreased, and its severity intensified. Moreover, there was a significant relationship between aggression severity with admission type (P-value = 0.00), concurrent medical illness (P-value = 0.026), and substance abuse (P-value = 0.025). Conclusions: According to the obtained results, the factors affecting the aggression and early identification of patients with the potential of aggressive behavior is an effective management strategy for controlling these patients.

Download Full-text

Assessing Capacity in Psychiatric Patients With Acute Medical Illness Who Refuse Care

The Primary Care Companion For CNS Disorders ◽

10.4088/pcc.14br01666 ◽

2014 ◽

Cited By ~ 2

Author(s):

Marc Tunzi ◽

Jeffrey P. Spike

Keyword(s):

Psychiatric Patients ◽

Medical Illness

Download Full-text

Suicidal ideation and organic diseases in acute female psychiatric patients

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.732 ◽

2016 ◽

Vol 33 (S1) ◽

pp. s275-s275

Author(s):

P. Solano ◽

M. Ustulin ◽

R. Vecchio ◽

A. Rreshketa ◽

E. Pizzorno ◽

...

Keyword(s):

Suicidal Ideation ◽

Suicide Risk ◽

Psychiatric Patients ◽

Demographic Data ◽

The Elderly ◽

Physical Illness ◽

Psychiatric Clinic ◽

Medical Illness ◽

Chi Squared ◽

Competing Interest

IntroductionPhysical illness has been recognized as a major risk factor for suicidal behaviours, especially among females. A higher number of physical comorbidities has been associated with higher suicide- risk, thus having a greater burden among the elderly.Objectivesinvestigate this evidence to be able to estimate the load of physical illness on suicidality among psychiatric females of different age.AimsEvaluate the association between suicidal ideation, age, depression and physical comorbidities in a sample of acute females psychiatric in-patients.Methods81 psychiatric female in-patients were evaluated during their first day of hospitalization through MADRS, SSI and the presence of organic comorbidity has been collected together with demographic data. All the evaluations were carried out at the Psychiatric Clinic, University of Genova, Italy.ResultsMean age 48 (age–range value: 74, high variability). Pearson's Chi-squared test showed: significant association between SSI and MADRS (P = 0,027; α = 0,05); no association between SSI and age (P = 0,194; α=0,05); no association between SSI and presence medical illness (P = 0,132; α = 0,05); no association between SSI and number of medical illness (P = 0,186; α = 0,05).ConclusionsOur results show that the levels of suicidal ideation in psychiatric females are independent from age, presence and number of physical comorbidities. Suicidal ideation appears to be associated only with levels of depression. Our results challenge evidence from a large number of current studies and, if confirmed by further research, would lead to reconsider major suicide risk factors. Further research to investigate these associations on larger samples is needed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Download Full-text