scholarly journals Begleiterkrankungen oder Folgeerkrankungen – das Phänomen der Komorbidität bei autoimmun blasenbildenden Dermatosen

2021 ◽  
pp. 1-3
Author(s):  
Michael Sticherling
Keyword(s):  
Mental Health ◽  
Cohort Study ◽  
Psychiatric Disorders ◽  
Psychiatric Symptoms ◽  
Integrated Approach ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Bidirectional Association ◽  
Broad Array ◽  
Subsequent Onset

<b>Background:</b> Bullous pemphigoid (BP) is an autoimmune blistering skin disease that takes a profound physical and mental toll on those affected. The aim of the study was to investigate the bidirectional association between BP and all bullous disorders (ABD) with a broad array of psychiatric disorders, exploring the influence of prescribed medications. <b>Methods:</b> This nationwide, register-based cohort study encompassed 6,470,450 individuals born in Denmark and alive from 1994 to 2016. The hazard ratios (HRs) of a subsequent psychiatric disorder in patients with BP/ABD and the reverse exposure and outcome were evaluated. <b>Results:</b> Several psychiatric disorders were associated with increased risk of subsequent BP (4.18-fold for intellectual disorders, 2.32-fold for substance use disorders, 2.01-fold for schizophrenia and personality disorders, 1.92–1.85–1.49-fold increased risk for organic disorders, neurotic and mood disorders), independent of psychiatric medications. The association between BP and subsequent psychiatric disorders was not significant after adjusting for BP medications, except for organic disorders (HR 1.27, CI 1.04–1.54). Similar results emerged with ABD. <b>Summary:</b> Psychiatric disorders increase the risk of a subsequent diagnosis of BP/ABD independent of medications, whereas medications used for the treatment of BP/ABD appear to account for the subsequent onset of psychiatric disorders. Clinically, an integrated approach attending to both dermatological and psychiatric symptoms is recommended, and dermatologists should remain vigilant for early symptoms of psychiatric disorders to decrease mental health comorbidity.

scholarly journals Psychiatric comorbidity in individuals with bullous pemphigoid and all bullous disorders in the Danish national registers

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Marianna Rania ◽  
Liselotte Vogdrup Petersen ◽  
Michael Eriksen Benros ◽  
Zhi Liu ◽  
Luis Diaz ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Bullous Pemphigoid ◽  
Psychiatric Comorbidity ◽  
Psychiatric Symptoms ◽  
Integrated Approach ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Bidirectional Association ◽  
Broad Array ◽  
Subsequent Onset

Abstract Background Bullous pemphigoid (BP) is an autoimmune blistering skin disease that takes a profound physical and mental toll on those affected. The aim of the study was to investigate the bidirectional association between BP and all bullous disorders (ABD) with a broad array of psychiatric disorders, exploring the influence of prescribed medications. Methods This nationwide, register-based cohort study encompassed 6,470,450 individuals born in Denmark and alive from 1994 to 2016. The hazard ratios (HRs) of a subsequent psychiatric disorder in patients with BP/ABD and the reverse exposure and outcome were evaluated. Results Several psychiatric disorders were associated with increased risk of subsequent BP (4.18-fold for intellectual disorders, 2.32-fold for substance use disorders, 2.01-fold for schizophrenia and personality disorders, 1.92–1.85-1.49-fold increased risk for organic disorders, neurotic and mood disorders), independent of psychiatric medications. The association between BP and subsequent psychiatric disorders was not significant after adjusting for BP medications, except for organic disorders (HR 1.27, CI 1.04–1.54). Similar results emerged with ABD. Conclusion Psychiatric disorders increase the risk of a subsequent diagnosis of BP/ABD independent of medications, whereas medications used for the treatment of BP/ABD appear to account for the subsequent onset of psychiatric disorders. Clinically, an integrated approach attending to both dermatological and psychiatric symptoms is recommended, and dermatologists should remain vigilant for early symptoms of psychiatric disorders to decrease mental health comorbidity.

scholarly journals Evolution of psychosocial burden and psychiatric symptoms in patients with psychiatric disorders during the Covid-19 pandemic

2021 ◽  
Author(s):  
Michael Belz ◽  
Philipp Hessmann ◽  
Jonathan Vogelgsang ◽  
Ulrike Schmidt ◽  
Mirjana Ruhleder ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Psychiatric Disorders ◽  
Stress Responses ◽  
Psychiatric Symptoms ◽  
High Stress ◽  
Specific Treatment ◽  
Time Range ◽  
Long Term Effects ◽  
Psychosocial Burden

AbstractThe Covid-19 pandemic highly impacts mental health worldwide. Patients with psychiatric disorders are a vulnerable risk population for worsening of their condition and relapse of symptoms. This study investigates the pandemic-related course of psychosocial burden in patients with pre-existing mental disorders. With the newly developed Goettingen psychosocial Burden and Symptom Inventory (Goe-BSI) psychosocial burden has been traced retrospectively (1) before the pandemic (beginning of 2020), (2) at its beginning under maximum lockdown conditions (March 2020), and (3) for the current state after maximum lockdown conditions (April/May 2020). The Goe-BSI also integrates the Adjustment Disorder New Module (ADNM-20), assesses general psychiatric symptoms, and resilience. A total of 213 patients covering all major psychiatric disorders (ICD-10 F0-F9) were interviewed once in the time range from April, 24th until May 11th, 2020. Across all diagnoses patients exhibited a distinct pattern with an initial rise followed by a decline of psychosocial burden (p < 0.001, partial η2 = 0.09; Bonferroni-corrected pairwise comparisons between all three time-points: p < 0.05 to 0.001). Female gender and high ADNM-20 scores were identified as risk factors for higher levels and an unfavorable course of psychosocial burden over time. Most psychiatric symptoms remained unchanged. Trajectories of psychosocial burden vary in parallel to local lockdown restrictions and seem to reflect an adaptive stress response. For female patients with pre-existing mental disorders and patients with high-stress responses, timely and specific treatment should be scheduled. With the continuation of the pandemic, monitoring of long-term effects is of major importance, especially when long incubation times for the development of mental health issues are considered.

Association between acute psychiatric bed availability in the Veterans Health Administration and veteran suicide risk: a retrospective cohort study

2021 ◽  
pp. bmjqs-2020-012975
Author(s):  
Peter J Kaboli ◽  
Matthew R Augustine ◽  
Bjarni Haraldsson ◽  
Nicholas M Mohr ◽  
M Bryant Howren ◽  
...  
Keyword(s):  
Mental Health ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Suicide Risk ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
Bed Occupancy ◽  
Increased Risk

BackgroundVeteran suicides have increased despite mental health investments by the Veterans Health Administration (VHA).ObjectiveTo examine relationships between suicide and acute inpatient psychiatric bed occupancy and other community, hospital and patient factors.MethodsRetrospective cohort study using administrative and publicly available data for contextual community factors. The study sample included all veterans enrolled in VHA primary care in 2011–2016 associated with 111 VHA hospitals with acute inpatient psychiatric units. Acute psychiatric bed occupancy, as a measure of access to care, was the main exposure of interest and was categorised by quarter as per cent occupied using thresholds of ≤85%, 85.1%–90%, 90.1%–95% and >95%. Hospital-level analyses were conducted using generalised linear mixed models with random intercepts for hospital, modelling number of suicides by quarter with a negative binomial distribution.ResultsFrom 2011 to 2016, the national incidence of suicide among enrolled veterans increased from 39.7 to 41.6 per 100 000 person-years. VHA psychiatric bed occupancy decreased from a mean of 68.2% (IQR 56.5%–82.2%) to 65.4% (IQR 53.9%–79.9%). VHA hospitals with the highest occupancy (>95%) in a quarter compared with ≤85% had an adjusted incident rate ratio (IRR) for suicide of 1.10 (95% CI 1.01 to 1.19); no increased risk was observed for 85.1%–90% (IRR 0.96; 95% CI 0.89 to 1.03) or 90.1%–95% (IRR 0.96; 95% CI 0.89 to 1.04) compared with ≤85% occupancy. Of hospital and community variables, suicide risk was not associated with number of VHA or non-VHA psychiatric beds or amount spent on community mental health. Suicide risk increased by age categories, seasons, geographic regions and over time.ConclusionsHigh VHA hospital occupancy (>95%) was associated with a 10% increased suicide risk for veterans whereas absolute number of beds was not, suggesting occupancy is an important access measure. Future work should clarify optimal bed occupancy to meet acute psychiatric needs and ensure adequate bed distribution.

Clubhouse Model and Its Impact on Psychiatric Hospitalization in Canada: A Cohort Study

2021 ◽  
pp. 1-16
Author(s):  
Matthew Joseph Russell ◽  
Natasha Lifeso ◽  
Jordan Fazio ◽  
Carley Piatt ◽  
Frank Kelton ◽  
...  
Keyword(s):  
Mental Health ◽  
Cohort Study ◽  
Administrative Data ◽  
Psychiatric Hospitalization ◽  
Bipolar Disorders ◽  
Increased Risk ◽  
Clubhouse Model ◽  
Mental Health Support ◽  
Health Support ◽  
The Relationship

We investigated the relationship between membership in an accredited Clubhouse for mental health support and psychiatric hospitalization in Canada using linked administrative data. Results show that Clubhouse members were less likely to be hospitalized after enrollment and after longer-term enrollment, and younger members diagnosed with schizophrenia and/or bipolar disorders were at increased risk of hospitalization compared to older members without such diagnoses. These findings provide evidence of the possible benefits of Clubhouses in Canada and the characteristics of members who may benefit from support.

Increased risk of psychiatric disorders in adult patients with vitiligo: A nationwide, population‐based cohort study in Taiwan

2020 ◽  
Vol 47 (5) ◽  
pp. 470-475 ◽  
Author(s):  
Chih‐Yu Chen ◽  
Wei‐Ming Wang ◽  
Chi‐Hsiang Chung ◽  
Chang‐Huei Tsao ◽  
Wu‐Chien Chien ◽  
...  
Keyword(s):  
Cohort Study ◽  
Psychiatric Disorders ◽  
Population Based ◽  
Adult Patients ◽  
Increased Risk

Headache as a risk factor for dementia: A prospective population-based study

Cephalalgia ◽  
2013 ◽  
Vol 34 (5) ◽  
pp. 327-335 ◽  
Author(s):  
Knut Hagen ◽  
Eystein Stordal ◽  
Mattias Linde ◽  
Timothy J Steiner ◽  
John-Anker Zwart ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Cox Regression ◽  
Subsequent Development ◽  
Population Based ◽  
Health Study ◽  
Cox Regression Analysis ◽  
Hazard Ratios ◽  
Increased Risk

Background Headache has not been established as a risk factor for dementia. The aim of this study was to determine whether any headache was associated with subsequent development of vascular dementia (VaD), Alzheimer’s disease (AD) or other types of dementia. Methods This prospective population-based cohort study used baseline data from the Nord-Trøndelag Health Study (HUNT 2) performed during 1995–1997 and, from the same Norwegian county, a register of cases diagnosed with dementia during 1997–2010. Participants aged ≥20 years who responded to headache questions in HUNT 2 were categorized (headache free; with any headache; with migraine; with nonmigrainous headache). Hazard ratios (HRs) for later inclusion in the dementia register were estimated using Cox regression analysis. Results Of 51,383 participants providing headache data in HUNT 2, 378 appeared in the dementia register during the follow-up period. Compared to those who were headache free, participants with any headache had increased risk of VaD ( n = 63) (multivariate-adjusted HR = 2.3, 95% CI 1.4–3.8, p = 0.002) and of mixed dementia (VaD and AD ( n = 52)) (adjusted HR = 2.0, 95% CI 1.1–3.5, p = 0.018). There was no association between any headache and later development of AD ( n = 180). Conclusion In this prospective population-based cohort study, any headache was a risk factor for development of VaD.

scholarly journals Risk of eating disorders in international adoptees: a cohort study using Swedish national population registers

2020 ◽  
Vol 29 ◽  
Author(s):  
M. Strand ◽  
R. Zhang ◽  
L. M. Thornton ◽  
A. Birgegård ◽  
B. M. D'Onofrio ◽  
...  
Keyword(s):  
Mental Health ◽  
Eating Disorders ◽  
Cohort Study ◽  
General Population ◽  
Anxiety Disorders ◽  
Elevated Risk ◽  
Compulsive Disorder ◽  
International Adoptees ◽  
Increased Risk ◽  
The Impact

Abstract Aims Compared to the general population, adoptees are more often referred to specialist psychiatric treatment, exhibit increased risk of suicide and display more symptoms of attention-deficit/hyperactivity-disorder. However, little is known about the impact of being an adoptee on the risk of developing an eating disorder. The aim of the present study was to assess whether international adoptees have a higher risk for eating disorders than native Swedes. Methods In the present retrospective cohort study, data from the Swedish total population registers on individuals born between 1979 and 2005 were used to assess whether international adoptees residing in Sweden (n = 25 287) have a higher risk for anorexia nervosa (AN) and other eating disorders (OED) than non-adoptees with Swedish-born parents from the general population (n = 2 046 835). The patterns of these results were compared to those for major depressive disorder (MDD), obsessive-compulsive disorder (OCD), and anxiety disorders to determine whether any observed effects were unique to eating disorders or reflected a more general impact on mental health outcomes. Results A survival analysis adjusting for relevant demographic covariates revealed an elevated risk of all examined psychiatric disorders in international adoptees: hazard ratios (95% confidence intervals) are 1.21 (1.04–1.41) for AN, 1.60 (1.44–1.79) for OED, 1.90 (1.81–2.00) for MDD, 1.25 (1.09–1.44) for OCD, and 1.69 (1.60–1.78) for anxiety disorders. Conclusions Elevated risk of eating disorders as well as of MDD, OCD, and anxiety disorders was found in international adoptees. A parallel pattern between AN and OCD was observed, which both display less elevated rates than the other diagnoses. A considerable number of biological, environmental, and societal factors have been suggested to explain the observed differences in mental health between adoptees and non-adoptees, but they remain primarily theoretical.

scholarly journals HIGH RISK OF NEW PSYCHIATRIC DISORDERS AND SUICIDAL BEHAVIOR IN DEMENTIA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S314-S314
Author(s):  
Amy Lai ◽  
Yixia Li ◽  
Amy Byers
Keyword(s):  
Psychiatric Disorders ◽  
Suicidal Behavior ◽  
Sociodemographic Factors ◽  
Department Of Veterans Affairs ◽  
Dementia Diagnosis ◽  
Dementia Patients ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Cox Proportional Hazard Models ◽  
Services Use

Abstract Occurrence of new mental health (MH) disorders in patients with dementia is neglected, with next to nothing known. We examined association between dementia diagnosis and risk of new psychiatric disorders and suicide, and MH services use. We merged four national databases from US Department of Veterans Affairs. Sample included 2,529,181 patients (≥50 years) in fiscal years (FY) 2012-2013 with no MH disorders. Dementia, psychiatric disorders (mood, anxiety, substance), suicidal behavior (ideation, plan, attempt, death by suicide) were identified by ICD-9/10 codes and national suicide databases. Hazard ratios (HR) were estimated using Cox proportional hazard models, with time-to-event defined as age at first diagnosis of MH disorder during FY 2014-2016. Analyses adjusted for medical/sociodemographic factors. Compared to those without dementia, dementia patients showed roughly 2-fold increased risk of new mood (HR: 2.19, 95% Wald CI: 2.15-2.24, p&lt;.001) or anxiety (HR: 1.56, 95% CI: 1.50-1.63, p&lt;.001) disorders. Recent dementia diagnosis was associated with highest risk of these disorders than prior or no diagnosis; for example, patients with recent diagnosis showed 72% greater risk of anxiety disorders (HR: 1.72, 95% CI: 1.63-1.81, p&lt;.001). Although patients with prior dementia diagnosis had lower risk of suicidal behavior, risk increased with recent dementia diagnosis. However, dementia patients with new MH disorders showed little MH services use (&lt; 20%). Patients with dementia have increased risk of new MH disorders, especially recent dementia diagnosis. Furthermore, MH services are underutilized, highlighting critical need for integration of such services in caring for dementia patients.

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