Underdiagnosis of psychiatric disorders in people with intellectual disabilities: Differences between psychiatric disorders and challenging behaviour

Background and purpose: The purpose of this study was to assess the level of mental disorders and challenging behaviour in individuals with intellectual disability (ID) supported by specialized services, but without a prior psychiatric diagnosis, and to compare the levels of different disorders depending on the severity of ID. Methods: This is a cross-sectional study ( N = 142) of population with ID. Inclusion criteria were the following: adult patients with ID and with no previous psychiatric diagnosis prior to this survey. The Wechsler Adults Intelligence Scale-II, the Psychiatric Assessment Schedule for Adults with Developmental Disability checklist and clinical interview, the Diagnostic Assessment for the Severely Handicapped scale and the Inventory for Client and Agency Planning were the assessment tools. Results: A previously undiagnosed mental disorder was found in 29.6% of the sample. The most prevalent mental disorders were major depressive and anxiety disorders. An association between psychiatric comorbidity and challenging behaviour was found only for mild/moderate ID, especially for affective disorders. Conclusions: The presence of a psychiatric as well as a medical comorbidity is associated with severe ID, unlike challenging behaviour. Clinical limitations of the study have been discussed.

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Screening of Biochemical Abnormalities in Suicide Attempters Irrespective of Psychiatric Diagnosis: A Cross-sectional Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/45810.14933 ◽

2021 ◽

Author(s):

Ashwini Kamble ◽

Vishwak Reddy Vatte ◽

Bheemathati Ranga Rao ◽

Sourya Reddy ◽

C Pradyumna ◽

...

Keyword(s):

Psychiatric Disorders ◽

Psychiatric Diagnosis ◽

Cross Sectional Study ◽

Sectional Study ◽

Serum Electrolytes ◽

Cross Sectional ◽

Suicide Attempters ◽

Complete Blood Counts ◽

Low Cholesterol ◽

Biochemical Abnormalities

Introduction: Empirical studies have documented the impact of membrane cholesterol on serotonergic function which might influence the suicidality in various psychiatric disorders. Most studies in last two decades demonstrated low cholesterol as potential predictor of suicidality in depression but trends of metabolic disorders and current status of hypercholesterolemia and biochemical abnormalities in suicidal spectrum population is scarce. Aim: The present study was aimed to comprehensively evaluate the blood levels of cholesterol and other biochemical abnormalities (serum electrolytes, proteins, blood pH etc.,) irrespective of any psychiatric disorders in suicide attempters. Materials and Methods: A cross-sectional study was conducted on a total of 202 patients who visited our emergency hospital services with the suicidal attempt from 1st January 2019 till 31st December 2019 for a period of 12 Months. Blood evaluation and analysis were done on the same day of hospitalisation for complete blood counts, serum electrolytes, proteins and cholesterol levels. Clinical and standardised psychological evaluations for psychiatric diagnosis were performed. The results were analysed and compared using descriptive and inferential statistics based on SPSS software 21.01. Results: Out of 202 total suicide attempters, 120 (59.4%) were males and 82 (40.6%) were females with most patients 111 (54.9%) falling in the age range of 20-29; while 175 (86.6%) of patients had their first ever suicide or deliberate harm. A total of 169 (83.7%) of patients had normal complete blood counts but 106 (52.5%) showed acidic pH (<7.3) while only 5 (2.5%) of the patients had alkalosis. Serum potassium was abnormal in 43 (21.3%) patients. Further serum chloride was deranged in 13(6.4%) while serum albumin was deranged in 17 (8.4%). About 27 (13.4%) found to have increased serum cholesterol and none of them had low cholesterol. Conclusion: Excessive and dampened reactivity of biomolecular parameters including hypercholesterolemia may modulate the neurobiological stress system associated with increased suicidality. This may be one of the predictors irrespective of the underlying psychiatric disorders.

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Prevalence and correlates of neurocognitive impairment and psychiatric disorders among schoolchildren in Wakiso District, Uganda: a cross-sectional study

Wellcome Open Research ◽

10.12688/wellcomeopenres.17005.1 ◽

2021 ◽

Vol 6 ◽

pp. 217

Author(s):

Margaret Nampijja ◽

Wilber Sembajjwe ◽

Harriet Mpairwe ◽

Richard Mpango ◽

Eugene Kinyanda

Keyword(s):

Mental Disorders ◽

Psychiatric Disorders ◽

Cross Sectional Study ◽

Neurocognitive Impairment ◽

Self Report ◽

Healthy Children ◽

Sectional Study ◽

Cross Sectional ◽

Targeted Screening ◽

General Populations

Background: There is limited data on the burden of mental disorders among ‘healthy’ children in Africa. We examined the prevalence and correlates of neurocognitive and psychiatric disorders among schoolchildren in Uganda. Methods: This cross-sectional study enrolled 322 schoolchildren aged 5-17years in Wakiso, Uganda. We assessed for neurocognitive impairment using the Kaufmann-Assessment-Battery, and psychiatric disorders (major-depressive-disorder (MDD), attention-deficit-hyperactivity-disorder (ADHD), generalised-anxiety-disorder (GAD), and substance-use-disorder (SUD)) using the parent version of the Child and Adolescent Symptom Inventory-5, and Youth Inventory-4R Self Report. Prevalence and risk factors were determined using percentages and logistic regression. Results: Twenty-five participants (8%) had neurocognitive impairment. Nineteen (5.9%) participants had MDD, nine (2.8%) had ADHD, seven (2.2%) had GAD, 14 (8.6%) had SUD; and 30 (9.3%) had any psychiatric disorder. None of the factors examined were associated with the disorders. Conclusions: The unexpectedly high burden of mental disorders in this general population of children warrants targeted screening of those at risk, and treatment of those affected. Further, future studies should extensively investigate the factors that underlie the identified psychiatric disorders in this and similar general populations.

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Fatigue among children with a chronic disease: a cross-sectional study

BMJ Paediatrics Open ◽

10.1136/bmjpo-2020-000958 ◽

2021 ◽

Vol 5 (1) ◽

pp. e000958

Author(s):

Merel M Nap-van der Vlist ◽

Geertje W Dalmeijer ◽

Martha A Grootenhuis ◽

Kors van der Ent ◽

Marry M van den Heuvel-Eibrink ◽

...

Keyword(s):

Chronic Disease ◽

Social Factors ◽

Participation Rate ◽

Cross Sectional Study ◽

Assessment Tools ◽

Sectional Study ◽

Cross Sectional ◽

Multivariable Regression Model ◽

Multivariable Regression ◽

Multidimensional Fatigue Scale

ObjectiveTo determine: (1) which biological/lifestyle, psychological and/or social factors are associated with fatigue among children with a chronic disease and (2) how much each of these factors contributes to explaining variance in fatigue.Design and settingThis was a cross-sectional study across two children’s hospitals.PatientsWe included children aged 8–18 years who visited the outpatient clinic with cystic fibrosis, an autoimmune disease or postcancer treatment.Main outcome measuresFatigue was assessed using the PedsQL Multidimensional Fatigue Scale. Generic biological/lifestyle, psychological and social factors were assessed using clinical assessment tools and questionnaires. Multiple linear regression analyses were used to test the associations between these factors and fatigue. Finally, a multivariable regression model was used to determine which factor(s) have the strongest effect on fatigue.ResultsA total of 434 out of 902 children were included (48% participation rate), with a median age of 14.5 years; 42% were male. Among these 434 children, 21.8% were severely fatigued. Together, all biopsychosocial factors explained 74.6% of the variance in fatigue. More fatigue was uniquely associated with poorer physical functioning, more depressive symptoms, more pressure at school, poorer social functioning and older age.ConclusionsFatigue among children with a chronic disease is multidimensional. Multiple generic biological/lifestyle, psychological and social factors were strongly associated with fatigue, explaining 58.4%; 65.8% and 50.0% of the variance in fatigue, respectively. Altogether, almost three-quarters of the variance in fatigue was explained by this biopsychosocial model. Thus, when assessing and treating fatigue, a transdiagnostic approach is preferred, taking into account biological, psychological and social factors.

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Perceived stress and depressive symptoms not neuropsychiatric symptoms predict caregiver burden in Alzheimer’s disease: a cross-sectional study

BMC Geriatrics ◽

10.1186/s12877-021-02136-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Manee Pinyopornpanish ◽

Kanokporn Pinyopornpanish ◽

Atiwat Soontornpun ◽

Surat Tanprawate ◽

Angkana Nadsasarn ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Depressive Symptoms ◽

Caregiver Burden ◽

Perceived Stress ◽

Neuropsychiatric Symptoms ◽

Cross Sectional Study ◽

Assessment Tools ◽

Sectional Study ◽

Cross Sectional

Abstract Background Caregiver burden affects the caregiver’s health and is related to the quality of care received by patients. This study aimed to determine the extent to which caregivers feel burdened when caring for patients with Alzheimer’s Disease (AD) and to investigate the predictors for caregiving burden. Methods A cross-sectional study was conducted. One hundred two caregivers of patients with AD at Maharaj Nakorn Chiang Mai Hospital, a tertiary care hospital, were recruited. Assessment tools included the perceived stress scale (stress), PHQ-9 (depressive symptoms), Zarit Burden Interview-12 (burden), Clinical Dementia Rating (disease severity), Neuropsychiatric Inventory Questionnaires (neuropsychiatric symptoms), and Barthel Activities Daily Living Index (dependency). The mediation analysis model was used to determine any associations. Results A higher level of severity of neuropsychiatric symptoms (r = 0.37, p < 0.01), higher level of perceived stress (r = 0.57, p < 0.01), and higher level of depressive symptoms (r = 0.54, p < 0.01) were related to a higher level of caregiver burden. The direct effect of neuropsychiatric symptoms on caregiver burden was fully mediated by perceived stress and depressive symptoms (r = 0.13, p = 0.177), rendering an increase of 46% of variance in caregiver burden by this parallel mediation model. The significant indirect effect of neuropsychiatric symptoms by these two mediators was (r = 0.21, p = 0.001). Conclusion Caregiver burden is associated with patients’ neuropsychiatric symptoms indirectly through the caregiver’s depressive symptoms and perception of stress. Early detection and provision of appropriate interventions and skills to manage stress and depression could be useful in reducing and preventing caregiver burden.

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Exposure to antibiotics and mental disorders in children: a community-based cross-sectional study

Environmental Geochemistry and Health ◽

10.1007/s10653-021-00840-2 ◽

2021 ◽

Author(s):

Jingjing Zhang ◽

Kaiyong Liu ◽

Liang Sun ◽

Linsheng Yang ◽

Xinji Liu ◽

...

Keyword(s):

Mental Disorders ◽

Cross Sectional Study ◽

Sectional Study ◽

Community Based ◽

Cross Sectional

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Symptoms of common mental disorders and adherence to antiretroviral therapy among adults living with HIV in rural Zimbabwe: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2021-049824 ◽

2021 ◽

Vol 11 (7) ◽

pp. e049824

Author(s):

Andreas D Haas ◽

Cordelia Kunzekwenyika ◽

Stefanie Hossmann ◽

Josphat Manzero ◽

Janneke van Dijk ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Suicidal Ideation ◽

Mental Disorders ◽

Common Mental Disorders ◽

Cross Sectional Study ◽

People Living With Hiv ◽

Art Adherence ◽

Sectional Study ◽

Cross Sectional ◽

Living With Hiv

ObjectivesTo examine the proportion of people living with HIV who screen positive for common mental disorders (CMD) and the associations between CMD and self-reported adherence to antiretroviral therapy (ART).SettingSixteen government-funded health facilities in the rural Bikita district of Zimbabwe.DesignCross-sectional study.ParticipantsHIV-positive non-pregnant adults, aged 18 years or older, who lived in Bikita district and had received ART for at least 6 months.Outcome measuresThe primary outcome was the proportion of participants screening positive for CMD defined as a Shona Symptoms Questionnaire score of 9 or greater. Secondary outcomes were the proportion of participants reporting suicidal ideation, perceptual symptoms and suboptimal ART adherence and adjusted prevalence ratios (aPR) for factors associated with CMD, suicidal ideation, perceptual symptoms and suboptimal ART adherence.ResultsOut of 3480 adults, 18.8% (95% CI 14.8% to 23.7%) screened positive for CMD, 2.7% (95% CI 1.5% to 4.7%) reported suicidal ideations, and 1.5% (95% CI 0.9% to 2.6%) reported perceptual symptoms. Positive CMD screens were more common in women (aPR 1.67, 95% CI 1.19 to 2.35) than in men and were more common in adults aged 40–49 years (aPR 1.47, 95% CI 1.16 to 1.85) or aged 50–59 years (aPR 1.51, 95% CI 1.05 to 2.17) than in those 60 years or older. Positive CMD screen was associated with suboptimal adherence (aPR 1.53; 95% CI 1.37 to 1.70).ConclusionsA substantial proportion of people living with HIV in rural Zimbabwe are affected by CMD. There is a need to integrate mental health services and HIV programmes in rural Zimbabwe.Trial registration numberNCT03704805.

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Relationship Pattern of Personality Disorder Traits in Major Psychiatric Disorders: A Cross-Sectional Study

Indian Journal of Psychological Medicine ◽

10.1177/0253717621999537 ◽

2021 ◽

pp. 025371762199953

Author(s):

Bhavneesh Saini ◽

Pir Dutt Bansal ◽

Mamta Bahetra ◽

Arvind Sharma ◽

Priyanka Bansal ◽

...

Keyword(s):

Personality Disorder ◽

Psychiatric Disorders ◽

Psychotic Disorders ◽

Age Of Onset ◽

Psychiatric Patients ◽

Cross Sectional Study ◽

Psychotic Symptoms ◽

Sectional Study ◽

Cross Sectional ◽

Neurotic Disorders

Background: Normal personality development, gone awry due to genetic or environmental factors, results in personality disorders (PD). These often coexist with other psychiatric disorders, affecting their outcome adversely. Considering the heterogeneity of data, more research is warranted. Methods: This was a cross-sectional study on personality traits in psychiatric patients of a tertiary hospital, over 1 year. Five hundred and twenty-five subjects, aged 18–45 years, with substance, psychotic, mood, or neurotic disorders were selected by convenience sampling. They were evaluated for illness-related variables using psychiatric pro forma; diagnostic confirmation and severity assessment were done using ICD-10 criteria and suitable scales. Personality assessment was done using the International Personality Disorder Examination after achieving remission. Results: Prevalence of PD traits and PDs was 56.3% and 4.2%, respectively. While mood disorders were the diagnostic group with the highest prevalence of PD traits, it was neurotic disorders for PDs. Patients with PD traits had a past psychiatric history and upper middle socioeconomic status (SES); patients with PDs were urban and unmarried. Both had a lower age of onset of psychiatric illness. Psychotic patients with PD traits had higher and lower PANSS positive and negative scores, respectively. The severity of personality pathology was highest for mixed cluster and among neurotic patients. Clusterwise prevalence was cluster C > B > mixed > A (47.1%, 25.2%, 16.7%, and 11.4%). Among subtypes, anankastic (18.1%) and mixed (16.7%) had the highest prevalence. Those in the cluster A group were the least educated and with lower SES than others. Conclusions: PD traits were present among 56.3% of the patients, and they had many significant sociodemographic and illness-related differences from those without PD traits. Cluster C had the highest prevalence. Among patients with psychotic disorders, those with PD traits had higher severity of psychotic symptoms.

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Minor psychiatric disorders and their associations in family caregivers of people with mental disorders

Ciência & Saúde Coletiva ◽

10.1590/1413-812320172211.06922016 ◽

2017 ◽

Vol 22 (11) ◽

pp. 3567-3578 ◽

Cited By ~ 3

Author(s):

Carlos Alberto dos Santos Treichel ◽

Vanda Maria da Rosa Jardim ◽

Luciane Prado Kantorski ◽

Aline dos Santos Neutzling ◽

Michele Mandagará de Oliveira ◽

...

Keyword(s):

Mental Disorders ◽

Psychiatric Disorders ◽

Family Caregivers ◽

Linear Trend ◽

Trend Test ◽

P Value ◽

Test Statistic ◽

Cross Sectional ◽

Self Reporting Questionnaire ◽

Minor Psychiatric Disorders

Abstract This study aims to analyze the occurrence of minor psychiatric disorder and their associations in relatives of people with mental disorders. This is a cross-sectional study of 1164 relatives. For the tracking of minor psychiatric disorders the Self-Reporting Questionnaire Scale (SRQ20) was used, adopting 6/8 as cut-off point. Bivariate analyzes were conducted using Chi-squared test. Trends among strata of independent variables were investigated in relation to the outcome using nonparametric linear trend test. Statistic significance was defined as p-value < 0.05. Crude and adjusted binary logistic regressions were conducted using as a basis the hierarchical model developed through a systematic literature review. It was observed in the population a prevalence of 46.9% for minor psychiatric disorders. Higher prevalence of minor psychiatric disorders were strongly associated with the female gender, older age, first degree family ties, not having a paid work, lower education level, lower income, health problems, lower quality of life and feeling of burden. Many factors are related to the emotional and mental illness of family caregivers, demanding health services to be prepared to recognize and intervene in these situations.

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Prevalence and factors associated with minor psychiatric disorders in hospital housekeeping workers*

Revista da Escola de Enfermagem da USP ◽

10.1590/s1980-220x2016026303239 ◽

2017 ◽

Vol 51 (0) ◽

Cited By ~ 1

Author(s):

Cintia da Silva Marconato ◽

Ana Carolina de Souza Magnago ◽

Tânia Solange Bosi de Souza Magnago ◽

Graziele de Lima Dalmolin ◽

Rafaela Andolhe ◽

...

Keyword(s):

Psychiatric Disorders ◽

Health Workers ◽

Leisure Activities ◽

Cross Sectional Study ◽

University Hospital ◽

Cross Sectional ◽

Factors Associated ◽

Study Population ◽

Self Reporting Questionnaire ◽

Minor Psychiatric Disorders

Abstract OBJECTIVE Investigating the prevalence and factors associated with minor psychiatric disorders (MPDs) in Hospital housekeeping workers. METHOD A cross-sectional study carried out in 2013 with workers from the cleaning service of a public university hospital in Rio Grande do Sul, Brazil. Data were collected through a form containing sociodemographic, occupational, habits and health variables. The Self-Reporting Questionnaire-20 was used in order to evaluate MPDs. RESULTS The study population consisted of 161 workers. The overall prevalence of suspected MPD was 29.3%. The chances of suspected MPDs were higher in workers with Effort-Reward Imbalance, those who did not have time or who occasionally had time for leisure activities, and those taking medications. CONCLUSION The prevalence of MPDs was similar to that found in the literature for health workers. Therefore, we consider it important to include these workers in institutional programs for continuing health education.

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