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 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 Melanoma is associated with an increased risk of bullous pemphigoid: a large population-based longitudinal study

2021 ◽  
Author(s):  
Khalaf Kridin ◽  
Jennifer E. Hundt ◽  
Ralf J. Ludwig ◽  
Kyle T. Amber ◽  
Dana Tzur Bitan ◽  
...  
Keyword(s):  
Bullous Pemphigoid ◽  
Statistical Significance ◽  
Large Population ◽  
Underlying Mechanism ◽  
Population Based ◽  
Control Subjects ◽  
Increased Risk ◽  
Bidirectional Association ◽  
History Of ◽  
Incident Cases

AbstractThe association between bullous pemphigoid (BP) and melanoma is yet to be investigated. We aimed to assess assess the bidirectional association between BP and melanoma and to delineate the epidemiological features of patients with both diagnoses. A population-based cohort study was performed comparing BP patients (n = 3924) with age-, sex- and ethnicity-matched control subjects (n = 19,280) with regard to incident cases of melanoma. A case–control design was additionally adopted to estimate the risk of BP in individuals with a preexisting diagnosis of melanoma. The prevalence of preexisting melanoma was higher in patients with BP than in control subjects (1.5% vs. 1.0%, respectively; P = 0.004). A history of melanoma confers a 50% increase in the risk of subsequent BP (OR 1.53; 95% CI 1.14–2.06). This risk was higher among males (OR 1.66; 95% CI 1.09–2.54) and individuals older than 80 years (OR 1.63; 95% CI 1.11–2.38), and persisted after adjustment for multiple putative confounders including PD-1/PDL-1 antagonists (adjusted OR 1.53; 95% CI 1.14–2.06). Conversely, the risk of melanoma among patients with BP was slightly elevated, but did not reach the level of statistical significance (adjusted HR 1.13; 95% CI 0.73–1.74). Patients with a dual diagnosis of BP and melanoma were older at the onset of BP and had lower body mass index. A history of melanoma is associated with a 50% increase in the incidence of subsequent BP. Physicians managing patients with both conditions should be aware of this association. Further research is warranted to reveal the underlying mechanism of these findings.

What Are the Psychosocial Factors Associated With Migraine in the Child? Comorbid Psychiatric Disorders, Family Functioning, Parenting Style, or Mom’s Psychiatric Symptoms?

2018 ◽  
Vol 33 (2) ◽  
pp. 174-181 ◽  
Author(s):  
Gozde Kandemir ◽  
Selma Tural Hesapcioglu ◽  
Aysegül N. Citak Kurt
Keyword(s):  
Psychiatric Disorder ◽  
Family Functioning ◽  
Psychiatric Disorders ◽  
Parenting Style ◽  
Psychiatric Comorbidity ◽  
Psychiatric Symptoms ◽  
Treatment Plan ◽  
Depression And Anxiety ◽  
Factors Associated ◽  
Migraine Group

Objective: Psychiatric diagnoses, parenting style, family functioning among children and adolescents with migraine, and psychiatric symptoms of their mothers were examined. Methods: The K-SADS and other measurements were used to assess psychiatric disorders in 50 children with migraine (aged 8-18) and matched 50 controls. Results: At least one psychiatric disorder was diagnosed in 56% of the migraine group. The presence of any psychiatric disorder in children (odds ratio [OR] = 2.765, P = .027) and somatization symptoms in their mothers (OR = 2.061, P = .025) were increasing the risk of migraine diagnosis. The parenting style scale assessments revealed that parents in the migraine group grant their children less autonomy. Conclusion: Psychiatric comorbidity, especially depression and anxiety disorders, is more common in children with migraine. The frequency of eating disorder is also higher. Evaluating comorbidity, family functioning, and particularly affective responsiveness in migraine families may guide the clinician to a targeted treatment plan.

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.

scholarly journals Psychiatric illness and regression in individuals with Phelan-McDermid syndrome

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Teresa M. Kohlenberg ◽  
M. Pilar Trelles ◽  
Brittany McLarney ◽  
Catalina Betancur ◽  
Audrey Thurm ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Intellectual Disability ◽  
Psychiatric Disorders ◽  
Psychiatric Illness ◽  
Psychiatric Symptoms ◽  
Structured Interview ◽  
Autism Spectrum ◽  
Scaffolding Protein ◽  
International Registry ◽  
Increased Risk

Abstract Background Phelan-McDermid syndrome (PMS) is a genetic condition characterized by intellectual disability, speech and language deficits, hypotonia, autism spectrum disorder, and epilepsy. PMS is caused by 22q13.33 deletions or mutations affecting SHANK3, which codes for a critical scaffolding protein in excitatory synapses. SHANK3 variants are also known to be associated with an increased risk for regression, as well as for psychiatric disorders, including bipolar disorder and catatonia. This study aimed to further describe these phenomena in PMS and to explore any relationship between psychiatric illness and regression after early childhood. Methods Thirty-eight people with PMS were recruited to this study through the Phelan-McDermid Syndrome Foundation based on caregiver report of distinct development of psychiatric symptoms. Caregivers completed a clinician-administered semi-structured interview focused on eliciting psychiatric symptomatology. Data from the PMS International Registry were used to confirm genetic diagnoses of participants and to provide a larger sample for comparison. Results The mean age of the 38 participants was 24.7 years (range = 13 to 50; SD = 10.06). Females (31 of 38 cases; 82%) and sequence variants (15 of 38 cases; 39%) were over-represented in this sample, compared to base rates in the PMS International Registry. Onset of psychiatric symptoms occurred at a mean age of 15.4 years (range = 7 to 32), with presentations marked by prominent disturbances of mood. Enduring substantial loss of functional skills after onset of psychiatric changes was seen in 25 cases (66%). Symptomst indicative of catatonia occurred in 20 cases (53%). Triggers included infections, changes in hormonal status, and stressful life events. Conclusions This study confirms that individuals with PMS are at risk of developing severe neuropsychiatric illness in adolescence or early adulthood, including bipolar disorder, catatonia, and lasting regression of skills. These findings should increase the awareness of these phenotypes and lead to earlier diagnosis and the implementation of appropriate interventions. Our findings also highlight the importance of genetic testing in the work-up of individuals with intellectual disability and acute psychiatric illness or regression. Future research is needed to clarify the prevalence and nature of psychiatric disorders and regression among larger unbiased samples of individuals with PMS.

scholarly journals Cardiovascular risk factors among patients with schizophrenia, bipolar, depressive, anxiety, and personality disorders

2016 ◽  
Vol 35 ◽  
pp. 8-15 ◽  
Author(s):  
M. Pérez-Piñar ◽  
R. Mathur ◽  
Q. Foguet ◽  
S. Ayis ◽  
J. Robson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Psychiatric Disorders ◽  
Physical Inactivity ◽  
Social Deprivation ◽  
Tobacco Consumption ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Primary Care Practices

AbstractBackgroundThe evidence informing the management of cardiovascular risk in patients with psychiatric disorders is weak.MethodsThis cohort study used data from all patients, aged ≥ 30, registered in 140 primary care practices (n = 524,952) in London to estimate the risk of developing diabetes, hypertension, hyperlipidemia, tobacco consumption, obesity, and physical inactivity, between 2005 and 2015, for patients with a previous diagnosis of schizophrenia, depression, anxiety, bipolar or personality disorder. The role of antidepressants, antipsychotics and social deprivation in these associations was also investigated. The age at detection of cardiovascular risk factor was compared between patients with and without psychiatric disorders. Variables, for exposures and outcomes, defined from general practitioners records, were analysed using multivariate regression.ResultsPatients with psychiatric disorders had an increased risk for cardiovascular risk factors, especially diabetes, with hazard ratios: 2.42 (2.20–2.67) to 1.31 (1.25–1.37), hyperlipidemia, with hazard ratios: 1.78 (1.60–1.97) to 1.25 (1.23–1.28), and obesity. Antidepressants, antipsychotics and social deprivation did not change these associations, except for smoking and physical inactivity. Antidepressants were associated with higher risk of diabetes, hypertension and hyperlipidemia. Antipsychotics were associated with a higher risk of diabetes. Antidepressants and antipsychotics were associated with lower risk of other risk factors. Patients with psychiatric conditions have later detection of cardiovascular risk factors. The interpretation of these results should acknowledge the lower rates of detection of risk factors in mentally ill patients.ConclusionsCardiovascular risk factors require special clinical attention among patients with psychiatric disorders. Further research could study the effect of antidepressants and antipsychotics on cardiovascular risk factors.

Childhood and adolescent mental health of NICU graduates: an observational study

2020 ◽  
Vol 105 (7) ◽  
pp. 684-689
Author(s):  
Andreea Chiorean ◽  
Calan Savoy ◽  
Karen Beattie ◽  
Salhab el Helou ◽  
Maysoon Silmi ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychiatric Disorder ◽  
Children And Adolescents ◽  
Psychiatric Disorders ◽  
Oppositional Defiant Disorder ◽  
Psychiatric Comorbidity ◽  
Separation Anxiety Disorder ◽  
Self Report ◽  
Oppositional Defiant ◽  
Increased Risk

ObjectiveTo investigate the mental health of children and adolescents admitted to neonatal intensive/special care units (NICUs) in infancy.MethodsThis cross-sectional study used a provincially representative cohort from the 2014 Ontario Child Health Study. Parents provided data on psychiatric disorders using the MINI International Neuropsychiatric Interview for Children and Adolescents in 3141 children aged 4–11 years (NICU n=389; control n=2752) and in 2379 children aged 12–17 years (NICU n=298; control n=2081). Additionally, 2235 adolescents aged 12–17 years completed the interview themselves (NICU n=285; control n=1950). Odds of psychiatric disorder were compared in those admitted and controls.ResultsBased on parent reports, NICU graduates aged 4–11 years had increased adjusted ORs (95% CI) of 1.78 (1.39 to 2.28) for any psychiatric disorder, with a marginal prevalence of 32.4% in NICU participants and 27.6% in controls. At this age, NICU graduates also had increased ORs of 1.74 (1.25 to 2.40) for psychiatric comorbidity, 1.48 (1.04 to 2.11) for oppositional defiant disorder, 1.61 (1.19 to 2.19) for attention-deficit hyperactivity disorder, 4.11 (2.33 to 7.25) for separation anxiety disorder and 2.13 (1.37 to 3.31) for specific phobia. At 12–17 years, 40.5% and 30.5% of NICU graduates and 30.6% and 17.9% of controls had any psychiatric disorder as reported by parents and self-report, respectively. Parents and adolescents, respectively, reported increased adjusted ORs (95% CI) of 1.63 (1.18 to 2.26) and 1.55 (1.13 to 2.11) for any disorder, 1.64 (1.06 to 2.54) and 1.74 (1.11 to 2.73) for psychiatric comorbidity, and 1.89 (1.22 to 2.93) and 3.17 (2.03 to 4.95) for oppositional defiant disorder.ConclusionsNICU graduates are at increased risk for psychiatric disorders during childhood and adolescence.

Physical and Psychiatric Comorbidity in General Practice

1996 ◽  
Vol 169 (2) ◽  
pp. 236-242 ◽  
Author(s):  
S. R. Kisely ◽  
D. P. Goldberg
Keyword(s):  
General Practice ◽  
Psychiatric Comorbidity ◽  
Psychiatric Symptoms ◽  
General Health Questionnaire ◽  
Psychiatric Morbidity ◽  
Female Gender ◽  
Medical Illness ◽  
Social Disability ◽  
Increased Risk ◽  
Research Interview

BackgroundThe aim of this study was to determine the association between physical and psychiatric morbidity among general practice patients and to explore the influence of possible intervening variables.MethodPhysical and psychiatric morbidity in 1620 consecutive patients attending their general practitioner (GP) was assessed using a two-stage design. Ninety-four per cent of the patients (n=1523) were successfully screened using the General Health Questionnaire (GHQ–12); 428 of the 602 patients (71%) eligible for the second stage were interviewed using the Composite International Diagnostic Instrument adapted for use in primary health care (CIDI–PHC), the Brief Disability Questionnaire (BDQ) and the Groningen Social Disability Schedule (GSDS) to assess psychiatric, physical and social status. Assessments of physical and psychiatric morbidity were also obtained from the patients' GPs.ResultsThere was a significant association between physical and psychiatric morbidity, although patients with four symptoms or less of physical illness were no more likely to be psychiatric cases than those with none. The association was accounted for by patients at the severe end of the physical continuum with five or more medically explained somatic symptoms: these were twice as likely to be psychiatric cases as those with no such symptoms. Female gender, social disability and physical disability were all significantly more likely to be associated with psychiatric disorder, whether measured by GP or research interview; and these relationships remained after the data were corrected for age differences.ConclusionsPatients in general practice with moderate to severe physical morbidity are at increased risk of developing psychiatric illness, and when medical illness is present, psychiatric symptoms are more severe. As physical and psychiatric comorbidity is relatively common in general practice, the specific needs of these patients should receive greater attention.

Family Environment and Its Correlation with Anxiety and Depression: A Study on Heart Patients

2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Dr. Meena Jain ◽  
Saloni Chandalia
Keyword(s):  
Heart Disease ◽  
Family Environment ◽  
Heart Attack ◽  
Psychiatric Symptoms ◽  
Disease Risk ◽  
Positive Association ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Increased Risk ◽  
Artery Disease

This research paper deals with the Family Environment and its Correlation with Anxiety and Depression level among persons with Heart Disease. There had been a number of researches that investigated that ischemic heart disease patients who suffer significant anxiety have close to a 5-fold increased risk of experiencing frequent angina and those with depression have more than a 3-fold increased risk for these episodes. This observed link between psychiatric symptoms and angina underlines the importance of treating anxiety and depression in cardiac patients, according to study co author Dr Mark D Sullivan (University of Washington School of Medicine, Seattle). To gather the needed data, Hamilton Anxiety Scale and Becks Depression Inventory were used. As stated from literatures, for people with heart dysfunction, depression and anxiety can increase the risk of an adverse cardiac event such as a heart attack or blood clots. For people who do not have heart disease, depression and anxiety can also increase the risk of a heart attack and development of coronary artery disease. Researchers have also emphasized on the role of family psychosocial environment and its positive association with the Coronary Heart Disease risk.

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