The Impact of Psychiatric Comorbidities on Readmissions for Diabetes in Youth

Abstract Purpose Depression at all ages is recognized as a global public health concern, but less is known about the welfare burden following early-life depression. This study aimed to (1) estimate the magnitude of associations between depression in adolescence and social transfer payments in adulthood; and (2) address the impact of major comorbid psychopathology on these associations. Methods This is a longitudinal cohort study of 539 participants assessed at age 16–17 using structured diagnostic interviews. An ongoing 25-year follow-up linked the cohort (n = 321 depressed; n = 218 nondepressed) to nationwide population-based registries. Outcomes included consecutive annual data on social transfer payments due to unemployment, work disability, and public assistance, spanning from age 18 to 40. Parameter estimations used the generalized estimating equations approach. Results Adolescent depression was associated with all forms of social transfer payments. The estimated overall payment per person and year was 938 USD (95% CI 551–1326) over and above the amount received by nondepressed controls. Persistent depressive disorder was associated with higher recipiency across all outcomes, whereas the pattern of findings was less clear for subthreshold and episodic major depression. Moreover, depressed adolescents presenting with comorbid anxiety and disruptive behavior disorders evidenced particularly high recipiency, exceeding the nondepressed controls with an estimated 1753 USD (95% CI 887–2620). Conclusion Adolescent depression is associated with considerable public expenditures across early-to-middle adulthood, especially for those exposed to chronic/persistent depression and psychiatric comorbidities. This finding suggests that the clinical heterogeneity of early-life depression needs to be considered from a longer-term societal perspective.

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The association of psychiatric and neurological comorbidities with outcomes in traumatic injury patients

The International Journal of Psychiatry in Medicine ◽

10.1177/0091217421989147 ◽

2021 ◽

pp. 009121742198914

Author(s):

Jennifer Brady ◽

R David Hayward ◽

Elango Edhayan

Keyword(s):

Length Of Stay ◽

Psychiatric Illness ◽

Traumatic Injury ◽

Lower Mortality ◽

Linear Modeling ◽

Psychiatric Comorbidities ◽

Trauma Outcomes ◽

Hospital Stays ◽

The Impact ◽

The Relationship

Introduction Mental illness is a well-known risk factor for injury and injury recidivism. The impact of pre-existing psychiatric illness on trauma outcomes, however, has received less attention. Our study examines the relationship of pre-existing psychiatric illness on trauma outcomes including length of stay, cost, and mortality. Methods Patient data were obtained from the Healthcare Cost and Utilization Project’s State Inpatient Database. All patients admitted for trauma in the Detroit metropolitan area from 1/1/2006 to 12/31/2014 were included. The relationship between individual psychiatric comorbidities (depression, psychosis, and other neurological disorders) and outcomes were evaluated with logistic regression (mortality) and generalized linear modeling (length of stay and cost). Results Over 260,000 records were reviewed. Approximately one-third (29.9%) of patients had one or more psychiatric diagnoses. Patients with depression had longer hospital stays (RR = 1.12, p < 0.001) and higher costs (RR = 1.07, p < 0.001), but also lower mortality (OR = 0.69, p < 0.001). Patients with psychosis had longer stays (RR = 1.18, p < 0.001), higher costs (RR = 1.02, p = 0.002), and lower mortality (OR = 0.61, p < 0.001). Patients with other neurological comorbidities had higher mortality (OR = 1.23, p < 0.001), longer stays (RR = 1.29, p < 0.001), and higher costs (RR = 1.10, p < 0.001). Conclusion Patients with a psychiatric disorder required longer care and incurred greater costs, whereas mortality was higher for only those with a neurological disorder. Identifying patients’ psychiatric comorbidities at the time of admission for trauma may help optimize treatment. Addressing these conditions may help reduce the cost of trauma care.

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5 The Impact of Psychiatric Comorbidities on the Length of Hospital Stay in Patients with Heart Failure

Heart ◽

10.1136/heartjnl-2016-309890.5 ◽

2016 ◽

Vol 102 (Suppl 6) ◽

pp. A4-A5

Author(s):

Paul Carter ◽

Andrew Carter ◽

Jennifer Reynolds ◽

Hardeep Uppal ◽

Suresh Chandran ◽

...

Keyword(s):

Heart Failure ◽

Hospital Stay ◽

Length Of Hospital Stay ◽

Psychiatric Comorbidities ◽

Patients With Heart Failure ◽

The Impact

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Isolating the Impact of Psychiatric Consultations in the General Hospital: Psychiatric Comorbidities and Nursing Intensity

The International Journal of Psychiatry in Medicine ◽

10.2190/b8x2-6j98-xkxe-8plb ◽

1990 ◽

Vol 19 (2) ◽

pp. 173-180 ◽

Cited By ~ 4

Author(s):

John S. Lyons ◽

Janet C. Scherubel ◽

Rachel L. Anderson ◽

James A. Swartz

Keyword(s):

General Hospital ◽

Psychiatric Comorbidities ◽

The Impact

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13.3 The Impact of Psychiatric Comorbidities in Transition of Care for Adolescents with Epilepsy

Journal of the American Academy of Child & Adolescent Psychiatry ◽

10.1016/j.jaac.2021.09.159 ◽

2021 ◽

Vol 60 (10) ◽

pp. S185-S186

Author(s):

Yang Cai ◽

Jane Timmons-Mitchell ◽

Elia Pestana-Knight ◽

Krystel Tossone ◽

Carrie Cuomo ◽

...

Keyword(s):

Transition Of Care ◽

Psychiatric Comorbidities ◽

The Impact

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Suicidal/self-harm behaviors among cancer patients: a population-based competing risk analysis

Psychological Medicine ◽

10.1017/s0033291720004250 ◽

2020 ◽

pp. 1-10

Author(s):

Vera Yu Men ◽

Clifton Robert Emery ◽

Tai-Chung Lam ◽

Paul Siu Fai Yip

Keyword(s):

Cancer Patients ◽

Cumulative Incidence ◽

Competing Risk ◽

Contributing Factors ◽

Age And Gender ◽

Psychiatric Comorbidities ◽

Risk Of Death ◽

Self Harm ◽

And Gender ◽

The Impact

Abstract Background Cancer patients had elevated risk of suicidality. However, few researches studied the risk/protective factors of suicidal/self-harm behaviors considering the competing risk of death. The objective of this study is to systematically investigate the risk of suicidal/self-harm behaviors among Hong Kong cancer patients as well as the contributing factors. Methods Patients aged 10 or above who received their first cancer-related hospital admission (2002–2009) were identified and their inpatient medical records were retrieved. They were followed for 365 days for suicidal/self-harm behaviors or death. Cancer-related information and prior 2-year physical and psychiatric comorbidities were also identified. Competing risk models were performed to explore the cumulative incidence of suicidal/self-harm behavior within 1 year as well as its contributing factors. The analyses were also stratified by age and gender. Results In total, 152 061 cancer patients were included in the analyses. The cumulative incidence of suicidal/self-harm behaviors within 1 year was 717.48/100 000 person-years. Overall, cancer severity, a history of suicidal/self-harm behaviors, diabetes and hypertension were related to the risk of suicidal/self-harm behaviors. There was a U-shaped association between age and suicidal/self-harm behaviors with a turning point at 58. Previous psychiatric comorbidities were not related to the risk of suicidal/self-harm behaviors. The stratified analyses confirmed that the impact of contributing factors varied by age and gender. Conclusions Cancer patients were at risk of suicidal/self-harm behaviors, and the impacts of related factors varied by patients' characteristics. Effective suicide prevention for cancer patients should consider the influence of disease progress and the differences in age and gender.

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Psychiatric Comorbidities among Children with Attention Deficit Hyperactivity Disorders

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2020/v32i2330720 ◽

2020 ◽

pp. 85-96

Author(s):

Sahar Sayed Ahmed Shaaban ◽

Mohammad Abd El-Hakeem Seleem ◽

Adel Abd El –Kareem Badawy ◽

Mai Abd El–Raouf Eissa

Keyword(s):

Conduct Disorder ◽

Attention Deficit ◽

Nocturnal Enuresis ◽

Autism Spectrum ◽

Tic Disorders ◽

Psychiatric Comorbidities ◽

Total Problem ◽

Oppositional Defiant ◽

Significant Difference ◽

The Impact

Background and Purpose: Attention Deficit Hyperactivity Disorder (ADHD) is the most common neurodevelopmental disorder in children. The purpose of this study is to explore the rate of psychiatric comorbidities among children with ADHD and investigating the impact of comorbidities on function of children. Subjects and Methods: Sixty-four children of both genders who fulfilled DSM-5 criteria for ADHD were included. All subjects were subjected to IQ assessment, Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS), Conners Rating Scale, and Child Behavior Check List (CBCL). Results: Combined subtype was the commonest (50%) followed by hyperactive-impulsive (31.25%), then inattentive (18.75%). Psychiatric comorbid disorder among pediatric cases with ADHD was ODD (31.25%), followed by nocturnal enuresis (23.44%), conduct disorders (18.75%), motor tic disorders (15.63%), anxiety disorders (12.50%), depressive disorders (10.94%), substance abuse disorders (9.38%), autism spectrum disorders (7.81%), vocal tic disorders (1.56%). There was a statistically significant difference between gender and conduct disorder and SUDs (P <0.05). There was no significant difference in the distribution of comorbidities among subtypes except for conduct disorder (P<0.05). There was a significant difference between comorbidities and severity of ADHD, according to the Conners scale (P<0.05). There was a significant difference between comorbidities number and different CBCL parameters (P<0.05). There was a significant negative correlation between the number of comorbidities and total competence and positive correlation with the total problem (P<0.05). Conclusions: The presence of comorbid disorders among pediatric cases with ADHD is the rule rather than the exception. Oppositional defiant disorder, followed by nocturnal enuresis, are the most common comorbid diseases. Comorbidities number is negatively correlated with total competence and positively correlated with the total problem.

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Impact of psychiatric comorbidities on emergency surgical patients’ outcomes

BJPsych Open ◽

10.1192/bjo.2021.647 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S242-S243

Author(s):

Hongying Chen ◽

Michael Devine ◽

Waqar Khan ◽

Iqbal Z Khan ◽

Ronan P Waldron ◽

...

Keyword(s):

Intellectual Disability ◽

University Hospital ◽

Discharge Destination ◽

Electronic Patient Records ◽

Psychiatric Comorbidities ◽

Medical Disorders ◽

Inpatient Outcomes ◽

Wide Range ◽

Significant Difference ◽

The Impact

AimsPsychiatric disorders are increasingly prevalent and present as a comorbidity in many hospitalized patients. Studies have demonstrated that the presence of comorbid psychiatric conditions (CPC) is associated with worsened inpatient outcomes. Emergency surgical admissions and the impact of CPC on their outcomes has not been studied in Ireland to date. This study aims to provide a comprehensive analyses of the relationship between a wide range of psychiatric comorbidities and surgical presentations.MethodThe Hospital In-Patient Enquiry (HIPE) and prospectively maintained electronic patient records were used to identify all surgical emergency admissions between 31st August 2019 and 1st September 2020 to Mayo University Hospital, Ireland. Patient demographics, comorbidities, primary diagnoses, length of stay (LoS), discharge destination, and surgical interventions were recorded. Subgroup analyses were performed examining LoS variation in the type of surgical presentation. Physical comorbidities were scored using the Charlson Comorbidity Index (CCI). Statistical calculations were performed using SPSS.ResultA total of 995 admissions were recorded. The presence of CPC increased the overall mean LoS by 1.9 days (p = .002). This trend was observed in both operative and conservative management. Significant increase in LoS was noted in patients with a comorbid depression (2.4 days, p = .003), dementia (2.8 days, p = .019), and intellectual disability (6.7 days, p = .007). Subgroup analysis revealed greater LoS in patients with CPC diagnosed with non-specific abdominal pain (1.4 days, p = .019), skin and soft tissue infections (2.5 days, p = .040), bowel obstruction (4.3 days, p = .047), and medical disorders (18.6 days, p = .010). The odds of nursing home or convalescence as a discharge destination was 2.44 (95% CI: 1.37–4.35, p = 0.002) in patients with CPC and the odds of self-discharge against medical advice in this population was 4.89 (95% CI: 1.43–16.70, p = 0.005). No significant difference was observed in mortality and readmission rates.ConclusionPsychiatric comorbidities significantly impact length of hospital stay and influence discharge planning in surgical inpatients. Greater vigilance is required in providing care for patients with psychiatric comorbidities, particularly those with depression, dementia and intellectual disability. Better optimisation of facilities and a more personalised approach to patients with CPC are required to improve inpatient outcomes and resource allocation.

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Pain, Anxiety, Depression, and Quality of Life in Patients with Vulvodynia

Dermatology ◽

10.1159/000503321 ◽

2019 ◽

Vol 236 (3) ◽

pp. 255-261 ◽

Cited By ~ 2

Author(s):

Maria José Tribó ◽

Carla Canal ◽

Josep-E. Baños ◽

Gemma Robleda

Keyword(s):

Quality Of Life ◽

Unknown Origin ◽

Anxiety And Depression ◽

Cross Sectional ◽

Psychiatric Comorbidities ◽

Pain Anxiety ◽

Burning Pain ◽

Anxiety Depression ◽

The Impact

Background/Aims: The term vulvodynia refers to vulvar pain of unknown origin lasting at least 3 months. Psychiatric comorbidities are a common feature and, along with pain, may severely affect patients’ wellbeing. We aimed to determine the characteristics of pain in vulvodynia, to correlate characteristics with symptoms of anxiety and depression, and to analyse the impact of these factors on patients’ quality of life. Methods: This cross-sectional observational study analysed pain, anxiety, and depression and the effects of these factors on quality of life. Pain, anxiety, and depression were assessed using validated tools in 110 women. Results: Statistical analyses found correlations between pain and anxiety and between anxiety and worsened quality of life. Patients often reported stinging, burning, pain, itching, and dyspareunia, pointing to the importance of temporal, localisation, punctate pressure, thermal, tactile sensitivity, and emotional tension characteristics. Most patients had severe pain related to psychiatric comorbidities and decreased quality of life. Conclusion: Using descriptors of pain quality and assessing anxiety and depression might help to define subgroups of patients that may benefit from different therapeutic approaches and thus enable treatments to be tailored to individual patients.

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