scholarly journals Prescription for psychiatric patients in a Brazilian public hospital: cross-sectional study

Author(s):  
Maria R. Fernandes ◽  
Laura J. Lopes ◽  
Milla P. Rocha ◽  
Laís P. Almeida ◽  
Tânia R. Ferreira ◽  
...  

Background: The growing use of psychotropic drugs has been attributed to a higher frequency of psychiatric disorders diagnosed, interaction of new drugs on the pharmaceutical market, and new therapeutic indications of existing drugs. Given this scenario, the adequacy of the use of psychotropic drugs needs to be analyzed considering the scientific evidences. Objectives: To assess the appropriateness of drug prescriptions used by psychiatric patients in a public hospital in Sorocaba, according to the best available scientific evidence, and to describe the profile of this population. Methods: This cross-sectional study collected data from clinical records of patients with psychiatric disorders hospitalized in the psychiatric sector of the Sorocaba Hospital Complex, state of São Paulo, Brazil, between August 2015 and December 2016. The outcomes measured were: inappropriate use, presence of contraindication and serious or contraindicated drug interactions, according to the information available on the Dynamed® and Micromedex® 2.0 databases. Results: Patients were predominantly adults, and diagnosed with paranoid schizophrenia or bipolar affective disorder. Antipsychotics, benzodiazepines, and lithium accounted for 84.0% (n=2,938) of the 3,500 drugs prescribed for mental disorders. There were 2,157 (61.6%) inappropriate prescriptions, of which 81.9% corresponded to antipsychotics, benzodiazepines, and lithium. There were 1,712 prescriptions with drug combinations that risked causing drug interactions, predominantly involving antipsychotic use (67.0%). Conclusion: The study revealed a high number of inappropriate prescriptions, pointing to a need for greater prescription adequacy to ensure effective safe treatment for psychiatric patients.

2021 ◽  
pp. 025371762199953
Author(s):  
Bhavneesh Saini ◽  
Pir Dutt Bansal ◽  
Mamta Bahetra ◽  
Arvind Sharma ◽  
Priyanka Bansal ◽  
...  

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.


Author(s):  
Suganya Ganesan ◽  
Nitya Selvaraj ◽  
Vinoth Krishna Dass ◽  
Nalinidevi Jayabalan ◽  
Meher Ali Rajamohammad ◽  
...  

Background: In spite of many progresses in treatment of psychiatric disorders, medication nonadherence plays an important role in worsening of clinical condition and affects quality of life among psychiatric patients. There are numerous factors contributing for medication nonadherence among patients with mental illness. So, this study was conducted to assess psychiatric patients’ adherence of medication and to improve their quality of life with psychiatric disorder. The objectives of the study were to analyze impact of pharmacophilia and pharmacophobia on medication adherence among patients with psychiatric disorders at a tertiary care hospital and to assess quality of life among pharmacophilic and pharmacophobic patients.Methods: A cross-sectional study was conducted in outpatient psychiatric department for a period of two months. After obtaining informed voluntary consent, patient’s socio-demographic details, diagnosis, and treatment were recorded from prescription slip. Patients above 18yr age with psychiatric diagnosis as per International Classification of Diseases 10 (ICD-10) and receiving at least one psychotropic medication for >1 month were enrolled in study and assessed using: Drug attitude inventory classification (DAI-10); Medication Rating Scale (MARS); Quality of life enjoyment and satisfaction Questionnaire-Short Form (Q-LES-Q-SF).Results: Among 130 patients, 116 were pharmacophilic and 14 were pharmacophobic as per DAI-10 scale. 81.9% of pharmacophilic were adherent to prescribed medication assessed using MARS scale only 14.3% were pharmacophobic. The quality of life was better in pharmacophilic compared to pharmacophobic group (p=0.002) using Q-LES-Q-SF.Conclusions: This study concluded that pharmacophilic patients have higher adherence and good quality of life index compared to pharmacophobic. Proper counselling of pharmacophobic patients by psychiatrists could improve adherence and QOL.


2020 ◽  
Author(s):  
Siyun Zou ◽  
Zi-Han Liu ◽  
Xiaona Yan ◽  
Huan Wang ◽  
Yulong Li ◽  
...  

Abstract Background: The pattern of fatigue in older psychiatric patients during the COVID-19 outbreak was unknown. This study examined the prevalence of fatigue and its association with quality of life (QOL) in clinically stable older patients with psychiatric disorders during the COVID-19 outbreak. Methods: This is a multicenter, cross-sectional study. Fatigue, depression, pain, insomnia symptoms, and QOL were assessed with standardized instruments. Results: A total of 1,063 patients were recruited. The prevalence of fatigue was 47.1% (95%CI: 44.1% - 50.1%). Analysis of covariance revealed that QOL was significantly lower in patients with fatigue compared to those without (P=0.011). Multiple logistic regression analysis revealed that more severe depression (OR=1.15, P<0.001), insomnia symptoms (OR=1.08, P<0.001) and pain (OR=1.43, P<0.001) were significantly associated with fatigue.Conclusions: Fatigue was common among clinically stable older patients with psychiatric disorders during the COVID-19 outbreak. Considering its negative impact on QOL, regular assessment of fatigue and appropriate treatment warrant attention in this subpopulation.


Author(s):  
Nadir Yalçın ◽  
Nesligül Özdemir ◽  
Halime Tuna Çak Esen ◽  
Sadriye Ebru Çengel Kültür ◽  
Kutay Demirkan

2020 ◽  
Author(s):  
Siyun Zou ◽  
Zi-Han Liu ◽  
Xiaona Yan ◽  
Huan Wang ◽  
Yulong Li ◽  
...  

Abstract Background: The pattern of fatigue in older psychiatric patients during the COVID-19 outbreak was unknown. This study examined the prevalence of fatigue and its association with overall quality of life (overall QOL) in clinically stable older patients with psychiatric disorders during the COVID-19 outbreak. Methods: This was a multicenter, cross-sectional study. Fatigue, depressive symptoms, pain, insomnia symptoms, and overall QOL were assessed with standardized instruments. Results: A total of 1,063 patients were recruited. The prevalence of fatigue was 47.1% (95%CI: 44.1% - 50.1%). An analysis of covariance revealed that overall QOL was significantly lower in patients with fatigue compared to those without (P=0.011). A multiple logistic regression analysis revealed that more severe depressive symptoms (OR=1.15, P<0.001), insomnia symptoms (OR=1.08, P<0.001) and pain (OR=1.43, P<0.001) were significantly associated with fatigue.Conclusions: Fatigue is common among clinically stable older patients with psychiatric disorders during the COVID-19 outbreak. Considering its negative impact on overall QOL, regular assessment of fatigue and appropriate treatment warrant attention in this subpopulation.


2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Siyun Zou ◽  
Zi-Han Liu ◽  
Xiaona Yan ◽  
Huan Wang ◽  
Yulong Li ◽  
...  

Abstract Background The pattern of fatigue in older psychiatric patients during the COVID-19 outbreak was unknown. This study examined the prevalence of fatigue and its association with overall quality of life (overall QOL) in clinically stable older patients with psychiatric disorders during the COVID-19 outbreak. Methods This was a multicenter, cross-sectional study. Fatigue, depressive symptoms, pain, insomnia symptoms, and overall QOL were assessed with standardized instruments. Results A total of 1063 patients were recruited. The prevalence of fatigue was 47.1% (95%CI: 44.1–50.1%). An analysis of covariance revealed that overall QOL was significantly lower in patients with fatigue compared to those without (P = 0.011). A multiple logistic regression analysis revealed that more severe depressive symptoms (OR = 1.15, P < 0.001), insomnia symptoms (OR = 1.08, P < 0.001) and pain (OR = 1.43, P < 0.001) were significantly associated with fatigue. Conclusions Fatigue is common among clinically stable older patients with psychiatric disorders during the COVID-19 outbreak. Considering its negative impact on overall QOL, regular assessment of fatigue and appropriate treatment warrant attention in this subpopulation.


2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Dilnessa Fentie ◽  
Tariku Derese ◽  
Bekele Yazie ◽  
Yibeltal Getachew

Abstract Background Metabolic syndrome is a major public health challenge in both developed and developing countries. The burden of this disease is high, even in patients with psychiatric disorders. However, very little is known about the association between metabolic syndrome and psychiatric illness in Ethiopia. Therefore, the aim of this study was to investigate the magnitude of metabolic syndrome and its components among psychiatric clients. Methods A comparative cross-sectional study was undertaken between psychiatric patients and age—and sex-matched non-psychiatric controls at the Dilchora referral hospital. The study included 192 study participants (96 psychiatric patients and 96 non- psychiatric controls from general medical and surgical patients). The National Cholesterol Education Program: Adult Treatment Panel III criteria were used to diagnose metabolic syndromes. The data were cleaned and analyzed using the Statistical Package for Social Sciences, Version 21. All intergroup comparisons for continuous data were performed using an independent sample t-test, whereas categorical data were analyzed using the Chi-square test. Logistic regression analysis was used to identify the association between metabolic syndrome and the associated variables. Results The magnitude of metabolic syndrome among psychiatric patients was 36.5% (95%CI: 27.6, 47.4) compared to non-psychiatric control patients, 21.9% (95%CI: 13.5, 30.3), p = 0.02. The prevalence of MetS components, such as waist circumference (25.0% vs. 14.3%), lower-high density lipoprotein level (35.4% vs. 20.8%), higher systolic blood pressure (41.7% vs. 29.2%) and higher fasting blood glucose (40.6% vs. 18.8%) showed statistically significant differences between the exposed and non-exposed groups. Age greater than 50 years (AOR: 2.8, CI: 1.14, 20.0, p < 0.05); being female (AOR: 7.4, CI: 2.0, 27.6, p < 0.05), being urban residence (AOR: 6.4, CI: 2.2, 20.6, p < 0.05), ever alcohol intake (AOR: 5.3, CI: 1.3, 21.2), being physically inactive (AOR: 3.52, CI: 1.1, 12.9, p < 0.05) and family history of hypertension (AOR: 2.52, CI: 1.1, 12.2, p < 0.05) were independent predictors of metabolic syndrome (p < 0.05). Conclusions There is a high burden of metabolic syndrome and its components in patients with severe psychiatric disorders. Therefore, screening and mitigation strategies for metabolic syndrome and their components should be implemented in the management of psychiatric disorders.


2021 ◽  
pp. 089198872110600
Author(s):  
Natasja Schutter ◽  
Tjalling J Holwerda ◽  
Hanna Kuipers ◽  
Rien H. L. Van ◽  
Max L. Stek ◽  
...  

purpose Loneliness in adults increases with age. Although loneliness has been found to be associated with psychiatric disorders and dementia, no information is available on prevalence of loneliness in older psychiatric patients. The aims of this study were to examine prevalence of loneliness in older psychiatric outpatients, including gender differences and associations with psychiatric disorders and social isolation. Methods Cross-sectional study in an outpatient clinic for geriatric psychiatry between September 2013 and February 2018. Interviews were done in 181 patients. Results 80% of participants were lonely. Loneliness was associated with having contacts in less social network domains, in women but not in men. There were no associations with DSM-IV-TR-classifications. However, loneliness was associated with higher scores on questionnaires for depression and cognitive function. Intensity of treatment did not differ significantly between lonely and non-lonely participants. Conclusion Loneliness is highly prevalent in older psychiatric outpatients, with men and women equally affected. Loneliness should be assessed in all older psychiatric patients, especially when they show high scores on symptom checklists or have a restricted social network.


Author(s):  
Luis Fernando Valladales-Restrepo ◽  
Nathalia Marcela Peña-Verjan ◽  
Katherine Vargas-Díaz ◽  
Jorge Enrique Machado-Alba

Aim: The objective was to determine the prevalence of the potentially inappropriate antipsychotics and anticholinergics used in patients with Parkinson's disease. Materials & methods: A cross-sectional study identified the prescription of antipsychotics, anticholinergics and drugs for the treatment of Parkinson's disease. The anticholinergic burden was evaluated, and quetiapine and clozapine were considered to be adequate antipsychotics. Results: 2965 patients with Parkinson's disease were identified. The presence of psychiatric disorders and other neurological pathologies was associated with a greater probability of receiving potentially inappropriate antipsychotic prescriptions. The presence of greater number of comorbidities was associated with a greater probability of receiving anticholinergics. Conclusion: Older age and associated comorbidities, especially psychiatric and neurological comorbidities, increase the likelihood of patients with Parkinson's disease being prescribed antipsychotics and anticholinergics.


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