Comorbidity of Mental Disorder in Patients with Chronic Dis-ease: A Comparative Study of Heroin Dependence Patients and Diabetes Mellitus Patients

Background: Chronic patients are at greater risk for a psychiatric problem than the normal population; yet, the increased rate of mental disorder among one chronic patient compared to another chronic patient is uncertain. We aimed to assess the rate of mental disorder among people with heroin dependence and diabetes mellitus in comparison with the healthy population. Methods: This cross-sectional study was carried out in Kuala Lumpur, Malaysia in 2017-2020. The study consisted of 648 participants including heroin dependence patients, diabetes mellitus patients, and healthy population. The GHQ-28 and SCL-90-R scales were used to assess mental disorder among the study populations. Results: The current study revealed the rate of mental disorder among heroin dependence patients, diabetes mellitus patients, and healthy population respectively at 52.1%, 49.5%, and 23.2% using SCL-90-R and GHQ-28. The rate of mental disorder in both heroin dependent (OR 95%= 3.59: 2.37-5.44) and diabetic groups (OR 95%=3.25: 2.14-4.92) were significantly more than the healthy population; however, the odds ratio of mental disorder was not significantly different between heroin dependent and diabetic groups. Furthermore, the results revealed an acceptable agreement between SCL-90-R and GHQ-28 to detect mental disorders (Kappa=0.60; P<0.001). Conclusion: People with diabetes mellitus and heroin dependence have significantly poorer mental health than healthy people in Malaysia have. Furthermore, the equivalent rate of mental disorder among such patients suggests that heroin dependence patients are not more distressed than diabetes mellitus patients are. However, further comparative studies are needed to prove these findings.

Home Care as a Safe Alternative during COVID-19 Crisis

High mortality rate for the coronavirus disease (COVID-19) has been reported worldwide in nursing home residents, and the global concern about the safety of patients and professionals in these institutions is relevant. A large part of post-acute and chronic patient care in Brazil is performed at home through Home Care (HC) services. The objectives of this chapter are to describe the main measures that can be implemented in patient homes in order to keep professionals, patients, and family members safe and to analyze the safety of choosing the home as the place of care during a pandemic, especially in contrast to the results observed in long-term care facilities. COVID-19 infection data among home care patients, obtained after a year of severe epidemic in Brazil, demonstrate that home care is safe and is associated with a low incidence and low lethality related to the new coronavirus.