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Psychiatric Disorders (psychiatric + disorders)
Kinds of Psychiatric Disorders Selected AbstractsProbabilities of alcohol high-risk drinking, abuse or dependence estimated on grounds of tobacco smoking and nicotine dependenceADDICTION, Issue 6 2003Ulrich John ABSTRACT Aims, To estimate probabilities of alcohol high-risk drinking, alcohol abuse and alcohol dependence on grounds of smoking-behaviour related variables and single nicotine dependence criteria. Design, Cross-sectional population-based study. Setting, Adult population of a region in north Germany. Participants, Cigarette smokers (n = 2437) among a random sample of 4075 females and males aged 18,64, drawn in 1996. Measurement, Smoking, nicotine dependence according to the Diagnostic and Statistical Manual of Psychiatric Disorders (DSM-IV) and the Fagerström Test for Nicotine Dependence (FTND); increasing alcohol-related harm (ARH): high-risk drinking, DSM-IV alcohol abuse, remitted and current alcohol dependence diagnosed by the Composite International Diagnostic Interview (CIDI). Findings, Having smoked 30 cigarettes or more per day, onset of smoking at the age of 17 or younger, nicotine dependence and single nicotine dependence criteria revealed odds ratios higher than 4.0 for alcohol dependence. For alcohol dependence, a logistic regression model showed an increased odds ratios for male gender, smoking for 25 years or more, no attempt to quit or cut down, continuation of smoking despite problems, craving for nicotine, withdrawal experience 1 day or longer, smoking first cigarette in the morning 5 minutes or less after waking. The probability of increasing ARH was more likely in males, smokers for 25 years or more, no attempt to quit or cut down, continuation of smoking despite problems and smoking first cigarette in the morning 5 minutes or less after waking. Conclusions, Gender and single nicotine dependence criteria show particularly high probabilities of alcohol dependence and increasing ARH. Interventions need to take these connections into account. [source] Shared Mechanisms and Comorbidities in Neurologic and Psychiatric DisordersHEADACHE, Issue 2001Stephen D. Silberstein MD Migraine may be comorbid with several other neurologic and psychiatric conditions, including mood disorders (eg, depression, anxiety, panic disorder), epilepsy, stroke, and essential tremor. Comorbidity presents physicians with opportunities and challenges for both diagnosis and treatment. All diseases must be considered, and therapeutic strategies may need to be modified to avoid potential drug interactions. Comorbidities also may provide clues to the pathophysiologies and any shared mechanisms of the two disorders. Longitudinal studies have demonstrated a bidirectional influence between migraine and major depression, but not between migraine and other severe headache. Migraine is strongly and consistently associated with panic disorder. The risk of migraine in epilepsy is increased particularly in individuals with head trauma, partial seizures, and a positive family history of migraine. The influence is bidirectional. There is also growing evidence of an association between migraine and stroke, particularly among women of childbearing age and individuals who experience migraine with aura. Lastly, a bidirectional association between migraine and essential tremor also exists. These findings suggest that migraine, major depression, epilepsy, and essential tremor share one or more common etiologies. Clinicians should be mindful of them as they design treatment strategies, and also should consider the use of a single pharmacologic agent that is effective for all conditions. [source] Dual Diagnosis , Substance Misuse and Psychiatric DisordersJOURNAL OF ADVANCED NURSING, Issue 5 2005Rod Thomson MEd MSc DipAdEd DipHV RMN RGN RHV HonMFPH FRCN No abstract is available for this article. [source] Adults with intellectual disabilities: prevalence, incidence and remission of aggressive behaviour and related factorsJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 3 2009S.-A. Cooper Abstract Introduction Aggressive behaviours can be disabling for adults with intellectual disabilities (ID), with negative consequences for the adult, their family and paid carers. It is surprising how little research has been conducted into the epidemiology of these needs, given the impact they can have. This study investigates point prevalence, 2-year incidence and 2-year remission rates for aggressive behaviour (physically aggressive, destructive and verbally aggressive), and it investigates which factors are independently associated with aggressive behaviour. Methods All adults with ID , within a geographically defined area of Scotland, UK , were recruited to a longitudinal cohort. At baseline, assessments were undertaken of demography, lifestyle, supports, development, problem behaviours, disabilities and physical and mental health. These were repeated for a 2-year period. Results At baseline, the participation rate was 1023 (65.5%). After 2 years, the cohort retention was 651 adults. The point prevalence of Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation (DC-LD) aggressive behaviour was 9.8% (95% confidence interval = 8.0,11.8%), 2-year incidence was 1.8%, and 2-year remission rate from all types of aggressive behaviour meeting DC-LD criteria was 27.7%. The factors independently associated with aggressive behaviours were lower ability, female gender, not living with a family carer, not having Down syndrome, having attention-deficit hyperactivity disorder and having urinary incontinence. Incidence of aggressive behaviour meeting DC-LD criteria in adult life is similar to that for each of psychotic, anxiety and organic disorders. Conclusions Aggressive behaviour is common among adults with ID, but contrary to previous suggestions, more than a quarter remit within the short to medium term. This is important knowledge for professionals as well as the person and her/his family and paid carers. There is much yet to learn about the mechanisms underpinning aetiology and maintenance of aggressive behaviour in this population, and exploratory epidemiological investigations such as this have a role to play in progressing research towards further hypothesis testing and trials to influence clinical practice, service development and policy. [source] Psychiatric diagnosis, intellectual disabilities and Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation (DC-LD)JOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 2003Sally-Ann Cooper Abstract Background Classification of psychopathology using operationalized diagnostic criteria is one component of psychiatric assessment. Previous literature has demonstrated that there are limitations in the International Classification of Diseases,10 (ICD-10) and the Diagnostic and Statistical Manual,IV (DSM-IV) when used with adults with intellectual disabilities. Methods A literature search using Medline, PsychLIT and hand searching of key journals identified the existing literature, which was reviewed by the Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation (DC-LD) Development Working Group. Key findings are integrated into this paper. This, together with expert consensus led to the development of DC-LD, a new psychiatric classificatory system devised specifically for use with adults with intellectual disabilities. The new diagnostic criteria and classification within DC-LD were piloted with 52 field investigators drawing on 709 clinical cases. Validity of DC-LD classification was measured by comparison between the criteria providing DC-LD diagnosis and the gold standard of learning disabilities psychiatric assessment. Results In 96.3% of cases, the DC-LD diagnosis was fully concordant with that of clinical opinion. The few discrepancies related to level of detail. Conclusion DC-LD accommodates the pathoplastic effect of intellectual disabilities on psychopathology. Its use will hopefully improve clinical practice and facilitate research, but further work to determine its usefulness and limitations is required. [source] Psychosocial Factors Affecting Adults With Intellectual Disabilities With Psychiatric Disorders in Cali, ColombiaJOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 3 2009Miguel Ángel Verdugo Abstract Increases in life expectancy have heightened concerns for people with intellectual disability (ID) who are growing old and who have be designated as "dually diagnosed",that is, who have, apart from their ID, a psychiatric disorder, and who because of this conjoint condition, are subjected to social exclusion due to three factors: old age, cognitive limitation, and mental illness. The objective of this study was to describe the psychosocial factors associated with the comorbidity between ID and psychiatric disorder of adults in the city of Cali, Colombia. Subjects were 50 dyads consisting of a carer and a person with ID. The Caregivers Questionnaire and the Integral Quality of Life Scale were adapted for use in the study. The analysis of information was based on three factors: person, family, and society. In the case of the personal factor, an adequate level of physical well-being and a good level of self-care were found in more than 60% of the adults with dual diagnosis, good adherence to treatment in 82%, and medium satisfaction in the individual-context relationship in 54%. With regard to the family factor, a high level of satisfaction of needs (84%) was found. Good family functioning was observed in 86%, while family participation in rehabilitation was reported to be between moderate and deficient in 60% of the cases. With respect to the social factor, cases of support between moderate and deficient were found in 68%, and a regular inclusion was observed in 48%. The authors conclude that the family functioning aspect appeared as the major protective factor, while the inclusion and social support were shown as the main risk factors. [source] Psychiatric Disorders in Property, Violent, and Versatile Offending Detained Male AdolescentsAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 1 2009Olivier Colins MEd This study examines the past year prevalence rate of psychiatric disorders in detained male adolescents and the relation between psychiatric disorders and type of offending. The Diagnostic Interview Schedule for Children (DISC-IV) was administered in a sample (N = 245) of male detained adolescents aged 12 to 17 years. Based on lifetime official criminal history, participants were classified into property, violent, and versatile subgroups. High rates of psychiatric disorders were found in all groups. In addition, property offenders reported significantly higher rates of depression, disruptive behavior disorders, substance use disorders and comorbidity than violent and versatile offenders. Overall, versatile offenders did not differ from violent offenders, with the exception of more marijuana use disorder found in violent offenders. This study once more emphasizes that detained boys have substantial mental health needs, a finding that is generalizable across countries. In addition, the current study suggests that classifying detained juveniles by offense subgroups may carry clinical relevance. The long-term impact of these differences, and the possible effects of intervention, should be subject of further research. [source] Family History of Psychiatric Disorders and Alcohol and Substance Misuse in Patients with Bipolar I Disorder, Substance Use Disorder, or BothTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 3 2007Alfredo Sbrana MD Family history data were collected on first-degree relatives of 78 patients with bipolar I disorder (BD) and substance use disorder (SUD), 47 with BD only, and 35 with SUD only. The prevalence of psychiatric disorders was significantly higher in first-degree relatives of patients with BD + SUD (64%) and BD (61%) compared with first-degree relatives of SUD patients (20%). The prevalence of alcohol misuse was significantly higher in first-degree relatives of patients with BD + SUD (23.1%) and SUD alone (28.6%) compared to first-degree relatives of patients with BD (4.3%). Our findings suggest that BD and SUD do not share familial risk factors. [source] Substance Dependence and Other Psychiatric Disorders Among Drug Dependent Subjects: Race and Gender CorrelatesTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 2 2000Wilson M. Compton III M.D. Persons in drug treatment with drug dependence were interviewed with the NIMH Diagnostic Interview Schedule to ascertain DSM-III-R disorders. Lifetime prevalence rates were 64% for alcohol dependence, 44% for antisocial personality disorder (ASPD), 39% for phobic disorders, 24% for major depression, 12% for dysthymia, 10% for generalized anxiety disorder, 3% for panic disorder, 3% for mania, 3% for obsessive compulsive disorder, 2% for bulimia, 1% for schizophrenia, and 1% for anorexia. When stratified by race and age, significant main effects were seen, but there were no significant interactions except in "any non-substance disorder" and in the mean number of non-substance use disorders. Caucasians had a higher mean number of drug dependence disorders and higher overall rates of "any other" disorder than African-Americans, and Caucasians and males had higher mean numbers of non-substance use disorders than African-Americans and females, respectively. This was related to rates of alcohol, cannabis, and hallucinogen dependence, and ASPD rates that were higher among men than women and higher among Caucasian respondents than African-American for alcohol, cannabis, hallucinogen, opiate and sedative dependence, major depression, dysthymia, and generalized anxiety disorder. In contrast, women had higher rates than men of amphetamine dependence, phobic disorder, major depression, dysthymia, panic disorder, obsessive compulsive disorder, and mania. African-Americans had higher rates than Caucasians of amphetamine, cocaine, and phencyclidine dependence, but for no comorbid disorders were the rates higher among African-Americans than Caucasians. The differences according to gender in rates of disorders among substance dependent persons are consistent with the results of general population surveys, but the differences in rates according to race are in contrast to these same community surveys. Limitations in the utility of the concept of race as a valid category diminish the generalizability of the findings; however, one possible explanation is differential treatment seeking in African-American and Caucasian populations that would result in the differences seen. [source] Mental health economic studies from developing countries reviewed in the context of those from developed countriesACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2000A. Shah Objective: Mental health economic studies from developing countries were reviewed in the context of such studies from developed countries. Method: Mental health economic studies were ascertained through a systematic Medline search, chasing references at the end of papers acquired from the initial medline search and details of studies furnished by members of the WHO collaborating centre. Results: Only a small number of mental health economic studies from developing countries were identified. They were mainly cost-of-illness and cost-effectiveness studies. Conclusion: Psychiatric disorders impose a significant burden in developing countries. It is not always possible to extrapolate findings from developed countries to developing countries. Potential avenues for future research and development are discussed. [source] Research Submission: Chronic Headache and Comorbibities: A Two-Phase, Population-Based, Cross-Sectional StudyHEADACHE, Issue 8 2010Ariovaldo Da Silva Jr MD Background., Studies using resources of a public family health program to estimate the prevalence of chronic daily headaches (CDH) are lacking. Objectives., To estimate the 1-year prevalence of CDH, as well as the presence of associated psychiatric and temporomandibular disorders (TMD) comorbidities, on the entire population of a city representative of the rural area of Brazil. Methods., This was a cross-sectional, population-based, 2-phase study. In the first phase, health agents interviewed all individuals older than 10 years, in a rural area of Brazil. In the second stage, all individuals who reported headaches on 4 or more days per week were then evaluated by a multidisciplinary team. CDH were classified according to the second edition of the International Classification of Headache Disorders (ICHD-2). Medication overuse headache was diagnosed, as per the ICHD-2, after detoxification trials. Psychiatric comorbidities and TMD were diagnosed based on the DSM-IV and on the Research Diagnostic Criteria for Temporomandibular Disorders criteria, respectively. Results., A total of 1631 subjects participated in the direct interviews. Of them, 57 (3.6%) had CDH. Chronic migraine was the most common of the CDH (21, 36.8%). Chronic tension-type headache (10, 17.5%), medication overuse headache (13, 22.8%) and probable medication overuse headache (10, 17.5%) were also common. Psychiatric disorders were observed in 38 (67.3%) of the CDH subjects. TMD were seen in 33 (58.1)% of them. Conclusions., The prevalence of CDH in the rural area of Brazil is similar to what has been reported in previous studies. A significant proportion of them have psychiatric comorbidities and/or TMD. In this sample, comorbidities were as frequent as reported in convenience samples from tertiary headache centers. (Headache 2010;50:1306-1312) [source] Major affective disorders and schizophrenia: a common molecular signature?,HUMAN MUTATION, Issue 9 2006Ann Van Den Bogaert Abstract Psychiatric disorders, including affective disorders (AD) and schizophrenia (SZ) are among the most common disabling brain diseases in Western populations and result in high costs in terms of morbidity as well as mortality. Although their etiology and pathophysiology is largely unknown, family-, twin-, and adoption studies argue for a strong genetic determination of these disorders. These studies indicate that there is between 40 and 85% heritability for these disorders but point also to the importance of environmental factors. Therefore, any research strategy aiming at the identification of genes involved in the development of AD and SZ should account for the complex nature (multifactorial) of these disorders. During the last decade, molecular genetic studies have contributed a great deal to the identification of genetic factors involved in complex disorders. Here we provide a comprehensive review of the most promising genes for AD and SZ, and the methods and approaches that were used for their identification. Also, we discuss the current knowledge and hypotheses that have been formulated regarding the effect of variations on protein functioning as well as recent observations that point to common molecular mechanisms. Hum Mutat 27(9), 833,853, 2006. © 2006 Wiley-Liss, Inc. [source] Psychiatric disorders and the use of mental health services among children involved in bullyingAGGRESSIVE BEHAVIOR, Issue 2 2001Kirsti Kumpulainen Abstract This study had two aims: to evaluate the relationship between bullying and psychiatric disorders and to study the probability of using mental health services among children involved in bully/victim problems. The data consisted of interviews with 423 parents and 420 children. Diagnostic measures were based on the Isle of Wight Interview. Children involved in bullying as bullies, bully-victims, and victims were compared with other children. Children involved in bully/victim problems were more prone to have psychiatric disorders than noninvolved children. The probability of being disturbed was highest among male bullies, followed by male bully-victims and female victims (9.5-fold, 7.9-fold, and 4.3-fold, respectively) compared with noninvolved same-sex children. The most common diagnoses among children involved in bully/victim problems were attention deficit disorder, oppositional/conduct disorder, and depression. Furthermore, children involved in bully/victim problems were more likely to have used mental health services at some time during their lives and also during the previous 3 months. Special attention should be paid to children's mental health when dealing with bullying problems at school. Referral pathways to mental health services and factors affecting the referral processes among children should be further studied. Aggr. Behav. 27:102,110, 2001. © 2001 Wiley-Liss, Inc. [source] Psychiatric disorders and family functioning in children and adolescents with functional abdominal pain syndromeJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 7pt1 2008Ahmad Ghanizadeh Abstract Background and Aim:, Functional abdominal pain syndrome (FAPS) is a functional gastrointestinal disorder. There is a heightened risk when conducting potentially dangerous and unnecessary medical investigations and procedures in children with FAPS. The aim of this study was to survey the rate of the psychiatric disorders and family functioning in children and adolescents with FAPS. Methods:, The subjects were a consecutive new sample of 45 children and adolescents with FAPS, 45 with an organic abdominal pain, and 45 pain-free comparison subjects aged 5,18 years that were interviewed using the Farsi version of K-SADS. Family functioning and the severity of pain were also studied. Results:, About 51.1% of patients with FAPS suffered from at least one psychiatric disorder. Psychiatric disorders in the FAPS patients studied included general anxiety disorder (8.9%), obsessive-compulsive disorder (11.1%), attention deficit hyperactivity disorder (15.6%), separation anxiety disorder (24.4%), and major depressive disorder (15.6%). Except for generalized anxiety disorder and tic disorder, the other disorders were significantly more common in the FAPS group than in the two other control groups. Family functioning scores were not significantly different between groups. Discussion:, There is a high rate of psychiatric disorders in children and adolescents with FAPS in Iran, but our study found fewer incidences of disorders than previous reports have indicated. Family dysfunction difficulties in FAPS children are not more common than those in the control groups. [source] Sensory impairments, intellectual disability and psychiatryJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 6 2001S. Carvill Abstract The present review looks at: (1) prevalence studies of sensory impairments in people with intellectual disability (ID); (2) studies looking at psychological and psychiatric disorders in people with sensory impairments; and (3) studies that have examined the association of sensory impairments with autism. Research has indicated that sensory impairments are more common in people with ID. Psychiatric disorders are believed to be more common in children with visual impairment (VI) when associated with other handicaps. Some authors believe that hearing impairment (HI) can result in personality disorders. Studies have also shown a higher prevalence of psychiatric disorders in children with HI and a higher incidence of deaf people in psychiatric hospitals than in the general population. Psychiatric disorders in children with HI are particularly associated with low IQ and low communication ability, especially in those with multiple handicaps. There is little evidence for a higher incidence of schizophrenia in people with HI. Blind people demonstrate many autistic-like features and there has been discussion in the literature as to their cause. Deaf people also demonstrate some similar features to those in autism, but an association with autism has not been conclusively made. Deaf-blind people commonly demonstrate problem behaviour (e.g. self-injury). Usher syndrome, which is the most common cause of deaf-blindness, is associated with psychiatric disorders, particularly psychosis. The need for assessment of sensory functioning in people with ID, the difficulties inherent in this and the need for specialist services is stressed. [source] Psychiatric disorders in advanced cancerCANCER, Issue 8 2007Michael Miovic MD Abstract BACKGROUND. Emotional distress and psychiatric disorders are common among patients with advanced cancer. Oncologists play an important role in screening for these conditions, providing first-line treatment and referring patients for further evaluation and treatment when indicated. METHODS. The literature on psycho-oncology was reviewed, focusing on the epidemiology, assessment, and treatment of psychiatric disorders (adjustment disorders, major depression, anxiety and post-traumatic stress, personality disorders, substance abuse, and major mental disorders such as schizophrenia and bipolar disorder) in patients with advanced cancer. Communication skills and the role of the oncologist in dealing with end-of-life issues were also reviewed. Relevant data were summarized from the most recent systematic reviews, epidemiological studies, and intervention trials. Clinical recommendations are provided. RESULTS. About 50% of patients with advanced cancer meet criteria for a psychiatric disorder, the most common being adjustment disorders (11%,35%) and major depression (5%,26%). Both psychosocial and pharmacological treatments are effective for anxiety and depression, although existing studies have methodological limitations. Collaboration with mental health specialists is recommended for patients with personality disorders, major mental illness, and substance abuse problems. Effective communication involves active listening, exploring emotion and meaning, addressing prognosis, and discussing end-of-life issues when relevant. CONCLUSIONS. Treating psychiatric conditions improves quality of life in patients with advanced cancer. Oncologists play a key role in screening for psychiatric disorders, initiating first-line treatments for depression and anxiety, and communicating with patients and caregivers about prognosis and end-of-life issues. Cancer 2007. © 2007 American Cancer Society. [source] Relating psychiatric disorders, offender and offence characteristics in a sample of adolescent sex offenders and non-sex offendersCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 1 2007A.Ph. Van Wijk Introduction,Several studies have paid attention to the relationship between psychiatric disorders and adolescent offending but few have distinguished different types of offenders, especially within the category of youngsters who have committed sex offences. Aim,To test for relationships between psychiatric disorder and specific offence category among young male offenders. Method,Nationwide data were extracted from Dutch Forensic Psychiatric Services (FPD) files for five groups of offenders, as defined by their index offence: 308 violent sex offenders; 134 non-violent sex-offenders; 270 sex offenders against children; 3148 violent offenders and 1620 offenders charged with any crime other than interpersonal body contact crimes. They were compared on individual characteristics and psychiatric diagnoses according to DSM-IV criteria. Having a diagnosis of a paraphilia alone was exclusively associated with sex offending, therefore all such youths were excluded from further analyses. The OVERALS technique was used to explore possible relationships between offence, psychiatric diagnoses, sociodemographic and individual characteristics among the remaining young men for whom all pertinent data were available (n = 1894). Results,Sex offenders constituted a distinct group of juvenile delinquents. Developmental disorders were more common among non-violent sex offenders and child molesters. Violent offences were more typical of delinquents from immigrant backgrounds. Conclusion,Group differences in types of psychiatric diagnoses may reflect differences in aetiological factors for the various types of sexual and other delinquent behaviour, and this would be worthy of further study. Copyright © 2007 John Wiley & Sons, Ltd. [source] Brief communication: A randomized study of iterative hypothesis testing in undergraduate psychiatric educationACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2010K. G. Kahl Kahl KG, Alte C, Sipos V, Kordon A, Hohagen F, Schweiger U. A randomized study of iterative hypothesis testing in undergraduate psychiatric education. Objective:, Iterative hypothesis testing (IHT) or related strategies of diagnostic decision making have been taught in many curricula for medical students but not in psychiatry. We therefore asked whether the addition of training in IHT may add to the quality of the psychiatry course. Method:, Seventy-two medical students were randomized to four weeks problem-based learning or to IHT. Knowledge and skills of the students were tested using a multiple choice exam and simulated patients. Results:, Iterative hypothesis testing-trained students recognized more diagnostic items and more often identified comorbid psychiatric disorders and acute suicidal tendencies. Acquisition of general psychiatric knowledge and global satisfaction with the course were similar in both groups. Conclusion:, We conclude that teaching IHT to medical students may enhance their clinical ability to recognize complex disease patterns. Further studies are required concerning the enhancement of clinical skills in the psychiatric specialty. [source] The relationship between major depression and marital disruption is bidirectionalDEPRESSION AND ANXIETY, Issue 12 2009Andrew G. Bulloch Ph.D. Abstract Background: Marital status is important to the epidemiology of psychiatric disorders. In particular, the high prevalence of major depression in individuals with separated, divorced, or widowed status has been well documented. However, the literature is divided as to whether marital disruption results in major depression and/or vise versa. We examined whether major depression influences changes of marital status, and, conversely, whether marital status influences the incidence of this disorder. Methods: We employed data from the longitudinal Canadian National Population Health Survey (1994,2004), and proportional hazards models with time-varying covariates. Results: Major depression had no effect on the proportion of individuals who changed from single to common-law, single to married, or common-law to married status. In contrast, exposure to depression doubled the proportion of transitions from common-law or married to separated or divorced status (HR=2.0; 95% CI 1.4,2.9 P<0.001). Conversely an increased proportion of nondepressed individuals with separated or divorced status subsequently experienced major depression (hazard ratio, HR=1.3; 95% CI 1.0,1.5 P=0.04). Conclusion: The high prevalence of major depression in separated or divorced individuals is due to both an increased risk of marital disruption in those with major depression, and also to the higher risk of this disorder in those with divorced or separated marital status. Thus a clinically significant interplay exists between major depression and marital status. Clinicians should be aware of the deleterious impact of major depression on marital relationships. Proactive management of marital problems in clinical settings may help minimize the psycho-social "scar" that is sometimes associated with this disorder. Depression and Anxiety, 2009. © 2009 Wiley-Liss, Inc. [source] Genetics of anxiety disorders: the complex road from DSM to DNA,DEPRESSION AND ANXIETY, Issue 11 2009Jordan W. Smoller M.D. Sc.D. Abstract Anxiety disorders are among the most common psychiatric disorders, affecting one in four individuals over a lifetime. Although our understanding of the etiology of these disorders is incomplete, familial and genetic factors are established risk factors. However, identifying the specific casual genes has been difficult. Within the past several years, advances in molecular and statistical genetic methods have made the genetic dissection of complex disorders a feasible project. Here we provide an overview of these developments, with a focus on their implications for genetic studies of anxiety disorders. Although the genetic and phenotypic complexity of the anxiety disorders present formidable challenges, advances in neuroimaging and experimental animal models of anxiety and fear offer important opportunities for discovery. Real progress in identifying the genetic basis of anxiety disorders will require integrative approaches that make use of these biologic tools as well as larger-scale genomic studies. If successful, such efforts may yield novel and more effective approaches for the prevention and treatment of these common and costly disorders. Depression and Anxiety, 2009. © 2009 Wiley-Liss, Inc. [source] Obsessive-compulsive disorder among African Americans and blacks of Caribbean descent: results from the national survey of American life,DEPRESSION AND ANXIETY, Issue 12 2008Joseph A. Himle Ph.D. Abstract Background: There is limited research regarding the nature and prevalence of obsessive-compulsive disorder (OCD) among various racial and ethnic subpopulations within the United States, including African Americans and blacks of Caribbean descent. Although heterogeneity within the black population in the United States has largely been ignored, notable differences exist between blacks of Caribbean descent and African Americans with respect to ethnicity, national heritage, and living circumstances. This is the first comprehensive examination of OCD among African Americans and blacks of Caribbean descent. Methods: Data from the National Survey of American Life, a national household probability sample of African Americans and Caribbean blacks in the United States, were used to examine rates of OCD among these groups. Results: Lifetime and 12-month OCD prevalence estimates were very similar for African Americans and Caribbean blacks. Persistence of OCD and rates of co-occurring psychiatric disorders were very high and also similar between African American and Caribbean black respondents. Both groups had high levels of overall mental illness severity and functional impairment. Use of services was low for both groups, particularly in specialty mental health settings. Use of anti-obsessional medications was also rare, especially among the Caribbean black OCD population. Conclusions: OCD among African Americans and Caribbean blacks is very persistent, often accompanied by other psychiatric disorders, and is associated with high overall mental illness severity and functional impairment. It is also likely that very few blacks in the United States with OCD are receiving evidence-based treatment and thus considerable effort is needed to bring treatment to these groups. Depression and Anxiety, 2008. Published 2008 Wiley-Liss, Inc. [source] Sleep-related memory consolidation in depression: an emerging field of researchDEPRESSION AND ANXIETY, Issue 12 2008Orla Patricia Hornung Ph.D. Abstract Sleep-related memory consolidation has received increasing attention in recent years. Because previous research has focused on healthy young adults, only very few studies have been conducted in patients with psychiatric disorders so far. The investigation of sleep-related memory consolidation in depression offers a wide range of future research opportunities and can therefore be regarded as an emerging field of research. This article gives a short overview of current knowledge of sleep-related memory consolidation in healthy young adults and builds a bridge to psychiatry and depression, where further research is urgently needed. Depression and Anxiety, 2008. © 2007 Wiley-Liss, Inc. [source] Psychometric evaluation of the mini-social phobia inventory (Mini-SPIN) in a treatment-seeking sample,DEPRESSION AND ANXIETY, Issue 6 2007Justin W. Weeks M.A. Abstract The Mini-Social Phobia Inventory (Mini-SPIN) is a 3-item, self-rated screening instrument to assess social anxiety disorder, but its psychometric properties have not yet been examined in a sample seeking treatment for psychiatric disorders. We analyzed responses from 291 adults who telephoned the Adult Anxiety Clinic of Temple (AACT) seeking treatment for social anxiety or generalized anxiety and worry. The Mini-SPIN demonstrated strong internal consistency. Support for the convergent validity of the Mini-SPIN was provided by moderate correlations with several self-report measures and a clinician-administered measure of social anxiety completed by the subsample of callers who later came to the AACT for evaluation. Furthermore, the Mini-SPIN correlated significantly with two of three measures of functional disability, but not with a measure of life satisfaction. Correlations with measures of other constructs were nonsignificant, providing support for the discriminant validity of the Mini-SPIN. In addition, a cutoff score of 6 on the Mini-SPIN yielded strong sensitivity and diagnostic efficiency in the subsample of treatment seekers that later completed pretreatment evaluation, although the specificity of this cutoff score was not optimal in this sample. Overall, the Mini-SPIN demonstrated sound psychometric properties in this treatment-seeking sample. Depression and Anxiety 24:382,391, 2007. Published 2006 Wiley-Liss, Inc. [source] Prevalence of social phobia and its comorbidity with psychiatric disorders in IranDEPRESSION AND ANXIETY, Issue 7 2006Mohammad-Reza Mohammadi M.D. Abstract This study explored the prevalence of social phobia (SP) in the general population of Iran, the sociodemographic characteristics of subjects with SP, and its comorbidity with the other lifetime psychiatric disorders. Our study was part of the nationwide study on the prevalence of psychiatric disorders in Iran. Overall, 25,180 Iranian subjects, age 18 years and over, from urban and rural areas of Iran were selected by a clustered random sampling method and interviewed face-to-face by 250 trained clinical psychologists using DSM-IV diagnostic criteria. Out of 12,398,235 households, 7,795 households in the form of 1,559 clusters of five households were selected. The statistical framework was based on the household lists available from the Department of Health in the provinces. The response rate was 90%. The lifetime prevalence of SP was 0.82%. The rate was 0.4% in males and 1.3% in females. The rate was higher in younger age groups and widows/widowers. It was not related to educational level and residential area. Specific phobia (66.7%), obsessive,compulsive disorder (17.4%), major depressive disorder (15%), and panic disorder (12.1%) were the most common lifetime psychiatric disorders among subjects with SP. The rate of SP in Iran is more similar to that in other Asian countries, and it is lower than that in Western countries. The rate of other psychiatric disorders among subjects with SP is more than that in the general population, and the most common psychiatric disorders were the other anxiety disorders and major depressive disorder. Depression and Anxiety 23:405,411, 2006 © 2006 Wiley-Liss, Inc. [source] Regional cerebral brain metabolism correlates of neuroticism and extraversionDEPRESSION AND ANXIETY, Issue 3 2006Thilo Deckersbach Ph.D. Abstract Factor-analytic approaches to human personality have consistently identified several core personality traits, such as Extraversion/Introversion, Neuroticism, Agreeableness, Consciousness, and Openness. There is an increasing recognition that certain personality traits may render individuals vulnerable to psychiatric disorders, including anxiety disorders and depression. Our purpose in this study was to explore correlates between the personality dimensions neuroticism and extraversion as assessed by the NEO Five-Factor Inventory (NEO-FFI) and resting regional cerebral glucose metabolism (rCMRglu) in healthy control subjects. Based on the anxiety and depression literatures, we predicted correlations with a network of brain structures, including ventral and medial prefrontal cortex (encompassing anterior cingulate cortex and orbitofrontal cortex), insular cortex, anterior temporal pole, ventral striatum, and the amygdala. Twenty healthy women completed an 18FFDG (18F-fluorodeoxyglucose) positron emission tomography (PET) scan at rest and the NEO-FFI inventory. We investigated correlations between scores on NEO-FFI Neuroticism and Extraversion and rCMRglu using statistical parametric mapping (SPM99). Within a priori search territories, we found significant negative correlations between Neuroticism and rCMRglu in the insular cortex and positive correlations between Extraversion and rCMRglu in the orbitofrontal cortex. No significant correlations were found involving anterior cingulate, amygdala, or ventral striatum. Neuroticism and Extraversion are associated with activity in insular cortex and orbitofrontal cortex, respectively. Depression and Anxiety 23:133,138, 2006. © 2006 Wiley-Liss, Inc. [source] Panic disorder and suicidal ideation in primary careDEPRESSION AND ANXIETY, Issue 1 2006Daniel J. Pilowsky M.D., M.P.H. Abstract The purpose of this study was to ascertain whether panic disorder (PD) and suicidal ideation are associated in an inner-city primary care clinic and whether this association remains significant after controlling for commonly co-occurring psychiatric disorders. We surveyed 2,043 patients attending a primary care clinic using the Primary Care Evaluation of Mental Disorders (PRIME-MD) Patient Health Questionnaire, a screening instrument that yields provisional diagnoses of selected psychiatric disorders. We estimated the prevalence of current suicidal ideation and of common psychiatric disorders including panic disorder and major depression. A provisional diagnosis of current PD was received by 127 patients (6.2%). After adjusting for potential confounders (age, gender, major depressive disorder [MDD], generalized anxiety disorder, and substance use disorders), patients with PD were about twice as likely to present with current suicidal ideation, as compared to those without PD (adjusted odds ratio [AOR]=1.84; 95% confidence interval [CI]: 1.06,3.18; P=.03). After adjusting for PD and the above-mentioned potential confounders, patients with MDD had a sevenfold increase in the odds of suicidal ideation, as compared to those without MDD (AOR=7.00; 95% CI: 4.42,11.08; P<.0001). Primary care patients with PD are at high risk for suicidal ideation, and patients with PD and co-occurring MDD are at especially high risk. PD patients in primary care thus should be assessed routinely for suicidal ideation and depression. Depression and Anxiety 23:11,16, 2006. © 2005 Wiley-Liss, Inc. [source] Patterns of comorbidity in panic disorder and major depression: findings from a nonreferred sampleDEPRESSION AND ANXIETY, Issue 2 2005Joseph Biederman M.D. Abstract Previous findings in referred adult samples document major depression as having important moderating effects on the patterns of comorbidity for panic disorder and major depression. This study evaluated whether these patterns of comorbidity are moderated by referral bias. Panic disorder (PD) and major depression (MD) were used to predict the risk for comorbid psychiatric disorders and functional outcomes using data from a large sample of adults who had not been ascertained on the basis of clinical referral (N=1,031). Participants were comprehensively assessed with structured diagnostic interview methodology to evaluate childhood and adult comorbid psychiatric disorders. PD increased the risk for anxiety disorders, independently of MD. MD increased the risk for mania, antisocial personality disorder, psychoactive substance use disorder, disruptive behavior disorders, overanxious disorder, social phobia, and generalized anxiety disorder, independently of PD. These results extend to nonreferred samples' previously reported findings documenting that MD has important moderating effects on patterns of comorbidity for PD and indicate that patterns of comorbidity for PD are not due to referral bias. Depression and Anxiety 21:55,60, 2005. © 2005 Wiley-Liss, Inc. [source] Problematic internet use: Proposed classification and diagnostic criteriaDEPRESSION AND ANXIETY, Issue 4 2003Nathan A. Shapira M.D., Ph.D. Abstract Since the mid-1990s, there have been frequent reports of individuals whose use of the computer and internet is problematic. Given the recent expansion and the expected increase in internet availability and usage in the coming years, it is important that healthcare professionals be informed about this behavior and its associated problems. Recently, psychological and psychiatric literature has described individuals that exhibit problematic internet use who often suffer from other psychiatric disorders. In the face of this comorbidity, it is essential to evaluate whether these individuals represent a distinct class of disorder, or a manifestation/coping mechanism related to other underlying diagnosis. In either event, problematic internet use negatively impacts social and emotional functioning. Based on the current limited empirical evidence, problematic internet use may best be classified as an impulse control disorder. It is therefore imperative that problematic internet use be appropriately identified among symptomatic individuals. For these reasons, we propose specific diagnostic criteria that will allow for consistent identification and assist in further study of this behavior. Depression and Anxiety 17:207,216, 2003. © 2003 Wiley-Liss, Inc. [source] The current status of urban-rural differences in psychiatric disordersACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2010J. Peen Peen J, Schoevers RA, Beekman AT, Dekker J. The current status of urban,rural differences in psychiatric disorders. Objective:, Reviews of urban,rural differences in psychiatric disorders conclude that urban rates may be marginally higher and, specifically, somewhat higher for depression. However, pooled results are not available. Method:, A meta-analysis of urban,rural differences in prevalence was conducted on data taken from 20 population survey studies published since 1985. Pooled urban,rural odds ratios (OR) were calculated for the total prevalence of psychiatric disorders, and specifically for mood, anxiety and substance use disorders. Results:, Significant pooled urban,rural OR were found for the total prevalence of psychiatric disorders, and for mood disorders and anxiety disorders. No significant association with urbanization was found for substance use disorders. Adjustment for various confounders had a limited impact on the urban,rural OR. Conclusion:, Urbanization may be taken into account in the allocation of mental health services. [source] From age correction to genome-wide associationACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2009S. Cohen-Woods Objective:, Eric Strömgren was one of the pioneers of psychiatric genetics and family studies. There has now been an explosion of interest in this field and research progress, including linkage and association studies, whole genome genotyping, copy number variants and epigenetics is reviewed here. Method:, An overview of this area of psychiatric research is presented and discussed based on the relevant literature aiming at giving a recent status of the progress. Results:, Broadly speaking linkage and association are complementary approaches used to locate genes contributing to the genetic aetiology of psychopathology. Linkage can be detected over comparatively large distances, however power is problematic when searching for quantitative trait loci with small effect sizes. In contrast, association studies can detect small effects but only over very small distances. Therefore, while several genome-wide linkage studies in psychiatric disorders have been performed, the majority of association studies have investigated specific functional candidate genes. Conclusion:, Due to very recent technological advancements, genome-wide association studies have now become possible and have identified some completely novel susceptibility loci. Other recent advances include the discovery of epigenetic phenomena and copy number variants. [source] | |||||||||||||||||||||||||||||||||||||||||||