Prevalence of gastroesophageal reflux disease in major depressive disorder: a population-based study.

BACKGROUND: Gastroesophageal reflux disease (GERD) is a common physical disease among psychiatric patients. OBJECTIVE: We conducted this study to investigate the prevalence and risk of GERD in patients with major depressive disorder (MDD) in Taiwan. METHODS: We conducted a cross-sectional study using the National Health Insurance Research Database in Taiwan. The study subjects included 4790 patients with MDD and 728,749 people in the general population during 2005. Distributions of GERD as well as age, gender, income, region of residence, and medical comorbidities, such as diabetes mellitus, hypertension, renal disease, hyperlipidemia, and ischemic heart disease, in the 2 groups were examined by χ(2)-tests. Multivariate logistic regression models were used to analyze the associations between MDD and GERD. RESULTS: The 1-year prevalence rates of GERD in patients with MDD and the general population were 3.75% and 1.05%, respectively. The prevalence rate of GERD was significantly higher in patients with MDD in all age, sex, insurance amount, region, and urbanicity subgroups (all p < 0.001). The multivariate logistic regression analysis showed that patients with MDD were significantly associated with an increased rate for GERD ([Odds Ratio] = 3.16; 95% Confidence Interval = 2.71-3.68; p < 0.001). CONCLUSION: The prevalence of GERD was significantly higher in patients with MDD. In clinical practice, psychiatrists should pay attention to the possibility of GERD symptoms, such as heartburn, regurgitation, or dysphagia, and should consider consulting Gastroenterology specialists when clinically indicated.

Juvenile Huntington's disease presenting as difficult-to-treat seizure and the first episode of psychosis.

OBJECTIVE: The objective was to describe a case of juvenile Huntington's disease that first presented with seizures and psychosis. METHODS: A male patient with no history of epilepsy and psychiatric disorder had his first seizure at the age of 20 years, which was followed by 3 years of psychotic disorder. RESULTS: Laboratory investigations were normal, and mild diffuse cortical atrophy was detected using magnetic resonance imaging. Both the seizures and psychosis were difficult to treat. Three years later, chorea and personality changes appeared. Genetic tests revealed an expanded allele with 60 CAG repeats, confirming the typical Huntington's disease characteristic. CONCLUSION: Patients with difficult-to-treat seizures and the first episode of psychosis should be considered for the diagnosis of juvenile Huntington's disease.