Somatic multicomorbidity and disability in patients with psychiatric disorders in comparison to the general population: a quasi-epidemiological investigation in 54,826 subjects from 40 countries (COMET-G study).

BACKGROUND: The prevalence of medical illnesses is high among patients with psychiatric disorders. The current study aimed to investigate multi-comorbidity in patients with psychiatric disorders in comparison to the general population. Secondary aims were to investigate factors associated with metabolic syndrome and treatment appropriateness of mental disorders. METHODS: The sample included 54,826 subjects (64.73% females; 34.15% males; 1.11% nonbinary gender) from 40 countries (COMET-G study). The analysis was based on the registration of previous history that could serve as a fair approximation for the lifetime prevalence of various medical conditions. RESULTS: About 24.5% reported a history of somatic and 26.14% of mental disorders. Mental disorders were by far the most prevalent group of medical conditions. Comorbidity of any somatic with any mental disorder was reported by 8.21%. One-third to almost two-thirds of somatic patients were also suffering from a mental disorder depending on the severity and multicomorbidity. Bipolar and psychotic patients and to a lesser extent depressives, manifested an earlier (15-20 years) manifestation of somatic multicomorbidity, severe disability, and probably earlier death. The overwhelming majority of patients with mental disorders were not receiving treatment or were being treated in a way that was not recommended. Antipsychotics and antidepressants were not related to the development of metabolic syndrome. CONCLUSIONS: The finding that one-third to almost two-thirds of somatic patients also suffered from a mental disorder strongly suggests that psychiatry is the field with the most trans-specialty and interdisciplinary value and application points to the importance of teaching psychiatry and mental health in medical schools and also to the need for more technocratically oriented training of psychiatric residents.

Results of the COVID-19 mental health international for the health professionals (COMET-HP) study: depression, suicidal tendencies and conspiracism.

INTRODUCTION: The current study aimed to investigate the rates of anxiety, clinical depression, and suicidality and their changes in health professionals during the COVID-19 outbreak. MATERIALS AND METHODS: The data came from the larger COMET-G study. The study sample includes 12,792 health professionals from 40 countries (62.40% women aged 39.76 ± 11.70; 36.81% men aged 35.91 ± 11.00 and 0.78% non-binary gender aged 35.15 ± 13.03). Distress and clinical depression were identified with the use of a previously developed cut-off and algorithm, respectively. STATISTICAL ANALYSIS: Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses, and Factorial Analysis of Variance (ANOVA) tested relations among variables. RESULTS: Clinical depression was detected in 13.16% with male doctors and 'non-binary genders' having the lowest rates (7.89 and 5.88% respectively) and 'non-binary gender' nurses and administrative staff had the highest (37.50%); distress was present in 15.19%. A significant percentage reported a deterioration in mental state, family dynamics, and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (24.64% vs. 9.62%; p < 0.0001). Suicidal tendencies were at least doubled in terms of RASS scores. Approximately one-third of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop clinical depression was associated with a history of Bipolar disorder (RR = 4.23). CONCLUSIONS: The current study reported findings in health care professionals similar in magnitude and quality to those reported earlier in the general population although rates of clinical depression, suicidal tendencies, and adherence to conspiracy theories were much lower. However, the general model of factors interplay seems to be the same and this could be of practical utility since many of these factors are modifiable.

Evaluation of mental health and occupational stress in Mexican medical residents / Evaluación de la salud mental y el estrés laboral en médicos residentes mexicanos

Abstract Introduction Since mental health disorders are an emerging problem in medical residents, its detection and attention must be a priority. Objetive To compare the frequency of psychopathology in residents according to sociodemographic and clinical characteristics. Method We conducted a cross-sectional study evaluating the presence of psychopathology, as well as sociodemographic and clinical characteristics in 644 residents through online questionnaires. Results Among participants, 55.7% reported a psychiatric disorder at some point and 29.2% a current one; only 41.5% were under treatment. Additionally, 8.1% had attempted suicide, of which 32.4% attempted it during residency. We found that 6.5% of women and 3.3% of men presented "risk of psychopathology," with a higher percentage of men presenting "severe psychopathology." Individuals with "risk of psychopathology" presented significantly higher scores on all of the questionnaires, compared to those with "absence of psychopathology." Discussion and conclusion Residents with occupational stress also presented higher risks of psychopathology, suicide, and substance use. Being under psychiatric treatment significantly improved the scores on the different scales. Because residency is a period that may increase the probability of suffering psychopathology, interventions should be aimed at reducing occupational stress and bringing specialized care.

Resumen Introducción Dado que los trastornos de salud mental son un problema emergente en los médicos residentes, su detección y atención deben ser una prioridad. Objetivo Comparar la frecuencia de psicopatología en médicos residentes de acuerdo con las características clínicas y sociodemográficas. Método Realizamos un estudio transversal donde evaluamos la presencia de psicopatología, así como características clínicas y sociodemográficas en 644 médicos residentes por medio de cuestionarios en línea. Resultados Entre los participantes, el 55.7% reportó haber tenido un trastorno psiquiátrico en algún momento de su vida y el 29.2% al momento del estudio, de los cuales solo el 41.5% estaba bajo tratamiento psiquiátrico. Asimismo, el 8.1% había intentado suicidarse a lo largo de su vida y el 32.4% lo intentó durante la residencia. Encontramos que el 6.5% de las mujeres y el 3.3% de los hombres presentaban "riesgo de psicopatología", y un mayor porcentaje de hombres presentaron "psicopatología grave". Las personas con "riesgo de psicopatología" contaron con puntuaciones significativamente más altas en todos los cuestionarios, en comparación con los individuos con "ausencia de psicopatología". Discusión y conclusión Los residentes con estrés laboral también presentaron mayor riesgo de psicopatología, suicidio y uso de sustancias. Estar bajo tratamiento psiquiátrico mejoró significativamente los puntajes en las diferentes escalas. Debido a que la residencia es un período que puede aumentar la probabilidad de sufrir psicopatología, las intervenciones deben estar dirigidas a reducir el estrés ocupacional y brindar atención especializada.