Psychiatric Morbidity in Irritable Bowel Syndrome.

Psychiatric morbidity is frequent among outpatients with Irritable Bowel Syndrome (IBS) attending gastroenterology clinics. The lifetime prevalence of major depressive and anxiety disorders in IBS patients are up to 76% and 54% respectively. The point prevalence of Major depressive disorder and Anxiety disorders in IBS patients are ranged 9.6 to 54% and from 11.1 to 52.4% respectively. IBS is not usually life-threatening but it has a significant impact on quality of life. So, screening for psychiatric disorders in IBS patients attending Gastroenterology clinics is worthwhile. The objective of this study was to evaluate psychiatric morbidity among the patients with IBS. This cross sectional comparative study was conducted in the Department of Psychiatry, Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh during the period from January 2012 to June 2012. Inclusion criteria were patients of irritable bowel syndrome fulfilling the Rome-III criteria, age between 18 to 60 years irrespective of sex. Patients with any red flag sign, serious cognitive impairment such as dementia, schizophrenia, mania, delusional disorder, prior history of abdominal surgery and other chronic diseases were excluded. One hundred and ten patients with IBS were selected according to inclusion and exclusion criteria and categorized as IBS group. Another 110 age and sex matched subjects were selected as control group. The mean±SD age of the patients was 34.3±12.2 years which was almost identical to control group (p=0.820). Most of the patients (66.4%) were below the age of 40 years. There were 64 (58.2%) male and 46 (41.8%) female which was similar to control group (p=0.643). Psychiatric co-morbidity was most frequent in IBS patients (56.4%) as compared to control group (16.4%) p value <0.001. The most common psychiatric disorders were Anxiety disorders (22.7%), followed by major depressive disorder (19.1%) and somatization disorder (14.5%). The results of this study suggest that a significant number of patients with IBS suffer from psychiatric disorders than control, which are similar to the IBS group in age and gender.

Substance Use among the Patients with First Episode Psychosis.

Substance Use Disorder is a frequent problem in Bangladesh and many of these patients develop psychosis. Substance use can cause psychosis and it can modify the course of psychosis. This cross-sectional study was done to see the proportion of substance use in patients with First-Episode Psychosis (FEP) in two tertiary care hospitals in Dhaka, Bangladesh mentioned here as Bangabandhu Sheikh Mujib Medical University and Dhaka Medical College Hospital; from November 2007 March 2009. Fifty consecutive FEP patients were taken as subjects and 50 healthy attendants were recruited as control. Mean age of the patients was 27.24, male (62%) are more having first-episode psychosis than female (38%). Majority of the patients were unmarried (64%). Regarding occupation students were 34%, followed by unemployed 24% and service18%. In control group's occupation; service 34%, housewife 22%. Life time substance use was found double in patients with first-episode psychosis than control. Cannabis was found to be the most common substance causing psychosis. Among the lifetime substance users in fist-episode psychosis patients 77.78% were male where as, in control group 100% patients were male. However, the researcher did not find any of the first-episode psychosis patients taking current use of substance (abuse and /or dependence). The small size of the present study was only 50. Future prospective study is required having large sample size to see the outcome of substance use in first-episode psychosis.