Physical health in individuals with psychiatric disorders in Austria.

INTRODUCTION: The association between severe psychiatric disorders and metabolic syndrome is well documented and goes along with a reduced life expectancy. The prevalence of medical comorbidities in individuals suffering from psychiatric disorders in Austria has not yet been examined; aim of this study was to analyze the prevalence of comorbid somatic disorder in individuals diagnosed with psychiatric disorders in Austria. METHODS: Patients (n = 600) with a life-time diagnosis of mood and anxiety disorders undergoing a six-week course of intensive treatment in a psychiatric rehabilitation center were recruited. Prevalent somatic and psychological conditions, anamnestic data, medical history, blood samples, clinical and psychological tests as well as medication were examined to determine somatic and psychiatric diagnoses. RESULTS: Metabolic disorders were highly prevalent especially in individuals diagnosed with affective disorders, respectively in bipolar disorder. Furthermore, obesity and thyroid dysfunction were found in about 40% of individuals diagnosed with bipolar disorder in the present study. Significant gender differences were found in CVD and hypertension with higher prevalence in men, while thyroid dysfunction occurred more often in women also compared to the general female population. CONCLUSIONS: Characterizing somatic comorbidity in individuals with psychiatric disorders can stimulate research to better understand possible shared etiologic factors and has public health implications for improving models of care. This could have a positive effect on the course of mental disorders, and additionally improve social integration and life expectancy. Knowledge about sex differences should be used to further improve individualized treatment of individuals with psychiatric disorders.

Psychopathic personality factor "Fearless dominance" is related to low self-reported stress-levels, fewer psychiatric symptoms, and more adaptive stress coping in psychiatric disorders.

The aim of this cross-sectional study was to test the idea that the psychopathic trait "Fearless dominance" (FD) may be associated with reduced psychological stress symptoms and better stress coping strategies in psychiatric patients, whereas the factor "Self-centered impulsivity" (SCI) may be associated with more stress and maladaptive stress coping. The investigation included 626 individuals with psychiatric disorders treated in a psychiatric rehabilitation program. The participants were tested with the Psychopathic Personality Inventory Revised (PPI-R) and completed several clinical scales measuring stress experience and stress coping (Symptom-Checklist Revised, Trier Inventory for Chronic Stress, The Stress Coping Style Questionnaire 78). Consistent with the hypothesis, structural equation modeling results showed that self-reported stress levels and adaptive stress coping strategies might be explained by psychopathic FD traits in the psychiatric sample. Supplemental subscale analyses showed that especially the PPI-R scales Stress Immunity and Social Influence were positively related to adaptive stress coping. The second model of SCI did not fit our data well. In conclusion, individuals with psychopathic FD traits may experience less stress symptoms during residential care. Well-designed prospective trials may ultimately answer the question whether psychopathic traits could be viewed as serving a buffer function in the development of depression.