Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 5.089
Filtrar
1.
Epidemiol Psychiatr Sci ; 29: e78, 2019 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-31839014

RESUMO

AIMS: Associations between childhood abuse and various psychotic illnesses in adulthood are commonly reported. We aim to examine associations between several reported childhood adverse events (sexual abuse, physical abuse, emotional abuse, neglect and interpersonal loss) among adults with diagnosed psychotic disorders and clinical and psychosocial outcomes. METHODS: Within a large epidemiological study, the 2010 Australian National Survey of Psychosis (Survey of High Impact Psychosis, SHIP), we used logistic regression to model childhood adverse events (any and specific types) on 18 clinical and psychosocial outcomes. RESULTS: Eighty percent of SHIP participants (1466/1825) reported experiencing adverse events in childhood (sexual abuse, other types of abuse and interpersonal loss). Participants reporting any form of childhood adversity had higher odds for 12/18 outcomes we examined. Significant associations were observed with all psychosocial outcomes (social dysfunction, victimisation, offending and homelessness within the previous 12 months, and definite psychosocial stressor within 12 months of illness onset), with the strongest association for homelessness (odds ratio (OR) = 2.82). Common across all adverse event types was an association with lifetime depression, anxiety and a definite psychosocial stressor within 12 months of illness onset. When adverse event types were non-hierarchically coded, sexual abuse was associated with 11/18 outcomes, other types of abuse 13/18 and, interpersonal loss occurring in the absence of other forms of abuse was associated with fewer of the clinical and psychosocial outcomes, 4/18. When adverse events types were coded hierarchically (to isolate the effect of interpersonal loss in the absence of abuse), interpersonal loss was associated with lower odds of self-reproach (OR = 0.70), negative syndrome (OR = 0.75) and victimisation (OR = 0.82). CONCLUSIONS: Adverse childhood experiences among people with psychosis are common, as are subsequent psychosocial stressors. Mental health professionals should routinely enquire about all types of adversities in this group and provide effective service responses. Childhood abuse, including sexual abuse, may contribute to subsequent adversity, poor psychosocial functioning and complex needs among people with psychosis. Longitudinal research to better understand these relationships is needed, as are studies which evaluate the effectiveness of preventative interventions in high-risk groups.


Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Abuso Sexual na Infância/psicologia , Maus-Tratos Infantis/psicologia , Transtornos Psicóticos/epidemiologia , Adolescente , Adulto , Adultos Sobreviventes de Eventos Adversos na Infância/estatística & dados numéricos , Idoso , Ansiedade/epidemiologia , Ansiedade/psicologia , Austrália/epidemiologia , Criança , Maus-Tratos Infantis/estatística & dados numéricos , Abuso Sexual na Infância/estatística & dados numéricos , Depressão/epidemiologia , Depressão/psicologia , Feminino , Humanos , Acontecimentos que Mudam a Vida , Masculino , Pessoa de Meia-Idade , Prevalência , Transtornos Psicóticos/psicologia , Classe Social , Estresse Psicológico , Adulto Jovem
2.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(7. Vyp. 2): 5-12, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31532585

RESUMO

OBJECTIVE: To analyze indicators of the referral rate for highly specialized inpatient psychiatric care in adolescents with psychotic disorders. MATERIAL AND METHODS: Clinical/dynamic and statistical methods were used to study the data of patients, aged 14-17 years, with psychotic mental disorders according to ICD-10, as well as the indicators of their hospitalization in psychiatric consulting and medical institution during the calendar year. RESULTS AND CONCLUSION: The analysis of 2017 data shows that 6.3% of hospitalized children and adolescents have a psychotic disorder, the vast majority (82.3%) of whom are adolescents, aged 14-17 years (149 patients, including 79 boys, 70 girls). Of 181 patients referred to the hospital with a diagnosis of a psychotic disorder, the preliminary diagnostic judgment was not confirmed during hospitalization in 30 (16.6%) patients, in the course of therapy in 24 (13.3%) cases. The prevalence of patients with endogenous psychoses (about 80% in the structure of schizophrenic process, schizoaffective, affective pathology), the prevalence of older adolescents, gender relations in psychotic disorders of different nosological nature are revealed.


Assuntos
Transtornos Psicóticos , Esquizofrenia , Adolescente , Criança , Feminino , Hospitalização , Humanos , Classificação Internacional de Doenças , Masculino , Prevalência , Transtornos Psicóticos/epidemiologia , Esquizofrenia/epidemiologia
3.
Psychiatr Danub ; 31(Suppl 3): 338-344, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488750

RESUMO

INTRODUCTION: Mental difficulties are common in the postpartum period. They can manifest in a mild form, but also as serious disorders which need to be treated in a timely manner. The most common psychological problem is "Baby blues" characterized by relatively short duration without consequences and treatment is largely unnecessary. Postpartum depression is characterized by a sense of sadness, loss of interest, insomnia, discomfort, loss of energy, reduced concentration. Postpartum psychosis is the most serious disorder but is also rare and may have serious consequences for the mother and child. Important factors in the postpartum mental problems/difficulties are genetic factors, situation of unwanted pregnancy, a feeling of discomfort with the role of motherhood and sudden hormonal changes. AIM: to investigate the frequency and type of mental problems in postpartum period, as well as possible type of help needed by the women in postpartum period. SUBJECTS AND METHODS: One hundred (112) respondents participated in the survey. The survey was conducted from November to December 2017 through a "google docs" application. The survey was placed on different social networks, and the participation in the survey was voluntary and anonymous. A series of 14 questions with the offered answers was used in the survey. RESULTS: The results of the survey have shown that psychological difficulties and disturbances in the postpartum period to be common problems encountered by almost 50% of women (44.46%). The most common difficulty is Baby blues, followed by postpartum depression and anxiety disorders. Age and the mode of birth did not affect the emergence of changes, while social factors such as family support had a great impact. CONCLUSION: The provision of information to the mothers can help, but inaccurate information can do the opposite. Thus, the role of health care professionals is important for helping mothers in that period to prevent certain difficulties as well as in identifying and referring mothers to seek help in a timely fashion.


Assuntos
Ansiedade/epidemiologia , Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/psicologia , Mães/psicologia , Período Pós-Parto/psicologia , Transtornos Psicóticos/epidemiologia , Ansiedade/psicologia , Criança , Feminino , Humanos , Recém-Nascido , Mães/educação , Gravidez , Gravidez não Desejada/psicologia , Transtornos Psicóticos/psicologia , Inquéritos e Questionários
4.
Indian J Med Res ; 149(4): 489-496, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-31411172

RESUMO

Background & objectives: Substance use disorders are a major public health concern in Punjab. However, reliable estimates of prevalence of substance use disorders are not available for the State. The present study reports estimates of prevalence of substance use disorders in Punjab, conducted as part of National Mental Health Survey, India. Methods: Using multistage stratified random cluster sampling, 2895 individuals from 719 households of 60 clusters (from 4 districts of Punjab) were interviewed. Mini International Neuropsychiatric Interview and Fagerstrom nicotine dependence scale were used to assess substance use disorders. Results: The sample comprised almost equal numbers of males and females. Nearly 80 per cent had less than or equal to high school education, and 70 per cent were married. The weighted prevalence of alcohol and other substance use disorders was 7.9 and 2.48 per cent, respectively. The prevalence of tobacco dependence was 5.5 per cent; 35 per cent households had one person with substance use disorder. The prevalence was highest in the productive age group (30-39 yr), urban metro and less educated persons. The prevalence of alcohol and other substance use disorders was much higher in Punjab as compared to other States where survey was done. Tobacco dependence was lowest in Punjab. Majority (87%) of the persons with substance use disorders did not suffer from any other mental disorder. Treatment gap was 80 per cent. Interpretation & conclusions: Punjab has a high burden of substance use disorders. The estimates will help clinicians and policymakers to plan the strategies against the menace of substance use disorders effectively.


Assuntos
Transtornos Mentais/epidemiologia , Transtornos Psicóticos/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Tabagismo/epidemiologia , Adulto , Feminino , Inquéritos Epidemiológicos , Humanos , Índia/epidemiologia , Masculino , Transtornos Mentais/patologia , Pessoa de Meia-Idade , Transtornos Psicóticos/patologia , Transtornos Relacionados ao Uso de Substâncias/patologia , Inquéritos e Questionários , Tabagismo/patologia , Adulto Jovem
5.
BMC Res Notes ; 12(1): 360, 2019 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-31238959

RESUMO

OBJECTIVE: Common mental disorder has a high prevalence in the general population worldwide. One in four patients visiting any health services has at least one mental disorders and negatively impacts quality of life, physical wellbeing, poor level of functioning, and poor medication adherence. However, research into common mental illness and associated factors among people with outpatient medical patients in low and meddle-income countries is limited. Therefore, this study aimed to explore common mental disorder and associated factors among persons with outpatient medical illness in Ethiopia. RESULT: The prevalence of common mental disorder was found to be 39.2% with [95% CI 34.2%, 44.1%]. In the multivariate logistic regression, female sex [AOR: 2.03, 95% CI 1.28, 3.22], poor social support [AOR: 3.56 (95% CI 2.21, 5.73)], Diabetes mellitus [AOR: 5.25, 95% CI 2.35, 11.73], and substance use [AOR: 1.93, 95% CI 1.23, 3.04] were factors significantly associated with common mental disorder.


Assuntos
Hospitais , Pacientes Ambulatoriais , Transtornos Psicóticos/epidemiologia , Adolescente , Adulto , Estudos Transversais , Etiópia/epidemiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prevalência , Adulto Jovem
6.
Depress Anxiety ; 36(7): 586-595, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31066996

RESUMO

BACKGROUND: Obsessive-compulsive symptoms (OCS) in youth are common, have heterogeneous manifestations, and have been shown to be associated with serious psychopathology. While early-life trauma exposure is associated with increased risk for obsessive-compulsive disorder (OCD), its association with different OCS and its clinical relevance for serious psychopathology is unclear. Here we aimed to evaluate associations among traumatic stressful events (TSE), OCS, and serious psychiatric conditions in community youth. METHODS: We studied nonmental-help seeking youths from the Philadelphia Neurodevelopmental Cohort (N = 7054, aged 11-21, 54% females, 52% prepubertal), assessed for lifetime TSE exposure and OCS. Regression models investigated cross-sectional associations of TSEs with OCS, and associations with depression, suicide ideation and psychosis. Models examined sex and puberty effects, controlling for age and socioeconomic status. RESULTS: Trauma exposure was associated with higher OCS rates, especially in females (Trauma × Sex interaction Wald = 7.93, p = 0.005) and prepuberty (Trauma × Puberty interaction Wald = 7.68, p = 0.006). TSEs were associated with all OCS manifestations, most prominently with bad intrusive thoughts (odds ratio [OR] = 1.63). Assaultive TSEs, especially sexual assault, showed stronger associations with OCS compared with nonassaultive TSEs. While TSEs and OCS were independently associated with depression, suicide ideation, and psychosis, a significant interaction was observed only in association with increased rates of psychosis (Trauma × OCS interaction Wald = 5.08, p = 0.024). CONCLUSION: Early-life trauma is associated with OCS in a dose-response manner, more so in females and prepuberty. The trauma-OCS association varied by load, type of trauma, and by OCS subtypes. Trauma-OCS appears a detrimental combination in association with psychosis.


Assuntos
Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/psicologia , Trauma Psicológico/epidemiologia , Trauma Psicológico/psicologia , Adolescente , Criança , Estudos de Coortes , Comorbidade , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Psicopatologia , Transtornos Psicóticos/epidemiologia , Índice de Gravidade de Doença , Fatores Sexuais , Delitos Sexuais/psicologia , Delitos Sexuais/estatística & dados numéricos , Ideação Suicida , Adulto Jovem
7.
Ophthalmic Epidemiol ; 26(4): 279-285, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31062638

RESUMO

Purpose: Vision loss has been associated with negative health outcomes, but population-level data on vision loss are lacking, and there are limited data on low vision-associated outcomes among women, minorities, and older age groups. The objective of this study was to determine the prevalence of vision loss in a nationally representative sample of older US adults and examine its association with hip fracture, depression, anxiety, and dementia. Methods: Cross-sectional analysis of Medicare claims data from 2014. Blindness and low vision, hip fracture, depression, anxiety, and dementia were identified using Chronic Condition Warehouse indicator variables based on ICD-9 and CPT codes. Multivariable logistic regression models were built to examine whether sociodemographic factors were associated with vision loss and to determine the relationships between vision loss and hip fracture and neuropsychiatric outcomes. Results: The prevalence of low vision in the Medicare population was 994/100,000 and increased significantly with age, Black (1,854/100,000) or Hispanic (2,862/100,000) race/ethnicity, female gender (1,181/100,000), and Medicaid eligibility (2,975/100,000). After adjusting for relevant comorbidities, low vision was significantly associated with hip fracture (adjusted odds ratio [AOR] 2.54, 95% CI: 2.52-2.57), depression (AOR 3.99, 95% CI: 3.97-4.01), anxiety (AOR 2.93, 95% CI: 2.91-2.95), and dementia (AOR 3.91, 95% CI: 3.88-3.93). Conclusion: Blindness and low vision are common in older Americans, especially among racial and ethnic minorities and lower income individuals, and associated with hip fracture, depression, anxiety, and dementia. The prevention and treatment of vision loss may reduce health disparities and negative health outcomes in the aging population.


Assuntos
Cegueira/epidemiologia , Disparidades em Assistência à Saúde , Fraturas do Quadril/etiologia , Medicare/estatística & dados numéricos , Transtornos Psicóticos/etiologia , Transtornos da Visão/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Cegueira/complicações , Estudos Transversais , Feminino , Fraturas do Quadril/epidemiologia , Humanos , Masculino , Morbidade/tendências , Transtornos Psicóticos/epidemiologia , Estudos Retrospectivos , Estados Unidos/epidemiologia , Transtornos da Visão/complicações
8.
Nord J Psychiatry ; 73(4-5): 281-287, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31140342

RESUMO

Background: Psychosis is associated with a high prevalence of substance use, leading to worsened prognosis. Less is known about how comorbid substance abuse may influence the effectiveness of antipsychotic medications. The aim of this study was to compare the effectiveness of second generation antipsychotics in patients with psychosis with and without substance use. Methods: All patients (n = 226) were aged >18 years old had symptom level scores of ≥4 on selected psychosis items on the Positive and Negative Syndrome Scale and met ICD-10 diagnostic criteria for psychosis. Information on substance use was collected based on the Clinician Drug Use Scale. Patients were grouped at baseline according to the presence of substance use, medication history and diagnosis group. Clinical symptoms at baseline and changes at follow-up were assessed with the PANSS. Results: At baseline about 30% of the patients used substances, most frequently cannabis followed by methamphetamine. About half (47%) of the patients had no prior exposure to antipsychotic medication at inclusion. Patients who had consumed substances showed no substantial differences in the PANSS score reduction as a result of antipsychotic medication compared to patients without substance. There were, however, some group differences in relation to pattern of change that were influenced by medication history. Substance use was found to be related to stronger reduction of positive symptoms from week 4 to week 27. Conclusion: Substance use alone did not influence antipsychotic effectiveness in this sample of patients with psychosis.


Assuntos
Antipsicóticos/uso terapêutico , Transtornos Psicóticos/tratamento farmacológico , Transtornos Psicóticos/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/tratamento farmacológico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto , Estudos de Coortes , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Esquizofrenia/tratamento farmacológico , Esquizofrenia/epidemiologia , Resultado do Tratamento
9.
Br J Sports Med ; 53(12): 746-753, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31097458

RESUMO

Bipolar and psychotic disorders are relatively common and likely to have a significant impact on quality of life and functioning which, in the context of elite sport, includes a potential negative impact on sporting performance. For this narrative review article, the literature on bipolar and psychotic disorders in elite athletes was comprehensively searched, and little empirical research was found. A diagnosis of bipolar or psychotic disorders may be challenging in elite athletes because of complicating factors related to the modifying role of exercise and potential precipitating impact of substance use. Medications used to treat bipolar and psychotic disorders may have side effects particularly problematic for elite athletes. Future research should be tailored to the specific characteristics and needs of elite athletes and to the sporting context in which the disorders may arise. Specifically, further research is needed on the prevalence and incidence of these conditions in elite athletes and the impact of both the disorders and their treatments on sporting performance.


Assuntos
Atletas/psicologia , Transtorno Bipolar/epidemiologia , Transtornos Psicóticos/epidemiologia , Desempenho Atlético , Transtorno Bipolar/diagnóstico , Humanos , Prevalência , Transtornos Psicóticos/diagnóstico , Qualidade de Vida
10.
Nord J Psychiatry ; 73(4-5): 264-272, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31134834

RESUMO

Aim: Posttraumatic stress disorder (PTSD) in parents can have severe consequences also for their children. Prevalence of PTSD is high among refugees. Refugee children have been reported to perform poorly in school. The aim of this study was to investigate the impact of PTSD in refugee and native Swedish parents on children's school performance and to compare the impact of PTSD with that of other major psychiatric disorders. Methods: Register study where multiple regression models were used to analyse school performance in 15-16-year-olds in a national cohort (n = 703,813). PTSD and other major psychiatric disorders (bipolar, depression and/or psychotic disorders) were identified from out- and in-patient hospital care. Results: Maternal and paternal PTSD were associated with lower grades, with adjusted effects of 0.30-0.37 SD in refugee and 0.46-0.50 SD in native Swedish families. Impact of PTSD was greater than that of other psychiatric disorders and comorbidity to PTSD did not increase this impact. Although the impact of PTSD on grades was greater in children in native Swedish families, consequences with regard to eligibility to secondary education were greater for children in refugee families, where 35% of these children were ineligible. Conclusions: Parental PTSD has major consequences for children's school performance and contributes to the lower school performance in children in refugee families in Sweden. Identification and treatment of PTSD in refugee parents is important for offspring educational achievement. Psychiatric clinics and treatment centres need to have a strategy for support, including educational support, to the offspring of their patients with PTSD.


Assuntos
Desempenho Acadêmico/psicologia , Filho de Pais Incapacitados/psicologia , Pais/psicologia , Refugiados/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adolescente , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/psicologia , Estudos de Coortes , Feminino , Humanos , Masculino , Prevalência , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/psicologia , Sistema de Registros , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Suécia/epidemiologia
12.
Psychiatry Res ; 275: 181-188, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30925305

RESUMO

BACKGROUND: Current research has shown that experiencing childhood trauma may predispose individuals for psychosis and expression of Psychotic like experiences (PLEs). We aimed to examine the prevalence and characteristics of PLEs and depressive and negative experiences in a sample of Tunisian college students, and to evaluate the impact of childhood traumas in the occurrence and severity of these experiences at the time of the survey. METHOD: A total of 482 college students (63.7% female; aged 18-32) participated in a cross-sectional survey. The Positive Subscale of Community Assessment of Psychotic Experiences (CAPE) was used to measure PLEs. The Childhood Trauma Questionnaire was used to assess childhood trauma and neglect. RESULTS: 53.5% (n = 258) of the students reported at least one positive PLE 'nearly always', and 40.9% (n = 197) reported at least one negative PLE with this frequency. After controlling for demographic variables (gender, age) and psychosocial factors (drug use, depression, anxiety and stress), sexual abuse significantly contributed to PLEs. CONCLUSION: There is a need for further cross-cultural research regarding the phenotypal expression of PLEs and its associated variables. Child sexual abuse victims should receive systematic and complete psychological screening during their adolescence/ early adulthood including, among others, PLEs and psychotic symptoms.


Assuntos
Abuso Sexual na Infância/psicologia , Transtornos Psicóticos/psicologia , Estudantes/psicologia , Adolescente , Adulto , Ansiedade/epidemiologia , Ansiedade/psicologia , Criança , Estudos Transversais , Depressão/epidemiologia , Depressão/psicologia , Feminino , Humanos , Masculino , Prevalência , Transtornos Psicóticos/epidemiologia , Inquéritos e Questionários , Tunísia/epidemiologia , Universidades , Adulto Jovem
13.
Lancet Psychiatry ; 6(5): 427-436, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30902669

RESUMO

BACKGROUND: Cannabis use is associated with increased risk of later psychotic disorder but whether it affects incidence of the disorder remains unclear. We aimed to identify patterns of cannabis use with the strongest effect on odds of psychotic disorder across Europe and explore whether differences in such patterns contribute to variations in the incidence rates of psychotic disorder. METHODS: We included patients aged 18-64 years who presented to psychiatric services in 11 sites across Europe and Brazil with first-episode psychosis and recruited controls representative of the local populations. We applied adjusted logistic regression models to the data to estimate which patterns of cannabis use carried the highest odds for psychotic disorder. Using Europe-wide and national data on the expected concentration of Δ9-tetrahydrocannabinol (THC) in the different types of cannabis available across the sites, we divided the types of cannabis used by participants into two categories: low potency (THC <10%) and high potency (THC ≥10%). Assuming causality, we calculated the population attributable fractions (PAFs) for the patterns of cannabis use associated with the highest odds of psychosis and the correlation between such patterns and the incidence rates for psychotic disorder across the study sites. FINDINGS: Between May 1, 2010, and April 1, 2015, we obtained data from 901 patients with first-episode psychosis across 11 sites and 1237 population controls from those same sites. Daily cannabis use was associated with increased odds of psychotic disorder compared with never users (adjusted odds ratio [OR] 3·2, 95% CI 2·2-4·1), increasing to nearly five-times increased odds for daily use of high-potency types of cannabis (4·8, 2·5-6·3). The PAFs calculated indicated that if high-potency cannabis were no longer available, 12·2% (95% CI 3·0-16·1) of cases of first-episode psychosis could be prevented across the 11 sites, rising to 30·3% (15·2-40·0) in London and 50·3% (27·4-66·0) in Amsterdam. The adjusted incident rates for psychotic disorder were positively correlated with the prevalence in controls across the 11 sites of use of high-potency cannabis (r = 0·7; p=0·0286) and daily use (r = 0·8; p=0·0109). INTERPRETATION: Differences in frequency of daily cannabis use and in use of high-potency cannabis contributed to the striking variation in the incidence of psychotic disorder across the 11 studied sites. Given the increasing availability of high-potency cannabis, this has important implications for public health. FUNDING SOURCE: Medical Research Council, the European Community's Seventh Framework Program grant, São Paulo Research Foundation, National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust and King's College London and the NIHR BRC at University College London, Wellcome Trust.


Assuntos
Abuso de Maconha/epidemiologia , Transtornos Psicóticos/epidemiologia , Adulto , Brasil/epidemiologia , Estudos de Casos e Controles , Europa (Continente)/epidemiologia , Feminino , Humanos , Incidência , Masculino , Abuso de Maconha/complicações , Pessoa de Meia-Idade , Razão de Chances , Transtornos Psicóticos/etiologia , Adulto Jovem
14.
BMC Psychiatry ; 19(1): 91, 2019 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-30876474

RESUMO

BACKGROUND: Hazardous alcohol use has often been found to be more prevalent amongst psychiatric outpatients than the general population. Additionally, it has also been associated with poorer outcomes. The study aimed to investigate (1) the prevalence and (2) socio-demographic and clinical correlates of hazardous alcohol use, as well as (3) the relationship between hazardous alcohol use and quality of life in an outpatient sample with First Episode Psychosis (FEP) in Singapore. METHODS: Baseline data (N = 280) was extracted from a longitudinal study investigating smoking and alcohol use amongst outpatients with FEP in a psychiatric hospital. Information on socio-demographics, hazardous alcohol use, and quality of life was collected through a self-report survey. Hazardous alcohol use was ascertained by total scores of 8 or higher on the Alcohol Use Disorders Identification Test (AUDIT). Data was analysed using logistic regression and linear regression analyses. RESULTS: The prevalence of hazardous alcohol use over the past 12-month period was 12.9%. Those who had never smoked in their lifetime (vs current smokers) and those with a diagnosis of brief psychotic disorder (vs schizophrenia spectrum disorders) were found to have significantly lower odds of hazardous alcohol use. Hazardous alcohol use was also associated with lower negative symptom scores. Lastly, hazardous alcohol use was found to significantly predict lower scores on the physical health, social relationship and environment domains of quality of life. CONCLUSIONS: The association between hazardous alcohol use and lower negative symptom scores is a surprising finding that needs to be further explored. The significant impact of hazardous alcohol use in reductions in quality of life suggests that early screening and interventions could benefit patients with hazardous alcohol use and comorbid psychosis.


Assuntos
Alcoolismo/epidemiologia , Alcoolismo/psicologia , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/psicologia , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/diagnóstico , Comorbidade , Feminino , Hospitais Psiquiátricos , Humanos , Estudos Longitudinais , Masculino , Transtornos Psicóticos/diagnóstico , Qualidade de Vida/psicologia , Singapura/epidemiologia , Adulto Jovem
15.
Psychiatry Res ; 275: 108-114, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30897392

RESUMO

Early psychosis programs treat high ratios of migrants, given they display higher rates of psychosis. Studies on this topic are limited and less is known about outcomes. The aim of this study was to compare the premorbid, baseline and outcome profile of patients according to migration (M) and migration in psychosocial adversity (MA) in order to explore if there were differences suggesting particular needs in terms of treatment. 257 early psychosis patients aged 18-35 years old were followed-up over 36 months. MA (29.6%) and M (17.9%) were compared to patients who were born in Switzerland (NM). At entry to the program, MA patients had poorer functional levels and higher symptom intensity. MA patients were more likely to report past exposure to trauma. While M patients have similar outcome compared to NM patients, MA patients were less likely to reach symptom remission, displayed lower functioning and were more likely to relapse. Results suggests that migration in adversity is a potential determinant of functional impairment in early psychosis. While patients who migrated in other contexts have a better outcome, patients who experienced migration in adversity have specific needs considering they are less integrated and more likely to have been exposed to trauma.


Assuntos
Migração Humana , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/psicologia , Adolescente , Adulto , Idade de Início , Feminino , Seguimentos , Humanos , Masculino , Estudos Prospectivos , Recidiva , Suíça/epidemiologia , Adulto Jovem
16.
BMC Psychiatry ; 19(1): 83, 2019 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-30832646

RESUMO

BACKGROUND: Experiencing conflict and displacement can have a negative impact on an individual's mental health. Currently, prevalence of mental health disorders (MHDs) at the primary care level in post-conflict areas within the Northern Province of Sri Lanka is unknown. We aimed to explore this prevalence in conflict-affected populations attending primary care, using a structured package of validated screening tools for MHDs. METHODS: This cross-sectional study aimed to determine factors related to mental health disorders at the primary care level in Northern Province, Sri Lanka. A structured interview was conducted with internally displaced adults attending 25 randomly selected primary care facilities across all districts of Northern Sri Lanka (Jaffna, Mannar, Mullaitivu, Vavuniya). Participants were screened for depression, anxiety, psychosis, PTSD, and somatoform symptoms. RESULTS: Among 533 female and 482 male participants (mean age 53.2 years), the prevalence rate for any MHD was 58.8% (95% CI, 53.8-61.4), with 42.4% screening positive for two or more disorders (95% CI, 38.6-46.1). Anxiety prevalence was reported at 46.7% (95% CI, 41.9-51.5), depression at 41.1% (95% CI, 38.7-44.5), PTSD at 13.7% (95% CI, 10.6-16.8), somatoform symptoms at 27.6% (95% CI, 23.6-31.5), and psychosis with hypomania at 17.6% (95% CI, 13.3-21.9). CONCLUSION: This is the first study at the primary care level to investigate prevalence of MHDs among conflict-affected populations in the Northern Province, Sri Lanka. Results highlight unmet mental health needs in the region. Training intervention to integrate mental health services into primary care is planned.


Assuntos
Transtornos Mentais/epidemiologia , Saúde Mental/estatística & dados numéricos , Atenção Primária à Saúde/organização & administração , Guerra , Adolescente , Ansiedade/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Prevalência , Transtornos Psicóticos/epidemiologia , Sri Lanka/epidemiologia , Adulto Jovem
17.
Psychiatry Res ; 274: 294-300, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30826577

RESUMO

Few studies have compared the content and appraisal of hallucinatory experiences (HE) by people with psychosis and those without. This study compared the characteristics of HE, and their appraisals, in individuals with psychotic disorder, non-psychotic mental disorder and no disorder in the general population. Participants (n = 253) aged between 30-33 years who reported HE were recruited from a birth cohort and assessed for lifetime diagnoses of mental disorders. They were allocated to groups based on their diagnosis and their HE were rated to assess their form, content and associated appraisals. Compared to those with no mental disorder, participants with a psychotic disorder had almost twelve times the odds of appraising their HE as distressing and dangerous and nine times the odds of experiencing recurrent HE. Those with a non-psychotic disorder had more than twice the odds of recurrent HE compared to those with no disorder. Overall, HE showed more similarities than differences across the diagnostic groups. Negative appraisals of HE and their recurrence differentiated clinical from non-clinical populations. Screening for HE and assessment of their associated appraisals is essential in those seeking care for mental health difficulties. Interventions aimed at modifying maladaptive appraisals can assist in reducing hallucination related distress.


Assuntos
Alucinações/diagnóstico , Alucinações/psicologia , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Adulto , Estudos de Coortes , Feminino , Alucinações/epidemiologia , Humanos , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/psicologia , Adulto Jovem
18.
J Clin Neurosci ; 63: 37-42, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30827884

RESUMO

Antiepileptic drugs (AEDs) have adverse psychotropic effects (APEs). To explore the risk factors for AED-induced APEs, we compared Chinese outpatients with epilepsy with and without AED-induced APEs. We reviewed the medical data of outpatients with epilepsy enrolled in the Epilepsy Long-term Follow Up Registry Study (ELFURS) between January 1, 2003 and December 31, 2015. Data on demographics, comorbidities, variables related to epilepsy, AED use, and APEs were collected. APEs were determined by experienced epileptologists based on the definition of "adverse drug reaction (ADR)" proposed by the World Health Organization (WHO) in 1972, and the causality relationship between APEs and suspected medications was assessed based on the WHO-UMC scale. APEs included effects on memory, sleep, behavior, mood, psychotic symptoms, and others in this study. We divided the study population into patients with and without AED-induced APEs and then compared the differences between the two groups using univariate and multivariate methods. A total of 3074 eligible patients were included in this study (1001 patients with AED-induced APEs and 2073 patients without AED-induced APEs). Of all APEs, the effects on memory and sleep were most pronounced. The results show that the female sex (odds ratio [OR] 1.242, 95% confidence interval [CI] 1.055-1.463), psychotic disorder comorbidities (OR 1.815, 95% CI 1.159-2.841), polytherapy with AEDs (OR 1.400, 95% CI 1.061-1.847), and the duration of epilepsy (OR 1.010, 95% CI 1.000-1.020) are significant nondrug risk factors for AED-induced APEs. Recognizing risk factors for APEs may help determine optimal treatment strategies for epilepsy.


Assuntos
Anticonvulsivantes/efeitos adversos , Epilepsia/tratamento farmacológico , Transtornos Psicóticos/etiologia , Adulto , Anticonvulsivantes/uso terapêutico , Feminino , Humanos , Masculino , Pacientes Ambulatoriais/estatística & dados numéricos , Transtornos Psicóticos/epidemiologia
19.
PLoS One ; 14(3): e0213711, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30870479

RESUMO

BACKGROUND: Data on the course of mental disorders during imprisonment are scarce. Longitudinal studies from high-income Western countries point to improvements of symptoms over time. The aim of the present study was to assess mental disorders and symptoms three years after baseline evaluation at imprisonment and to determine predictors of change in a South American prison context. METHODS: Consecutively admitted prisoners in Santiago de Chile were assessed at intake and reassessed after three years using the Mini International Neuropsychiatric Interview and the Symptom-Check-List 90 Revised (SCL-90-R). The global severity index (GSI) was calculated with standard deviations (SD) and compared using paired t-tests. The prevalence of mental disorders at baseline and at follow-up were compared using McNemar tests. Analyses of variance were conducted to evaluate whether prespecified socio-demographic variables and disorders at baseline predicted symptom change at follow-up. RESULTS: 73 (94%) out of 78 prisoners participated. The prevalence of major mental illnesses was lower at follow-up: 47 (64%) at intake vs. 23 (32%) at follow-up had major depression (p<0.001); 22 (30%) at intake vs. 10 (14%) at follow-up had psychosis (p = 0.008). The mean GSI improved from 1.97 (SD 0.65) at intake to 1.16 (SD 0.82) at follow-up (p<0.001). Depression at baseline (F = 9.39; [Formula: see text] = 0.137; ß = -0.67; p = 0.003) and working or studying during imprisonment (F = 10.61; [Formula: see text] = 0.152; ß = -0.71; p = 0.002) were associated with strong improvement of the GSI at follow-up, whereas psychosis at intake was associated with relatively small symptom improvement (F = 12.11; [Formula: see text] = 0.17; ß = 0.81; p = 0.001). CONCLUSIONS: In a resource poor prison context in South America, mental health symptoms and disorders improve considerably over three years during imprisonment. This applies especially to people with depression at intake. Offers to work or study during imprisonment may improve mental health outcomes.


Assuntos
Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Prisioneiros/psicologia , Prisões , Adulto , Idoso , Chile , Depressão/diagnóstico , Depressão/epidemiologia , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Transtornos Mentais/terapia , Saúde Mental , Pessoa de Meia-Idade , Testes Neuropsicológicos , Pobreza , Prevalência , Escalas de Graduação Psiquiátrica , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/epidemiologia , Avaliação de Sintomas , Adulto Jovem
20.
Psychiatry Res ; 273: 603-612, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30731429

RESUMO

In Canada, about 6,000 youth are homeless every night, many of whom suffer from addiction and psychotic disorders. To facilitate the exit out of homelessness, access to care and to improve psychosis and addiction outcomes, a new intensive outreach intervention team (EQIIP SOL) was created in Montreal (2012). It offers intensive outreach services dedicated to homeless youth suffering from first episode psychosis and addiction (HYFEPA) in addition to an early psychosis intervention service (EIS) in collaboration with the Addiction Psychiatry Unit. Our aim is to describe the characteristics, clinical, functional and housing outcomes of HYFEPA followed by EQIIP SOL. This two years long prospective longitudinal study with all HYFEPA (n = 42) admitted to EQIIP SOL between 2012-2015 reports at multiple time points, clinical (CGI, GAF), functional (SOFAS, work/study, housing autonomy) and substance use disorder (DUS, AUS) outcomes and acute services use (hospitalizations, emergency room visits). We observed that, at baseline, HYFEPA showed poor prognostic factors (eg. cluster B personality, substance use disorders, legal problems, childhood trauma and lower education level). The majority reached housing stability after 6 months and their functioning and illness severity improved with time. This suggests that HYFEPA improve with an intensive outreach intervention team integrated to an EIS.


Assuntos
Jovens em Situação de Rua/psicologia , Transtornos Psicóticos/psicologia , Transtornos Psicóticos/terapia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Transtornos Relacionados ao Uso de Substâncias/terapia , Adolescente , Adulto , Canadá/epidemiologia , Criança , Feminino , Seguimentos , Pessoas em Situação de Rua/psicologia , Humanos , Estudos Longitudinais , Masculino , Estudos Prospectivos , Transtornos Psicóticos/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA