Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.566
Filtrar
1.
J Clin Psychiatry ; 83(3)2022 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-35452197

RESUMO

Objective: Mood disorders often co-occur with attention-deficit/hyperactive disorder (ADHD), disruptive behavior disorders (DBDs), and aggression. We aimed to determine if polygenic risk scores (PRSs) based on external genome-wide association studies (GWASs) of these disorders could improve genetic identification of mood disorders.Methods: We combined 6 independent family studies that had genetic data and diagnoses for mood disorders that were made using different editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM). We identified mood disorders, either concurrently or in the future, in participants between 6 and 17 years of age using PRSs calculated using summary statistics of GWASs for ADHD, ADHD with DBD, major depressive disorder (MDD), bipolar disorder (BPD), and aggression to compute PRSs.Results: In our sample of 485 youths, 356 (73%) developed a subthreshold or full mood disorder and 129 (27%) did not. The cross-validated mean areas under the receiver operating characteristic curve (AUCs) for the 7 models identifying participants with any mood disorder ranged from 0.552 in the base model of age and sex to 0.648 in the base model + all 5 PRSs. When included in the base model individually, the ADHD PRS (OR = 1.65, P < .001), Aggression PRS (OR = 1.27, P = .02), and MDD PRS (OR = 1.23, P = .047) were significantly associated with the development of any mood disorder.Conclusions: Using PRSs for ADHD, MDD, BPD, DBDs, and aggression, we could modestly identify the presence of mood disorders. These findings extend evidence for transdiagnostic genetic components of psychiatric illness and demonstrate that PRSs calculated using traditional diagnostic boundaries can be useful within a transdiagnostic framework.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno Depressivo Maior , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/genética , Criança , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/genética , Estudo de Associação Genômica Ampla , Humanos , Transtornos do Humor/diagnóstico , Transtornos do Humor/epidemiologia , Transtornos do Humor/genética , Herança Multifatorial/genética , Fatores de Risco
2.
Epilepsy Res ; 182: 106917, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35390702

RESUMO

OBJECTIVE: Epilepsies are severe chronic neurological diseases that impair several domains in life and are often accompanied by various somatic and psychiatric comorbidities. Associations between epilepsy and its comorbidities remain poorly understood. As epidemiological research mainly relies on cross-sectional designs and descriptive results, homogeneities regarding comorbidities in individuals suffering from epilepsy remain uncovered. Therefore, we aimed to identify clusters of individuals based on selected seizure-related variables and somatic comorbidities, and their respective risk of experiencing affective disorders, using a Latent Class Analysis (LCA). METHODS: Latent class analysis, is a model-driven statistical approach, which aims at latent, unobservable clusters on selected disease features. LCA has therefore the potential for uncovering previously unobservable groups or classes with similar comorbidity patterns. It allows for comparisons between those classes regarding risk or promotive factors - such as affective disorders. Our data derives from the Austrian cohort of the European Study on Burden and Care of Epilepsy (ESBACE; http://www.esbace.eu/). In ESBACE, multiple factors were collected to get a detailed picture on prevalence, epilepsy-related variables and comorbidities in a population-based cohort from the region of Salzburg, Austria. We used LCA to identify epilepsy-somatic-comorbidity-clusters and further, compared them to the observed the risk of suffering from affective disorders. RESULTS: The prevalence of epilepsy in the study region was 9.14/1000 inhabitants. LCA unveiled a three-cluster solution, of which one cluster, mainly consisting of individuals with mixed seizure types, higher age, and discrete somatic comorbidities (stroke, cardiovascular - and respiratory/pulmonary diseases) had a higher risk of experiencing affective disorders. SIGNIFICANCE: To our knowledge, this is the first large scale study that uses LCA to identify epilepsy-related comorbidity phenotypes, and therefore it might open a new way for epidemiological research.


Assuntos
Epilepsia , Transtornos Respiratórios , Comorbidade , Estudos Transversais , Epilepsia/complicações , Epilepsia/epidemiologia , Humanos , Análise de Classes Latentes , Transtornos do Humor/complicações , Transtornos do Humor/epidemiologia , Prevalência , Convulsões/complicações
3.
J Affect Disord ; 307: 221-236, 2022 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-35378151

RESUMO

BACKGROUND: A strong bond between parents and their children is essential in promoting healthy psychological development. Poor quality parent-child relationships can render children vulnerable to various adverse outcomes. Although extensive research has highlighted the association between abnormal parent-child bonding and mood and anxiety-related psychopathology in offspring, no systematic review or meta-analysis has assessed this relationship in adults. METHODS: A literature search was conducted in five databases (MEDLINE, Embase, PsycINFO, CINAHL, Web of Science) on January 4th, 2021. Studies that assessed the relationship between parental bonding and the presence of a mood or anxiety disorder in adults were eligible for inclusion. RESULTS: Fifty-seven studies were included in the systematic review (n = 44 in the meta-analysis). Quantitative results indicated that individuals with major depression, panic disorder, or persistent depressive disorder reported lower parental care and higher overprotection compared to individuals without psychiatric diagnoses. Qualitative results indicated that individuals with diagnoses of mood or anxiety disorders tended to report higher parental abuse than controls. LIMITATIONS: The measures of parental bonding used by the included studies are retrospective and subject to biases. All studies had a case-control design and thus, causal-relationships cannot be drawn from the results. CONCLUSIONS: Our findings suggest that poor-quality parental bonding early in life may place offspring at greater risk for mood and anxiety disorders during adulthood. Future research should extend these results by confirming the relationship between parental bonding and other psychiatric disorders, as well as identifying which factors mediate the relationship between abnormal parental bonding and psychiatric disorders.


Assuntos
Transtornos de Ansiedade , Transtorno Depressivo Maior , Adulto , Ansiedade , Transtornos de Ansiedade/epidemiologia , Criança , Transtorno Depressivo Maior/epidemiologia , Humanos , Transtornos do Humor/epidemiologia , Transtornos do Humor/etiologia , Pais/psicologia , Estudos Retrospectivos
4.
Artigo em Russo | MEDLINE | ID: mdl-35394726

RESUMO

OBJECTIVE: To estimate the efficacy of antidepressants in the treatment of anhedonia in mood disorders (MD) comorbid with alcohol use disorder (AUD), considering melatonin concentration in the patient's blood serum. MATERIAL AND METHODS: Seventy patients, aged 18-65 years old, with MD, including patients with- (group F3+F10, n=36) or without comorbid AUD (group F3, n=34), were examined. Control group consisted of 26 healthy volunteers. Clinical-dynamic evaluation was carried out using SIGH-SAD and SHAPS-C. Melatonin concentration was measured with MAGPIX analyzer (Luminex, USA). The statistical analysis was carried out using the SPSS (V. 23.0) standard package. RESULTS: In the case of MD/AUD comorbidity anhedonia symptom does not respond well to psychopharmacotherapy during four weeks (p=0.192, Wilcoxon test) whereas anhedonia in «pure¼ MD does (p=0.007, Wilcoxon test). At the same time, only patients with «pure¼ MD have a statistically significant decrease in melatonin concentration in blood serum compared with the control group (p=0.025, p=0.031, Mann-Whitney test), on the contrary, in the case of MD/AUD comorbidity, a relative increase in melatonin concentration (p>0.05 Mann-Whitney test) was demonstrated. CONCLUSION: The relatively low response of anhedonia symptom in the case of MD/AUD comorbidity compared with the «pure¼ MD, makes perspective using antidepressants with prodophaminergic mechanism of action in this cohort of patients. Furthermore, in MD/AUD comorbidity, contrary to «pure¼ MD, a relative increase in melatonin concentration in blood serum was detected, therefore it could be a limitation to prescribing antidepressants directly or indirectly modulating melatoninergic system.


Assuntos
Alcoolismo , Melatonina , Adolescente , Adulto , Idoso , Alcoolismo/diagnóstico , Alcoolismo/tratamento farmacológico , Alcoolismo/epidemiologia , Anedonia , Comorbidade , Humanos , Melatonina/uso terapêutico , Pessoa de Meia-Idade , Transtornos do Humor/diagnóstico , Transtornos do Humor/tratamento farmacológico , Transtornos do Humor/epidemiologia , Adulto Jovem
5.
JAMA Ophthalmol ; 140(4): 373-381, 2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35266979

RESUMO

Importance: Children with strabismus have poorer functional vision and decreased quality of life than those without strabismus. Objective: To evaluate the association between strabismus and mental illness among children. Design, Setting, and Participants: This cross-sectional study analyzed claims data from the OptumLabs Data Warehouse, a longitudinal deidentified commercial insurance claims database, from 12 005 189 patients enrolled in the health plan between January 1, 2007, and December 31, 2017. Eligibility criteria included age younger than 19 years at the time of strabismus diagnosis, enrollment in the health plan between 2007 and 2018, and having at least 1 strabismus claim based on International Classification of Diseases, Ninth Revision, Clinical Modification and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Clinical Modification codes. Controls were children in the same database with no eye disease codes other than refractive error reported. Demographic characteristics and mental illness claims were compared. Statistical analysis was conducted from December 1, 2018, to July 31, 2021. Main Outcomes and Measures: Presence of mental illness claims. Results: Among the 12 005 189 patients (6 095 523 boys [50.8%]; mean [SD] age, 8.0 [5.9] years) in the study, adjusted odds ratios for the association of mental illnesses with strabismus were 2.01 (95% CI, 1.99-2.04) for anxiety disorder, 1.83 (95% CI, 1.76-1.90) for schizophrenia, 1.64 (95% CI, 1.59-1.70) for bipolar disorder, 1.61 (95% CI, 1.59-1.63) for depressive disorder, and 0.99 (95% CI, 0.97-1.02) for substance use disorder. There was a moderate association between each strabismus type (esotropia, exotropia, and hypertropia) and anxiety disorder, schizophrenia, bipolar disorder, and depressive disorder; odds ratios ranged from 1.23 (95% CI, 1.17-1.29) for the association between esotropia and bipolar disorder to 2.70 (95% CI, 2.66-2.74) for the association between exotropia and anxiety disorder. Conclusions and Relevance: This cross-sectional study suggests that there was a moderate association between strabismus and anxiety disorder, schizophrenia, bipolar disorder, and depressive disorder but not substance use disorder. Recognizing that these associations exist should encourage mental illness screening and treatment for patients with strabismus.


Assuntos
Esotropia , Exotropia , Esquizofrenia , Estrabismo , Adulto , Transtornos de Ansiedade/epidemiologia , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Transtornos do Humor/diagnóstico , Transtornos do Humor/epidemiologia , Qualidade de Vida , Esquizofrenia/epidemiologia , Estrabismo/diagnóstico , Estrabismo/epidemiologia , Adulto Jovem
6.
Cartilage ; 13(1): 19476035221087703, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35333656

RESUMO

OBJECTIVE: To identify the prevalence of mood disorder diagnoses in patients undergoing cartilage transplantation procedures and determine the relationship between mood disorders, opioid usage, and postoperative health care costs. DESIGN: Patients with current procedural terminology (CPT) codes for osteochondral autograft transplantation (OAT), osteochondral allograft transplantation (OCA), and autologous chondrocyte implantation (ACI) were identified in the Truven Health Marketscan database (January 2009-September 2014). Patients were grouped based on having a preoperative mood disorder diagnosis (preMDD). Preoperative opioids, postoperative opioids ≥90 days, and health care costs within the year postoperative were compared for those with and without mood disorders. Costs were analyzed, adjusting for preoperative cost, sex, age, and opioid usage, for those with and without mood disorders. RESULTS: A total of 3,682 patients were analyzed (ACI: 690, OAT: 1,294, OCA: 1,698). A quarter of patients had preMDD (ACI: 25.4%, OAT: 20.6%, OCA: 22.7%). Postoperative opioid use was more prevalent in preMDD patients (OAT: 37.1% vs. 24.1%, P < 0.001; OCA: 30.4% vs. 24.8%, P = 0.032; ACI: 33.7% vs. 26.2%, P = 0.070) (odds ratio [OR] ranged from 1.29 to 1.86). First-year postoperative log-transformed costs were significantly greater for preMDD patients (ACI: $7,733 vs. $5,689*, P = 0.012; OAT: $5,221 vs. $3,823*, P < 0.001; OCA: $6,973 vs. $3,992*, P < 0.001; *medians reported). The estimated adjusted first postoperative year cost increase for preMDD OCA patients was 41.7% (P < 0.001) and 28.0% for OAT patients (P = 0.034). There was no statistical difference for ACI patients (P = 0.654). CONCLUSION: Cartilage transplantation patients have a high prevalence of preoperative mood disorders. Opioid use and health care costs were significantly greater for patients with preoperative mood disorder diagnoses. LEVEL OF EVIDENCE: Level III, retrospective therapeutic study.


Assuntos
Cartilagem Articular , Fraturas Intra-Articulares , Analgésicos Opioides/uso terapêutico , Cartilagem Articular/cirurgia , Condrócitos/transplante , Custos de Cuidados de Saúde , Humanos , Articulação do Joelho/cirurgia , Transtornos do Humor/epidemiologia , Estudos Retrospectivos
7.
Front Public Health ; 10: 768400, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35273935

RESUMO

Background: According to the integrated theoretical model, adolescents' behaviors were the outcome of the complex interplay between multiple levels. Non-suicidal self-injury (NSSI) is a serious and high prevalent problem among adolescents with mood disorders. However, a systematic perspective on psychosocial correlates among Chinese clinical adolescents is still rare. Method: The impact of several factors at the individual (i.e., sex, age, self-esteem, and psychological distress), family (i.e., family structure, family income, and family support), and social level (i.e., living environment, peer support, and teacher support) on the frequency of NSSI behaviors were investigated in the current study. This research included 621 Chinese adolescents with mood disorders from 20 hospitals. Results: Three-steps hierarchical regression analyses indicated that lower levels of psychological distress and higher levels of self-esteem were most associated with less frequency of NSSI behaviors. In addition, family support was negatively associated with the frequency of NSSI behaviors. After controlling the factors at individual and family levels, no significant association was found between the factors at the social level and the frequency of NSSI behaviors. Conclusion: These findings provide preliminary support for the notion that adolescent self-esteem and family support may effectively shield them from problematic behavior; nevertheless, adolescents suffering from more emotional pain can be even riskier. Thus, further intervention strategies should consider the non-independence of individual capacities, co-combinatory effects of mood disorder, and family environment in treating those vulnerable Chinese adolescents.


Assuntos
Comportamento do Adolescente , Comportamento Autodestrutivo , Adolescente , Comportamento do Adolescente/psicologia , Humanos , Transtornos do Humor/epidemiologia , Prevalência , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia
8.
BMC Psychiatry ; 22(1): 194, 2022 03 18.
Artigo em Inglês | MEDLINE | ID: mdl-35300648

RESUMO

BACKGROUND: The early detection of patients at risk of developing schizophrenia and bipolar disorder, and more broadly mood spectrum disorder, is a public health concern. The phenotypical overlap between the prodromes in these disorders calls for a simultaneous investigation into both illness trajectories. METHOD: This is an epidemiological, retrospective, multicentre, descriptive study conducted in the Grand-Est region of France in order to describe and compare early symptoms in 205 patients: 123 of which were diagnosed with schizophrenia and 82 with bipolar disorder or mood spectrum disorder. Data corresponding to the pre-morbid and prodromal phases, including a timeline of their onset, were studied in child and adolescent psychiatric records via a data grid based on the literature review conducted from birth to 17 years of age. RESULTS: Two distinct trajectories were highlighted. Patients with schizophrenia tended to present more difficulties at each developmental stage, with the emergence of negative and positive behavioural symptoms during adolescence. Patients with mood spectrum disorder, however, were more likely to exhibit anxiety and then mood-related symptoms. Overall, our results corroborate current literature findings and are consistent with the neurodevelopmental process. We succeeded in extracting a decision tree with good predictability based on variables relating to one diagnosis: 77.6% of patients received a well-indexed diagnosis. An atypical profile was observed in future mood spectrum disorder patients as some exhibited numerous positive symptoms alongside more conventional mood-related symptoms. CONCLUSION: The combination of all these data could help promote the early identification of high-risk patients thereby facilitating early prevention and appropriate intervention in order to improve outcomes.


Assuntos
Transtorno Bipolar , Esquizofrenia , Adolescente , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/psicologia , Criança , Árvores de Decisões , Humanos , Transtornos do Humor/diagnóstico , Transtornos do Humor/epidemiologia , Estudos Retrospectivos , Esquizofrenia/diagnóstico , Esquizofrenia/epidemiologia
9.
BMJ Open ; 12(3): e055070, 2022 03 11.
Artigo em Inglês | MEDLINE | ID: mdl-35277405

RESUMO

OBJECTIVES: To investigate predictors of falls and fractures leading to hospitalisation in people with affective disorders. DESIGN: Cohort study. SETTING: The South London and Maudsley National Health Service (NHS) Foundation Trust (SLaM) Biomedical Research Centre (BRC) Case Register. PARTICIPANTS: A large cohort of people with affective disorders (International Classification of Diseases- 10th version [ICD-10] codes F30-F34) diagnosed between January 2008 and March 2016 was assembled using data from the SLaM BRC Case Register. PRIMARY AND SECONDARY OUTCOME MEASURES: Falls and fractures leading to hospitalisation were ascertained from linked national hospitalisation data. Multivariable Cox proportional hazards analyses were administrated to identify predictors of first falls and fractures. RESULTS: Of 36 101 people with affective disorders (mean age 44.4 years, 60.2% female), 816 (incidence rate 9.91 per 1000 person-years) and 1117 (incidence rate 11.92 per 1000 person-years) experienced either a fall or fracture, respectively. In multivariable analyses, older age, analgesic use, increased physical illness burden, previous hospital admission due to certain comorbid physical illnesses and increase in attendances to accident and emergency services following diagnosis were significant risk factors for both falls and fractures. Having a history of falls was a strong risk factor for recurrent falls, and a previous fracture was also associated with future fractures. CONCLUSIONS: Over a mean 5 years' follow-up, approximately 8% of people with affective disorders were hospitalised with a fall or fracture. Several similar factors were found to predict risk of falls and fracture, for example, older age, comorbid physical disorders and analgesic use. Routine screening for bone mineral density and fall prevention programmes should be considered for this clinical group.


Assuntos
Fraturas Ósseas , Medicina Estatal , Adulto , Estudos de Coortes , Feminino , Fraturas Ósseas/epidemiologia , Hospitalização , Humanos , Masculino , Transtornos do Humor/complicações , Transtornos do Humor/epidemiologia
10.
J Affect Disord ; 307: 171-177, 2022 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-35331824

RESUMO

BACKGROUND: Though the association between anxiety disorders and suicidal behavior is well-described, the impact of anxiety symptoms on suicidal thoughts and behaviors (STB) across different mood disorders is still unclear. METHODS: We performed a registry-based retrospective study utilizing outcome measure data collected by the National Network of Depression Centers (NNDC), a nationwide nonprofit consortium of 26 leading clinical and academic member centers in the United States. The sample consisted of 2607 outpatients with mood disorders (major depressive disorder or bipolar disorders). Demographic and clinical variables were compared based on the presence or absence of STB and severity of anxiety symptoms (minimal, mild, moderate, and severe). Univariate and multivariable logistic regressions were conducted to examine the correlations of STB, considering multicollinearity. RESULTS: Patients with mild, moderate, and severe anxiety symptoms had higher odds of STB than those with minimal symptoms. Gender, marital status, age, and depressive symptoms were other strong predictors of STB. There was no difference in the odds of STB between patients with major depressive disorder (MDD) and those with bipolar disorders (BD). However, the odds of suicidal ideation were slightly lower among patients with BD than those with MDD. LIMITATIONS: Our sample was comprised only of outpatients, limiting the generalization of our findings. Other limitations include the lack of structured interviews for diagnostic characterization of the patients and the utilization of data on anxiety and mood obtained solely through self-report scales. CONCLUSIONS: We found a cross-sectional association between the severity of anxiety symptoms and STB among patients with mood disorders. This study demonstrates the need for a suicide risk assessment in patients with mood disorders reporting anxiety symptoms.


Assuntos
Transtorno Depressivo Maior , Ideação Suicida , Ansiedade , Estudos Transversais , Transtorno Depressivo Maior/epidemiologia , Humanos , Transtornos do Humor/epidemiologia , Estudos Retrospectivos , Fatores de Risco
11.
Matern Child Health J ; 26(4): 770-777, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35344149

RESUMO

OBJECTIVES: Data are scarce regarding the prevalence and predictors of perinatal mood and anxiety disorders (PMADs) among Black women. The purpose of this study was to examine the prevalence and predictors of symptoms of PMADS among Black women. METHODS: Black women completed a paper survey between August 2019 and October 2019. Binomial logistic regression was employed to examine predictors of PMAD symptoms. RESULTS: The prevalence of symptoms of PMADs was 56%. A higher proportion of women with PMADs had experienced depression (16% vs. 32%, p = 0.006); physical (18% vs. 31%, p = 0.030), emotional (35% vs. 61%, p = 0.000), or sexual abuse (12% vs. 29%, p = 0.002); and symptoms of depression or anxiety before pregnancy (18% vs. 46%, p = 0.000). After adjusting for socio-demographics in multivariate analysis, experiencing symptoms of depression or anxiety before pregnancy (adjusted odds ratio [aOR] = 3.445, p = 0.001) was positively associated with experiencing symptoms of PMADs, whereas higher levels of self-esteem (aOR = 0.837, p = 0.000) were negatively associated with experiencing symptoms of perinatal mood and anxiety disorders. CONCLUSIONS FOR PRACTICE: The prevalence of PMAD symptoms among this sample of Black women was alarmingly high. Women who experienced PMADs were more likely to report adverse childhood experiences (e.g., physical, emotional, and/or sexual abuse). By understanding the prevalence of PMADs and the factors associated with these disorders, healthcare professionals can improve diagnosis and treatment rates among this understudied and underserved population.


Assuntos
Transtornos de Ansiedade , Ansiedade , Ansiedade/epidemiologia , Ansiedade/psicologia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/psicologia , Feminino , Humanos , Transtornos do Humor/diagnóstico , Transtornos do Humor/epidemiologia , Parto , Gravidez , Prevalência
12.
World Neurosurg ; 161: e252-e267, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35123021

RESUMO

BACKGROUND: Affective disorders, such as depression and anxiety, are exceedingly common among patients with metastatic cancer. The aim of this study was to investigate the relationship between affective disorders and health care resource utilization in patients undergoing surgery for a spinal column metastasis. METHODS: A retrospective cohort study was performed using the 2016-2018 National Inpatient Sample database. All adult patients (≥18 years) undergoing surgery for a metastatic spinal tumor were identified using the International Classification of Diseases, Tenth Revision, Clinical Modification coding systems. Patients were categorized into 2 cohorts: no affective disorder (No-AD) and affective disorder (AD). Patient demographics, comorbidities, hospital characteristics, intraoperative variables, postoperative adverse events (AEs), length of stay (LOS), discharge disposition, and total cost of hospital admission were assessed. A multivariate logistic regression analysis was used to identify independent predictors of increased cost, nonroutine discharge, and prolonged LOS. RESULTS: Of the 8360 patients identified, 1710 (20.5%) had a diagnosis of AD. Although no difference was observed in the rates of postoperative AEs between the cohorts (P = 0.912), the AD cohort had a significantly longer mean LOS (No-AD, 10.1 ± 8.3 days vs. AD, 11.6 ± 9.8 days; P = 0.012) and greater total cost (No-AD, $53,165 ± 35,512 vs. AD, $59,282 ± 36,917; P = 0.011). No significant differences in nonroutine discharge were observed between the cohorts (P = 0.265). On multivariate regression analysis, having an affective disorder was a significant predictor of increased costs (odds ratio, 1.45; confidence interval, 1.03-2.05; P = 0.034) and nonroutine discharge (odds ratio, 1.40; confidence interval, 1.06-1.85; P = 0.017), but not prolonged LOS (P = 0.067). CONCLUSIONS: Our study found that affective disorders were significantly associated with greater hospital expenditures and nonroutine discharge, but not prolonged LOS, for patients undergoing surgery for spinal metastases.


Assuntos
Transtornos do Humor , Aceitação pelo Paciente de Cuidados de Saúde , Adulto , Gastos em Saúde , Humanos , Transtornos do Humor/epidemiologia , Estudos Retrospectivos , Coluna Vertebral , Estados Unidos/epidemiologia
13.
J Psychosom Res ; 155: 110725, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35121506

RESUMO

OBJECTIVE: This study aimed to compare data on mood and anxiety disorders of pregnant women before and during the COVID-19 pandemic. METHODS: The study sample included 253 women evaluated on their first postpartum day during the COVID-19 pandemic. Mood and anxiety disorders were determined by the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Data from sample was compared with data from previous study that was completed and published prior to the COVID-19 pandemic. RESULTS: The prevalence rate of mood and anxiety disorders during the COVID-19 pandemic was 7.1% and 13.0%, respectively. The most common specific disorder was generalized anxiety disorder (7.1%). Compared to period before the COVID-19 pandemic, the prevalence of mood and anxiety disorders in the current sample was not significantly different. CONCLUSION: Results of this study suggest that pregnant women may have not be under higher risk for mood and anxiety disorders during the COVID-19 pandemic compared to before the pandemic.


Assuntos
COVID-19 , Pandemias , Ansiedade/epidemiologia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , COVID-19/epidemiologia , Depressão/epidemiologia , Feminino , Humanos , Transtornos do Humor/epidemiologia , Gravidez , Gestantes , Prevalência
14.
J Clin Psychiatry ; 83(2)2022 02 08.
Artigo em Inglês | MEDLINE | ID: mdl-35143122

RESUMO

Objective: The COVID-19 pandemic and the related containment measures can represent a traumatic experience, particularly for populations living in high incidence areas and individuals with mental disorders. The aim of this study was to prospectively examine posttraumatic stress disorder (PTSD), anxiety, and depressive symptoms since the end of the first COVID-19 pandemic wave and Italy's national lockdown in subjects with mood or anxiety disorders living in 2 regions with increasing pandemic incidence.Methods: 102 subjects with a DSM-5 anxiety or mood disorder were enrolled from June to July 2020 and assessed at baseline (T0) and after 3 months (T1) with the Impact of Event Scale-Revised, Patient Health Questionnaire-9, Generalized Anxiety Disorder 7-Item, and Work and Social Adjustment Scale. At T1, subjects were also assessed by means of the Trauma and Loss Spectrum Self-Report for PTSD.Results: At T0, subjects from the high COVID-19 incidence area showed higher levels of traumatic symptoms than those from the low COVID-19 incidence area (P < .001), with a decrease at T1 with respect to T0 (P = .001). Full or partial DSM-5 PTSD related to the COVID-19 pandemic emerged in 23 subjects (53.5%) from the high COVID-19 incidence area and in 9 (18.0%) from the low COVID-19 incidence area (P < .001).Conclusions: Subjects with mood or anxiety disorders presented relevant rates of PTSD, depressive, and anxiety symptoms in the aftermath of the lockdown, and in most cases these persisted after 3 months. The level of exposure to the pandemic emerged as a major risk factor for PTSD development. Further long-term studies are needed to follow up the course of traumatic burden.


Assuntos
Ansiedade , COVID-19 , Controle de Doenças Transmissíveis , Depressão , Transtornos do Humor , Transtornos de Estresse Pós-Traumáticos , Ansiedade/diagnóstico , Ansiedade/etiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/psicologia , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/estatística & dados numéricos , Efeitos Psicossociais da Doença , Depressão/diagnóstico , Depressão/etiologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Seguimentos , Humanos , Incidência , Itália/epidemiologia , Masculino , Recuperação da Saúde Mental/tendências , Pessoa de Meia-Idade , Transtornos do Humor/diagnóstico , Transtornos do Humor/epidemiologia , Transtornos do Humor/terapia , Avaliação de Resultados em Cuidados de Saúde , SARS-CoV-2 , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/etiologia
16.
J Headache Pain ; 23(1): 14, 2022 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-35062883

RESUMO

BACKGROUND: Few prospective population-based studies have evaluated the bidirectional relationship between headache and affective disorder. The aim of this large-scale population-based follow-up study was to investigate whether tension-type headache (TTH) and migraine had increased risk of developing anxiety and depression after 11 years, and vice-versa. METHODS: Data from the Trøndelag Health Study (HUNT) conducted in 2006-2008 (baseline) and 2017-2019 (follow-up) were used to evaluate the bidirectional relationship between migraine and TTH and anxiety and depression measured by Hospital Anxiety and depression Scale (HADS). The population at risk at baseline consisted of respectively 18,380 persons with HADS score ≤ 7 and 13,893 without headache, and the prospective data was analyzed by Poisson regression. RESULTS: In the multi-adjusted model, individuals with HADS anxiety (HADS-A) and depression scores (HADS-D) of ≥8 at baseline nearly doubled the risk of migraine (Risk rations (RR) between 1.8 and 2.2) at follow-up whereas a 40% increased risk (RR 1.4) was found for TTH. Vice versa, the risk of having HADS-A and HADS-D scores of ≥8 at follow-up were increased for TTH (RR 1.3) and migraine (RR 1.3-1.6) at baseline. Migraine with aura was associated with 81% (RR 1.81, 95% 1.52-2.14) increased risk of HADS-A score of ≥8. CONCLUSIONS: In this large-scale population-based follow-up study we found a bidirectional relationship between anxiety and depression and migraine and TTH. For anxiety, this bidirectional association was slightly more evident for migraine than TTH.


Assuntos
Cefaleia , Transtornos do Humor , Estudos Transversais , Seguimentos , Cefaleia/epidemiologia , Humanos , Transtornos do Humor/epidemiologia , Estudos Prospectivos
17.
Acta Paediatr ; 111(3): 490-499, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34986519

RESUMO

AIM: To estimate psychiatric comorbidity in childhood onset immune-mediated inflammatory diseases (IMID). METHODS: The PRISMA guidelines were followed, and the protocol was registered at Prospero (ID: CRD42021233890). Literature was searched in PubMed, PsycINFO and Embase. Original papers on prevalence rates of diagnosed psychiatric disorders and/or suicide in paediatric onset inflammatory bowel disease (pIBD), rheumatic diseases (RD) and autoimmune liver diseases were selected. Pooled prevalence rates of psychiatric disorders (grouped according to ICD-10 criteria) within the various IMID were calculated using random-effects meta-analysis. Risk of bias was evaluated by the Newcastle-Ottawa scale. RESULTS: Twenty-three studies were included; 13 describing psychiatric disorders in pIBD and 10 in RD. Anxiety and mood disorders were mostly investigated with pooled prevalence rates in pIBD of 6% (95% confidence interval (CI): 4%-9%) and 4% (95%CI: 2%-8%), respectively, in register-based studies, and 33% (95%CI: 25%-41%) and 18% (95%CI: 12%-26%), respectively, in studies using psychiatric assessment. In RD, rates were 13% (95%CI: 12%-15%) for anxiety disorders and 20% (95%CI: 15%-26%) for mood disorders based on psychiatric assessment. CONCLUSION: Anxiety and depression are commonly reported in childhood onset IMID. Physicians should be attentive to mental health problems in these patients as they seem overlooked.


Assuntos
Transtornos de Ansiedade , Ansiedade , Ansiedade/epidemiologia , Transtornos de Ansiedade/epidemiologia , Criança , Comorbidade , Humanos , Transtornos do Humor/epidemiologia , Prevalência
18.
J Affect Disord ; 301: 448-453, 2022 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-35065087

RESUMO

OBJECTIVES: It is essential to clinically distinguish bipolar affective disorder from unipolar affective disorders. However, patients previously diagnosed with unipolar affective disorder are sometimes later diagnosed with bipolar affective disorder, known as diagnostic conversion. Here we investigated diagnostic conversion using data from a nationwide population-based register. METHODS: We obtained claims data from 2007 to 2020 in Korea's Health Insurance Review Agency database and identified a cohort of patients who were diagnosed with unipolar depression in 2009 without prior psychiatric diseases within the previous 2 years. We studied the rate of diagnostic conversion and risk factors, especially antidepressants. RESULTS: About 6.5% of patients underwent diagnostic conversion during the observation period. Younger age at disease onset and usage of antidepressants increased the relative risk for diagnostic conversion. Patients using serotonin-norepinephrine reuptake inhibitors (SNRI) showed more than twice the risk compared to no usage of antidepressant. LIMITATION: First, this study was based on the population-based register data. Thus, we defined the patient cohort diagnosed with unipolar depression with strict inclusion criteria. Second, the exposure time differed between different antidepressants. Third, we estimated the relative risk for diagnostic conversion compared to no use of antidepressants. Moreover, we could not rule out the potential influence of antidepressant polypharmacy. CONCLUSION: We confirmed diagnostic conversion in some patients and identified younger age or usage of antidepressants, especially SNRI, as risk factors. Because unipolar and bipolar affective disorders show different disease courses or prognoses and have different treatment strategies, clinicians should be mindful of diagnostic conversion.


Assuntos
Transtorno Bipolar , Transtorno Depressivo , Antidepressivos/uso terapêutico , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/tratamento farmacológico , Transtorno Bipolar/epidemiologia , Transtorno Depressivo/psicologia , Humanos , Transtornos do Humor/diagnóstico , Transtornos do Humor/tratamento farmacológico , Transtornos do Humor/epidemiologia , Fatores de Risco
19.
Asian J Psychiatr ; 68: 102966, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34974375

RESUMO

How patients with pre-existing psychiatric disorders are responding to the COVID-19 pandemic remains unclear, and no comprehensive studies have yet been performed. To elucidate (1) which psychiatric disorders were exacerbated during the initial phase of the COVID-19 pandemic and (2) the contributing factors, we prospectively assessed psychiatric symptoms of 1592 psychiatric outpatients in a single-center study using the Global Assessment of Functioning (GAF) before the state of emergency was declared in Japan and during two months under the state of emergency (study period: April 8 to June 7, 2020). We conducted a chi-squared test for the relationship between psychiatric diagnostic category (ICD-10) and exacerbation. To control for confounders, we conducted a logistic regression analysis using sex, age, diagnostic category, and pre-pandemic GAF score as independent variables. Exacerbation rates of patients with mood disorders (F3) and neurotic disorders (F4) were 4.32% and 5.37%, respectively, and were significantly higher than those for patients with organic disorders (F0) and schizophrenic disorders (F2) (X2 (9, N = 1592) = 27.8, p < .01). Logistic regression analysis revealed that patients with F3 and female patients were significantly more affected than patients with other disorders or male patients, respectively (odds ratio (95% confidence interval) = 2.4 (1.2-4.6), p < .01 for F3; 3.1 (1.5-6.6), p < .01 for females). These findings suggest a need for careful management of patients with mood disorders and female psychiatric patients during a pandemic.


Assuntos
COVID-19 , Transtornos Mentais , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Transtornos do Humor/epidemiologia , Pandemias , SARS-CoV-2
20.
Can J Psychiatry ; 67(2): 130-139, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34714183

RESUMO

BACKGROUND: International evidence on the frequency of mood or anxiety disorders among migrant groups is highly variable, as it is dependent on the time since migration and the socio-political context of the host country. Our objective was to estimate trends in the prevalence of diagnosed mood or anxiety disorders among recent (<5 years in Canada) and settled (5-10 years in Canada) migrant groups, relative to the general population of Ontario, Canada. METHODS: We used a repeated cross-sectional design consisting of four cross-sections spanning 5 years each, constructed using health administrative databases from 1995 to 2015. We included all Ontario residents between the ages of 16 and 64 years. We assessed differences in the prevalence of mood or anxiety disorders adjusting for age, sex, and neighbourhood-level income. We further evaluated the impact of migrant class and region of birth. RESULTS: The prevalence of mood or anxiety disorders was lower among recent (weighted mean = 4.10%; 95% confidence interval [CI], 3.59% to 4.60%) and settled (weighted mean = 4.77%; 95% CI, 3.94% to 5.61%) migrant groups, relative to the general population (weighted mean = 7.39%; 95% CI, 6.83% to 7.94%). Prevalence estimates varied greatly by region of birth and migrant class. We found variation in prevalence estimates over time, with refugee groups having the largest increases between 1995 and 2015. CONCLUSIONS: Our findings highlight the complexity of mood and anxiety disorders among migrant groups, and that not all groups share the same risk profile. These results can be used to help inform health service allocation and the development of supportive programs for specific migrant groups.


Assuntos
Migrantes , Adolescente , Adulto , Transtornos de Ansiedade/epidemiologia , Estudos Transversais , Humanos , Pessoa de Meia-Idade , Transtornos do Humor/epidemiologia , Ontário/epidemiologia , Prevalência , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...