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ABSTRACT Background: The proportion of elderly drivers is increasing, and they have an increased risk of traffic accidents and traffic death. The increased risk has been associated with health problems such as cardiovascular disease and a decline in other key factors related to safe driving that also affect healthy elderly drivers. Materials and methods: We used data from three nationwide registers (Register of road and off-road accidents investigated by Finnish Road Accident Investigation Teams, Care Registers for Health Care and Cause of death register) to analyse somatic and psychiatric morbidity associated with fatal motor vehicle accidents (FMVA) involving elderly drivers in Finland. Deceased elderly drivers were divided into three age groups (65-74 years, 75-84 years and 85 years or over), and we analysed the prevalence of hospital-diagnosed diseases, sociodemographic and other factors affecting the ability to drive at the time of FMVA between these groups. Results: Elderly drivers accounted for almost one fifth (17.2%) of all driver deaths in FMVAs in Finland between 1990–2011. 89.2% of these deaths involved male drivers. Among the oldest, diseases of the circulatory system were most common. The diseases of the nervous system and driving under the influence of alcohol were most common among the younger group. Differences between age groups of elderly drivers, concerning morbidity and other variables studied, were emphasized. Conclusions: Our findings highlight the need for further attention on variation between different age groups of elderly drivers when evaluating fitness to drive.

Background: As a prerequisite to start a medical practice in India, Foreign Medical graduates on returning have to sit for FMGE (Foreign Medical Graduate's Exam), organized by NBE. The time and effort involved by the students with adjustments to various changes in educational and examination pattern may manifest as psychiatric morbidities while awaiting a positive outcome. Aim: To evaluate depression, anxiety, stress, and insomnia in Foreign Medical Graduate students and to understand the various factors associated with them. Materials and Methods: A total of 80 MBBS students appearing for FMGE were enrolled during the period of April 2023 to May 2023, after obtaining their written consent on the Google form to participate in this study. The participants answered a semi-structured proforma consisting of information about sociodemographic data, DASS-21 (depression, anxiety, and stress severity scale), ISI scale (insomnia severity index), and RSES (Rosenberg self-esteem scale). Results: In this study, 76.2%, 80%, 72.5%, and 78.8% of students were found to be suffering from depression, anxiety, stress, and insomnia, respectively. A significant statistical correlation was found between anxiety and the students appearing for July FMGE 2023. Stress and depression were associated with insecurities/comparisons faced by the participants due to peers clearing the examination before them. Low self-esteem was associated with 3 or more failed attempts for FMGE and the presence of other stressors preceding/concurrent while preparing for FMGE. Clinical insomnia was found to be statistically significant with depression, anxiety as well as stress in this study. Multiple regression analysis showed that stress and anxiety predicted depression while the young age of the student, low socioeconomic status, low self-esteem, stress, and depression predicted anxiety. Stress was found to be associated with anxiety, depression, and insomnia. Insomnia was corelated with having extension in the UG course and stress while low self-esteem was corelated with students who were attempting for the July 2023 examination and anxiety. Conclusion: The significantly high proportion of psychiatric morbidities among Foreign Medical Graduates is suggestive of the need for the necessary psychological aid and counseling as these foreign medical graduates can be viewed as an opportunity to correct India's physician shortage. [ABSTRACT FROM AUTHOR]

Introduction: Several psychological and social factors influence the incidence, treatment, and outcome of cancer patients. Depressive symptoms are more common in cancer patients, particularly in late stages. Women in Indian settings often exhibit delayed treatment-seeking behaviour. Aim: To assess the prevalence, type, and severity of psychiatric morbidity as well as the duration, type, and stage of illness in gynaecological oncology patients. Materials and Methods: This cross-sectional study was conducted among 100 gynaecological oncology patients aged 18 to 65 years, who were attending the gynaecologic Outpatient Department (OPD) and ward at a tertiary care hospital. The study took place at Government Rajaji Hospital, Madurai, between May 2013 and November 2013. Data was collected using a semistructured questionnaire from the patient and a reliable informant, after obtaining informed consent. The data was entered into Microsoft Excel and analysed using Statistical Package for Social Sciences (SPSS) software version 20.0. Central values, dispersion, and Chi-square tests were calculated. Results: The sample comprised 100 gynaecological oncology patients, with 30 (30%) diagnosed with malignancy, 43 (43%) with a benign condition, and 27 (27%) under investigation. Among the 100 patients assessed, 34 (34%) had psychiatric morbidity. There was a significantly higher prevalence among older patients, those with more than six months’ duration of gynaecological morbidity, and those exhibiting non fatal suicidal behaviour. Conclusion: Psychiatric morbidity is highly prevalent in gynaecological oncology patients. Depression was found to be more frequent and severe in patients with cancer. A previous history of suicidal attempts and a family history of psychiatric illness are important predictors of psychiatric morbidity in this population. Future studies on a larger population should explore the biological relationship between gynaecological oncology and psychiatric illness.

Background: During the perimenopausal phase, women experience a myriad of somatic symptoms as well as changes in mood and emotions which could be related to the endocrine changes and psychological factors during this transition. Aim: The aim was to assess the prevalence of somatic symptoms and psychiatric morbidity in perimenopausal women. Material and Methods: By purposive sampling, 100 women in the age group of 45–55 years were included in the study with their consent. They were assessed with a self-made sociodemographic proforma, Mini-International Neuropsychiatric Interview (MINI), depression, anxiety, stress scale (DASS 21), Menopause Rating Scale, big five inventory scale (BFI-10), and social support scale. Results: Psychiatric morbidity was seen in 41% of perimenopausal women, out of which 32% showed somatic symptoms. Seventeen percent had mild-to-moderate depressive features, 17% showed mild-to-moderate anxiety, and 7% were dysthymic. Conclusion: Prevalent life stressors seemed to affect the transition into menopause for many women which directly corresponded to the prevalence of psychiatric morbidity and somatic symptoms in them.

Background: The COVID-19 pandemic has been associated with multiple psychiatric problems in the general population as well as in those admitted with the infection. Studies done so far have mainly focused on the general population. It is important to address the needs and gaps in mental and psychological aspect of health of patients admitted with the infection to improve their overall prognosis. This study was undertaken with the aim to study the pattern of psychiatric referrals of hospitalized COVID-19 patients and to find out if there is any association between their socio-demographics, severity of COVID-19 infection, inflammatory markers, and co-morbidities. Materials and Methods: A descriptive, retrospective chart analysis of the record of 160 psychiatry referrals for COVID-19 patients seen by the on-call psychiatrist from May 2020 to October 2020 in a tertiary care hospital was undertaken. Sociodemographic data, severity of COVID-19 infection, blood investigation reports, psychiatric symptoms, diagnosis and management were recorded, tabulated, and analyzed using SPSS 20. Results: Referrals were more for individuals having moderate-to-severe COVID-19 infection, in elderly patients and in males. The most common reason for referral was disorientation (27.5%) and insomnia (27.5%), followed by the patient having a preexisting psychiatric illness (15%). The most common psychiatric diagnosis was delirium secondary to general medical condition, (28%), followed by anxiety and depressive spectrum disorders (23.75%). 32.5% of the patients referred had a past history of psychiatric illness, the most common being substance use disorder, followed by major depressive disorder and mixed anxiety depression. With the increase in the age of the individuals, the number of referrals for males was significantly more as compared to females (P = 0.00). No statistically significant association was found between age (P = 0.83), gender (P = 0.99), and psychiatric diagnosis. No significant association was found between the severity of COVID-19 and psychiatric diagnosis (P = 0.69). Conclusion: It is essential to screen for psychiatric disorders in patients admitted for COVID, as it goes a long way in reducing the overall morbidity and improves patient cooperation for various procedures which could be life-saving.

Introduction: Several psychological and social factors influence the incidence, treatment, and outcome of cancer patients. Depressive symptoms are more common in cancer patients, particularly in late stages. Women in Indian settings often exhibit delayed treatment-seeking behaviour. Aim: To assess the prevalence, type, and severity of psychiatric morbidity as well as the duration, type, and stage of illness in gynaecological oncology patients. Materials and Methods: This cross-sectional study was conducted among 100 gynaecological oncology patients aged 18 to 65 years, who were attending the gynaecologic Outpatient Department (OPD) and ward at a tertiary care hospital. The study took place at Government Rajaji Hospital, Madurai, between May 2013 and November 2013. Data was collected using a semistructured questionnaire from the patient and a reliable informant, after obtaining informed consent. The data was entered into Microsoft Excel and analysed using Statistical Package for Social Sciences (SPSS) software version 20.0. Central values, dispersion, and Chi-square tests were calculated. Results: The sample comprised 100 gynaecological oncology patients, with 30 (30%) diagnosed with malignancy, 43 (43%) with a benign condition, and 27 (27%) under investigation. Among the 100 patients assessed, 34 (34%) had psychiatric morbidity. There was a significantly higher prevalence among older patients, those with more than six months' duration of gynaecological morbidity, and those exhibiting non fatal suicidal behaviour. Conclusion: Psychiatric morbidity is highly prevalent in gynaecological oncology patients. Depression was found to be more frequent and severe in patients with cancer. A previous history of suicidal attempts and a family history of psychiatric illness are important predictors of psychiatric morbidity in this population. Future studies on a larger population should explore the biological relationship between gynaecological oncology and psychiatric illness. [ABSTRACT FROM AUTHOR]

Background: During the perimenopausal phase, women experience a myriad of somatic symptoms as well as changes in mood and emotions which could be related to the endocrine changes and psychological factors during this transition. Aim: The aim was to assess the prevalence of somatic symptoms and psychiatric morbidity in perimenopausal women. Material and Methods: By purposive sampling, 100 women in the age group of 45-55 years were included in the study with their consent. They were assessed with a self-made sociodemographic proforma, Mini-International Neuropsychiatric Interview (MINI), depression, anxiety, stress scale (DASS 21), Menopause Rating Scale, big five inventory scale (BFI-10), and social support scale. Results: Psychiatric morbidity was seen in 41% of perimenopausal women, out of which 32% showed somatic symptoms. Seventeen percent had mild-to-moderate depressive features, 17% showed mild-to-moderate anxiety, and 7% were dysthymic. Conclusion: Prevalent life stressors seemed to affect the transition into menopause for many women which directly corresponded to the prevalence of psychiatric morbidity and somatic symptoms in them. [ABSTRACT FROM AUTHOR]

Background: As a prerequisite to start a medical practice in India, Foreign Medical graduates on returning have to sit for FMGE (Foreign Medical Graduate’s Exam), organized by NBE. The time and effort involved by the students with adjustments to various changes in educational and examination pattern may manifest as psychiatric morbidities while awaiting a positive outcome. Aim: To evaluate depression, anxiety, stress, and insomnia in Foreign Medical Graduate students and to understand the various factors associated with them. Materials and Methods: A total of 80 MBBS students appearing for FMGE were enrolled during the period of April 2023 to May 2023, after obtaining their written consent on the Google form to participate in this study. The participants answered a semi-structured proforma consisting of information about sociodemographic data, DASS-21 (depression, anxiety, and stress severity scale), ISI scale (insomnia severity index), and RSES (Rosenberg self-esteem scale). Results: In this study, 76.2%, 80%, 72.5%, and 78.8% of students were found to be suffering from depression, anxiety, stress, and insomnia, respectively. A significant statistical correlation was found between anxiety and the students appearing for July FMGE 2023. Stress and depression were associated with insecurities/comparisons faced by the participants due to peers clearing the examination before them. Low self-esteem was associated with 3 or more failed attempts for FMGE and the presence of other stressors preceding/concurrent while preparing for FMGE. Clinical insomnia was found to be statistically significant with depression, anxiety as well as stress in this study. Multiple regression analysis showed that stress and anxiety predicted depression while the young age of the student, low socioeconomic status, low self-esteem, stress, and depression predicted anxiety. Stress was found to be associated with anxiety, depression, and insomnia. Insomnia was corelated with having extension in the UG course and stress while low self-esteem was corelated with students who were attempting for the July 2023 examination and anxiety. Conclusion: The significantly high proportion of psychiatric morbidities among Foreign Medical Graduates is suggestive of the need for the necessary psychological aid and counseling as these foreign medical graduates can be viewed as an opportunity to correct India’s physician shortage.

BackgroundSouth Africa's rates of psychiatric morbidity are among the highest in sub-Saharan Africa and are foregrounded by the country's long history of political violence during apartheid. Growing evidence suggests that in utero stress exposure is a potent developmental risk factor for future mental illness risk, yet the extent to which the psychiatric effects of prenatal stress impact the next generation are unknown. We evaluate the intergenerational effects of prenatal stress experienced during apartheid on psychiatric morbidity among children at ages 17-18 and also assess the moderating effects of maternal age, social support, and past household adversity.MethodsParticipants come from Birth-to-Twenty, a longitudinal birth cohort study in Soweto-Johannesburg, South Africa's largest peri-urban township which was the epicentre of violent repression and resistance during the final years of the apartheid regime. Pregnant women were prospectively enrolled in 1990 and completed questionnaires assessing social experiences, and their children's psychiatric morbidity were assessed at ages 17-18.ResultsFull data were available from 304 mother-child pairs in 2007-8. Maternal prenatal stress in 1990 was not directly associated greater psychiatric morbidity during at ages 17-18. Maternal age and past household adversity moderated the intergenerational mental health effects of prenatal stress such that children born to younger mothers and late adolescent/young adult children experiencing greater household adversity exhibited worse psychiatric morbidity at ages 17-18. Social support did not buffer against the long-term psychiatric impacts of prenatal stress.ConclusionsGreater prenatal stress from apartheid predicted adverse psychiatric outcomes among children born to younger mothers and adolescents/young adults who experienced greater concurrent stress. Our findings suggest that prenatal stress may affect adolescent mental health, have stress-sensitising effects, and represent possible intergenerational effects of trauma experienced under apartheid in this sample.

Aim: Childhood stressors can increase adult stress perception and may accumulate over the lifespan to impact symptoms of multiple sclerosis (MS). Growing evidence links childhood stressors (e.g., abuse, neglect) to fatigue, pain, and psychiatric morbidity in adults with MS; yet literature in this area is lacking a comprehensive lifespan approach. The aim of this cross-sectional study was to examine contributions of childhood and adulthood stressor characteristics (i.e., count, severity), on three individual outcomes: fatigue, pain interference, and psychiatric morbidity in People with MS (PwMS). Methods: An online survey was distributed through the National MS Society. Hierarchical block regression modeling was used to sequentially assess baseline demographics, childhood stressors, and adult stressors per outcome. We hypothesized that child and adult stressors would significantly contribute to fatigue, pain interference, and psychiatric morbidity. Results: Overall, 713 PwMS informed at least one final analytic model. Both childhood and adult stressors significantly contributed to pain interference and psychiatric morbidity. Adult stressor severity independently correlated with psychiatric morbidity (P < 0.0001). Childhood stressors significantly contributed to fatigue (LR test P < 0.0001). Childhood stressor severity independently significantly correlated with both fatigue likelihood (P = 0.03) and magnitude (P < 0.001). Conclusions: This work supports a relationship between stressors across the lifespan and fatigue, pain, and psychiatric morbidity in PwMS. Stressor severity may have an important role which may not be captured in count-based trauma measurement tools. Clinicians and researchers should consider lifetime stress when addressing fatigue, pain, and psychiatric morbidity among PwMS.

Background: The COVID-19 pandemic has been associated with multiple psychiatric problems in the general population as well as in those admitted with the infection. Studies done so far have mainly focused on the general population. It is important to address the needs and gaps in mental and psychological aspect of health of patients admitted with the infection to improve their overall prognosis. This study was undertaken with the aim to study the pattern of psychiatric referrals of hospitalized COVID-19 patients and to find out if there is any association between their socio-demographics, severity of COVID-19 infection, inflammatory markers, and co-morbidities. Materials and Methods: A descriptive, retrospective chart analysis of the record of 160 psychiatry referrals for COVID-19 patients seen by the on-call psychiatrist from May 2020 to October 2020 in a tertiary care hospital was undertaken. Sociodemographic data, severity of COVID-19 infection, blood investigation reports, psychiatric symptoms, diagnosis and management were recorded, tabulated, and analyzed using SPSS 20. Results: Referrals were more for individuals having moderate-to-severe COVID-19 infection, in elderly patients and in males. The most common reason for referral was disorientation (27.5%) and insomnia (27.5%), followed by the patient having a preexisting psychiatric illness (15%). The most common psychiatric diagnosis was delirium secondary to general medical condition, (28%), followed by anxiety and depressive spectrum disorders (23.75%). 32.5% of the patients referred had a past history of psychiatric illness, the most common being substance use disorder, followed by major depressive disorder and mixed anxiety depression. With the increase in the age of the individuals, the number of referrals for males was significantly more as compared to females (P = 0.00). No statistically significant association was found between age (P = 0.83), gender (P = 0.99), and psychiatric diagnosis. No significant association was found between the severity of COVID-19 and psychiatric diagnosis (P = 0.69). Conclusion: It is essential to screen for psychiatric disorders in patients admitted for COVID, as it goes a long way in reducing the overall morbidity and improves patient cooperation for various procedures which could be life-saving. [ABSTRACT FROM AUTHOR]

Introduction: Around 2.2 billion of the world's population are children and adolescents. Ninety percentage live in low-and middle-income countries, where they make up 30%–50% of the population. This study examines mental health issues and their association with gender in Melmaruvathur, teenage school children. Materials and Methods: After receiving approval from the Ethics Committee, a descriptive cross-sectional questionnaire-based study was carried out on adolescents who were attending school in Melmaruvathur. The participants in the study filled out the questionnaires. The power of the study was set at 80%, and the significance level was set at 0.05. The estimated size of the sample was 500. The duration of the study was approximately 1 ½ years, beginning on June 1, 2021, and ending on December 30, 2022. The age range was anywhere between 11 and 17 years, participants had to be adolescents who attended school. Those who had participated in mental health training programs in the past were not allowed to participate. Results: There were about 43.4% of females and 56.6% of males among the study participants. About 3.0% had very high conduct problems, 5.80% had high conduct problems, 1.4% had very high hyperactivity, around 1.80% had very high emotional problems, around 7.40% had very high peer problems, and 6.80% had very low prosocial. There was no statistically significant difference between the genders regarding conduct problems, hyperactivity problems, emotional problems, peer problems, and prosocial. In the case of females, 77.52% had a total difficulty score that was quite close to the average and in males, 81.53% received a total difficulty score that was quite close to the average. Conclusion: The findings are significant for several reasons, including the understanding of gender-specific vulnerabilities, the creation of youth mental health interventions that are more specifically focused on youth, and the peculiarities of the home setting. [ABSTRACT FROM AUTHOR]

Abstract Aims This study compared those living with and without an intestinal stoma in relation to physical and psychological health, stress and coping, quality of life and resilience. Also, identifying factors that could be used to promote better self‐care in stoma patients in the future. Design A cross‐sectional and comparative study design was employed. Methods Participants were recruited via email and social media (Facebook and Twitter) between August 2018 and March 2019, to complete an online survey. The data were analysed using analysis of variance to examine group difference and a series of hierarchical linear regression analyses determining predictors of psychological well‐being. Results Of 278 participants aged 18–68 years who completed the survey, 129 (46%) had a stoma and reported significantly poorer physical health. Approximately one‐fifth experienced problems with stoma management. Psychological well‐being was mediated by the duration of living with a stoma (under 3 years) and frequency of leaks (weekly and monthly).

Background: Violence in psychiatric patients is a major concern to both public and mental health professionals. Risk of violence (ROV) in patients can cause a high degree of psychological stress on caregivers that may predispose them to various psychological problems. Aim: To estimate the ROV in patients with severe mental illness and to estimate the relationship between the ROV among severely mentally ill and the psychiatric morbidity in their primary caregivers. Methods: A cross-sectional study was conducted at a tertiary care center involving 308 patient subjects and their caregivers. Socio-demographic data were collected using a proforma, and caregivers were diagnosed based on the International Classification of Diseases-10 using Mini International Neuropsychiatric Interview (MINI)-Plus. ROV was assessed using Historical Clinical Risk Management (HCR)-20, Version 3. Statistical analysis was done using the Chi-square test for association and odds ratio and its 95% confidence interval for the strength of association. Results: High ROV was found in 32.5% of the severely mentally ill. Caregivers reported a high rate of psychiatric disorders (44.8%), of which 71.7% were mood disorders. A significant association was found between ROV in patients and psychiatric morbidity in their caregivers (p = 0.001). Conclusion: ROV is high among the severely mentally ill. There is a high rate of psychiatric morbidity among caregivers of patients with a high ROV. There is a significant association between psychiatric morbidity in caregivers and ROV in patients.

Introduction: Everyone has a fundamental right to enjoy the best possible level of physical and mental health, irrespective of race or gender. The incarcerated are taken away from their friends and relatives, regardless of their mental state. There is a high prevalence of mental illness among male and female prisoners, as per various studies. The aim of the study is to assess the prevalence of psychiatric morbidity among prisoners without a past history of psychiatric illnesses, to determine the association of socio-demographic factors, and to assess the prevalence of various psychiatric disorders in this population. Methods: A cross-sectional study was conducted on 200 male prisoners by simple random sampling. The assessment was done using a self-prepared socio-demographic proforma and Mini International Neuropsychiatric Interview. Result: The prevalence of any psychiatric morbidity was observed to be 86%, and the most commonly seen morbidity was substance use disorder (81%), followed by adjustment disorders (20%), and 96% had a low risk for suicide. There was almost equal representation of age groups: 74% of prisoners were married or widowed, 90% belonged to rural residences, 75% of the participants had secondary education or below, almost 95% were below poverty line, and 92% were employed previously. Conclusion: In our study, we found that the most common reason for imprisonment was murder and other causes like abkari, family law related, as well as political issues. Almost 12% and 18% reported crime in the family and crime by peers. The most commonly seen morbidity was substance use disorder (81%), followed by adjustment disorders (20%). Around 96% had a low risk for suicide.

Introduction: According to the WHO, non-communicable diseases cause 71% of all deaths globally. Despite many studies showing a significant association between non-communicable diseases (NCDs) and cognitive decline, it is not researched in Tamil Nadu. Hence, this study was conducted to screen for psychiatric morbidity and cognitive impairment (CI) among NCD patients in Southern Chennai. Aims: The aim of this study was to estimate the prevalence of psychiatric morbidity and CI and their associated factors among NCD patients attending NCD clinics of tertiary care hospitals. Methods and Material: A cross-sectional study was carried out in NCD patients (n = 343) attending an NCD clinic in a tertiary care hospital. Basic sociodemographic and clinical details were obtained by a semi-structured questionnaire. Cognition function and psychiatric morbidity were assessed using mini-mental state examination, patient health questionnaire 9 and generalised anxiety disorder 7 tools, respectively. Results: The mean age of the study participants was 58 years. Of 343 participants, 19.2% had severe CI, 26.8% had severe depression, and 29.7% had severe anxiety. Among 180 participants aged 59–86 years, 25.5% participants had osteoarthritis; of these, 41.3% had severe CI (P < 0.0001), 82.6% had severe depression (P < 0.0001) and 63% had severe anxiety (P < 0.027), and their association was statistically significant. Conclusions: This study concludes that about one-fourth of the NCD patients suffered from CI and psychiatric morbidity, which are of rising concern. Musculoskeletal diseases are neglected to be assessed under NCDs, and in this study, osteoarthritis was found to be significantly associated with depression, anxiety and CI.

Introduction: Individuals with permanent orthopedic disability face many adversities and may suffer more from psychiatric illnesses as compared to the normal population. This may affect their self‑esteem and quality of life. Aim: To study the impact of psychiatric morbidity on quality of life and self‑esteem in subjects with permanent orthopedic disability. Methodology: The study was conducted by the Department of Psychiatry, of a tertiary care hospital from August 1, 2018, to August 1, 2019. A total of 50 subjects over the age of 18 years with permanent orthopedic disability were consecutively enrolled in the department of orthopedics. Orthopedical disability of subjects was assessed and diagnosed by one senior consultant of the Orthopaedics department. Clearance from the Institute’s Ethics Committee was obtained before the start of the study. Psychiatric morbidity was screened in the Mini International Neuropsychiatric Interview. Psychiatric diagnosis was confirmed by two senior consultants of the Psychiatry department and as per the International Classification of Diseases‑10th edition‑Clinical Description and Diagnostic Guidelines. Self‑esteem and quality of life were assessed on Rosenberg Self‑esteem Scale (RSES) and WHO‑ Quality of Life‑BREF (WHO QoL Bref), respectively. Results: Statistically significant impact of presence of psychiatric morbidity on Question 1 (P = 0.010), Question 2 (P = 0.002), physical domain (P = 0.001), psychological domain (P = 0.001), social relationship domain (P = 0.001), and environmental domain (P = 0.001) of WHO‑QoL‑Bref was observed. Subjects with psychiatric illness had lower mean scores as compared to subjects without psychiatric illness. The impact of psychiatric morbidity was also statistically significant on RSES scores (P = 0.000). Conclusion: Psychiatric morbidity impacts the quality of life index and self‑esteem negatively in individuals with a permanent orthopedic disability. [ABSTRACT FROM AUTHOR]

Background: Among the Indian adolescents, the prevalence of psychiatric morbidity and alcohol use disorders (AUD) are 7.3% and 1.3%. However, no separate data are available for indigenous tribal populations. This study estimated the prevalence of psychiatric morbidity and AUD and associated socio-demographic factors among adolescents in the tribal communities in three widely varying states in India. Methods: Using validated Indian versions of the MINI 6.0, MINI Kid 6.0, and ICD-10 criteria, we conducted a cross-sectional survey from January to May 2019 in three Indian sites: Valsad, Gujarat (western India); Nilgiris, Tamil Nadu (south India); and East Khasi Hills district of Meghalaya (north-east India) on 623 indigenous tribal adolescents. Results: Aggregate prevalence of any psychiatric morbidity was 15.9% (95% CI: 13.1–19.0) (males: 13.6%, 95% CI: 10.0–18.1; females: 17.9%, 95% CI: 13.9–22.6), with site-wise statistically significant differences: Gujarat: 23.8% (95% CI: 18.1–30.2), Meghalaya: 17.1% (95% CI: 12.4–22.7), Tamil Nadu: 6.2% (95% CI: 3.2–10.5). The prevalence of diagnostic groups was mood disorders 6.4% (n = 40), neurotic- and stress-related disorders 9.1% (n = 57), phobic anxiety disorder 6.3% (n = 39), AUD 2.7% (n = 17), behavioral and emotional disorders 2.7% (n = 17), and obsessive-compulsive disorder 2.2% (n = 14). These differed across the sites. Conclusion: The prevalence of psychiatric morbidity in adolescent tribals is approximately twice the national average. The most common psychiatric morbidities reported are mood (affective) disorders, neurotic- and stress-related disorders, phobic anxiety disorder, AUD, behavioral and emotional disorders, andobsessive-compulsive disorder. [ABSTRACT FROM AUTHOR]

Background: Amputation of a limb is equivalent to loss of a person's life. Psychological aspects are essential factors in dealing with the disability and functional outcome is a significant concern. Longitudinal studies have not examined the experience and determinants of common mental health problems and functional outcome in lower limb amputees. Materials and Methodology: A total of 103 lower limb amputees were recruited and followed up for 6 months. Patients were assessed on Hospital Anxiety and Depression Scale (HADS) and Social Functioning (SF-36) Quality of life, semi-structured clinical interview for psychiatric disorders and phantom limb at baseline (in hospital), at 2 weeks, 3 months and 6 months, respectively after discharge. Holistic care was provided through psychological counselling, supportive sessions, medications if required, rehabilitation counselling, prosthesis implantation, and treatment as usual. Results: Holistic care resulted in a statistically significant reduction in anxiety, depression and overall psychiatric morbidity as measured on HADS (p < 0.001). There was a significant improvement in all the domains of SF-36 (p -< 0.001) except the role of limitation due to physical activity. The intervention also resulted in a statistically significant reduction in the presence of phantom limbs. Conclusion: Amputees should be provided holistic care under one roof, which was found to be very useful in treating psychiatric morbidity, social functioning and quality of life. [ABSTRACT FROM AUTHOR]

A comparative cross-sectional study was conducted among 991 pregnant and 674 non-pregnant women of reproductive age attending healthcare facilities in Ibadan, Nigeria using the General Health Questionnaire-12 (GHQ), and WHO self-reporting questionnaire (SRQ). Logistic regression analysis was conducted to identify predictors of psychiatric morbidity at p < 0.05. A significantly higher proportion of pregnant women experienced psychological distress on the GHQ (51.8%) and psychiatric morbidity on SRQ (33.3%) compared with 28.6% and 18.2% of non-pregnant women, respectively. Predictors of psychiatric morbidity among pregnant women were the type of facility, poor satisfaction and communication with partners, the experience of violence in the home, previous abortions, and previous history of depression. Psychiatric morbidity among non-pregnant women was predicted by younger age, previous history of depression, poor satisfaction and communication with partners. There is a need for early identification of psychiatric morbidity among women of reproductive age, to ensure early interventions and prevent long-term disability. What is already known on this subject? Psychiatric morbidity has immense effects on a woman's quality of life, social functioning, obstetric outcome, and economic productivity. What do the results of this study add? Psychiatric morbidity among women of reproductive age is high. Pregnant women when compared to non-pregnant women had significantly higher rates of psychiatric morbidity. This high prevalence of psychiatric morbidity in both groups was predicted by poor satisfaction and communication with partners, and a previous history of depression. What are the implications of these findings for clinical practice and/or further research? Simple screening for women of reproductive age attending healthcare facilities may help with the early identification of psychiatric morbidity leading to prompt interventions, and preventing long-term disability. [ABSTRACT FROM AUTHOR]

Aims: This study compared those living with and without an intestinal stoma in relation to physical and psychological health, stress and coping, quality of life and resilience. Also, identifying factors that could be used to promote better self‐care in stoma patients in the future. Design: A cross‐sectional and comparative study design was employed. Methods: Participants were recruited via email and social media (Facebook and Twitter) between August 2018 and March 2019, to complete an online survey. The data were analysed using analysis of variance to examine group difference and a series of hierarchical linear regression analyses determining predictors of psychological well‐being. Results: Of 278 participants aged 18–68 years who completed the survey, 129 (46%) had a stoma and reported significantly poorer physical health. Approximately one‐fifth experienced problems with stoma management. Psychological well‐being was mediated by the duration of living with a stoma (under 3 years) and frequency of leaks (weekly and monthly). [ABSTRACT FROM AUTHOR]

Introduction: According to the WHO, non-communicable diseases cause 71% of all deaths globally. Despite many studies showing a significant association between non-communicable diseases (NCDs) and cognitive decline, it is not researched in Tamil Nadu. Hence, this study was conducted to screen for psychiatric morbidity and cognitive impairment (CI) among NCD patients in Southern Chennai. Aims: The aim of this study was to estimate the prevalence of psychiatric morbidity and CI and their associated factors among NCD patients attending NCD clinics of tertiary care hospitals. Methods and Material: A cross-sectional study was carried out in NCD patients (n = 343) attending an NCD clinic in a tertiary care hospital. Basic sociodemographic and clinical details were obtained by a semi-structured questionnaire. Cognition function and psychiatric morbidity were assessed using mini-mental state examination, patient health questionnaire 9 and generalised anxiety disorder 7 tools, respectively. Results: The mean age of the study participants was 58 years. Of 343 participants, 19.2% had severe CI, 26.8% had severe depression, and 29.7% had severe anxiety. Among 180 participants aged 59–86 years, 25.5% participants had osteoarthritis; of these, 41.3% had severe CI (P < 0.0001), 82.6% had severe depression (P < 0.0001) and 63% had severe anxiety (P < 0.027), and their association was statistically significant. Conclusions: This study concludes that about one-fourth of the NCD patients suffered from CI and psychiatric morbidity, which are of rising concern. Musculoskeletal diseases are neglected to be assessed under NCDs, and in this study, osteoarthritis was found to be significantly associated with depression, anxiety and CI. [ABSTRACT FROM AUTHOR]

Abstract Purpose Research suggests that women in prison have more mental health problems than men and are prone to suffer from more severe psychiatric disorders. This study utilizes national registry data to describe demographic and psychiatric gender differences in Norwegian prisons, and to investigate comorbid psychiatric disorders and time trends in psychiatric morbidity among women. Methods Longitudinal data from the Norwegian Prison Release Study linked with the Norwegian Patient Registry and data from Statistics Norway provided information on health care utilization, socioeconomic status, and history of psychiatric disorders among all individuals (nwomen = 5,429; nmen = 45,432) who were incarcerated in a Norwegian prison between 2010 and 2019. Results Women were more likely than men to have a history of any psychiatric disorder (75% vs. 59%). Substance use disorders and dual disorders were highly prevalent in both genders, yet highest among women (56 and 38% respectively, versus 43 and 24% among men). From 2010 to 2019, we found a considerable increase in the 12-month prevalence of most diagnostic categories among women entering prison. Conclusion Psychiatric and dual disorders are highly prevalent in Norwegian prisons, and especially among women. The proportion of women entering prison with a recent history of mental health problems has increased rapidly over the last decade. Women’s prison institutions need to adjust health and social services, and awareness about substance use and other psychiatric disorders in order to meet the increasing proportion of women facing these challenges.

Background: Human immunodeficiency virus/ Acquired immunodeficiency syndrome (HIV/AIDS), has remained a disease of public health concern, with the largest burden being found in sub Saharan Africa. The advent of anti-retroviral therapy (ART) has significantly reduced the mortality of the disease, thereby transforming it to a chronic disorder, with significant co-morbid psychiatric sequalae. Objectives: To determine the prevalence and pattern of psychiatric morbidity among PLWHA attending Aminu Kano Teaching Hospital, Kano. Materials and methods: This was a cross sectional study of adult patients with HIV/AIDS attending outpatient clinic at the S.S. Wali Virology Centre of Aminu Kano Teaching Hospital who gave informed consent. Systematic random sampling technique was used. Patients aged 18years and above who had been on ARV drugs for at least one year were included, while those who had a medical emergency and needed immediate attention were excluded. Socio demographic characteristics were obtained using a socio-demographic questionnaire and psychiatric morbidity was assessed with the MINI International Neuropsychiatry Interview. Results: A total of 420 participants were recruited in the study with a male to female ratio of 1:1.5 and mean age of 40.4±10.0 years. The prevalence of a psychiatric disorder was 22.1% out of whom 5.0% had more than one psychiatric diagnosis. Major depression was the most common (11%) psychiatric disorder. Generalized Anxiety disorder, substance abuse, post-traumatic stress disorder and alcohol abuse accounted for 7.6%, 5.5%, 2.4% and 1.7% of psychiatric disorders respectively. Conclusion: Psychiatric disorders are common in PLWHA, with major depression being the commonest.

Background: Breast cancer causes a wide range of physical and psychological issues. Breast cancer treatment affects woman's body image and sexuality which can impact psychological well-being and quality of life (QOL). Aims: This study aimed to assess body image concern among breast cancer patients and to compare it with healthy women and to assess QOL and psychological reaction among breast cancer patients. Settings and Design: This was a comparative cross-sectional study, conducted at a tertiary care hospital on breast cancer patients compared to age-matched healthy women taken as controls. Materials and Methods: Data were collected using a semi-structured questionnaire, Body Image Scale, European Organization for Research and Treatment of Cancer Breast Cancer-Specific QOL Questionnaire, Hamilton Anxiety Rating Scale, and Hamilton Depression Rating Scale. Statistical Analysis Used: Data were analyzed with Epi Info 7. Mean and standard deviation for continuous variables and percentages and Chi-square test for categorical variables were used. P < 0.05 was considered statistically significant. Results: Breast cancer patients were having high body image concern as compared to healthy women. On QOL assessment, scores of body image and future perspective were comparatively low-low level of functioning and scores were high for breast symptoms and hair loss-high level of symptomatology. More patients had significant anxiety and depressive symptoms. Conclusions: Breast cancer patients were having high body image concern and poor QOL as compared to age-matched healthy women, associated with significant depression and anxiety.

Aim: This study aims to evaluate the prevalence of psychiatric morbidity and suicidal behavior by using a structured diagnostic interview in patients of chronic kidney disease currently on dialysis. An additional aim of the study was to evaluate the impact of psychiatric morbidity on quality of life (QOL). Methodology: One hundred and ten patients undergoing hemodialysis were evaluated, at least 24 h after the last dialysis on Mini International Neuropsychiatric Interview PLUS (MINI PLUS), Columbia Suicide Severity Rating Scale (C-SSRS), and Beck Depression Inventory Second Edition. Results: On MINI-PLUS, about two-thirds (67.3%) of the study sample fulfilled at least one-lifetime psychiatric diagnosis and half of the study participants fulfilled a current psychiatric diagnosis. More than one-fourth (29.1%) of the study participants had more than one psychiatric diagnosis. Among various psychiatric disorders, depressive disorders were the most common (45.5%). About one-third of the participants had suicidality, as assessed on MINI-PLUS and C-SSRS. Compared to those without psychiatric morbidity, those with psychiatric morbidity had a poor QOL. Conclusions: In view of the high psychiatric morbidity and its negative impact on the QOL of patients undergoing hemodialysis, there is a need for close liaison between nephrologists, transplant surgeons and mental health professionals.

Purpose: Research suggests that women in prison have more mental health problems than men and are prone to suffer from more severe psychiatric disorders. This study utilizes national registry data to describe demographic and psychiatric gender differences in Norwegian prisons, and to investigate comorbid psychiatric disorders and time trends in psychiatric morbidity among women. Methods: Longitudinal data from the Norwegian Prison Release Study linked with the Norwegian Patient Registry and data from Statistics Norway provided information on health care utilization, socioeconomic status, and history of psychiatric disorders among all individuals (nwomen = 5,429; nmen = 45,432) who were incarcerated in a Norwegian prison between 2010 and 2019. Results: Women were more likely than men to have a history of any psychiatric disorder (75% vs. 59%). Substance use disorders and dual disorders were highly prevalent in both genders, yet highest among women (56 and 38% respectively, versus 43 and 24% among men). From 2010 to 2019, we found a considerable increase in the 12-month prevalence of most diagnostic categories among women entering prison. Conclusion: Psychiatric and dual disorders are highly prevalent in Norwegian prisons, and especially among women. The proportion of women entering prison with a recent history of mental health problems has increased rapidly over the last decade. Women's prison institutions need to adjust health and social services, and awareness about substance use and other psychiatric disorders in order to meet the increasing proportion of women facing these challenges. [ABSTRACT FROM AUTHOR]

Background: Anxiety and depression in patients with asthma have been linked to frequent exacerbations, increased use of healthcare resources, and poor asthma control. Objectives: In the current study,we examined the correlations between asthma and symptoms of depression/anxiety in adolescents with asthma referred to Masih Daneshvari and Mofid hospitals during 2020 - 2021. Methods: The current observational, cross-sectional study was conducted by administering the Spence Children Anxiety Scale and a demographic information checklist among 105 subjects. Asthma severity was measured using forced expiratory volume in 1 second (FEV1), FEV1/forced vital capacity (FVC), the number of short-acting β-2 agonists used per week or month, the number of night awakenings per week or month, having asthma symptoms in daily activities, the number of asthma attacks needing oral corticosteroids per year, and the number of disease exacerbations per week or month. Data were analyzed, and the correlation between the variables was investigated through linear regression and ordinal logistic regression. Results: Patients with a mean age of 11.3 ± 2.5 years showed a mean overall anxiety score of 14 ± 9 out of 114. There was a significant negative correlation between the overall score of anxiety disorders and FEV1 and FEV1/FVC (P < 0.001). There was also a direct correlation between the overall score of anxiety disorders and the frequency of using β-2 agonists, the number of night awakenings, interference with normal functions, and exacerbation frequency (P < 0.001). Conclusions: Our findings indicated a significant association between anxiety disorders and asthma in children. Considering the high prevalence of asthma in Iran than the global average, studying the underlying mechanisms of anxiety and psychological and environmental variables in children with asthma can aid in developing effective psychological therapies. [ABSTRACT FROM AUTHOR]

Abstract Objective Previous research has demonstrated that individual risk of mental illness is associated with individual, co-resident, and household risk factors. However, modelling the overall effect of these risk factors presents several methodological challenges. In this study we apply a multilevel structural equation model (MSEM) to address some of these challenges and the impact of the different determinants when measuring mental health risk. Study design and setting Two thousand, one hundred forty-three individuals aged 16 and over from 888 households were analysed based on the Household Survey for England-2014 dataset. We applied MSEM to simultaneously measure and identify psychiatric morbidity determinants while accounting for the dependency among individuals within the same household and the measurement errors. Results Younger age, female gender, non-working status, headship of the household, having no close relationship with other people, having history of mental illness and obesity were all significant (p

Background: To assess the prevalence of psychiatric morbidity and stress burden among the patients with limb fractures and compare them with age and gender matched control group. Materials and Methods: The cross-sectional study was conducted on 25 patients each of lower and upper limb fractures, presenting 2 weeks or more after the fracture to orthopedics OPD of Dayanand Medical College and Hospital. Psychiatric manifestations and stress burden were assessed using Mini International Neuropsychiatric Interview (M.I.N.I.), perceived stress scale (PSS), and impact of event scale-revised (IES-R) on the patients. It was compared to an equal number of age and gender matched normal control group. Results: Majority of the patients with limb fractures were male (70%). The upper limb fracture was in age group of 18–30 years (52%), and those with lower limb fracture were >50 years of age (48%). Most common psychiatric morbidity seen in patients was major depressive disorder (52%) which was statistically significant in comparison with control group. The impact of trauma on patients resulted in avoidance and hyperarousal symptoms significantly in lower limb fracture patients than upper limb ones (P < 0.05). Conclusions: The long bone injuries in patient cause significant psychiatric morbidity which increases the stress burden in such patients due to immobility and pain.

Aim and objective: To study the psychiatric morbidity among transgender population. Materials and methods: A cross-sectional study was done using convenience sampling. Sixty consenting transgenders, fulfilling criteria for gender dysphoria based on DSM-5 criteria, were included. The study was done for a period of 18 months. Tools used: For assessing the sociodemographic profile, semi-structured pro forma was used, and for assessing psychiatric morbidities, Mini International Neuropsychiatric Interview (MINI)-plus scale was used. Results: Among 60 participants, 36 (76.6%) had psychiatric morbidity, of which 16 (26.7%) had substance-use disorder, 10 (16.7%) among them had alcohol dependence, and 6 (10%) had nonalcoholic substance-use disorders, such as cannabis, benzodiazepines, and cocaine. Ten (16.7%) participants qualified for the diagnosis of depressive disorder among which six (10%) had mild depression and four (6.7%) had moderate depression. Dysthymia was present in four (6.6%) individuals. Eleven (18.3%) participants had adjustment disorder. Three (5%) of them had anxiety disorder and two (3.3%) had insomnia. Conclusion: Substance use and depression were found to be the most common psychiatric disorders among this population followed by adjustment disorders. As this population is at higher risk of developing other psychiatric problems, regular screening and timely intervention are needed to prevent or treat their psychiatric comorbidities. Clinical significance: The study highlights that there are various psychiatric morbidities prevalent among transgender population, mainly due to the various life adversities they face, which points toward encouraging and creating awareness toward the need for reducing discrimination and accepting the transgender persons in the families, friends, and the community groups which will help them in mainstreaming, achieve welfare, and reduce their psychosocial problems. The findings of this study may help to inform the development of appropriately targeted and tailored mental health interventions and resilience-building programs for transgender population.

Context: Gender is an important factor in determining mental health and mental disease. Women are particularly vulnerable to mental health disorders due to a lack of family support, stigma surrounding mental illness, separation, emotional stress, financial dependency, domestic violence, sexual assault, and human trafficking. Destitute or homeless women have a disproportionately high risk of mental illness. Aims: To determine the prevalence of psychiatric illness and related psychosocial determinants among inmates of a state-run home for women. Settings and Design: This is a single-center, cross-sectional descriptive study. Inmates of a state home for women in the northern part of Karnataka who met the inclusion and exclusion criteria were recruited. Materials and Methods: Eighty participants were evaluated using semi-structured proforma for psycho-social aspects. MINI-PLUS version 5.0 was used to screen the inmates for psychiatric morbidity and the diagnosis was confirmed using the International Classification of Diseases-10. Appropriate statistical tools were applied for the analysis. Results: Majority of the participants (78.75%) were diagnosed to have some psychiatric illness. The most common psychiatric morbidity was psychosis (35%), followed by affective disorders such as major depressive disorder (15%), bipolar disorders (10%), somatization disorders (7.5%), dysthymia (6.5%), and anxiety disorder (5%). Some of the psychosocial factors assessed, namely, marital status, employment status, and poor family support were significantly associated with psychiatric morbidity. Conclusion: This research focuses on psychiatric morbidity, overall clinical profile, and the impact of numerous psychosocial factors on mental health in this vulnerable population. To enhance the general mental health of such a vulnerable group, better policymaking, timely psychiatric interventions, and rehabilitation are required.

The present review sought to examine and summarise the unique experience of concurrent pain and psychiatric conditions, that is often neglected, within the population of homeless individuals. Furthermore, the review examined factors that work to aggravate pain and those that have been shown to improve pain management. Electronic databases (MEDLINE, EMBASE, psycINFO, and Web of Science) and the grey literature (Google Scholar) were searched. Two reviewers independently screened and assessed all literature. The PHO MetaQAT was used to appraise quality of all studies included. Fifty-seven studies were included in this scoping review, with most of the research being based in the United States of America. Several interacting factors were found to exacerbate reported pain, as well as severely affect other crucial aspects of life that correlate directly with health, within the homeless population. Notable factors included drug use as a coping mechanism for pain, as well as opioid use preceding pain; financial issues; transportation problems; stigma; and various psychiatric disorders, such as post-traumatic stress disorder, depression, and anxiety. Important pain management strategies included cannabis use, Accelerated Resolution Therapy for treating trauma, and acupuncture. The homeless population experiences multiple barriers which work to further impact their experience with pain and psychiatric conditions. Psychiatric conditions impact pain experience and can work to intensify already adverse health circumstances of homeless individuals.

Objective: To study the effects of COVID-related psychiatric morbidity on the psychological resilience of male patients. Study Design: Cross-sectional study. Place and Duration of Study: Pak Emirates Military Hospital (PEMH), Rawalpindi and PNS Shifa, Karachi Pakistan from Apr to Jul 2020. Methodology: One hundred and thirteen male patients filled out the depression, anxiety and stress scale (DASS-21) on day zero and the Connor-Davidson resilience scale (CDRS) on day 180. Mean values were calculated for each component of DASS21 and resilience. Pearson correlation was applied to establish statistical significance. Results: The mean values were highest for stress (2.65±4.52), followed by depression (2.02±5.28) and then anxiety (3.63±5.96). The mean resilience was found to be 72.4±14.2. There was a significant negative correlation between each of the three measurements of DASS-21 and its total value with resilience (p

Background: Tuberculosis is the leading cause of infectious death in India and has multidimensional ramifications on an individual. Prevalence of psychiatric morbidity is high in Tuberculosis and is often neglected. Untreated psychiatric morbidity can adversely affect the treatment compliance, long term outcome and Quality of Life of such patients. Aims & Objectives: To determine the prevalence of psychiatric morbidity, its impact on Quality of Life in patients of pulmonary TB and study the relationship between psychiatric morbidity with its clinical correlates. Material & Methods: This was a cross sectional study conducted at a tertiary care hospital among 100 patients of Pulmonary Tuberculosis attending the OPD of Respiratory Medicine between Jan 2021 to Jan 2022, using a semi structured proforma and International Classification of Disease (ICD)-10 criteria were used to confirm the diagnosis. Rating scales such as Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D) were used to assess the severity of anxiety and depression respectively. WHO- QOL BREF - World Health Organization- Quality of life Scale was used to assess the quality of life of patient. Data was analysed using Microsoft SPSS 20.00 Version. Results: The prevalence of Major Depressive Disorder accounted for 42% and Generalised Anxiety Disorder constituted 30% of the TB patients. Among socio-demographic variables, there was positive statistical association of Depression with unemployment, unmarried marital status and Muslim religion. Among clinical variables presence of medical comorbidity, sputum positivity, dyspnoea, past history of tuberculosis and substance abuse showed positive association with psychiatric morbidity. All the domains (Physical, Psychological, Environmental, Social) had better QoL scores in TB cases without psychiatric morbidity and this difference was found to be statistically significant. Conclusions: Psychiatric morbidity has very high prevalence in patients of pulmonary tuberculosis. Thorough evaluation and management of psychiatric morbidity and strengthening of consultation-liaison services can improve the treatment adherence, long term outcome and overall quality of life of patients suffering from tuberculosis. [ABSTRACT FROM AUTHOR]

Aim: This study aims to evaluate the prevalence of psychiatric morbidity and suicidal behavior by using a structured diagnostic interview in patients of chronic kidney disease currently on dialysis. An additional aim of the study was to evaluate the impact of psychiatric morbidity on quality of life (QOL). Methodology: One hundred and ten patients undergoing hemodialysis were evaluated, at least 24 h after the last dialysis on Mini International Neuropsychiatric Interview PLUS (MINI PLUS), Columbia Suicide Severity Rating Scale (C-SSRS), and Beck Depression Inventory Second Edition. Results: On MINI-PLUS, about two-thirds (67.3%) of the study sample fulfilled at least one-lifetime psychiatric diagnosis and half of the study participants fulfilled a current psychiatric diagnosis. More than one-fourth (29.1%) of the study participants had more than one psychiatric diagnosis. Among various psychiatric disorders, depressive disorders were the most common (45.5%). About one-third of the participants had suicidality, as assessed on MINI-PLUS and C-SSRS. Compared to those without psychiatric morbidity, those with psychiatric morbidity had a poor QOL. Conclusions: In view of the high psychiatric morbidity and its negative impact on the QOL of patients undergoing hemodialysis, there is a need for close liaison between nephrologists, transplant surgeons and mental health professionals. [ABSTRACT FROM AUTHOR]

Background: Breast cancer causes a wide range of physical and psychological issues. Breast cancer treatment affects woman's body image and sexuality which can impact psychological well-being and quality of life (QOL). Aims: This study aimed to assess body image concern among breast cancer patients and to compare it with healthy women and to assess QOL and psychological reaction among breast cancer patients. Settings and Design: This was a comparative cross-sectional study, conducted at a tertiary care hospital on breast cancer patients compared to age-matched healthy women taken as controls. Materials and Methods: Data were collected using a semi-structured questionnaire, Body Image Scale, European Organization for Research and Treatment of Cancer Breast Cancer-Specific QOL Questionnaire, Hamilton Anxiety Rating Scale, and Hamilton Depression Rating Scale. Statistical Analysis Used: Data were analyzed with Epi Info 7. Mean and standard deviation for continuous variables and percentages and Chi-square test for categorical variables were used. P < 0.05 was considered statistically significant. Results: Breast cancer patients were having high body image concern as compared to healthy women. On QOL assessment, scores of body image and future perspective were comparatively low-low level of functioning and scores were high for breast symptoms and hair loss-high level of symptomatology. More patients had significant anxiety and depressive symptoms. Conclusions: Breast cancer patients were having high body image concern and poor QOL as compared to age-matched healthy women, associated with significant depression and anxiety. [ABSTRACT FROM AUTHOR]

Introduction: Indian students are subjected to enormous stress to compete and perform since competitive exams have been made mandatory to enter professional courses. Inability to handle performance pressure, meet parental expectations, and achieve aspirations may lead to psychological distress and subsequent depression. Aim: To estimate the prevalence of depression and anxiety and identify the associated factors among National Eligibility cum Entrance Test (NEET) aspirants in the Chennai, India. Materials and Methods: The present community-based, cross-sectional analytical study was conducted at various NEET coaching centres in Chennai, Tamil Nadu, India, among 250 NEET aspirants between July 2021 and August 2021. A pretested, semi-structured, self-administered online questionnaire with 45 questions, consisting of the Beck Depression Inventory-II and Beck Anxiety Inventory, in the English language was used. Categorical data were presented as frequency and proportions. Pearson's Chi-square test was used to evaluate differences between groups for categorised variables. Results: Out of the total 250 students, 147 (58.8%) were males and mean age of the participants was 19.38±1.146 years. Overall, 112 (45%) participants had attempted NEET-Undergraduate (UG) exam once and 94 (38%) participants had two attempts. The overall prevalence of depressive symptoms was n=148 (59.2%) and anxiety symptoms were seen in all 250 (100%) participants. Symptoms of severe depression were high among those with three previous attempts(44) and those awaiting their first NEET attempt. The number of previous attempts had a statistically significant (p-value<0.001) association with the severity of anxiety symptoms. Conclusion: This high morbidity of depressive and anxiety symptoms highlights the need for access to preventive and curative mental health services for students preparing for highly competitive exams like NEET. [ABSTRACT FROM AUTHOR]

Objective: To look for the psychiatric morbidity and associated socio-demographic factors among patients who tested positive and isolated for COVID-19. Study Design: Cross-sectional study. Place and Duration of Study: Combined Military Hospital, Malir Pakistan, from Mar to May 2020. Methodology: All patients who tested positive for COVID-19 and were admitted to the COVID-19 Ward without complications were included in the study. General Health Questionnaire-12 (GHQ-12) was administered to look for the presence of psychiatric morbidity. Results: Out of 61 patients included in the study, 45(73.7%) showed the presence of psychiatric morbidity, while 16(26.3%) did not show psychiatric morbidity when screened with GHQ-12. 43(70.4%) were male, while 18(29.6%) were female. The mean age of the patients was 35.21±2.355 years. The advanced age and female gender have a statistically significant relationship (p-value<0.05) with the presence of psychiatric morbidity among patients of COVID-19. Conclusion: Many patients had psychiatric morbidity after being tested positive for COVID -19 and were isolated in the health facility. Female patients and patients aged more than 40 years were found to be more at risk of developing psychiatric morbidity among the patients admitted to COVID -19 ward. [ABSTRACT FROM AUTHOR]

Background: Mental health has become a public health concern worldwide, and the number of affected individuals is rising. Therefore, further research must be conducted to identify potential risk factors to develop optimal prevention strategies to mitigate mental health disorders. Methods: Using Taiwanese Nutrition and Health Survey data collected from 2013–2016, we conducted a cross-sectional study to examine whether adherence to the Taiwan Daily Food Guide affects mental health conditions. Study participants were adults aged ≥19 years. The dietary assessment was conducted using a validated food frequency questionnaire. The presence of psychiatric morbidity was defined as a five-item Brief Symptom Rating Scale (BSRS-5) score of ≥10. Logistic regression models were used to determine whether Taiwan Daily Food Guide adherence was related to the presence of psychiatric morbidity. Results: After adjusting for potential confounders, we observed protective associations between adherence to the Taiwan Daily Food Guide and psychiatric morbidity risk. Conclusion: The Taiwan Daily Food Guide might reduce the risk associated with psychiatric morbidity and could be a reference for developing a national food guide for mental health. [ABSTRACT FROM AUTHOR]

Abstract Background The number of people seeking gender reassignment (GR) has increased everywhere and these increases particularly concern adolescents and emerging adults with female sex. It is not known whether the psychiatric needs of this population have changed alongside the demographic changes. Methods A register-based follow-up study of individuals who contacted the nationally centralized gender identity services (GIS) in Finland in 1996–2019 (gender dysphoria [GD] group, n = 3665), and 8:1 age and sex-matched population controls (n = 29,292). The year of contacting the GIS was categorized to 5-year intervals (index periods). Psychiatric needs were assessed by specialist-level psychiatric treatment contacts in the Finnish Care Register for Hospital Care in 1994–2019. Results The GD group had received many times more specialist-level psychiatric treatment both before and after contacting specialized GIS than had their matched controls. A marked increase over time in psychiatric needs was observed. Among the GD group, relative risk for psychiatric needs after contacting GIS increased from 3.3 among those with the first appointment in GIS during 1996–2000 to 4.6 when the first appointment in GIS was in 2016–2019. When index period and psychiatric treatment before contacting GIS were accounted for, GR patients who had and who had not proceeded to medical GR had an equal risk compared to controls of needing subsequent psychiatric treatment. Conclusion Contacting specialized GIS is on the increase and occurs at ever younger ages and with more psychiatric needs. Manifold psychiatric needs persist regardless of medical GR.

Two types of disasters – natural and, respectively, generated by humans – have been involved in psychiatric morbidity. Generally, the disasters generated by humans lead more frequently to persistent symptoms and psychiatric disorders. The severity of disaster agents and the degree of individual or population exposure to the disaster are considered predictors of psychiatric morbidity. Gender is a strong predictor of post-traumatic anxiety and depressive disorders. A second robust predictor of disaster mental health outcomes in individuals is represented by preexisting psychiatric disorders. Other but less consistent predictors of post-traumatic stress disorder (PTSD) after disasters include age, education and socioeconomic status. The disasters most frequently associated with detrimental consequences were those with an increased level of community destruction and those from developing countries with lower socioeconomic status. Supportive group interventions are recommended in the first days after the trauma. There is no consistent evidence regarding the effectiveness of early psychopharmacological approaches. Medication is recommended for symptoms’ improvement, especially in severe psychiatric symptoms that significantly impair functioning. Cognitive-behavioral short-term interventions in the first two weeks after trauma, focused on education, anxiety management training, imaginary and in vivo exposure therapy and in cognitive restructuring, proved the most effective. [ABSTRACT FROM AUTHOR]

Objective: Previous research has demonstrated that individual risk of mental illness is associated with individual, co-resident, and household risk factors. However, modelling the overall effect of these risk factors presents several methodological challenges. In this study we apply a multilevel structural equation model (MSEM) to address some of these challenges and the impact of the different determinants when measuring mental health risk.Study Design and Setting: Two thousand, one hundred forty-three individuals aged 16 and over from 888 households were analysed based on the Household Survey for England-2014 dataset. We applied MSEM to simultaneously measure and identify psychiatric morbidity determinants while accounting for the dependency among individuals within the same household and the measurement errors.Results: Younger age, female gender, non-working status, headship of the household, having no close relationship with other people, having history of mental illness and obesity were all significant (p < 0.01) individual risk factors for psychiatric morbidity. A previous history of mental illness in the co-residents, living in a deprived household, and a lack of closeness in relationships among residents were also significant predictors. Model fit indices showed a very good model specification (CFI = 0.987, TLI = 0.980, RMSEA = 0.023, GFI = 0.992).Conclusion: Measuring and addressing mental health determinants should consider not only an individual's characteristics but also the co-residents and the households in which they live. [ABSTRACT FROM AUTHOR]

Background: To assess the prevalence of psychiatric morbidity and stress burden among the patients with limb fractures and compare them with age and gender matched control group. Materials and Methods: The cross-sectional study was conducted on 25 patients each of lower and upper limb fractures, presenting 2 weeks or more after the fracture to orthopedics OPD of Dayanand Medical College and Hospital. Psychiatric manifestations and stress burden were assessed using Mini International Neuropsychiatric Interview (M.I.N.I.), perceived stress scale (PSS), and impact of event scale-revised (IES-R) on the patients. It was compared to an equal number of age and gender matched normal control group. Results: Majority of the patients with limb fractures were male (70%). The upper limb fracture was in age group of 18-30 years (52%), and those with lower limb fracture were >50 years of age (48%). Most common psychiatric morbidity seen in patients was major depressive disorder (52%) which was statistically significant in comparison with control group. The impact of trauma on patients resulted in avoidance and hyperarousal symptoms significantly in lower limb fracture patients than upper limb ones (P < 0.05). Conclusions: The long bone injuries in patient cause significant psychiatric morbidity which increases the stress burden in such patients due to immobility and pain. [ABSTRACT FROM AUTHOR]

Abstract Background Seasonal Affective Disorder is a recurrent depressive disorder which usually begins in the fall/winter and enters into remission in the spring/summer, although in some cases may occur in the summer with remission in the autumn-winter. In this study the authors evaluated the association between seasonal changes in mood and behavior with psychiatric disturbance. Method Descriptive, cross-sectional study. Participants, students attending higher education and vocational courses (N = 324), were evaluated with the Seasonal Pattern Assessment Questionnaire (SPAQ) and the Screening Scale for Mental Health (ER80). Results Among the respondents, 12.7% showed seasonal affective disorder (SAD), 29.0% showed subsyndromal seasonal affective disorder (s-SAD) and 58.3% did not show significant seasonal affective symptomatology. As for psychiatric morbidity, 36.6% of subjects with SAD and 13.8% of those with s-SAD were considered “psychiatric cases” whereas for subjects without SAD this value was only 3.2%. Conclusions There is a statistically significant association between psychiatric morbidity and seasonal affective disorder. This association corroborates the importance of the Seasonal Pattern Assessment Questionnaire in screening for seasonal fluctuations in mood and behavior related disorders, and the clinical need for recognition of these conditions, particularly associated suffering and disabilities.

Objective: An integral part of the genetic counselling process is the assessment of psychiatric morbidity. The objectives of this study were first to assess psychometric properties of the General Health Questionnaire (GHQ-28items) in a Spanish sample at increased risk of hereditary cancer, and second evaluated the prevalence of psychiatric morbidity and the contribution of socio-demographic and clinical characteristics to predict distress. Methods: A cross-sectional study was designed with 766 patients. Psychometric analysis with exploratory factor analysis was performed. The influences of socio-demographic characteristics were investigated by multiple linear regression analyses. Results: Factor analysis supported the four-factor solution of the original GHQ-28; Depression and Social dysfunction scales were more stable than Anxiety and Somatic symptom scales. Psychiatric morbidity was detected in 212 (27.9%) patients. The variables predicting psychiatric morbidity were gender, age, patient affected by cancer, previous psychiatric treatment, and patients with relatives affected by cancer. The higher prevalence of psychiatric symptoms was in the age group from 41 to 59 years (16.73%), women (24.37%), patients affected by cancer (19.89%), patients without previous psychiatric treatment (20.82%), and patients with relatives affected by cancer (21.74%). Conclusion: Screening psychological distress should consider socio-demographic and clinical characteristics with reference to improve the quality of care. Trial registration: Clinical trials identifier: NCT04428710. [ABSTRACT FROM AUTHOR]

Abstract Background The coronavirus disease 2019 (COVID-19) is influencing all segments of society, including youth. Although the physical complaints in the time of COVID-19 are broadly-studied, a paucity of research targeted psychological ones on the precious youth population. This study aimed to describe the real-time state of Egyptian youth’s psychiatric morbidity, dietary changes, and coping methods during this pandemic and explore probable factors influencing them. A descriptive cross-sectional study was conducted using an online survey among 447 Egyptian participants aged 14–24 years. Sociodemographic data, dietary habits, and coping methods during COVID-19 were collected. The Arabic versions of the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder Scale (GAD-7), and the Insomnia Severity Index (ISI) were used to assess depression, anxiety and insomnia, respectively. Results Overall, 80.5%, 74.0%, and 73.8% of the participants had different grades of depression, anxiety, and insomnia symptoms. 37.4% gained weight. Emotional and night eating emerged as new habits during the pandemic among 17.9% and 29.3% of the participants, respectively. Each of depression, anxiety, and insomnia was significantly associated with each other, female gender and having a COVID-19 infected relative. Adolescents had significantly higher scores of depression and anxiety. Those with a history of physical illness had significantly higher scores of anxiety and insomnia. Bodyweight and dietary changes were significantly associated with depression, anxiety, and insomnia. Participants reported various positive and negative coping methods. Conclusion Psychiatric morbidity and dietary changes are evident in young people during COVID-19 pandemic. Psychological well-being and dietary habits are important but often overlooked components of youth well-being especially in challenging times. Depression, anxiety, and insomnia were almost always present and dietary changes were significantly associated with the presence of them.

Introduction: Psychiatric illnesses such as bipolar affective disorder, major depressive disorder, schizophrenia, and dementia can cause significant burden to patient as well as family members. About 14% of the global burden of disease is attributed to neuropsychiatric disorders. Half of the patients with psychiatric illness reported disability in all three domains of work, social, and family life. Aims: (1) To study if caring for patients with major psychiatric illness will lead to significant caregiver's burden. (2) To find the association between caregiver's burden and psychiatric morbidity among the caregivers. Materials and Methods: It is a cross-sectional study conducted at a tertiary care teaching hospital after obtaining institutional ethical clearance. One hundred caregivers of outpatients diagnosed with major psychiatric illness including schizophrenia, bipolar affective disorder, dementia, and major depressive disorder for a period not