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Currently, the evaluation of mental disorders in patients with Systemic lupus erythematosus (SLE) is essential in the management of the illness because of their impact in morbimortality. The main purpose of this study was to determine the prevalence of mental disorders in a group of patients with SLE in a tertiary referral hospital in Quito-Ecuador. The main diffuse central nervous system psychiatric syndromes in SLE (psychosis, anxiety and mood disorders) and cognitive dysfunction were evaluated with the MINI International Neuropsychiatric Interview and the Montreal scale, respectively. This was a descriptive, cross-sectional study which included patients 15 years and older diagnosed with SLE in a tertiary referral hospital in Quito, Ecuador. 85 patients diagnosed with SLE attending the internal medicine outpatient clinic during October 2017-May 2018 were included. A bivariate analysis of possible associations between these mental disorders with corticosteroid use, antiphospholipid syndrome (APS), and quality of life was also studied. Eighty-five patients, with an average age of 34.12 ± 11.5 years were included, of which 94% were females. 71% of participants (60 patients) had at least one mental disorder evaluated in this study. The most frequent was cognitive impairment (n = 43, 51%) followed by anxiety disorders (n = 35, 41%), mood disorders (n = 34, 40%) and psychosis (n = 1; 1%). 38% presented mild cognitive impairment and 13% had moderate cognitive impairment. Memory and visuospatial/executive function were the most affected domains in the cognitive assessment. 38% of participants were previously diagnosed with antiphospholipid syndrome, of which 78% had a mental disorder (OR = 1.83, p = 0.2). Most patients (n = 84; 99%) were treated with corticosteroids, of these, 59 patients presented a mental disorder (OR = 0.9, p = 0.8). Associations with APS or corticosteroid use were not statistically significant. However, the multivariate regression suggests an association between presence of mental disease and quality of life. There were statistically significant alterations in anxiety/depression and pain. There is a high prevalence of neuropsychiatric syndromes in this cohort of patients. Almost ¾ of our cohort had at least one mental disorder, the most common was cognitive impairment.

Leptin is an anorexigenic hormone well recognized by its role in mediating energy homeostasis. Recently, leptin has been associated with psychiatric disorders and interestingly, leptin treatment has shown antidepressant and anxiolytic effects. We examined the association of leptin levels and leptin (LEP) gene rs3828942 polymorphism with anxiety disorders considering sex differences. A cross-sectional population-based study, including 1067 young adults, of whom 291 presented anxiety disorders diagnosed by the Mini International Neuropsychiatric Interview (MINI 5.0). The rs3828942 polymorphism was genotyped by real-time PCR and ELISA measured leptin levels. Leptin levels were not associated with anxiety disorders after adjusting for sex and body mass index (BMI) [ß = - 0.009 (- 0.090-0.072); p = 0.832]. The distribution of rs3828942 genotypes was not associated with anxiety disorders. However, in a sex-stratified sample, the A-allele of rs3828942 polymorphism was associated with risk for GAD in women even when adjusting for confounding variables [OR = 1.87 (1.17-2.98); p = 0.008]. In a subsample of 202 individuals with GAD and control matched by sex and BMI, results suggest an interaction between genotypes and GAD diagnosis based on leptin levels only in the male group [F (1, 54) = 6.464; p = 0.0139]. Leptin is suggested to be related with the neurobiology of anxiety disorders in a sex-dependent manner since women carrying the A-allele of LEP rs3828942 present a higher risk for GAD, while leptin levels seem to be lower in men with GAD carrying A-allele. Studies on the relationship between leptin polymorphisms and levels are scarce and, therefore, further research is necessary.

OBJECTIVE Limited evidence is available to guide treatment of depression for persons with epilepsy. We evaluated the comparative effectiveness of sertraline and cognitive behavior therapy (CBT) for depression, quality of life, seizures, and adverse treatment effects. METHODS We randomly assigned 140 adult outpatients with epilepsy and current major depressive disorder to sertraline or weekly CBT for 16 weeks. The primary outcome was remission from depression based on the Mini International Neuropsychiatric Interview (MINI). Secondary outcomes included the Quality of Life in Epilepsy Inventory-89 (QOLIE-89) seizure rates, the Adverse Events Profile (AEP), the Beck Depression Inventory, and MINI Suicide Risk Module. RESULTS In the intention-to-treat analysis, 38 (52.8%; 95% confidence interval [CI] = ±12) of the 72 subjects assigned to sertraline and 41 (60.3%; 95% CI = ±11.6) of the 68 subjects in the CBT group achieved remission; the lower bound of efficacy for both groups was greater than our historical placebo control group upper bound of 33.7%. Difference in time to remission between groups was 2.8 days (95% CI = ±0.43; p = 0.79). The percent improvement of mean QOLIE-89 scores was significant for both the CBT (25.7%; p

Background: The global prevalence of mental disorders is high and has an increasing trend. In Nepal, there is dearth in literature on prevalence of mental disorders based on national representative sample. In this study, we aim to present the findings on the prevalence of mental disorders from the pilot study of National Mental Health Survey, Nepal. Methods: A cross-sectional study was conducted among 1647 participants aged 13 years and above in three districts of Nepal: Dhanusha, Bhaktapur and Dolakha each representing three ecological regions. Mini International Neuropsychiatric Interview (MINI) standard version 7.0.2 for DSM-5 was used for adults (aged 18 years and above), and kid version of the same tool was used for children (aged 13-17 years) in Nepali language. Separate sets of questions were added for epilepsy and dissociative conversion disorder that were not in the Mini International Neuropsychiatric Interview tool. Prevalence of assessed mental disorders was reported separately for adults and children.Results: The current prevalence of mental disorders among adults and children were 13.2% and 11.2% respectively. Substance use disorder, dissociative conversion disorder, major depressive disorder, alcohol use disorder and psychotic disorder were common among adults. Similarly, psychotic disorder, agoraphobia, major depressive disorder, and anxiety disorders were common among children. Current suicidality was present among 10.9% adults and 8.7% children.Conclusions: Our findings from the pilot study have given insight into the prevalence of different mental disorders in the survey areas. These findings can be utilized for planning the National Mental Health Survey, Nepal. Keywords: Mental disorders; mental health survey; MINI; Nepal; pilot study.

To determine the short-term, lagged, and cumulative effects of psychosocial factors (PSF) on the incidence of depression and anxiety. Major depressive disorders (MDD) and generalized anxiety disorders (GAD) were diagnosed in 2006 and 2010 using the Mini International Neuropsychiatric Interview among 5684 workers from the French SIP cohort. The outcome considered here was diagnosis of MDD and/or GAD (MDD/GAD) in 2010. The frequency of 17 PSF, covering labour intensity and working time, emotional demand, autonomy, social relationships, conflict of values, and job insecurity, was self-reported in 2006 and 2010. For each PSF, four groups (A–D) were considered: exposed neither in 2006 nor in 2010 (A as the reference), exposed in 2010 but not in 2006 (B as a short-term association), exposed in 2006 but not in 2010 (C as a lagged association), exposed in both 2006 and 2010 (D as a cumulative association). In men, short-term and cumulative—and to a lesser extent lagged—associations of four labour-intensity factors with MDD/GAD occurrence were observed (high volume of work, pressure at work, high complexity, and long working hours). In women, the short-term and cumulative associations of five PSF were observed, mostly emotional demand factors, lack of reward and work–family imbalance. Job insecurity had strong, short-term, cumulative and lagged associations in both men and women. According to PSF and gender, the results suggest that the relationships between PSF exposure and MDD/GAD were mostly short-term and cumulative rather than lagged.

Purpose Disorders of mother-infant bonding have been described since early 20th Century. Previous studies have looked at the prevalence of bonding disorders among mothers with postpartum psychiatric disorders. However, its frequency among healthy postpartum mothers is less studied. Methods Two hundred and fifty mother-infant dyads were studied using the Mini International Neuropsychiatric Interview (MINI), the Stafford Interview, Bangalore Maternal Behaviour Scale (BMBS) and Tamil versions of the Edinburgh Postnatal Depression Scale (EPDS) and the Postpartum Bonding Questionnaire (PBQ). The mothers were interviewed between 4 weeks to six months postpartum. In addition, thirty one mothers with a lifetime history of psychiatric disorders were interviewed using the above scales. Results The frequency of bonding disorders was found to be 24% among healthy postpartum mothers as against 45.2% in mothers with psychiatric disorder. However, the frequency of mild disorders of bonding was relatively lower at 5.6% among healthy mothers and 6.5% among mothers with psychiatric disorders. We found that mothers in India had a clinging / over-involved subtype of anxiety that prevented them from leaving their baby under care of another competent adult. While infant-related anxiety was seen in 10% of healthy mothers, about 20% of mothers with psychiatric diagnoses had anxiety. The presence of bonding disorders was not correlated with any maternal or infant related factors except difficulty in breastfeeding. Conclusions Disorders of mother infant bonding are seen in healthy postpartum mothers. The frequency of mild disorders of bonding appears to be similar across countries and this condition warrants further attention.

Objective: To estimate the prevalence of major depressive episode (MDE) in patients with presumptive pulmonary tuberculosis (pre-PTB, defined by cough lasting ≥ 3 weeks) and compare it between patients with pulmonary tuberculosis (PTB) and without PTB. Methods: Patients with pre-PTB (n=260) were screened for depression using the Patient Health Questionnaire (PHQ-9). Those individuals with scores ≥ 10 were subsequently assessed with the depression module of the Mini International Neuropsychiatric Interview (MINI-Plus) to confirm diagnosis. Associations of categorical variables with PTB and MDE were calculated using the chi-square test and OR. Results: PTB was confirmed in 98 patients (37.7%). A high proportion of both groups (active PTB and no PTB) screened positive for depression (60.2 vs. 62.1%, respectively). Among 159 patients who screened positive for depression, a subset of 97 (61.0%) were further evaluated with the MINI-Plus; current MDE was confirmed in 54.6% (53/97). On univariate and multivariate analysis, female sex was the only factor associated with the diagnosis of current MDE (p = 0.04). Conclusion: The prevalence of MDE was high among individuals with prolonged respiratory symptoms, independent of PTB diagnosis. This is consistent with other studies of depression in primary care in Brazil.

Summary Aims To investigate the association of IL10 SNPs in chronic hepatitis C (CHC) patients with and without the first major depressive episode (MDE), as well as their association with plasma levels of target cytokines. Methods A hundred and thirty two CHC patients (32 with and 100 without first MDE) and 98 controls were prospectively enrolled in this cross-sectional study. MDE was diagnosed by a psychiatrist, using the Mini International Neuropsychiatric Interview Plus 5.0. IL10 polymorphisms (−1082 G/A, −819C/T and −592C/A IL10 SNPs) were evaluated by Taqman SNP genotyping assay. Plasma concentrations of IL-2, IL-6, IL-10, IFN-γ and TNF-α were determined using the Human Th1/Th2 Cytometric Bead Array kit. The associations were investigated by logistic models. Results The frequencies of the studied IL10 SNPs did not differ between the CHC patients and controls. The first MDE was positive and independently associated with the IL10-1082*A, IL10-819*T and IL10-592*A (ATA) low producer haplotype (OR = 1.50; 95% CI = 1.11–2.04; P = 0.009) and current alcohol misuse (OR = 4.29; 95% CI = 1.22–15.05; P = 0.02), and inversely associated with increasing age (OR = 0.94; 95% CI = 0.91–0.98; P = 0.006). In addition, plasma level of TNF-α was significantly higher in the carriers than in the non-carriers of the IL10 ATA haplotype in patients with the first MDE. The IL-10 and IL-2 plasma levels were significantly higher in the carriers than in non-carriers of the IL10 GCC high producer haplotype, demonstrating the functionality of the studied IL10 polymorphisms. Conclusions This is the first study to demonstrate that the IL10 low producer ATA haplotype is associated with the first MDE in patients with CHC.

Objective The aim of this study was to assess morbidity and associated factors in patients with lung cancer (LC). Methods This study used a cross-sectional design with consecutive sampling. Study subjects were recruited from the LC outpatient clinic and inpatient ward in a medical center from March 2016 to February 2018. Patients with LC were enrolled and assessed using the Mini International Neuropsychiatric Interview, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Brief Fatigue Inventory, Numeric Pain Rating Scale, and the List of Threatening Experiences Questionnaire. Results One hundred and four patients were included in the study. The most prevalent psychiatric disorder was depressive disorder (25.0%), followed by adjustment disorder (17.3%), alcohol use disorder (3.8%), and insomnia disorder (3.8%). Fifty percent of patients had a psychiatric diagnosis. Using logistic regression analysis, it was found that severity of fatigue (OR=1.77; 95% CI, 1.03-3.03; p

The field of suicide prevention has been enriched by research on the association between spirituality and suicide. Many authors have suggested focusing on the various dimensions of religiosity in order to better understand the association between religion and suicidal risk, but it is unclear whether the relationship between spirituality and suicidality differs between countries with different cultures, life values, and sociohistorical experiences. To explore this, the aim of this multicenter study was to investigate the possible relationship between suicide and spirituality in Italy and Austria. In the two countries, two different groups of subjects participated: psychiatric patients and university students. The patients were evaluated with the Mini International Neuropsychiatric Interview. In addition, the following measures were used: a sociodemographic questionnaire, the Columbia-Suicide Severity Rating Scale-B, the Symptom-Checklist-90-Standard, and the Multidimensional Inventory for Religious/Spiritual Well-Being. Our results confirmed the multifactorial nature of the relation between suicide risk and the various religious/spiritual dimensions, including religious/spiritual well-being and hope immanent. However, regional differences moderated this relationship in both the clinical and nonclinical samples.

Background: Assessment of nicotine dependence among tobacco users is essential as highly dependent individuals have greater risk of developing tobacco related physical and psychiatric problems. There is little information about the tobacco use and nicotine dependence among psychiatric patients in developing countries, including Nepal. Objectives: To estimate the prevalence of tobacco use, the level of nicotine dependence and the psychiatric disorder specific prevalence among tobacco users visiting a psychiatry out-patient department. Materials and methods: A cross-sectional study was conducted in Out-patient setting of Department of Psychiatry, B. P. Koirala Institute of Health Sciences (BPKIHS). Ninety cases (calculated sample size) were enrolled. The Fagerström Test for Nicotine Dependence (FTND) was applied to assess the level of nicotine dependence and the Mini International Neuropsychiatric Interview (MINI) for diagnosis of Psychiatric disorders. Results: The prevalence of tobacco use was 55.6%. Tobacco use was more common among males (pvalue < 0.05). Smokeless form was the common form of tobacco. Majority of them had started their consumption in their adolescence. Most users had moderate nicotine dependence. Major depressive disorder and Alcohol dependence were the most common diagnoses among tobacco users. Conclusion: More than half of the psychiatry out-patients consumed tobacco. Future studies that help to understand the relationship and possible mechanism of increased tobacco use in patients with psychiatry disorders are required. Tobacco control and prevention strategies should be initiated targeting vulnerable populations such as male gender and adolescent.

Background: Posttraumatic stress disorder (PTSD) is a disorder that occurs in some people who have experienced a severe traumatic event. Several genetic studies suggest that gene encoding proteins of catechol O-methyl-transferase (COMT) may be relevant for the pathogenesis of PTSD. Some researchers suggested that the elevation of interleukin-6 (IL6) correlates with major depression and PTSD. The aim of this study was to investigate whether the single nucleotide polymorphisms COMT rs4680 (Val158Met) and IL6 rs1800795 are associated with PTSD and contribute to the severity of PTSD symptoms. Subjects and methods: This study comprised 747 participants that experienced war between 1991 and 1999 in the South Eastern Europe conflicts. COMT rs4680 (Val158Met) and IL6 rs1800795 genotypes were determined in 719 participants (369 with and 350 without PTSD). The Mini International Neuropsychiatric Interview (M.I.N.I.), the Clinician Administrated PTSD Scale (CAPS) questionnaire and the Brief Symptom Inventory (BSI) were used for data collection. Results: Regarding the COMT gene polymorphism, the results of the regression analyses for BSI total score were significant in the lifetime PTSD group in the dominant (P=0.031) and the additive allelic model (P=0.047). Regarding the IL6 gene, a significant difference was found for the recessive model predicting CAPS total score in the lifetime PTSD group (P=0.048), and indicated an association between the C allele and higher CAPS scores. n the allelic, genotypic and rezessive model, the results for BSI total score were significant in the lifetime PTSD group (P=0.033, P=0.028 and P=0.009), suggesting a correlation of the C allele with higher BSI scores Conclusion: Although our nominally significant results did not withstand correction for multiple tests they may support a relevance of the COMT (Val158Met) and IL6 rs1800795 polymorphism for aspects of PTSD in war traumatized individuals.

This case-control study assessed the prevalence of psychiatric disorders in Arab (Saudi) patients with narcolepsy using a structured clinical interview. The study included 74 adult patients with narcolepsy and 265 controls matched for age and sex. Narcolepsy diagnosis was made according to the International Classification of Sleep Disorders-Third Edition. Psychiatric disorders were diagnosed via using a validated Arabic version of the Mini International Neuropsychiatric Interview DSM-IV (MINI version 6). A multivariate logistic regression model was used to assess the potential influence of narcolepsy on the comorbidity of psychiatric disorders. The mean age of the patients was 29.4 ± 10.2 years, and males accounted for 81% of the study sample. Forty-four patients (60%) were diagnosed with narcolepsy type-1 (NT1) and 30 (40%) with narcolepsy type-2 (NT2). Psychiatric disorders were diagnosed in 45% of patients with narcolepsy compared with 15% of the controls (p

Introduction: Major depressive disorder is a major mental health problem and is the fourth most important cause of loss of disability-adjusted life years worldwide. Aim: The study aimed to assess the association of depression among women diagnosed with breast cancer. Methodology: A descriptive, cross-sectional study was done on 102 females diagnosed with breast cancer. Women were recruited using purposive sampling technique. Patients were evaluated on Mini International Neuropsychiatric Interview Version 6.0.0 to screen other psychiatric comorbidities. Hamilton depression 17-item, rating scale was used to measure severity of depression. Results: The prevalence of depression was 47.05% in women diagnosed with breast cancer. Majority of the patients (54.1%) had mild depression. Correlations of clinical and Sociodemographic variables with parameters of depression were not significant. Conclusions: Depression is commonly associated psychiatric morbidity in patients diagnosed with breast cancer. The severity of depression is independent of the sociodemographic and clinical variables of patients with breast cancer.

Objectives This study was conducted to re-validate the clinical efficacy of the Korean Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Rating Scale (K-AARS), which is a self-report scale for ADHD in adults, and to determine the clinical utility and cut-off scores of K-AARS. Methods The participants were 135 drug naive adults with ADHD and 144 healthy controls. To diagnose ADHD based on the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, two board-certified pediatric psychiatrists interviewed the participants and completed the Mini International Neuropsychiatric Interview. K-AARS was applied to all participants. K-AARS comprises six clinical subscales, one impairment subscale, and one driving behavior subscale. The receiver operating characteristic analysis was conducted to calculate the cut-off scores of K-AARS. Results All subscale scores, including six clinical subscale, impairment subscale, and driving behavior subscale scores, were found to be significant in distinguishing adults with ADHD from healthy controls. The sensitivity and specificity of the six clinical subscales were 63.0-77.0% and 66.7-79.9%, respectively. The combined total score of the six clinical subscales, had a sensitivity of 80.0% and specificity of 79.9%. Conclusion The discriminative power of K-AARS for the diagnosis of ADHD in adults was excellent, and K-AARS and the empirical diagnosis of adults can be useful in diagnosing ADHD in adulthood.

Human T-cell lymphotropic virus type 1 (HTLV-1) has low prevalence rates, but is endemic in some regions of the world. It is usually a chronic asymptomatic infection, but it can be associated with serious neurologic and urinary conditions. Hepatitis C virus (HCV) is broadly spread out worldwide. The majority of these infections have a chronic course that may progress to cirrhosis and hepatocellular carcinoma. Objectives: To compare sociodemographic and mental health (risk behaviors, depression, and suicide) aspects, and quality of life among patients with HCV or HTLV-1. Methods: Observational, comparative and cross-sectional study involving outpatients with HCV or HLTV-1 infection. Sociodemographic characteristics, risk behaviors and quality of life were assessed through the questionnaires Mini International Neuropsychiatric Interview – MINI Plus (depression and suicide) and Medical Outcomes Study 36-Item Short-Form Health Survey (quality of life). Univariate and multivariate statistical analyses (hierarchical logistic regression) were conducted. Results: 143 individuals with HCV and 113 individuals with HTLV-1 infection were included. Males were predominant in the HCV group (68.8%) and females in the HTLV-1 group (71.7%). The frequency of risk behaviors (sexual and drug use) was greater in those with HCV (p

OBJECTIVE To investigate association between major depressive disorder (MDD) and quality of life in patients with neurological disorder. METHODS This cross-sectional study was carried out at a Malaysian hospital between April 2016 and December 2016 using convenience sampling. Patients aged ≥18 years with intracranial tumour or other brain disorders were invited to participate. Quality of life was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life questionnaire version 3.0; diagnosis of MDD was made using Mini International Neuropsychiatric Interview. RESULTS Of 122 patients approached, 100 (66 women and 34 men) were included (response rate, 93.5%), with a mean age of 45.3 years. The prevalence of MDD in patients with neurological disorder was 30%. Compared with non-depressed patients, patients with MDD had poorer global health status / quality of life (p = 0.003), and reduced physical (p = 0.003), role (p = 0.021), emotional (p < 0.001), cognitive (p = 0.004), and social (p = 0.007) functioning, as well as more symptoms of fatigue (p = 0.004), pain (p < 0.001), dyspnoea (p = 0.033), insomnia (p < 0.001), appetite loss (p = 0.002), constipation (p = 0.034), diarrhoea (p = 0.021), and financial difficulties (p = 0.039). CONCLUSION Patients with MDD had reduced quality of life. Fatigue, pain, dyspnoea, insomnia, appetite loss, constipation, diarrhoea, and financial difficulties were prevalent among patients with MDD.

Introduction: Suicide attempt is a self-injurious behavior with a non-fatal outcome. An insight into psychosocial factors and methods used can be used to device effective preventive strategies. Aims: The aim is to study the psycho-social factors and to find the frequency of different methods used in attempted suicides. Materials and Methods: This study is a descriptive, cross-sectional, hospital-based analysis of attempted suicides. 44 consecutive attempted suicides admitted in the emergency ward and referred to the Psychiatry department were taken into the study. A Semi-structured intake Performa consisting of socio-demographic data, detailed history of current suicide attempt, and access to means were noted. MINI (Mini International Neuropsychiatric Interview), Hamilton Depression rating scale, Beck's suicide intent scale, and Barratt's impulsiveness scale were used to screen the patients. SPSS 20 was used for statistical analysis. Results: In the study it was found that majority of people who attempted suicide were of young age, females, married, fully employed, belonged to class IV socioeconomic status and attempts were made equally during day and night. The most common method was drug-overdose followed by poisoning with Organo-Phosphorous compounds. Mental illness was found only in 34% individuals, of which most common was depression. And one-fourth of the individuals had contact with General Practitioner within one month of the suicide attempt. Conclusion: The need for psycho-education and social skills training in adolescents and young adults is implicated in the study. Awareness among the general physicians about suicide prevention would help in bringing down the number of attempts as would strict control of, over the counter drugs and storage of organo-phosphorous compounds. Keywords: Suicide, Methods, Depression, Drug overdose.

Purpose The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) is an efficient tool for rapid detection of depression, an important comorbid condition in persons with epilepsy (PWE). Since social and cultural differences can potentially affect the cutoff score of NDDI-E, in this study, the reliability and validity of the Indian version of the NDDI-E in PWE was determined. Method After ethical clearance, 217 PWE above 18 years of age, on antiepileptic drugs (AEDs), attending neurology outpatient department (OPD) of All India Institute of Medical Sciences (AIIMS), New Delhi, India, were evaluated for depression using the NDDI-E (Indian version) and Mini International Neuropsychiatric Interview (MINI-Module A, version 6.0.0) as reference standard. Informed consent was taken before recruitment. Receiver operating characteristic (ROC) analysis and Cronbach's α, a measure of the internal consistency and reliability, were carried out to validate cutoff and questionnaire, respectively. Results Of the 217 PWE (112 males/105 females), mean age of 28.6 ± 9.4 years, with generalized (69.1%) or focal seizures (30.9%), 41.5% and 10.6% were diagnosed with depression using MINI and NDDI-E Indian version (at cutoff > 15), respectively. However, at a cutoff score of > 11, the Indian version of NDDI-E had a sensitivity of 96.67%, a specificity of 84.25%, a positive predictive value of 81.31%, and a negative predictive value of 97.27%. ROC analysis showed an area under the curve (AUC) of 0.9547 (confidence interval (CI) 95% = 0.929–0.979; standard error (SE): 0.0127). With the Indian version of NDDI-E, the Cronbach's α value was 0.877. Conclusion A periodic assessment of PWE using a quickly administrable and reliable tool for screening depression is highly desirable given the high incidence. In the Indian population with a cutoff of > 11, NDDI-E is a reliable and valid instrument to screen depression in PWE.

Background Anxiety disorders are common and associated with reduced quality of life, impaired physical and mental health and an increased economic burden for society. While evidence exists for the effectiveness of exercise treatment for depression, there is a need for high-quality randomized clinical trials (RCT) with a focus on anxiety disorders. Further research is also warranted regarding outcomes of cognitive function, other health-related variables, dose-response effects, work ability and potential mechanisms. Method/design Using a parallel, RCT design with three assessment points (baseline, post-intervention and one-year follow-up), we aim to assess the effect of a 12-week exercise intervention in primary care patients with anxiety disorders (n = 180), diagnosed using the Mini International Neuropsychiatric Interview (M.I.N.I; Swedish version 6.0.0d DSM-IV). Participants are randomly assigned to three physical exercise groups: one low-intensity training group, one moderate- to high intensity training group and one control non-exercise group. Assessments include measures of anxiety symptoms, cognitive function, physical health variables such as cardiovascular fitness, sick-leave and levels of hormones/cytokines in blood samples. Discussion Findings from this study will provide novel insights regarding the effects of exercise treatment on not only anxiety symptoms but also other outcomes including mental and physical health, cognitive function, dose-response effects, work ability/sick leave and on biomarkers that may help explain underlying mechanisms. Trial registration The trial was registered at ClinicalTrial.gov NCT03247270 August 8, 2017. Electronic supplementary material The online version of this article (10.1186/s12888-019-2169-5) contains supplementary material, which is available to authorized users.

Objective The aim of this study was to evaluate the clinical reliability and validity of the Chinese version of the Patient Health Questionnaire 9 (C-PHQ-9) in patients with epilepsy. Methods A total of 213 consecutive adult patients with epilepsy were evaluated. Receiver operating characteristic (ROC) analysis was performed using C-PHQ-9 and Chinese version of Patient Health Questionnaire 2 (C-PHQ-2) as predictors and the Mini International Neuropsychiatric Interview Plus Version 5.0.0 as the gold standard. Results The C-PHQ-9 was easily understood and quickly finished by the patients. According to the gold standard, the prevalence of current major depressive disorder in this population was 16.4%. Cronbach's α coefficient for the C-PHQ-9 was 0.860. The ROC analysis showed an area under the curve (AUC) of 0.888 (95% confidence interval [CI] = 0.838–0.927). At a cutoff score of > 6, the C-PHQ-9 had a sensitivity of 82.86%, a specificity of 84.27%, a positive predictive value of 50.9%, and a negative predictive value of 96.2%. The C-PHQ-2 at a cutoff score of > 1 resulted in the greatest balance of sensitivity and specificity (77.14% and 75.28%, respectively). Conclusion Our findings support a high reliability and validity for the C-PHQ-9 as a screening tool for the detection of current major depression in Chinese patients with epilepsy.

Background Kratom is a traditional medicinal herb widely used in Malaysia and Thailand. Despite its widespread use and statements by regulatory agencies on the potential for kratom-associated psychosis, there is little data regarding the prevalence of psychotic symptoms among kratom users. This study investigated the prevalence of psychosis among kratom users, described psychotic symptomatology and severity, while examining associations between kratom use characteristics and the occurrence of psychotic symptoms. Methods This cross-sectional clinical survey recruited 150 regular kratom users. The Mini International Neuropsychiatric Interview (MINI) and Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-V) diagnostic criteria were used to evaluate psychotic symptomatology among kratom users, and the Brief Psychiatric Rating Scale (BPRS) was used to assess the severity of psychiatric symptoms. Chi-square tests with Yate’s correction were performed to determine the association between kratom use characteristics and the occurrence of psychotic symptoms among kratom users in this study. Results Six out of 150 kratom users (4%) presented with any psychotic symptoms. The psychotic symptoms reported were positive symptoms and thought alienation, with a mean BPRS score of 33 (i.e., mild severity). Variables related to kratom use (such as intake of kratom with diphenhydramine, duration of kratom use, and quantity and frequency of daily kratom use) were not associated with the occurrence of psychotic symptoms among kratom users. Conclusion Although psychotic symptoms could occur among regular kratom users, they were rare and not significantly associated with kratom use characteristics. We found no evidence of elevated psychosis among regular users.

Contains fulltext : 207225.pdf (Publisher’s version ) (Open Access) BACKGROUND: Affective disorders, encompassing depressive-, anxiety-, and somatic symptom disorders, are the most prevalent mental disorders in later life. Treatment protocols and guidelines largely rely on evidence from RCTs conducted in younger age samples and ignore comorbidity between these disorders. Moreover, studies in geriatric psychiatry are often limited to the "younger old" and rarely include the most frail. Therefore, the effectiveness of treatment in routine clinical care for older patients and impact of ageing characteristics is largely unknown. OBJECTIVE: The primary aim of the Routine Outcome Monitoring for Geriatric Psychiatry & Science (ROM-GPS) - project is to examine the impact of ageing characteristics on the effectiveness of treatment for affective disorders in specialised geriatric mental health care. METHODS: ROM-GPS is a two-stage, multicentre project. In stage one, all patients aged >/=60 years referred to participating outpatient clinics for specialised geriatric mental health care will be routinely screened with a semi-structured psychiatric interview, the Mini International Neuropsychiatric Interview and self-report symptom severity scales assessing depression, generalized anxiety, hypochondria, and alcohol use. Patients with a unipolar depressive, anxiety or somatic symptom disorder will be asked informed consent to participate in a second (research) stage to be extensively phenotyped at baseline and closely monitored during their first year of treatment with remission at one-year follow-up as the primary outcome parameter. In addition to a large test battery of potential confounders, specific attention is paid to cognitive functioning (including computerized tests with the Cogstate test battery as well as paper and pencil tests) and physical functioning (including multimorbidity, polypharmacy, and different frailty indicators). The study is designed as an ongoing project, enabling minor adaptations once a year (change of instruments). DISCUSSION: Although effectiveness studies using observational data can easily be biased, potential selection bias can be quantified and potentially corrected (e.g. by propensity scoring). Knowledge of age-related determinants of treatment effectiveness, may stimulate the development of new interventions. Moreover, studying late-life depressive, anxiety and somatic symptom disorders jointly enables data-driven studies for more optimal classification of these disorders in later life. TRIAL REGISTRATION: Dutch Trial Register: NL6704 ( www.trialregister.nl ). Retrospectively registered on 2017-12-05. 12 p.

Background: The purpose of the study is to evaluate and compare the psychological impact of various therapeutic modalities in pediatric cancer by comparing them to healthy children across age groups. Methods: The semi-structured and the Mini International Neuropsychiatric interview (M.I.N.I Kids Test) were administered to 80 children including 40 cancer patients and 40 healthy children. Results: CNS tumors were the most common tumor 47.5% followed by heamatological malignancies 35% and Non CNS solid tumors 17.5%. About two thirds of the sample reported social problems followed by school problems in 57.5% of cases. By analyzing the mood changes, there was significant depression, anxiety disorders, panic attacks and separation anxiety between the patients and the control (p=

Objective The objective of this study was to validate the Chinese version of the Neurological Disorders Depression Inventory for Epilepsy (NDDIE) as a suicidality screening tool in Chinese people with epilepsy (PWE). Methods A consecutive cohort of PWE was recruited from West China Hospital and 363 Hospital. Each patient received a psychiatric evaluation with the Mini International Neuropsychiatric Interview (MINI) and the Chinese version of the NDDIE (C-NDDIE). Demographic and clinical characteristics were collected. Receiver operating characteristic (ROC) curve analysis was conducted. The best possible cutoff was identified with the highest Youden index. Specificity, sensitivity, positive, and negative predictive values were calculated. Results Among a total of 355 participants, 41 (11.5%) had a moderate to high suicide risk according to the Suicidality Module (SM) of the MINI. Receiver operating characteristic (ROC) curve analysis showed that item 4 (“I'd be better off dead”) of the NDDIE had an area under the curve (AUC) of 0.930 (95% confidence interval [CI] = 0.884–0.977), a sensitivity of 80.5%, a specificity of 94.9%, a positive predictive value (PPV) of 68.0%, a negative predictive value (NPV) of 97.7%, and the largest Youden index of 0.754 for a cutoff score of > 2. Conclusion Item 4 of the NDDIE is a valuable tool for screening suicidality in Chinese PWE.

Objective This study aimed to demonstrate that the Patient Health Questionnaire (PHQ)-8 is not less useful than the PHQ-9 as a screening test for major depressive disorder (MDD). Methods We performed a retrospective analysis of 567 patients in psychiatric outpatient units. The Mini International Neuropsychiatric Interview was used to diagnose MDD. We derived the validity and reliability of the PHQ-8 and PHQ-9. To evaluate the ability of the PHQ-8 and PHQ-9 to discriminate MDD, we drew receiver operating characteristic (ROC) curves and compared the areas under the curves (AUCs). Results Of the 567 participants, 207 (36.5%) were diagnosed with MDD. Cronbach's αs for the PHQ-8 and PHQ-9 were 0.892 and 0.876, respectively. Similar to the PHQ-9, the PHQ-8 was also associated with scores on the Hamilton Depression Rating Scale in a correlation analysis. When we drew ROC curves for the PHQ-8 and PHQ-9, there was no statistically significant difference in the AUCs. With a cutoff score of 10, the PHQ-8 showed a sensitivity of 58.3%, specificity of 83.1%, positive predictive value of 53.4%, and negative predictive value of 85.7%. Conclusion In a psychiatric outpatient sample, the PHQ-8 was as useful as the PHQ-9 for MDD screening.

Somatization Disorder (SD) is known to cause disability and impact the quality of life due to psychological and somatic distress. Though it is a Common Mental Disorder (CMD), the disorder tends to visit all levels of health care, among which prevalence of SD at tertiary care is 10.1%.To estimate current prevalence and its correlates of socio-clinical factors in SD at a quaternary mental health centre (QMHC).Total of 422 adult subjects were selected through systematic random sampling at first contact psychiatry outpatient clinic. Subjects were interviewed with Mini International Neuropsychiatric Interview Plus version 5.0.0, Clinical Global Impression Severity Scale and Sheehan Disability Scale.Current prevalence of SD was 5%. Significant correlates are observed with median age of 40.5 years, female, married,5 years of education, monthly income of₹ 10,357(85.5%) and lower socioeconomic status (75%).There is high prevalence of SD even at QMHC. The higher prevalence among adult population in this setup reflect the impairment of working population which invariably impact on national economy.Poverty continues to be a major contributing factor to SD causing double impact on the economy by affecting the working population the most.

Purpose Suicidality including suicidal ideation and attempt has been a critical issue in people with epilepsy, especially in people with drug-resistant epilepsy (PWDRE). Clinicians commonly ask about adverse effects of antiepileptic drugs (AEDs) using something like the Liverpool Adverse Events Profile (LAEP) at epilepsy clinics, but suicide is usually not of interest. A high risk of suicidality can increase mortality by committing suicide in PWDRE. This study aimed to investigate whether clinicians can discern a high risk of suicidality in PWDRE by referring to the LAEP. Methods We recruited PWDRE, aged from 19 to 68. They completed the 21-item LAEP, the suicidality module of the Mini International Neuropsychiatric Interview, and the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E). Through receiver operating characteristic curve analysis, we tested the usefulness of LAEP to detect a high risk of suicide. By this, we determined each cutoff point of the total LAEP score and the number of severe LAEP items, for detecting the risk. Results A hundred forty-four PWDRE participated in this study. Among them, 36 PWDRE (25.0%) had a high risk of suicidality. Either >45 of the total LAEP score or >8 of the number of severe LAEP items was a suggested optimal cutoff point for discerning the high risk of suicidality. LAEP had a correlation with the suicidality item of the NDDI-E. Conclusion The LAEP may inform a high risk of suicidality in PWDRE. Referring to this, clinicians can discern suicidal problems in their epilepsy clinics.

Obesity among children and adolescents is considered as one of the most serious public health concerns; low levels of testosterone have been associated with higher levels of morbidity and may have been associated with depression. To assess the relationship between the level of serum-free testosterone and depression in obese adolescent men in Sharkia Governorate. The present study was conducted on 240 age-matched healthy Egyptian adolescent men, collected from the obesity clinic, Internal Medicine Department, Zagazig University Hospital and five high schools in Sharkia Governorate; all the included participants were subjected to: (a) history taking; (b) physical examination (weight, height, BMI, waist circumference, waist to hip ratio, and Tanner stage using Prader orchidometer); (c) hormonal investigations (free testosterone, estradiol, follicular-stimulating hormone, and luteinizing hormone); (d) psychological assessment for depression using: Mini International Neuropsychiatric Interview for Children and Adolescents and children’s depression inventory. There was a significant inverse correlation between free testosterone levels and waist circumference among both control and obese cases (r= –0.31, P=0.031 and r= –0.30, P=0.01, respectively). The free testosterone level was significantly lower in obese cases with depression (2.81±2.32 pg/ml) in comparison with obese cases without depression (3.63±2.65 pg/ml) (P=0.04) and testosterone levels was significantly lower in obese cases having some depressive symptoms (feeling depressed, feeling restless, feeling guilty, eating disorders, sleeping disorders, feeling restless, and suicidality). There were significant inverse correlations (P

Purpose Fetal alcohol spectrum disorders (FASD) are a group of developmental disabilities related to prenatal alcohol exposure. FASD is a life-long lasting condition with various neurocognitive impairments and deficits in daily-life functioning. Research also indicates that FASD patients have an increased prevalence for substance use, substance related disorders and other psychiatric disorders. In Germany, data on adult FASD patients and their mental health are rare. The purpose of this paper is to describe substance use and comorbid psychiatric disorders (in addition to FASD) and suicide attempts in adult FASD patients. Design/methodology/approach The German version of the structured “Mini International Neuropsychiatric Interview (MINI)” was administered to a convenience sample of patients attending a specialized FASD diagnostic service at a German university hospital to assess psychiatric disorders. Current and lifetime substance use were examined using sections from the German version of the “European Addiction Severity Index (EUROP-ASI-R)” interview. Findings In total, 31 adults with FASD were included. Two patients were diagnosed with a substance related disorder, one for alcohol and one for cannabis. Nearly half of all patients fulfilled the diagnostic criteria for mild mental retardation, a further 16 per cent fulfilled the criteria for another current comorbid psychiatric disorder. In total, 26 per cent reported at least one suicide attempt. Originality/value Given that the body of research literature on FASD in adulthood is sparse, even a clinical sample of thirty individuals expands knowledge on mental health and substance use in the adult FASD population. The sample was comprehensively assessed using validated structured interviews on mental health, substance use and FASD.

Objective The nine-item Patient Health Questionnaire (PHQ-9), seven-item Generalized Anxiety Disorder scale (GAD-7), and ten-item Kessler Psychological Distress Scale (K-10) are valid and reliable measures of depression, anxiety and general distress. However, the time required in their administration may limit their use in routine care. This study examines the utility of shorter versions (PHQ-2, GAD-2, and K-6) as screening instruments and measures of treatment response. Method Data from research trial participants (n = 993) receiving internet-delivered cognitive behaviour therapy (iCBT) were analysed to establish discriminant validity of the short versions. Mini International Neuropsychiatric Interview (MINI) diagnoses were used as comparators. Criterion group validity, test–retest reliability, internal consistency, and responsiveness to treatment changes were examined. Analyses were replicated using data from patients receiving iCBT in routine care (n = 1389). Results Discriminant validity was excellent for the PHQ-2, and acceptable for the GAD-2 and K-6. Acceptable sensitivity and specificity were identified at a threshold of ≥3 for the PHQ-2 and GAD-2, and ≥14 for the K-6. The short versions were sensitive to treatment change. Conclusion The PHQ-2, GAD-2 and K-6 are useful screeners and efficient measures of treatment progress and outcomes in routine clinical care.

The aim of this study was to assess the association between anhedonia and metabolic syndrome (MetS) in a well-characterized community sample of individuals with a current depressive episode. This is a cross-sectional study with young adults aged 24-30 years old. Depressive episode and the presence of anhedonia was assessed using the Mini International Neuropsychiatric Interview - Plus version (MINI Plus). The MetS was assessed using the National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP III). The sample included 931 subjects, being 22 had depression without anhedonia, whereas 55 had depression with anhedonia. MetS was more prevalent among subjects with depression and anhedonia (43.6%) when compared to individuals without anhedonia and population control group. Moreover, subjects with depression and anhedonia have a significant increase of levels of glucose, triglycerides, total-cholesterol and LDL-cholesterol, as well as significant decreased in the HDL-cholesterol level. The present study showed that individuals with depression and anhedonia present higher prevalence of MetS. Our study suggests that the use of the concept of anhedonia may contribute to a better understanding of the complex relationship between depression and metabolic syndrome.

Objective A persistent low-grade inflammatory state has been described in patients with temporal lobe epilepsy (TLE) in the interictal period. Adipokines are cytokines produced by the adipose tissue that can influence inflammatory response. The purpose of this study was to evaluate the plasma levels of adipokines in patients with TLE in comparison with controls. In addition, we sought to investigate whether the levels of adipokines were associated with clinical parameters in TLE. Methods Forty patients with TLE and 40 controls were enrolled in this study. All participants were subjected to clinical assessment that included the Mini International Neuropsychiatric Interview (MINI) and the Hamilton Depression Rating Scale (HAM-D). Peripheral blood was drawn, and plasma levels of adipokines (adiponectin, leptin, and resistin) were measured by enzyme-linked immunoassay (ELISA). Results People with TLE presented higher leptin and lower adiponectin and resistin levels in comparison with controls. The levels of these adipokines correlated negatively with illness length but not with other clinical parameters. In a binary logistic regression model, higher leptin and lower adiponectin levels remained as significant predictors of TLE diagnosis. Conclusions These results corroborate the view that TLE is a multisystemic condition associated with low-grade inflammation.

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

Background Childhood maltreatment is associated with an increased risk of insecure/disorganized attachment and in turn with suicidal risk (SR). Out-of-family placement is aimed at interrupting child exposure to further abuse and at providing the necessary security for proper development via the establishment of an alternative attachment relationship. However, the actual protective role of this type of care is not clear given the high rates of SR among institutionalized or foster children. Objective The aim of this study was to examine whether 1) attachment to the biological parents mediates the association between abuse and SR and 2) attachment to a foster parent (whether from a foster home or an institution) moderates the effect of attachment to biological parents on SR. Participants The sample consisted of 77 adults (52 female; 25 male; mean age: 26.6 years) who received out-of-home care during childhood. Method The Childhood Trauma Questionnaire and the Mini International Neuropsychiatric Interview (for SR) were used. The Attachment Multiple Model Interview was also administered to assess attachment to each biological parent and to the foster parent. Results Results show that attachment (security and disorganization) to the biological mother mediates the link between abuse and SR and that attachment to the foster parent moderates the link between attachment to the biological mother and SR. Conclusions : Findings point to the importance of interventions aimed at supporting the establishment of a secure attachment relationship between children in care and their foster parents.

Introduction: Globus sensation is described as a constant feeling of a lump, something stuck or foreign body in the throat associated with an uncomfortable experience of dysphagia or choking. It is a common complaint in Ear, Nose and Throat clinics. The symptom is considered functional when no apparent organic cause is detected. In that case the symptoms must be positively identified as psychologically related to some underlying mental conflict or need. The objective of this study is to evaluate the occurrence of psychiatric Co-morbidities in patients complaining of globus sensation in throat coming to psychiatric clinic. Material and Method: A case-control study was done. Patients coming to Outpatient of psychiatry OPD which were referred from Ear, Nose and Throat Department of Lumbini Medical College Teaching Hospital with complain of globus and not having an organic explanation of the condition were included. Age, sex and socio-economic condition matched control group was selected from healthy visitors (1st degree relatives). Mini International Neuropsychiatric Interview, English version; 5.0.0.,HAM-D/HAM-A, were applied to rule out depression, anxiety and assess psychiatric co-morbidities. Final ICD-10 Criteria were done for diagnosis which were made from two psychiatrists. Results: About 64.28 % (n=45) of globus patients had psychiatric co-morbidities which was significantly higher (p

Genetic variants involved in adenosine metabolism and its receptors were associated with increased risk for psychiatric disorders, including anxiety, depression, and schizophrenia. Here, we examined an association between a single nucleotide polymorphism in A(2A) receptor gene (ADORA2A, rs2298383 SNP) with current depressive episode and symptom profile. A total of 1253 individuals from a cross-sectional population-based study were analyzed by the Mini International Neuropsychiatric Interview 5.0. Our data showed that the TT genotype of ADORA2A rs2298383 SNP was associated with reduced risk for depression when compared to the CC/CT genotypes (p = 0.020). This association remained significant after adjusting for confounding variables such as smoking, gender, socioeconomic class, and ethnicity (OR = 0.631 (95% CI 0.425–0.937); p = 0.022). Regarding the symptoms associated with depression, we evaluated the impact of the ADORA2A SNP in the occurrence of sad/discouraged mood, anhedonia, appetite changes, sleep disturbances, motion changes, energy loss, feelings of worthless or guilty, difficulty in concentrating, and presence of bad thoughts. Notably, the TT genotype was independently associated with reduced sleep disturbances (OR = 0.438 (95% CI 0.258–0.743); p = 0.002) and less difficulty in concentrating (OR = 0.534 (95% CI 0.316–0.901; p = 0.019). The cross-sectional design cannot evaluate the cause-effect relationship and did not evaluate the functional consequences of this polymorphism. Our data support an important role for ADORA2A rs2298383 SNP in clinical heterogeneity associated with depression. The presence of the TT genotype was associated with decrease risk for current depression and disturbances in sleep and attention, two of the most common symptoms associated with this disorder.

Objective This study aimed to validate the Chinese version of the 17-item Hamilton Rating Scale for Depression (C-HRSD-17) for use in adult patients with epilepsy (PWE). Methods A consecutive sample of Chinese adult PWE from a tertiary hospital was examined using the C-HRSD-17 and the Mini International Neuropsychiatric Interview (MINI) Plus Chinese Version 5.0.0. Results A total of 191 PWE completed the assessment of depression. According to the MINI, thirty patients (15.7%) had current major depressive disorder (MDD). The Cronbach's α coefficient for the C-HRSD-17 was 0.832. Receiver operating characteristic (ROC) analysis showed an area under the curve (AUC) of 0.983 (95% CI = 0.968–0.998). With a cutoff score of 9, the C-HRSD-17 demonstrated the best psychometric properties, with a sensitivity of 96.7%, a specificity of 93.8%, a positive predictive value (PPV) of 74.4%, and a negative predictive value (NPV) of 99.3%. Conclusion The C-HRSD-17 proved to be a valid and reliable assessment tool, with a cutoff score of 9 for screening of current MDD in Chinese adult PWE.

Background Illicit drug use is common in U.S. medical settings. A validated Single Drug Screening Question (SDSQ) containing the word “illegal” is widely used. As marijuana policies change, the present wording may not perform as expected in states legalizing use. This study compares the performance of the validated SDSQ with three different SDSQ wordings. Methods Patients, 18 years and older, presenting to a U.S. hospital emergency department were asked to complete a survey containing the existing SDSQ, three new SDSQ versions without the word “illegal,” and the Mini International Neuropsychiatric Interview. Patients were also encouraged to provide a sample for saliva drug testing. Results Of 297 eligible patients, 200 (67.3%) completed the survey and 141 (70.5% of interview participants) completed saliva testing. Overlapping confidence intervals on the Area Under the Curve (AUC) analysis confirmed that sensitivities of all SDSQs were statistically similar for detecting self-reported drug use (65–71%). Combining questionnaire and saliva testing increased drug use detection by 2% and resulted in lower SDSQ sensitivity (58–67%). Specificities were 99–100%. The SDSQ with the highest sensitivity was: “In the last twelve months, did you smoke pot (marijuana), use another street drug, or use a prescription medication “recreationally” (just for the feeling, or using more than prescribed)?” Conclusions All four SDSQs demonstrated acceptable sensitivity and high specificity. Removing the term ‘illegal’ does not result in higher, or lower, reported drug use, though results could vary in states with legalized marijuana. Future research should replicate this study in one or more of these states.

A esquizofrenia é uma doença mental crônica, caracterizada por distorções do pensamento e da percepção e do afeto, com frequência associados a comportamentos sociais inadequados. O objetivo desta pesquisa foi realizar um mapeamento de fatores sociodemográficos e clínicos de pacientes atendidos em um ambulatório de esquizofrenia e outras psicoses de um hospital público do sul do Brasil. Trata-se de uma pesquisa descritiva e correlacional em uma amostra por conveniência de 108 pacientes (59,3% masculino e 40,7% feminino), com idade média de 36 anos (mediana = 36, IIQ = 27,0 - 46,0). A coleta dos dados sociodemográficos e clínicos foram realizado por meio de um questionário e dos instrumentos Mini International Neuropsychiatric Interview (MINI), MINI Plus e Positive and Negative Syndrome Scale (PANSS-BR). Apenas 16% dos participantes tinham emprego remunerado. Os sintomas típicos do transtorno mostraram-se dentro do esperado (sintomas positivos, mediana = 13, IIQ = 9,25 – 16; sintomas negativos, média = 18,3, DP ± 6,3). O medicamento mais utilizado é a clozapina, um antipsicótico atipico, que possui evidências de eficácia em sintomas positivos e negativos e para modulação de comportamentos suicidas.Palavras-chave: Esquizofrenia. Perfil clínico. Variáveis sociodemográficas. ABSTRACT: Schizophrenia is a chronic mental illness characterized by distortions in thinking, perception and affection, frequently associated with inappropriate social behavior. The objective of this research was to map sociodemographic and clinical factors related to schizophrenia in patients attended at a public hospital in southern Brazil. It is a descriptive and correlational research in a convenience sample of 108 patients (59.3% male and 40.7% female), with a mean age of 36 years (median = 36, IIQ = 27.0-46, 0). The sociodemographic and clinical data were collected through a questionnaire and the Mini International Neuropsychiatric Interview (MINI), MINI Plus and Positive and Negative Syndrome Scale (PANSS-BR) instruments. Only 16% of the participants had paid employment. The typical symptoms of the disorder were within the expected (positive symptoms, median = 13, IIQ = 9.25 - 16, negative symptoms, mean = 18.3, SD ± 6.3). The most commonly used drug is clozapine, an atypical antipsychotic, which has evidence of efficacy in positive and negative symptoms and modulation of suicidal behavior.Keywords: Schizophrenia. Clinical profile. Sociodemographic variables.

Premenstrual dysphoric disorder (PMDD) is not well-studied in Arab populations. The goal of this study was to validate the Arabic version of the Premenstrual Symptoms Screening Tool (PSST) using the DSM diagnosis of PMDD as the gold standard. The PSST was translated and culturally adapted using back translation and the approval of the original author. We recruited 194 adult women (between October 2013 and March 2014) from two primary care centers in Doha, Qatar. A psychiatrist determined the diagnosis using the semi-structured Mini International Neuropsychiatric Interview, and another rater blinded to the diagnosis finalized the Arabic PSST and administered other clinical questionnaires. The data showed that premenstrual symptoms and PMDD were observed in about 37 percent and 15 percent, respectively, of the women enrolled. The mean age of the women with PMDD according to the PSST was about 30 years, and the majority had children. The Arabic PSST showed high specificity of 95.6 percent but low sensitivity of 26.7 percent. A factor analysis of the different items in Arabic PSST showed that the Arabic PSST could detect the cases with definite PMDD and thus can be a useful tool in primary care settings as this treatable disorder is underdiagnosed in the Arab populations.

Introduction: Nicotine dependent individuals among the tobacco users are in greater risk of having tobacco related disease and psychiatric co-morbidities. There is little information about the tobacco use and nicotine dependence among psychiatric patients in developing countries including Nepal. This study was done to estimate the prevalence of tobacco use, the level of nicotine dependence among the users and the psychiatric disorder specific prevalence among tobacco users admitted in psychiatry ward.Material And Method: A cross-sectional study was conducted in In-patient setting of Department of Psychiatry, BPKIHS. Ninety cases (size) were enrolled. The Fagerström Test for Nicotine Dependence (FTND) was applied to assess the level of nicotine dependence and the Mini International Neuropsychiatric Interview (M.I.N.I.) for diagnosis of Psychiatric disorders.Results: The prevalence of tobacco use was 62.2%. Tobacco use was more common among males (p value< 0.05).Smokeless form was the commonest form of tobacco. Majority of tobacco users had moderate nicotine dependence and had started the use in adolescence and in their 20s. Psychotic disorders were the most common diagnosis among the admitted patients.Conclusion: Tobacco use is common in patients with psychiatric disorders. Nicotine dependence should be looked into for holistic management. Treatment approaches should be tailored in tobacco users with comorbid psychiatric disorders, as this specific population has high prevalence of tobacco use and higher nicotine dependence. J Psychiatrists’ Association of Nepal Vol. 6, No. 2, 2017, Page: 54-59

Objective: Brain and nervous system cancer incidence was one of the ten most common cancers in Malaysia. The study intends to model the structural relationship of MDD, anxiety disorders, other psychiatric disorders, quality of life, coping styles and their associated factors among neurological disorder (brain tumour / brain disorder) patients. Methods: The EORTC-Quality of Life, Brief COPE, Single Item Social Support, MINI International Neuropsychiatric Interview and Patient Health Questionnaires were utilised in the study. Results: The multivariate normality kurtosis was 6.174 with c.r = 2.440 obtained in this SEM model. Chi-square normalized by degrees of freedom, (χ̰2 /df) =1.086, p= 0.353. The RMSEA was 0.03, TLI = 0.988 and CFI =0.999 were obtained in the study. All 8 paths out of 10 paths were significant with p-values less than 0.05 (two-tailed) with R2 values ranging from 0.48 to 0.55 which indicates that the variance explained ranged from 48% for emotional functioning to 55% for severity of depression. The severity of MDD has positive relationship with insomnia and panic disorder lifetime and negative relationship with self distraction coping styles. Meanwhile emotional functioning had negative relationship with fatigue, venting and panic disorder lifetime and positive relationship with global health status. The emotional functioning also was correlated negatively with the severity of MDD (p < 0.005). Conclusion: Therefore based on the path analysis, the main contributing factors of MDD severity were emotional functioning, insomnia, self distraction coping and panic disorder lifetime. The emotional functioning of the patients were influenced by the fatigue, global health status, venting coping styles and panic disorder lifetime and this increased the severity of MDD among the patients. Therefore the role of quality of life and coping styles on depression and anxiety should not be neglected. The clinician, health psychologist, psychiatrist, and counselor in this country need to implement better treatments for the effected patients.

Objectives This study aimed to assess the immediate stress and psychological impact experienced by quarantined patients undergoing hemodialysis and university hospital workers who treated patients Middle East respiratory syndrome (MERS) during its outbreak. Design The group of subjects consisted of 1800 hospital practitioners and 73 quarantined patients undergoing hemodialysis. The Impact of Events Scale–Revised (IES-R) was administered to the practitioners twice, once during the hospital shutdown and again one month after the shutdown. The Mini International Neuropsychiatric Interview and Hospital Anxiety and Depression Scale were administered to patients undergoing hemodialysis. Results During the initial stages of the MERS outbreak, healthcare workers who performed MERS-related tasks scored significantly higher on the total IES-R and its subscales. In the second assessment of the high-risk group, the sleep and numbness subscale scores from the IES-R differed depending on the implementation of home quarantine, and the intrusion subscale scores differed depending on the performance of MERS-related tasks. Conclusion Medical staff that performed MERS-related tasks showed the highest risk for post-traumatic stress disorder symptoms even after time had elapsed. The risk increased even after home quarantine. Prompt and continuous psychiatric intervention is needed in high mortality infectious disease outbreaks., Highlights • Little research on psychological impact of MERS outbreaks is available. • Medical staff that performed MERS-related tasks showed the highest risk for PTSD symptoms. • The risk increased even after home quarantine. • Prompt and continuous psychiatric intervention is needed in infectious diseases.

Background Electroconvulsive therapy (ECT) is well-established and effective for treatment-resistant depression (TRD), but in Canada and the USA, less than 1% of patients with TRD receive ECT mainly due to its cognitive adverse effects (i.e. amnesia). Thus, new treatment alternatives for TRD are urgently needed. One such treatment is magnetic seizure therapy (MST). ECT involves applying a train of high-frequency electrical stimuli to induce a seizure, whereas MST involves applying a train of high-frequency magnetic stimuli to induce a seizure. Methods In this manuscript, we introduce our international, two-site, double-blinded, randomized, non-inferiority clinical trial to develop MST as an effective and safe treatment for TRD. This trial will compare the efficacy of MST to right unilateral ultra-brief pulse width electroconvulsive therapy (RUL-UB-ECT) with a combined primary endpoint of remission of depression and superior cognitive adverse effects in 260 patients with TRD. Amelioration of suicidal ideation will be assessed as a secondary endpoint. Inpatients or outpatients, over 18 years of age with a MINI International Neuropsychiatric Interview (MINI) diagnosis of non-psychotic major depressive disorder (MDD) can be enrolled in the study provided that they meet illness severity and full eligibility criteria. Participants are randomized to receive MST or RUL-UB ECT, 2-3 days per week over seven weeks, or a maximum of 21 treatments. The study will involve before-, during-, and after-treatment assessments of depression severity, suicidal ideation, subjective side-effects, and cognitive performance consistent with an intent-to-treat study design approach. Discussion Positive results from this trial could have an immediate and tremendous impact for patients with TRD. If MST demonstrates comparable antidepressant treatment efficacy to ECT, but with greater cognitive safety, it could rapidly be adopted into clinical practice. Indeed, given that the administration of MST is nearly identical to ECT, the majority of ECT facilities in North America could readily adopt MST. Furthermore, the potential for cognitive safety could lead to improved treatment acceptability. Healthcare providers, patients and care partners, and policymakers would therefore demand this form of convulsive therapy. Trial status Enrollment for this study began on June 26, 2018, and is estimated to complete recruitment by July 2024. At the time of submission, we have enrolled and randomized 117 participants. Trial registration ClinicalTrials.gov NCT03191058, Registered on June 19, 2017. Primary sponsor: Daniel Blumberger (DMB), Principal Investigator Daniel.Blumberger@camh.ca, 416-535-8501 x 33662 Contact for public queries: DMB, Daniel.Blumberger@camh.ca Contact for scientific queries: ZJD, Zdaskalakis@health.ucsd.edu

Background The tuberous sclerosis-associated neuropsychiatric disorders (TAND) have not previously been studied in China. We aimed to assess the psychiatric level of individuals with TAND using the Mini International Neuropsychiatric Interview for Children (MINI-KID) in China. Results A total of 83.16% of individuals (79/95) had at least one TAND, and 70.53% (67/95) had an intellectual disability. The MINI-KID tool diagnosed 16 neuropsychiatric diseases, the most common of which were attention-deficit/hyperactivity disorder (ADHD) (51.58%, 49/95) and social anxiety disorder (30.53%, 29/95). The number of children with psychiatric diseases in the tuberous sclerosis complex (TSC) group was significantly greater than the number in the typically developing group (P Conclusions This study used the structured and systematic MINI-KID scale to determine the diagnosis of psychiatric co-morbidities in a relatively large sample, suggesting a higher rate. By comparing the status of individuals with TSC with typically developing children, the results suggests that neuropsychiatric co-morbidities are significantly higher in individuals with TSC. Research has revealed the frequent presence of two, three or more neuropsychiatric diseases in individuals with TSC.

Background The possibility of psychopathological symptoms and related risk factors among normal persons and patients infected during the outbreak of COVID-19 has been widely investigated. The mental health outcomes of the second wave of the pandemic remain unclear, especially those of patients with an infection. Thus, this study aims to explore the prevalence of and related risk factors associated with psychopathological symptoms among patients infected with COVID-19 during the second wave. Method A cross-sectional survey was conducted in five isolated wards of a designated hospital in Beijing, China, from July 1 to July 15, 2020. The Mini International Neuropsychiatric Interview (MINI) was conducted to assess psychiatric disorders, and a series of scales were used to measure self-reported psychopathological symptoms and psychosomatic factors. Multivariate regression analysis was used to analyze the risk factors associated with psychopathological symptoms. Results Among 119 participants with infections, the prevalence of generalized anxiety symptoms (51.3%), depressive symptoms (41.2%), and posttraumatic stress symptoms (PTSS)/posttraumatic stress disorder (PTSD) symptoms (33.6%) was observed. Loneliness, hope, coping strategies, and history of mental disorders were the shared risk or protective factors across several psychopathological symptoms. The perceived impact of COVID-19 is the specific risk factor associated with state anxiety symptoms. Conclusions The prevalence of symptoms of depression, anxiety, and PTSS/PTSD is high among patients with infections during the second wave of the pandemic in Beijing. Clinical doctors must realize that these patients will probably experience depressive disorder, anxiety disorders, and PTSS/PTSD, as well as some neuropsychiatric syndromes. Specific mental health care is urgently required to help patients manage the virus during the second wave of the pandemic.

Introduction: Generalized anxiety disorder (GAD) is a common pathology in modern life. Furthermore, Brazil ranks among one of the countries in Latin America with the highest increase in the number of suicides. Objective: The goal of this study is to evaluate the prevalence of GAD and suicide risk and their association in medical students from Belém - PA. Methods: The observational, cross-sectional and quantitative study included undergraduate medical students attending the 1st, 3rd and 5th years of Universidade do Estado do Pará as subjects of this research, totaling 153 students. It used a protocol created by the authors and the Mini International Neuropsychiatric Interview. The software BioEstat® 5.3 was used to perform the statistical analysis. Results: 52 (32,7%) of the 159 students have GAD and 48 (30,2%) pose a suicide risk, of which 18 have a mild risk (11,3%), 17 a moderate risk (10,7%) and 13 a high risk (8,2%). 46,7% and 50% of the 1st and 3rd-year students, respectively, have higher risk of suicide, which could be related to the competition faced during the University admission process and also during the first years of the clinical cycle. Of the 5th year students who pose a suicide risk, only 21,7% have high risk. Conclusion: It can be observed that GAD and suicide risk show high prevalence among medical students, which has to be investigated and treated aiming to reduce the impacts of those disorders on health professionals and students. Resumo: Introdução: O transtorno de ansiedade generalizada (TAG) é uma patologia comum da modernidade. Além disso, o Brasil figura entre um dos países da América Latina com o maior aumento do número de suicídios. Objetivo: Este estudo teve como objetivo avaliar a prevalência de TAG e risco de suicídio e a associação entre eles em estudantes de Medicina de Belém, no Pará. Métodos: O estudo observacional, transversal e quantitativo teve como sujeitos da pesquisa graduandos do curso de Medicina que estavam matriculados no primeiro, terceiro e quinto anos na Universidade do Estado do Pará, totalizando 159. Utilizaram-se questionário de autoria dos pesquisadores e o Mini International Neurophsychiatric Interview, sendo a análise estatística feita com o software BioEstat® 5.3. Resultados: Dos 159 estudantes, 52 (32,7%) apresentaram TAG; e 48 (30,2%), risco de suicídio, dos quais 18 tiveram risco leve (11,3%); 17, risco moderado (10,7%); e 13, risco elevado (8,2%). Dos alunos, 46,7% e 50%, respectivamente do primeiro e terceiro anos, apresentaram risco elevado de suicídio, fato que pode estar associado com a pressão do vestibular e do início do ciclo clínico. Dos alunos do quinto ano com risco de suicídio, somente 21,7% apresentaram risco elevado. Conclusão: Percebe-se uma importante taxa de TAG e de risco de suicídio entre os estudantes de Medicina, o que precisa ser investigado e trabalhado para minimizar os impactos desses transtornos nos discentes.

Objective Bipolar disorder (BD), particularly BD-II, is frequently misdiagnosed as recurrent depressive disorder (RDD) because past hypomanic episodes are missed. The self-report Hypomania Checklist-32 (HCL-32) is a sensitive and reliable instrument with validated transcultural stability for detecting a history of hypomanic symptoms. The 33-item Hypomania Checklist (HCL-33) is a slightly modified version of the HCL-32. Alongside the HCL-33 self-report version, a new instrument for external assessment was developed. The objective was validation of the psychometric properties and the accuracy of the Russian version of the HCL-33 to identify BD in patients with a current diagnosis of RDD. Method The HCL-33 was completed by 150 outpatients and inpatients with a formal diagnosis of RDD in two Moscow state psychiatric settings. International Classification of Disorders (ICD-10) diagnoses were established using the Russian version of the Mini International Neuropsychiatric Interview (MINI). Results A screening score of 16 on the HCL-33 was the optimal cut-off that maximized sensitivity (0.71) and specificity (0.69) for the BD diagnosis. The highest Area Under the Curve (AUC) value during Receiver Operator Characteristic (ROC) analysis was 0.773 distinguishing between BD and RDD. The Cronbach's alpha was 0.91, indicating good internal consistency. Principal component analysis identified two factors, “active/elated” and “risk-taking/irritable”. Limitations The study scope was limited by the specific nature of the sample and the absence of comparison with other BD screening scales including HCL-32. Conclusions The Russian version of the HCL-33 is a sensitive, accurate and reliable instrument for the screening of BD patients with depression.