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Objective: A thorough and comprehensive knowledge base on the extent of comorbidity of attention‐deficit/hyperactivity disorder (ADHD) and somatic conditions is needed. Method: We compared the prevalence of a wide range of somatic conditions in individuals with and without ADHD and described sex and lifecourse differences. Individuals with an ADHD diagnosis (N = 87,394) and age and sex‐matched individuals without an ADHD diagnosis were identified from a large health claims dataset representative of the general German population, including both primary and specialized care (N = 4.874,754). Results were provided for the full sample as well as stratified for sex and age (<12 years, 13–17 years, 18–29 years, 30–59 years, ≥60 years). Results: The results showed that ADHD is associated with a wide variety of somatic conditions across the entire lifecourse. Specifically neurological disorders such as Parkison's disease (odds ratio [OR]: 5.21) and dementia (OR: 2.23), sleep‐related disorders (OR: 2.38) and autoimmune disorders affecting the musculoskeletal, digestive, and endocrine system (fibromyalgia OR: 3.33; lupus OR: 2.17) are strongly and significantly associated with ADHD. Additionally, ADHD is associated with higher occurrence of common acute diseases typically treated by the general practitioner, hinting at an overall general lower health status. Sex differences in somatic comorbidity were not prominent. Age differences, in contrast, stood out: in particular endocrine, cardiovascular, and neurological disorders had an early onset in individuals with compared to individuals without ADHD. Conclusion: This research underlines the high burden of disease due to somatic conditions among individuals with ADHD. The findings indicate the need for preventive measures to reduce comorbidity. [ABSTRACT FROM AUTHOR]

The purpose of this review is both to evaluate the impact of the association of nosocomial infections, dental and somatic pathology in patients with depression, because the presence of comorbidities leads to an increase in health care costs, as well as to evaluate the importance of multidisciplinary care of these patients. Chronic depression correlated, independently, more frequently with the state of somatic health compared to episodic depression thus emphasizing the need for prompt treatment of depression. Nosocomial infections associated with depression are a constant concern in the medical field, despite significant advances in patient care. These infections, occurring within medical institutions, constitute a major problem in the health system, generating significant morbidity and mortality, and involving substantial socio-economic costs. There is a higher prevalence of cardiovascular diseases and strokes in patients suffering from recurrent depressive disorder. It is possible that anxiety through serotonergic dysfunction represents the physio-pathological link that establishes the depressionanxiety-somatic pathology connection. The physical health of patients with depression must also include prevention of oral pathology through oral hygiene advice, management of iatrogenic dry mouth and early dental visits. Osteo-articular diseases increase the risk of suicide, while cardiovascular diseases lead to an increase in the frequency of episodes and hospitalizations. [ABSTRACT FROM AUTHOR]

Introduction The co-occurrence of mental illness and somatic comorbidities is a major cause of increased morbidity and mortality within psychiatric patients, compared to the general population. This may be caused by an unhealthy lifestyle, side effects of psychotropic drugs and systematic barriers in healthcare provision. The underlying mechanisms remain under-investigated. Objectives We systematically investigated relevant barriers and risk factors to the utilization of primary care among severe mentally ill outpatients. Methods In a cross-sectional analysis, the psychiatric as well as somatic diagnoses of inpatients of a German psychiatric community hospital were identified. Furthermore, somatic and psychiatric medication, blood values (HBA1C) and sociodemographic data of the patients were analyzed. The frequencies of the somatic diagnoses were presented according to psychiatric diagnoses. By a Chi-Square goodness-of-Fit Test the distribution of somatic diagnoses and drug classes were verified according to the total cohort as well as for each psychiatric diagnosis and in respect to sex. Results Our results provide an overview of common comorbidities with regard to the psychiatric diagnosis. The medication, in relation to the recorded somatic comorbidities, as well as the blood values, allow a conclusion to be drawn about the extent and success of the treatment. Conclusions For the first time, real-life data on the somatic diagnoses and treatment of patients with a severe mental illness in a German hospital is presented. Our results will be used to create low-threshold interventions for the most relevant somatic comorbidities and to improve primary care of psychiatric patients through linking the care systems. Disclosure No significant relationships.

Introduction People followed at the department of psychiatry have a high prevalence of somatic pathologies that are generally not taken optimal care of in time, which implies excess mortality rate among these patients. Objectives To study somatic comorbidities in patients followed at the department of psychiatry of the regional hospital of Gabes (Tunisia). Methods We conducted a retrospective, descriptive and analytical study carried out on a clinical population who consult for the first time at the psychiatry department at the Gabes regional hospital during the period from January 1st, 2010 to December 31, 2013. Sociodemographic, clinical and therapeutic data of the patients were assessed. Data were analysed using the software SPSS (20th edition). Results The number of patients consulting for the first time at the psychiatry department during the study’s period was 1601 patients, with a mean age of 34 years and a sex ratio (M / F) of 0.96. Among these patients, 399 (24.9%) had somatic comorbidity. The most common somatic comorbidity was arterial hypertension (8.1% of patients, n=129 patients). Diabetes mellitus was ranked second with 99 patients (6.2%). The analytical study showed that depressive disorders were significantly more frequent in patients with hypertension (p

Aim. To assess five-year changes of somatic risk factors and comorbidities in patients with angina of effort.Material and methods. The study included 320 patients (143 men and 177 women aged 40-69 years) with coronary artery disease (CAD), class I-III angina of effort. Patients underwent examinations in 2012 in three medical centers of the Republic of Ingushetia (Russia), and in 2017 they were invited for a second complex examination with questionnaires, biochemical analysis, and instrumentation.Results. Over the five-year follow-up, there was an increase of men with class III effort angina up to 45%; a similar trend was observed in women. Both men and women experienced a three-fold increase in the incidence of type 2 diabetes. Initially and during the follow-up, chronic obstructive pulmonary disease was diagnosed 2 times more often in men than in women, which may be associated with smoking. A small increase in the total cholesterol level was recorded in the cohort; among women, these changes were significant. Target levels reach no more than 20% of patients. A significant increase of blood glucose levels over the 5-year period was observed in a cohort of men and women with effort angina.Conclusion. Over the 5-year follow-up, there was a clinical deterioration of the effort angina, which is associated with an increase in the incidence of some somatic diseases and the severity of the main behavioral and biological risk factors.

Background: Depression is associated with most somatic diseases, with an impact of poor prognosis and evolution, higher medical costs, and a higher level of functional disability. The aim of this study is to provide an overall picture of the broad range of somatic disorders associated with depression and to emphasize the need for suitable management. Methods: We collected data from 59 adult patients diagnosed with mild, moderate, and severe depression who benefitted from inpatient care at one point from March of 2020 until February of 2021. Using these data, we calculated the prevalence of multiple groups of comorbid somatic diseases and highlighted the correlations between the severity of the depressive episode and the multimorbidity status of each patient. Results: The most prevalent diagnosis groups were "metabolic, nutritional and endocrinologic diseases", followed by "diseases of the circulatory system" and "diseases of the nervous system". Correlations between the severity of depression and the multimorbidity status in each diagnosis group were identified. Conclusions: Our findings illustrate the strong connection between depression and a broad spectrum of somatic diseases. Consequently, we underscore the importance of an integrative approach for the adequate management of these cases. [ABSTRACT FROM AUTHOR]

Objective: To identify determinants within 3 different domains (ie, somatic comorbidities, cognitive functioning, and neuropsychiatric symptoms [NPS]) of health-related quality of life (HRQoL) over time in memory clinic patients without dementia.Methods: This longitudinal multicenter cohort study with a 3-year observation period recruited 315 individuals (age: 69.8 ± 8.6, 64.4% males, Mini-Mental State Examination score 26.9 ± 2.6). A multivariable explanatory model was built using linear mixed effects models (forward selection per domain) to select determinants for self-perceived HRQoL over time, as measured by the EuroQoL-5D visual analogue scale (EQ VAS).Results: Mean HRQoL at study entry was 69.4 ± 15.6. The presence of agitation, appetite and eating abnormalities, and eyes/ears/nose (ie, sensory impairment) comorbidities were associated with a change in HRQoL over time. Agitation was most strongly associated with HRQoL over time.Conclusions: The association of somatic comorbidities and NPS in memory clinic patients with course of HRQoL shows that these should receive more awareness, detection, and monitoring by clinicians. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the prevalence of unexplained extraoral symptoms in a group of patients with burning mouth syndrome (BMS) and compare the prevalence with that in patients with oral lichen planus (OLP) and age- and gender-matched controls. Methods: The occurrence of extraoral symptoms was analyzed in a group of 124 BMS patients, a group of 112 oral lichen planus (OLP) patients, and a group of 102 healthy patients. Oral symptoms were collected by a specialist in oral medicine and a general dentist, while data concerning unexplained extraoral symptoms were gathered by each specialist ward, ie, ophthalmology, gynecology, otolaryngology, gastroenterology, neurology, cardiology, internal medicine, and dermatology. A Fisher exact test (α = .05) and Kruskal-Wallis test (α = .05) were performed for statistical analysis. Results: In the BMS group, 98 (96.1%) patients reported unexplained extraoral symptoms, while 4 (3.9%) patients reported only oral symptoms. A painful symptomatology in different bodily regions was reported more frequently by BMS patients (83.3%) than by OLP patients (1.8%) and healthy patients (11.7%) (P < .0001). The differences in the overall unexplained extraoral symptoms between BMS (96.1%) and OLP patients (9.3%) (P < .0001) and between BMS (96.1%) and healthy patients (15.7%) (P < .0001) were statistically significant. The unexplained extraoral symptoms in BMS patients consisted of pain perceived in different bodily areas (odds ratio [OR]: 255; 95% confidence interval [CI]: 58.4-1112), ear-nose-throat symptoms (OR: 399.7; 95%CI: 89.2-1790), neurological symptoms (OR: 393; 95% CI: 23.8-6481), ophthalmological symptoms (OR: 232.3; 95% CI: 14.1-3823), gastrointestinal complaints (OR: 111.2; 95% CI: 42.2-293), skin/gland complaints (OR: 63.5; 95% CI: 3.8-1055), urogenital complaints (OR: 35; 95% CI: 12-101), and cardiopulmonary symptoms (OR: 19; 95% CI: 4.5-82). Conclusion: The great majority of BMS patients presented with several additional unexplained extraoral comorbidities, indicating that various medical disciplines should be involved in the BMS diagnostic process. Furthermore, the results suggest that BMS may be classified as a complex somatoform disorder rather than a neuropathic pain entity. [ABSTRACT FROM AUTHOR]

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

A vast number of veterans with posttraumatic stress disorder (PTSD) have chronic somatic comorbidities. However, their relationship with quality of life (QoL) has received little attention. We aimed to compare QoL of veterans with similar intensity of PTSD but different number of chronic somatic disorders. Of 129 veterans, 78% had at least one somatic disorder, and they reported lower QoL across all domains than veterans without somatic comorbidities. The greatest effect size was observed on social relationship (d = 0.65), it was notable on environment (d = 0.4) and psychological health (d = 0.38), and it was not relevant on physical health (d = 0.05). There was a negative correlation between the number of somatic disorders and scores on psychological health (rs = -0.217, p = 0.014), social relationships (rs = -0.248, p = 0.005), and environment (rs = -0.279, p = 0.001). The QoL of war veterans decreases significantly with the number of comorbid somatic conditions, particularly on the nonphysical domains of QoL. [ABSTRACT FROM AUTHOR]

Hintergrund: Obwohl eine große Zahl von Studien die generelle Wirksamkeit psychotherapeutischer Behandlungen depressiver Störungen zeigt, variiert die Wirksamkeit in Abhängigkeit von therapeuten- und patientenseitigen Einflussfaktoren sowie der Art des depressiven Störungsbildes.Ziel der Arbeit: Ziel ist die zusammenfassende Darstellung des aktuellen Wissens zu psychotherapeutischen Behandlungen bei Patienten mit chronischen bzw. therapieresistenten depressiven Störungen und bei Patienten mit psychischen oder somatischen Komorbiditäten.Material und Methoden: Im Rahmen der 2015 durchgeführten Revision der aktuell gültigen S3- bzw. Nationalen VersorgungsLeitlinie (NVL) Unipolare Depression erfolgte eine systematische Evidenzrecherche zu Psychotherapie bei spezifischen Patientengruppen. Diese Ergebnisse in Verbindung mit einem systematischen Rechercheupdate werden dargestellt.Ergebnisse: Für die spezifischen Patientengruppen der chronisch depressiven bzw. therapieresistenten Patienten sowie mit komorbiden psychischen oder somatischen Erkrankungen liegen Hinweise für die Wirksamkeit von Psychotherapie im Hinblick auf die Reduktion depressiver Symptome vor. Insbesondere für depressive Patienten mit psychischen Komorbiditäten ist die Evidenzlage allerdings noch nicht ausreichend.Diskussion: Basierend auf der aktuellen Evidenz und/oder auf klinischem Expertenkonsens empfiehlt die NVL eine alleinige Psychotherapie oder eine Kombination mit Antidepressiva bei den meisten der genannten Patientengruppen. Es bestehen Kenntnislücken, die deutlich machen, dass weitere wissenschaftliche Bemühungen notwendig sind, um die Behandlung spezifischer depressiver Patientengruppen weiter zu verbessern. [ABSTRACT FROM AUTHOR]

Introduction Avoidance of sexual intercourse has not been frequently studied among patients with chronic medical conditions and patients with coronary artery disease ( CAD) are not exception. Aim We aimed to (i) compare intercourse avoidance during the past 2 weeks among women with CAD and healthy controls; and (ii) to determine factors associated with intercourse avoidance during the past 2 weeks among women with CAD. Methods This study was conducted in an outpatient cardiology clinic in Tehran, Iran. The study included 152 married women with CAD and 50 controls. Socio-demographic and clinical data including the severity of angina ( WHO Rose Questionnaire), risk factors (cigarette smoking, hyperlipidemia, diabetes, and obesity), fatigue, physical function (visual analogue scale [ VAS]) and somatic comorbidities [ Ifudu index], symptoms of anxiety and depression ( Hospital Anxiety and Depression Scale [ HADS]), and dyadic adjustment ( Revised- Dyadic Adjustment Scale [ R- DAS]) were considered as independent variables. Logistic regression was used to determine predictors of sexual avoidance during the past 2 weeks. Main Outcome Measures The main outcome was intercourse avoidance over a 2-week period, measured by the Relation and Sexuality Scale ( RSS). Result Avoidance of intercourse during the past 2 weeks was higher among women with CAD than controls (73.0% vs. 56%, P = 0.024). According to the logistic regression, intercourse avoidance was positively associated with age (Odds ratio [ OR] = 1.127, 95% confidence interval [ CI] = 1.073, 1.185), somatic comorbidities ( OR = 1.137, 95% CI = 1.061, 1.218) and depressive symptoms ( OR = 1.150, 95% CI = 1.022, 1.293). Conclusion Our study suggests that among women with CAD, age, depressive symptoms and somatic comorbidities are associated with avoidance of intercourse. As having intercourse is safe among patients with stable CAD, all health professionals should discuss sexual behaviors with their female CAD patients, especially those that are older, with higher depressive symptoms or multiple comorbidities so as to allay fears about sexual functioning. Assari S . Intercourse avoidance among women with coronary artery disease. J Sex Med 2014;11:1709-1716. [ABSTRACT FROM AUTHOR]

Therapeutic strategies in Alzheimer's disease (AD) must take into account the characteristics of elderly people, who often have somatic comorbidities. Moreover, demented patients are more frequently frailer than older people. They have a higher number of admissions to hospital, a greater prevalence of complications and an increased risk of death. Therapeutic decisions for these patients have to be approached cautiously: aging, a more elevated comorbidity/polytherapy index and frailty contribute to enhance the risk of pharmacological adverse events and drug interactions. The aim of the present study was to focus on risk-benefit profile of pharmacological therapy for AD in relation to somatic comorbidities that often affect these patients. A Medline search (from 2001 to 2012) was performed using as key words dementia, Alzheimer's disease, drug treatment, somatic comorbidities, side effects/adverse events and elderly. Cholinesterase inhibitors (ChEIs) and memantine represent the main pharmacological strategies effective in reducing the progression of cognitive decline and functional loss in AD. Many conditions very common in the elderly may restrict the use of ChEIs and/or treatment efficacy in AD patients. Memantine has a good efficacy and tolerability profile with better safety in pulmonary, cardiovascular and central nervous system comorbidities compared to ChEIs. Drug interactions with memantine are also more favorable since they concern mostly drugs not commonly used in the elderly. Only a careful evaluation of the associated somatic diseases, taking into account different drugs safety indexes and tolerability, can lead to personalized treatment management, in order to maximize drug efficacy and optimize quality of life. [ABSTRACT FROM AUTHOR]

The prevalence of autism spectrum disorder (ASD) has increased considerably in the past decades. The primary care paediatrician plays an important role not only in the early recognition of ASD but also in its chronic management. Paediatricians need to be comfortable with the global care of children with ASD. The diagnostic assessment of children with ASD comprises the medical investigations to identify associated or underlying medical conditions. The most important associated conditions are seizures, feeding and gastrointestinal problems, sleep disturbances and dental abnormalities. The care of ASD patients is very demanding since along with the purely medical issues there are challenging behavioural and psychiatric conditions that need consideration and professional skills. [ABSTRACT FROM AUTHOR]

Abstract: Objective: A large number of irritable bowel syndrome (IBS) patients are additionally afflicted with other somatic intestinal and/or extraintestinal comorbidities. The occurrence of one or more comorbidities is correlated with enhanced medical help seeking, worse prognosis, and higher rates of anxiety and depression—all resulting in a reduced quality of life. The aims of this study were, firstly, to review the literature on comorbidities of IBS and to assess gastrointestinal and extraintestinal comorbidities, and, secondly, to evaluate explanatory hypotheses and possible common pathophysiological mechanisms. Methods: We systematically reviewed the scientific literature in the past 25 years, as cited in MEDLINE. Results: IBS patients present with a twofold increase in somatic comorbidities compared to controls, possibly caused by common pathophysiological mechanisms. Nevertheless, to date, there has been no convincing evidence for a consolidated underlying pathophysiology or somatization. Gastrointestinal disorders, such as functional dyspepsia, gastroesophageal reflux disease, functional constipation, and anal incontinence, occur in almost half of the patients. In a broad variety of extraintestinal comorbidities, fibromyalgia, chronic fatigue syndrome, and chronic pelvic pain are best documented and appear in up to 65%. Conclusion: The knowledge and structured assessment of comorbid somatic symptoms might allow to identify subgroups of IBS patients with special characteristics and lead to adaptation of the therapeutic concept. [Copyright &y& Elsevier]

Introduction: People followed at the department of psychiatry have a high prevalence of somatic pathologies that are generally not taken optimal care of in time, which implies excess mortality rate among these patients. Objectives: To study somatic comorbidities in patients followed at the department of psychiatry of the regional hospital of Gabes (Tunisia). Methods: We conducted a retrospective, descriptive and analytical study carried out on a clinical population who consult for the first time at the psychiatry department at the Gabes regional hospital during the period from January 1st, 2010 to December 31, 2013. Sociodemographic, clinical and therapeutic data of the patients were assessed. Data were analysed using the software SPSS (20th edition). Results: The number of patients consulting for the first time at the psychiatry department during the study's period was 1601 patients, with a mean age of 34 years and a sex ratio (M / F) of 0.96. Among these patients, 399 (24.9%) had somatic comorbidity. The most common somatic comorbidity was arterial hypertension (8.1% of patients, n=129 patients). Diabetesmellitus was ranked second with 99 patients (6.2%). The analytical study showed that depressive disorders were significantly more frequent in patients with hypertension (p<0.001), diabetes mellitus (p<0.001) and asthma (p=0.026). Conclusions: Somatic comorbidities were frequent in patients followed by the department of psychiatry. Paying attention to somatic comorbidities must be part of the evaluation of these patients in order to coordinate effectively with the somatic doctors. [ABSTRACT FROM AUTHOR]

Background: Using two logistic regression models, we determined the associates of poor physical and mental health related quality of life (HRQoL) among beta thalassemia patients., Methods: In this cross-sectional study which was conducted during 2006 and 2007 in outpatient adult thalassemia clinic, Blood Transfusion Organization, Tehran, Iran, Short Form 36 (SF-36) was used for measuring HRQoL in 179 patients with beta thalassemia (major/intermedia). We determined scores higher than third quartiles of obtained PCS and MCS scores as the cutoff points of good HRQoL. Poor HRQoL was defined scores lower than first quartiles of obtained PCS and MCS scores. Two distinct logistic regression models were used to derive associated variables including demographic, clinical, and psychological factors., Results: The regression models suggested that poor physical HRQoL was positively associated with somatic comorbidities (OR = 1.472, CI = 1.021-2.197, p = 0.048) and depression score (OR = 8.568, CI = 2.325-31.573, p = 0.001). The variables that were associated with poor mental HRQoL were anxiety score (OR = 9.409, CI = 1.022-89.194, p = 0.049) and depression score (OR = 20.813, CI = 4.320-100.266, p < 0.001)., Conclusions: Depression is associated with both poor physical and mental HRQoL among patients with major/intermedia beta thalassemia, however somatic comorbidities and anxiety are associated with poor physical and mental HRQoL, respectively.