¿Los hijos de pacientes con trastorno bipolar tienen una peor percepción de la calidad de sueño? / Do Children of Patients with Bipolar Disorder have a Worse Perception of Sleep Quality?

RESUMEN Introducción: los Hijos de Padres con Trastorno Bipolar (HPTB) constituyen una población de riesgo ya que pueden heredar el Trastorno Bipolar (TB) como también manifestaciones clínicas tempranas como seria las alteraciones en el sueño. Objetivo: comparar la presencia de trastornos psiquiátricos y las alteraciones en el sueño de los HPTB con los Hijos de Padres Control (HPC). Métodos: Se realizó un estudio analítico de corte transversal, que comparó HPTB versus HPC. Se entrevistaron con instrumentos validados para determinar la existencia de síntomas y trastornos psiquiátricos. Utilizamos las escalas: "Cuestionario de evaluación de sueño" y "Encuesta sobre hábitos de sueño en escolares" para determinarlas características del sueño y factores asociados con el mismo. Adicionalmente se obtuvo el registro de sueño (7-21 días) por medio de un reloj de actígrafia. Resultados: Se reunió una muestra con 42 sujetos (18 HPTB y 24 HPC). Se encontraron diferencias en la presentación de los trastornos psiquiátricos. El grupo de HPTB presento mayor frecuencia del trastorno depresivo mayor (TDM; p = 0,04) y el trastorno disruptivo de la regulación emocional (TDRE, p = 0,04). En el grupo de HPC por su parte se presentó una mayor frecuencia de Trastorno por Déficit de Atención e Hiperactividad (TDAH; p = 0,65) y de Trastorno de Ansiedad por Separación (TAS; p = 0,46). También se encontraron diferencias a nivel del sueño en las medidas subjetivas. En comparación con el HPC, el grupo de HPTB presento una peor percepción de la calidad de sueño (p = 0,02), una mayor presencia de pesadillas (p = 0,01), un menor tiempo total de sueño y una mayor latencia de sueño. Sin embargo, no se encontraron diferencias entre los dos grupos en las mediciones de actigrafías. Conclusiones: el grupo de HPTB presenta mayor frecuencia de trastornos del estado de ánimo, y a su vez una mayor presencia de alteraciones del sueño en las medidas subjetivas. Es posible que exista una asociación entre los síntomas afectivos, las alteraciones en el sueño y el consumo de café. No se encontraron diferencias en el perfil de sueño por actígrafía. © 2020 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España, S.L.U. Todos los derechos reservados. Children

ABSTRACT Introduction: The offspring of bipolar parents (BO) is a high-risk population for inheriting the bipolar disorder (BD) and other early clinical manifestations, such as sleep disturbances. Objective: To compare the presence of psychiatric disorders and sleep disturbances of BO versus offspring of control parents (OCP). Methods: A cross-sectional analytical study was conducted that compared BO versus OCP. The participants were assessed using valid tools to determine the presence of psychiatric symptoms or disorders. The "Sleep Evaluation Questionnaire" and "School Sleep Habits Survey" were used to determine sleep characteristics and associated factors. Sleep records (7-21 days) were also obtained by using an actigraphy watch. Results: A sample of 42 participants (18 BO and 24 OCP) was recruited. Differences were found in the presentation of the psychiatric disorder. The BO group showed a higher frequency of major depression disorder (MDD; P = .04) and Disruptive Mood Dysregulation Disorder (DMDD; P = .04). The OCP group showed a higher frequency of Attention Deficit and Hyperactivity Disorder (ADHD; P = .65), and Separation Anxiety Disorder (SAD; P = .46). Differences were also found in sleep by using subjective measurements. Compared to the OCP group, BO had a worse perception of quality of sleep (P = .02), a higher frequency of nightmares (P = .01), a shorter total sleep time, and a higher sleep latency. Nevertheless, no differences were found between groups in the actigraphy measurements. Conclusions: The BO group had a higher frequency of Mood Disorders, and at the same time a higher number of sleep disturbances in the subjective measurements. It is possible that there is an association between mood symptoms, sleep disturbances, and coffee intake. No differences were found in the sleep profile by using actigraphy. © 2020 Asociación Colombiana de Psiquiatría. Published by Elsevier España, S.L.U. All rights reserved.

A cross-sectional study of attitude towards psychiatry among undergraduate medical students

Background: Psychiatric disorders are common, affecting millions of population worldwide. Patients with psychiatric disorders, psychiatrists as professionals, and psychiatry as a subject are seen in negative attitudes. Prejudices and negative attitudes exist among medical professionals as well. Aims: This study aims to know the attitude of undergraduate medical students towards psychiatry and compare the attitude among students with or without exposure to clinical psychiatry postings. Materials and methods: This is a descriptive, cross-sectional study conducted at a medical college, Karnataka, South India. Undergraduate students belonging to all phases and consenting for the study were the participants. They were considered into two groups, students not exposed to psychiatry clinical posting and students exposed to psychiatry clinical postings, respectively. Apart from collecting sociodemographic details, a self-administered Attitude Towards Psychiatry?30 items questionnaire was used and t-test, chi-square/Fisher’s exact test were used for statistical analyses. Result: The sample consisted of 484 students, of which 52.3% vs 47.7% of students were not exposed to psychiatry vs exposed to psychiatry clinical postings respectively. Overall students reported having a positive attitude towards psychiatry. We found 96.1% of students with clinical exposure to psychiatry have a better attitude compared to 86.9% of students not exposed to psychiatry clinical postings. Conclusion: A positive attitude towards psychiatry is necessary for better care of patients as well as to reduce stigma regarding mental illness. As clinical exposure improves the positive attitude, there is always a scope for improvements in the form of better psychiatry training at the undergraduate level.

Tendencia de las hospitalizaciones en la Unidad de Corta Estadía de Psiquiatría del Hospital Clínico Herminda Martin durante 14 años / Trend of hospitalizations in the Short Stay of Psychiatry Unit of Herminda Martin Clinical Hospital for 14 years

INTRODUCCIÓN: La hospitalización psiquiátrica de corta estadía es un recurso necesario para tratar trastornos mentales con descompensación severa que no pueden resolverse ambulatoriamente. El conocimiento de sus resultados ayuda en la gestión clínica y administrativa. Este estudio tiene por objeto evaluar la evolución de indicadores hospitalarios, características sociodemográficas y clínicas de pacientes hospitalizados en unidad de corta estadía de psiquiatría. MATERIAL Y MÉTODO: Estudio longitudinal, retrospectivo, de tendencia, realizado sobre el universo constituido por 4.563 egresos de UCEP de Hospital de Chillán, Chile, durante 14 años, desde el 01/07/2005 al 30/06/2019. Se evaluaron variables hospitalarias, sociodemográficas y clínicas. RESULTADOS: en el período en estudio: Disminuyeron los egresos, se prolongó el promedio días estada, aumentó el índice ocupacional y disminuyó el índice de rotación. Un bajo número de pacientes, con predominio de adversidades socioeconómicas y psicosociales, se re-hospitalizó frecuentemente. A mayor número de internaciones mayor estadía. Se incrementaron las hospitalizaciones administrativas y judiciales; éstas últimas con mayor promedio de estada. Aumentó la hospitalización de varones, adolescentes, jóvenes y adultos mayores. Predominaron comunas y consultorios con mayor población, cercanía y acceso. Se mantuvo frecuencia de esquizofrenia y otros trastornos psicóticos y trastorno de personalidad, se duplicaron los trastornos afectivos, triplicaron los trastornos por sustancias, duplicó la patología dual, y el trastorno de personalidad fue frecuente en comorbilidad con trastorno por sustancias y trastornos afectivos. CONCLUSIONES: se requerirían estrategias con Sistema Judicial y Servicio de Salud, implementar unidad de adolescentes y unidad de adicción, y fortalecer atenciones multidisciplinarias para adultos mayores.

BACKGROUND: Short-stay psychiatric hospitalization is a necessary resource to treat mental disorders with severe decompensation that cannot be resolved outpatiently. Knowledge of your results helps in clinical and administrative management. This study aims to evaluate the evolution of hospital indicators, sociodemographic and clinics characteristics of inpatients in a short-stay unit of psychiatry. MATERIAL AND METHODS: Longitudinal, retrospective, trend study was conducted in a universe of 4,563 egress of short-stay psychiatric unit of Chile, for 14 years, from 01/07/2005 to 30/06/2019. Hospital indicators, sociodemographic and clinical variables were evaluated. RESULTS: during the period under study: The egress decreased, the average days were prolonged, the occupational index increased and the turnover rate decreased. A low number of patients, predominantly socioeconomic and psychosocial adversities, were frequently re-hospitalized. The greater the number of hospitalizations longest stay. Administrative and judicial hospitalizations were increased; the latter with the highest average stay. Hospitalization of males, adolescents, young people and older adults increased. Communes and primary care center with a greater population, proximity and access predominated. It remained frequency of schizophrenia and other psychotic disorders and personality disorders, doubled affective disorders, tripled substance disorders, doubled dual pathology, and personality disorder was common in comorbidity with substance disorder and affective disorders CONCLUSIONS: strategies would be required with the Judicial System and Health Service, implement adolescent unity and addiction unit, and strengthen multidisciplinary care for older adults.

Pathway to Holistic Care of Psychiatric Illness in National Servicemen Presenting in Primary Healthcare

@#This is a case study of a 22-year-old National Serviceman presenting with the main complaint of insomnia. This case demonstrates possible gaps in the integration of care between public and National Service healthcare. We illustrate a pathway which primary physicians may use to improve communication with National Service healthcare.

Assessment of psychiatric illness and other comorbidities associated with patients attending obesity clinic in Ahmedabad

Background: Psychosocial impact of obesity is of concern in the present world but remains less studied compared to its physical consequences. People who take treatment for obesity are reported to be positively associated with psychiatric illnesses and also personality characteristics or psychological conditions influence the obesity treatment. Objective: The objective of this study was to study the prevalence of psychiatric illness and comorbid conditions among people with overweight and obesity and to find out factors associated with psychiatric illness. Materials and Methods: A cross-sectional study was conducted in private obesity clinic, Ahmedabad. A total of 103 people attending obesity clinic were studied. Self-structured questionnaire and Hospital Anxiety and Depression Scale (HADS) were used. Results: Of 103, 87.5% (91) were female. Mean age of people attending obesity clinic was 35 ± 9.2 years. About 67.3% were housewife and 92.2% were educated up to secondary or above. Thirty-eight (38.8%) and 59 (57.2%) of 103 were found to be having overweight and obesity, respectively. About 69% of people with obesity belong to Grade 1 and 31% belong to Grade 2 and 3. Psychiatric illness was observed among 38.8% (40) of the obesity clinic attendees. Of 40, 32.5% were found to have abnormal level of HADS score and needed intervention. Of 103, 45.6% had comorbid conditions such as joint associated problems (25%), hypertension (16.5%), and hypothyroidism (14%). Among overweight and obese with comorbidities, 48.9% had psychiatric illness. Psychiatric illness was observed among 37% of people with duration of obesity >5 years. The study did not find any significant association between overweight and obese having comorbid conditions (z = 0.63, P > 0.05) and duration of obesity (z = 0.44, P > 0.05) with psychiatric illness. Conclusion: Both comorbidity and psychiatric illness are highly prevalent among obese people. This indicates early detection and intervention for both to decrease the morbidity and mortality among obese and overweight.

Assessment of Psychiatric Illness in Severe Acne Patients: An Institutional Based Study

Background: Acne is an inflammatory disorder of pilosebaceous units and is prevalent in adolescence. The field ofpsycho-dermatology encompasses all conditions involving themind and the skin. The present study was undertaken forassessing psychiatric illness in severe acne patients.Materials & Methods: A total of 100 severe acne patientswere enrolled in the present study. Complete demographic,clinical, past medical and detailed family history of all thepatients was obtained. All the results were recorded inMicrosoft excel sheet and were analyzed by SPSS software.Results: Among these 100 patients, psychiatric illness wasfound to be present in 21 patients. Anxiety and depressionwere found to be 8 and 7 patients respectively. Somatizationwas found to be present in 3 patients. Obsession was found tobe present in 2 patients. Males had significantly higherincidence of psychiatric illness among acne patients.Conclusion: Occurrence of psychiatric illness is a significantproblem among acne patients; especially among upper.

A Comparative Study Regarding The Difference In Attitude Of Interns Towards Psychiatric Illness And Chronic Medical Illness

Attitude of doctors towards a specific illness play major role in the care of patients. Internship, the final stage in MBBS training is important in developing attitudes towards different diseases. Psychiatric illnesses itself have stigma among doctors too. In our country there are little studies comparing the medical illness and psychiatric illness. In this study we tried to explore the attitude of interns towards Psychiatric illness and a chronic medical illness (Diabetes Mellitus). Total 136 interns who had completed their Psychiatric posting were included in this study. Medical Condition Regard Scale was used to assess the attitude towards the specific illness. The attitude of interns towards Psychiatric illness was comparable with the attitude towards Diabetes Mellitus.

Association between Psychiatric Illness and Social Support, Cognitive Functioning, Treatment Adherence and Functional ability in Chronic Kidney Disease Patients

Introduction: Chronic Kidney Disease (CKD) is emergingas an important chronic disease globally. In India, it isestimated that prevalence of CKD is around 15 -20%. Patientswith CKD are prone to develop psychiatric illness likedepression, anxiety, insomnia and even psychosis. Multiplefactors contribute to the risk of psychiatric morbidity inCKD. Psychiatric morbidity in CKD is associated withpoor adherence and outcome. Study aimed to determine theassociation of psychiatric morbidity in CKD with factors likesocial support, functional ability, cognitive functioning and itsimpact on treatment adherence in chronic kidney disease.Material and methods: Cross sectional study, conductedin department of nephrology, Kilpauk Medical College for6 months from February 2017 to August 2017. Consentingpatients in the age group of 18 – 60 years, diagnosed tohave CKD by consultant nephrologist and on varioustreatment modalities (conservative treatment, hemodialysis,renal transplantation) were included in this study. Patientsdiagnosed to have mental illness prior to the onset of CKDwere excluded.Results: A total of 110 patients consented to participate in thestudy. Of these, 36.4% (n=40) were in conservative treatment,31.8% (n= 35) were in hemodialysis, 31.8% (n=35) were postrenal transplant patients.Conclusion: Treatment adherence, social support systemand functional ability were better for patients on postrenal transplantation than either conservative treatment orhemodialysis

Predictors of length of stay in an acute psychiatric inpatient facility in a general hospital: a prospective study

Objective: There have been significant reductions in numbers of psychiatric beds and length of stay (LOS) worldwide, making LOS in psychiatric beds an interesting outcome. The objective of this study was to find factors measurable on admission that would predict LOS in the acute psychiatric setting. Methods: This was a prospective, observational study. Results: Overall, 385 subjects were included. The median LOS was 25 days. In the final model, six variables explained 14.6% of the variation in LOS: not having own income, psychiatric admissions in the preceding 2 years, high Clinical Global Impression and Brief Psychiatric Rating Scale scores, diagnosis of schizophrenia, and history of attempted suicide. All variables were associated with longer LOS, apart from history of attempted suicide. Conclusions: Identifying patients who will need to stay longer in psychiatric beds remains a challenge. Improving knowledge about determinants of LOS could lead to improvements in the quality of care in hospital psychiatry.

Prevalence of postpartum depression among Filipino mothers seen at the University of the East Ramon Magsaysay Memorial Medical Center, Inc. (UERMMMCI) from 2012-2013: A descriptive study

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> This paper sought to describe the prevalence rate of postpartum depression in patients seen for follow-up at the UERMMMCI Obstetrics and Gynecology Services from June 01, 2012 to May 31, 2013.</p><p style="text-align: justify;"><strong>METHODOLOGY:</strong> Participants of the study included mothers who sought consult at the Obstetrics and Gynecology Service of the UERMMMCI  Outpatient Department after giving birth. These participants were recruited via convenience sampling. A survey method was used to determine variables under study, which included age, relational status and length of relationship, occupation, income, presence of feto-maternal complications, and manner of delivery, while the Filipino version of the Edinburgh Postnatal Depression Scale (EPDS) was used to screen depression risk. Ethics approval was secured prior to study initiation. Analysis of data was done using SPSS v.16.0.</p><p style="text-align: justify;"><strong>RESULTS:</strong> A total of fifty-one mothers participated in the study. Of the total sample, the majority were of adult age and were unemployed. It was observed that 20% of the sample had an EPDS of 10 and above, with 6% having an EPDS score of 14 and above. Mothers who presented with higher EPDS scores were noted to have had a caesarean section delivery and feto-maternal complications after delivery.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> The study showed that the prevalence of post partum depression was clinically significant to warrant routine screening among mothers.</p>

Interview-based assessment of cognition is a strong predictor of quality of life in patients with schizophrenia and severe negative symptoms

Objective: To analyze the correlation between quality of life, symptoms, and cognition assessed by the interview-based Schizophrenia Cognition Rating Scale (SCoRS). Methods: Seventy-nine outpatients diagnosed with schizophrenia were evaluated with the Quality of Life Scale – Brazilian version (QLS-BR), the SCoRS, and symptoms scales (Positive and Negative Syndrome Scale [PANSS]). After determining the potential explanatory variables using Spearman’s correlation and Student’s t test results, we ran simple, multivariate, and decision-tree regression analyses to assess the impact of SCoRS and PANSS ratings on mean overall quality of life. Results: Cognitive deficits and negative symptoms were the best predictors of quality of life. A low degree of negative symptoms (PANSS negative < 11) was a strong predictor of better quality of life (QLS ∼ 75), regardless of SCoRS rating. Among participants with more severe negative symptoms, elevated cognitive impairment (interviewer SCoRS ∼ 44) was a predictor of worse quality of life (QLS ∼ 44). Conclusions: Cognitive impairment determined by interview-based assessment seems to be a strong predictor of quality of life in subjects with severe negative symptoms. These results support the usefulness of SCoRS for cognitive assessment that is relevant to the everyday life of patients with schizophrenia.

Is semantic verbal fluency impairment explained by executive function deficits in schizophrenia?

Objective: To investigate if verbal fluency impairment in schizophrenia reflects executive function deficits or results from degraded semantic store or inefficient search and retrieval strategies. Method: Two groups were compared: 141 individuals with schizophrenia and 119 healthy age and education-matched controls. Both groups performed semantic and phonetic verbal fluency tasks. Performance was evaluated using three scores, based on 1) number of words generated; 2) number of clustered/related words; and 3) switching score. A fourth performance score based on the number of clusters was also measured. Results: SZ individuals produced fewer words than controls. After controlling for the total number of words produced, a difference was observed between the groups in the number of cluster-related words generated in the semantic task. In both groups, the number of words generated in the semantic task was higher than that generated in the phonemic task, although a significant group vs. fluency type interaction showed that subjects with schizophrenia had disproportionate semantic fluency impairment. Working memory was positively associated with increased production of words within clusters and inversely correlated with switching. Conclusion: Semantic fluency impairment may be attributed to an inability (resulting from reduced cognitive control) to distinguish target signal from competing noise and to maintain cues for production of memory probes.

Association between duration of untreated bipolar disorder and clinical outcome: data from a Brazilian sample

Objective: Bipolar disorder (BD) is often left untreated for long periods, and this delay in treatment correlates with unfavorable prognosis. The present study sought to assess the magnitude of duration of untreated bipolar disorder (DUB) in Brazil. We hypothesized that DUB would be longer in Brazil than in developed countries, and would be associated with poor clinical outcomes. Methods: One hundred and fifty-two psychiatric outpatients were evaluated for BD diagnosis, demographics, DUB, and clinical outcomes. Results: The mean age and mean DUB were, respectively, 38.9±10.8 and 10.4±9.8 years. An extended DUB was associated with early onset of BD (p < 0.001), depression as first mood episode (p = 0.04), and presence of BD in a first-degree relative (p = 0.012). Additionally, a longer DUB was associated with poorer clinical outcomes, such as elevated rates of rapid cycling (p = 0.004) and anxiety disorders (p = 0.016), as well as lower levels of current full remission (p = 0.021). Conclusion: As DUB may be a modifiable variable, better medical education regarding mental health, more structured medical services, and population-wide psychoeducation might reduce the time between onset and proper management of BD, thus improving outcome.

Study on Mental Disorders in Abused Children / 신경정신의학

OBJECTIVES: Child abuse can affect mental and physical health of abused children. Accurate assessment of mental health of abused children is integral to providing proper treatment and preventing any further impact of childhood abuse on their future life. In this study, we investigated psychiatric illnesses among abused children. METHODS: Semi-structured interviews using the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version-Korean Version were conducted for 61 abused children after obtaining consent from their guardians. We also assessed the relationship between the demographic data of these abused children and their diagnoses. RESULTS: Among the abused children, more than half had more than one psychiatric disorder. The most frequently diagnosed disorders were attention-deficit/hyperactivity disorder, posttraumatic stress disorder, depressive disorder, and oppositional defiant disorder. The incidence of posttraumatic stress disorder was higher in abused girls compared with abused boys. Abused children had a higher suicide risk than the general population. Among the parents of abused children, 50.8% had alcohol use disorders. CONCLUSION: Among the abused children, 50.8% had psychiatric disorders. Administration of intensive psychiatric treatment to abused children, and prevention of child abuse by education, treatment, and monitoring high-risk parents is imperative.

Takotsubo Cardiomyopathy Associated with Chronic Psychiatric Stress in Major Depressive Disorder in an Elderly Patient

Takotsubo cardiomyopathy (TC) is a transient form of acute heart failure that most often occurs in postmenopausal women, typically triggered by a preceding emotional or physical stressor. A 74-year-old woman who suffered from chronic psychiatric stress visited National Medical Center for dyspnea. Acute emotional or physical stress could not be identified despite careful history taking. An electrocardiogram showed diffuse T-wave inversions with prolonged QT interval, and the echocardiogram showed akinesia of mid and apical segments of the left ventricle with hyperkinesia at the base. There was no significant stenosis on coronary angiography. Differing from the typical case of TC, which follows acute stress triggers, our case indicates that underlying chronic psychiatric illness exacerbation can lead to TC. We suggest that cardiologists and psychiatrists be aware of this predisposition to TC, especially in the circumstances of acute heart failure.

Adverse Drug Reaction Monitoring in Psychiatry Outpatient Department of a Tertiary Care Teaching Hospital.

To study the pattern of adverse drug reactions (ADR) in patients attending psychiatry OPD of a tertiary care teaching hospital. Patients attending psychiatry OPD with ADRs due to drugs prescribed for various psychiatric illnesses over a period of 1year were included in the study. Adverse event history, medication history and other relevant details were entered in the PvPI format. Causality was assessed by WHOUMC criteria. A total of 103 ADRs were reported from 85 prescriptions with a female preponderance. Majority of ADRs (45.7%) were seen with antidepressants as they were the commonly prescribed drugs followed by antipsychotics (33.3%) and others by sedative hypnotics and anticonvulsants. ADRs like somnolence topped the list (21.9%) followed by weight gain (18.4%), akathesia (6.8%) and drug induced restless legs syndrome (RLS) (5.8%). The reported ADRs were assessed for causality and maximum (80.6%) belong to the "possible" category. Maximum ADRs were seen with antidepressants followed by antipsychotics. Sedation and weight gain were the most commonly occurring ADRs.

Neuro-psychiatric complications of traumatic brain injury and orthopaedic injury: a comparative study

Background: Traumatic brain injury (TBI) has been found to increase the incidence of psychiatric illness such as depression and generalized anxiety disorder. Aims: To study the incidence of Psychiatric illness in individuals with TBI and in those with orthopaedic injury without evidence of TBI and to correlate the psychiatric illness in TBI with radiological findings. Methods: The study adopted a two group comparison cross sectional methodology. The study group comprised of 50 adult patients with TBI and control group of 50 adult patients with orthopaedic injury without TBI. The tools used were Socio-demographic Sheet (SDS), Mini International Neuropsychiatric Interview (MINI 6.0) Results: The overall incidence of psychiatric illness after TBI is significantly higher than those individuals with orthopaedic injury without TBI (22% vs. 8%). Also, presence of radiological abnormality in CT scan increases the incidence of psychiatric illness. Injury to right hemisphere, especially frontal lobe, increases the chances of major depression and injury to the left hemisphere, especially parietal lobe, increases the chances of generalised anxiety disorder. Conclusion: Presence of radiological abnormality and cerebral laterality were found to be associated with the development of psychiatric disorder after TBI.

Depressive morbidity among elderly individuals who are hospitalized, reside at long-term care facilities, and are under outpatient care in Brazil: a meta-analysis

Objectives: i) To investigate studies published between 1991 and 2010 on the prevalence of depressive morbidity (major depressive disorder [MDD], dysthymia and clinically significant depressive symptoms [CSDS]) among elderly Brazilians assisted at healthcare facilities; ii) to establish the prevalence of depression and identify its related factors; and iii) to conduct a meta-analysis to assess the prevalence of depressive syndrome among elderly individuals assisted or hospitalized at healthcare facilities. Methods: Studies were selected from articles dated between January 1991 and June 2010 and extracted from the MEDLINE, LILACS, and SciELO databases. Results: The final analysis consisted of 15 studies, distributed as follows: i) four sampled hospitalized patients, totaling 299 individuals, and found a prevalence of CSDS varying between 20 and 56%; ii) four sampled outpatients, totaling 1,454 individuals; the prevalence of CSDS varied between 11 and 65%, and the prevalence of MDD varied between 23 and 42%; and iii) seven sampled elderly individuals residing in long-term care facilities (LTCF), totaling 839 individuals, and the prevalence of CSDS varied between 11 and 65%. Conclusion: The present review indicated a higher prevalence of both MDD and CSDS among elderly Brazilians assisted at healthcare facilities. .

Prevalence of psychiatric comorbidities in temporal lobe epilepsy in a Southern Brazilian population / Prevalência de comorbidades psiquiátricas na epilepsia do lobo temporal em uma população do sul do Brasil

A great prevalence of psychiatric disorders in epilepsy is well demonstrated, although most studies have used unstructured psychiatric interviews for diagnosis. Here we present a study evaluating the prevalence of psychiatric comorbidities in a cohort of Southern Brazilian patients with temporal lobe epilepsy (TLE) using a structured clinical interview. We analyzed 166 patients with TLE regarding neuropsychiatric symptoms through the Structured Clinical Interview for DSM-IV. One hundred-six patients (63.9 percent) presented psychiatric comorbidities. Mood disorders were observed in 80 patients (48.2 percent), anxiety disorders in 51 patients (30.7 percent), psychotic disorders in 14 (8.4 percent), and substance abuse in 8 patients (4.8 percent) respectively. Our results agree with literature data where most authors detected mental disorders in 10 to 60 percent of epileptic patients. This wide variation is probably attributable to different patient groups investigated and to the great variety of diagnostic methods. Structured psychiatric interviews might contribute to a better evaluation of prevalence of psychiatric comorbidities in TLE.

Embora muitos estudos tenham demonstrado uma alta prevalência de transtornos psiquiátricos em pacientes com epilepsia, a maioria utilizou entrevistas psiquiátricas não-estruturadas para o diagnóstico. Este método pode levar a diferenças significativas nos resultados. Nós estudamos a prevalência de comorbidades psiquiátricas em pacientes com epilepsia do lobo temporal (ELT), utilizando uma entrevista clínica estruturada. Foram estudados 166 pacientes com ELT, aos quais foi aplicada a Entrevista Clínica Estruturada para o DSM-IV (SCID). Cento e seis pacientes (63,9 por cento) apresentaram comorbidades psiquiátricas. Transtornos de humor, observados em 80 pacientes (48,2 por cento), foram o transtorno neuropsiquiátrico mais comum. Transtornos de ansiedade, observados em 51 pacientes (30,7 por cento), foram a segunda comorbidade psiquiátrica mais frequente. Transtornos psicóticos foram encontrados em 14 (8,4 por cento), e abuso de substâncias foram observados em 8 pacientes (4,8 por cento), respectivamente. Nossos resultados estão de acordo com os dados da literatura, que demonstra problemas psiquiátricos em 10-60 por cento dos pacientes com epilepsia. A grande variação dos resultados pode ser atribuída aos diferentes grupos de pacientes estudados e à variabilidade de métodos diagnósticos empregados. Entrevistas psiquiátricas estruturadas podem contribuir para uma avaliação mais adequada da real prevalência de comorbidades psiquiátricas na ELT.