Cognitive Functions and Depression in Patients with Irritable Bowel Syndrome in Riyadh Region, Saudi Arabia

Objective: Irritable bowel syndrome (IBS) is associated with alterations in the gut-brain axis which influences various gastrointestinal and psychological functions. The cognitive performance and frequency of depression have not been previously assessed among Saudi patients with IBS so the primary aim was to study cognitive functions and depression in patients with IBS. Methods: This cross-sectional study enrolled Saudi males and females of more than 18 years of age living in Riyadh and Kharj cities, Central Region, Kingdom of Saudi Arabia. Participants were invited to complete 2 self-administered validated questionnaires. One questionnaire focused on Rome III criteria which classify functional GI disorders (FGIDs) in addition to the Patient Health Questionnaire (PHQ-9) which includes a set of 3 self-report scales designed to measure the major depressive disorder. Individuals who did not show IBS criteria have been enrolled as control subjects. Results: The overall prevalence of IBS among the enrolled subjects was 17.3% of whom women constituted (73.4%). Among subjects with IBS, 71.3% had mixed (constipation and diarrhea) type, 5.3% had diarrhea predominant type and 23.4% had constipation predominant IBS. Depression was significantly higher in IBS patients compared to control subjects. Among IBS cases, 20.2% had minimal depressive symptoms and 20.2% had major depression, mild severity. Major depression with moderate severity was found in 18.1% and major depression with severe severity was found in 28.7%. Depression was associated with impaired cognitive function in 25% of IBS patients. Conclusion: IBS was associated with depression and mild impairment of cognitive functions. The frequency of depression in IBS subjects suggests the importance of the psychological assessment of these patients and the integration of cognitive therapy with pharmacologic IBS therapy.

A case of gastric trichobezoar causing psychiatric problems / 소아과

Trichobezoar is characterized by the accumulation of hair in the gastrointestinal tract and usually occurs in those who have trichotillomania, other psychiatric disorders, or neurologic problems. Trichobezoar typically presents as gastric obstruction, including abdominal pain, vomiting, anorexia, and weight loss. A 9-year-old girl visited our clinic with the complaint of abdominal discomfort and vomiting. A review of her medical history revealed that she had trichophagia since the age of 5, and she felt that her parents had been strict with her. She underwent gastrotomy, during which a large trichobezoar was removed. This case highlights the importance of psychiatric and comprehensive approaches in patients with trichobezoar.

Health States of Residents near by US Military Camps / 항공우주의학회지

This study was conducted to evaluate the relation between health states of residents near by US military camps and noise caused by their aircrafts, in the cities of Chuncheon, Gunsan, and Daegue. From November 2001 to July 2002, we surveyed 426 residents for psychosocial well-being states, psychiatric problems, infertility and sleep disorders by questionnaire, and applied pure-tone audiometry to 83 residents for measuring hearing abilities at qualified medical institutes. The residents near by military camps were more suffered from psychosocial and psychiatric problems, infertility, and sleep disorders than residents of the control areas. In the aspects of psychiatric problems, residents living within 50m from the military camp boundaries had 5.42 times higher risk and those living at the outward had 3.57 times higher than the control residents. And nearby residents had more decreased hearing abilities than the control residents by over 10dB in whole frequencies, statistically confirmed by mixed model with age adjustment. The residents near by US military camps were suffered from psychosocial and psychiatric problems, infertility, sleep disorders and hearing disturbances, induced by noise of US military aircrafts.

Development and validation of a screening questionnaire for detection of adolescent psychiatric problems in primary care

BACKGROUND: Because of many physical, psychological, and social stresses, adolescence is a vulnerable period to psychiatric disorders. But in Korea, there is actually not enough time for primary care physicians to screen such patients during ordinary medical interviews. Therefore this research was done to develop and validate a brief screening questionnaire for the detection of adolescent patients with psychiatric problems. METHODS: Three family physicians in charge of their own adolescent clinics developed a five-item questionnaire for screening adolescents with psychiatric problems by reviewing related literature with consultation by a psychiatrist. After performing a pretest and gathering second opinions from other psychiatrists and nurse-teachers, final questionnaire was redeveloped. Verification of its reliability by using test-retest method and internal consistency by calculating Cronbach's alpha coefficient was done. Also inspection of its validity by comparing the scores of psychiatric patient group to normal group was done. And finally the discrimination point was obtained. RESULTS: For reliability Kappa value of new questionnaires ranged from 0.33 to 0.63. One item was dropped because of its negative influence to the internal consistency and the discrimination power. With the four final items, we estimated the validity for distinguishing psychiatric patients from the normal group by calculating the sensitivity and specificity of each cutting point of scores. For the each cutting point 1, 2, and 3, sensitivity was 85%, 75%, 40%, respectively, and specificity was 27%, 62%, 84%, respectively. We considered score 1 as the best cutting point because the purpose of the questionnaire was screening rather than diagnosis. CONCLUSION: A brief four-item screening questionnaire(SAPPO. Screening method of Adolescent Psychiatric Problems in Outpatient clinic) was developed and its reliability and validity was estimated.