Psychiatric comorbidity and quality of life in obese patients. Results from a case-control study.

OBJECTIVE: The authors sought to evaluate psychiatric comorbidity, subjective quality of life, and impact of psychopathology on quality of life measures in a clinical sample of patients attending a center for the diagnosis and treatment of obesity compared to a matched sample of non-obese subjects. METHODS: Two hundred ninety-three consecutive obese patients (48 males, 245 females, mean age 45.41 +/- 13.55 yrs; mean BMI 35.60 +/- 6.20) were compared with a control group made of 293 non obese subjects (48 males, 245 females, mean age 45.66 +/- 13.86 yrs; mean BMI 21.8 +/- 2.06); all subjects were interviewed by means of SCID I and SCID II and completed the WHO-QoL-Bref, a self-administered instrument for evaluation of subjective quality of life. RESULTS: Obesity was associated with a significant lifetime major risk both for axis I (OR = 3.47, p = 0.000) and axis II disorders (OR = 2.27, p = 0.000); obesity was also associated with significantly lower measures of subjective quality of life on physical, social, and psychological domains; comorbidity with axis I/II disorders was associated with lower QoL measures on WHO-QoL-Bref, in particular among obese patients. CONCLUSIONS: Obesity is significantly associated with a significant major risk of psychiatric comorbidity and poor quality of life; comorbid mental disorders play a significant role in worsening quality of life of obese patients; a multimodal approach to the treatment of obesity, including psychiatric evaluation and intervention, is needed to improve quality of life of patients.

Obesity and psychopathology. A study of psychiatric comorbidity among patients attending a specialist obesity unit.

AIMS: The study aims to evaluate the frequency of association between Axis I and II disorders according to DSMIVTR criteria and obesity, and use of mental health services in a clinical sample of patients attending a centre for the diagnosis and treatment of Obesity. METHODS: 150 consecutive patients (32 Males, 118 females, mean age 44.6 +/- 14.3 yrs; mean BMI 35.4 +/- 6.2) were interviewed by means of SCID I and SCID II. RESULTS: Lifetime Prevalence of Axis I disorders was 58% (males 50%; females 61%); the highest prevalence rate was found for Anxiety Disorders (approx 35%), whilst 30% of subjects were affected by Mood disorders, chiefly Major Depression (20%), and 18% by Eating Disorders. 28% of obese patients presented a Personality Disorder, 23% of patients being affected both by an Axis I and Axis II disorder. Mood Disorders, in particular Major Depression, were significantly prevalent among female obese. 50% of females and approx 37% males included in the sample had contacted mental health units for treatment. CONCLUSION: Data obtained in the present study confirm the high prevalence rates of mental disorders in obese patients seeking treatment. Specialist units should therefore include thorough psychiatric evaluation of patients as a routine practice.

Mass-media, violence and mental illness. Evidence from some Italian newspapers.

AIMS: Media reports related to people suffering from mental illness appear to deal prevalently with acts of violence and crimes. The present study focused on all newspaper reports relating to homicides, suicide, and other acts of violence, in an attempt to ascertain whether a different pattern emerged in some Italian newspapers in describing deeds committed by the mentally ill. MATERIALS AND METHODS: All articles published over a six-month period in the two main national and two main regional newspapers relating to homicides, suicides, and other acts of violence were selected. A comparison of reports regarding events attributed to mentally ill people was performed according to quantitative parameters. RESULTS: 2279 articles were considered; 54% regarded homicides, 8.2% suicides and attempted suicides, 2.1% homicides/suicides; the remaining 35.8% regarded other acts of violence. A significantly higher number of words, accompanying photos and a more stigmatizing language were used in reporting deeds when attributed to mentally ill people. CONCLUSION: An excessive emphasis on deeds related to a psychopathological condition still emerged in media reports, almost as though acts of violence committed by the mentally insane should be viewed in a different light. These findings support the hypothesis that media portrayal mirrors the enduring stereotype of "diversity" of the mentally ill.