Characteristics of alcohol use disorder patients based on MMPI-2 profile typology and comorbid disorder.

This study investigated the clinical characteristics of alcohol use disorder (AUD) patients using a typology based on the MMPI-2 to compare patients with and without comorbid disorders. A total of 244 patients with AUD at an alcohol specialty hospital were categorized into the two groups. The noncomorbid group (n = 142) had three profile types: a "normal profile type," with normal-range scores on clinical scales; a "depressive and worried profile type," with elevated clinical scales 2, 7, and 4; and a "mild psychological discomfort type," with scores within the normal range on clinical scales and relatively low on defensiveness scales. The comorbid group (n = 102) had two profile types: a "mild psychopathological type," with higher scores on infrequency scales and clinical scales 2, 4, 6, 7, and 8 and relatively lower defensiveness scale scores than type 2; and a "normal profile type" with all scale scores within the normal range. In both groups, the profile types were significantly differentiated on the Addiction Admission Scale (AAS) in the supplemental scales for substance abuse.

Hidradenitis Suppurativa and Comorbid Disorder Biomarkers, Druggable Genes, New Drugs and Drug Repurposing-A Molecular Meta-Analysis.

Chronic inflammation and dysregulated epithelial differentiation, especially of hair follicle keratinocytes, have been suggested as the major pathogenetic pathways of hidradenitis suppurativa/acne inversa (HS). On the other hand, obesity and metabolic syndrome have additionally been considered as an important risk factor. With adalimumab, a drug has already been approved and numerous other compounds are in advanced-stage clinical studies. A systematic review was conducted to detect and corroborate HS pathogenetic mechanisms at the molecular level and identify HS molecular markers. The obtained data were used to confirm studied and off-label administered drugs and to identify additional compounds for drug repurposing. A robust, strongly associated group of HS biomarkers was detected. The triad of HS pathogenesis, namely upregulated inflammation, altered epithelial differentiation and dysregulated metabolism/hormone signaling was confirmed, the molecular association of HS with certain comorbid disorders, such as inflammatory bowel disease, arthritis, type I diabetes mellitus and lipids/atherosclerosis/adipogenesis was verified and common biomarkers were identified. The molecular suitability of compounds in clinical studies was confirmed and 31 potential HS repurposing drugs, among them 10 drugs already launched for other disorders, were detected. This systematic review provides evidence for the importance of molecular studies to advance the knowledge regarding pathogenesis, future treatment and biomarker-supported clinical course follow-up in HS.

Psychiatric disorders in patients with intractable dizziness in the department of otolaryngology.

OBJECTIVE: Vertigo and dizziness are often not fully explained by organic illnesses, but instead may be related to psychiatric disorders. It is important to determine the types of psychiatric comorbidities that are frequent in cases of intractable dizziness. METHOD: The study subjects were 90 patients who had experienced intractable dizziness for more than three months and were referred to a psychiatrist when their symptoms could not be fully explained based on their physical illness. The patients' final diagnosis and questionnaire (DHI,SDS and STAI) scores were evaluated. RESULTS: Seventy percent (63/90) of patients with intractable dizziness had been diagnosed as having psychiatric conditions by the study psychiatrists. The most common diagnosis was unspecified depressive disorder. CONCLUSIONS: Psychiatric comorbidities seem to be more prevalent in certain subgroups of organic dizziness. We found a higher rate of depressive disorders in the sequelae of sudden deafness and migraine-related dizziness.

[Effectiveness of cognitive-behavioral therapy in children and adolescents with obsessive-compulsive disorders treated in an outpatient clinic]. / Alltagswirksamkeit kognitiver Verhaltenstherapie bei Kindern und Jugendlichen mit Zwangsstörungen in einer Ausbildungsambulanz.

Background: Cognitive-behavioral therapy (CBT) is considered as treatment of first choice for children and adolescents with obsessive-compulsive disorders (OCD). However, its effectiveness has so far mostly been examined in randomized controlled trials with strictly manualized interventions. Only few studies have examined whether the effectiveness of CBT for juvenile OCD generalizes to clinical practice. Method: To test the effectiveness of CBT under routine care conditions, data of n = 53 patients with parent-ratings and n = 53 patients with self-ratings that were treated in a university-based outpatient clinic for child and adolescent psychotherapy was analyzed. Pre-post-mean-comparisons, effect sizes and the clinical significance of changes of the symptoms were examined. Results: OCD and comorbid symptoms were significantly reduced during treatment. Strong effect sizes (Cohen's d) were found for parent rated (d = 0.91) and patient rated (d = 0.88) OCD symptoms. Moderate to strong pre-post-effect sizes were found for the reduction of parent rated (d = 0.55 to d = 0.87) and patient rated (d = 0.46 to d = 0.74) comorbid symptoms. The percentage of children and adolescents who achieved clinically significant improvements and no longer showed dysfunctional OCD symptoms post-treatment was 46.3 % according to the parent-ratings and 59.4 % according to the self-ratings. Concerning comorbid symptoms the same was reached for between 22.5 % and 45.5 % of the patients (parent-ratings) and between 32.0 % and 81.8 % (self-ratings) respectively. Conclusions: Significant reductions in both OCD and comorbid symptoms were demonstrated over the course of cognitive-behavioral therapy of juvenile OCD disorders in a university outpatient clinic for child and adolescent psychotherapy. These results indicate that routine CBT treatment is an effective way to treat juvenile OCD disorders in clinical practice.

Transcending Psychosis: The Complexity of Comorbidity in Schizophrenia.

Schizophrenic illness encompasses diverse clinical phenomena and consists of unclear underlying pathogeneses. For the past century, the comorbidities in schizophrenia have drawn persistent interest and debate due to its high prevalence rate and a need for better management. However, its clinical and biological diversity continue to challenge both the practicing clinicians and researchers. Emerging clinical and research evidence in the past decade suggest a distinct biopsychosocial pathogenesis and unique clinical attributes in some comorbid disorders in patients with schizophrenia. In addition, current evidence also supports improved outcomes with specific assessment and treatment of these subgroup of schizophrenia. The recent changes in DSV-5 and shift in the NIMH focus towards the real world clinical practice and research provide increased impetus to explore the pathogeneses and treatment of schizophrenia with comorbid disorders.

Deliberate self-harm among patients referring to the emergency room in damghan, iran.

OBJECTIVE: Deliberate self-harm (DHS) is a deviant behavior that has been not completely emphasized in health-related studies in Iran. The current study was conducted to explore the prevalence and reasons associated with the incidence of DSH in patients referring to the emergency room of Baradaran-e Rezaee Hospital in Damghan, Iran. METHODS: Fifty-four clients with the mean age of 29.4 (±10.3) years participated in this cross-sectional study in 2010. Firstly, demographics and details of substance use were collected based on items elicited from the Addiction Severity Index (ASI) and a researcher-made questionnaire. Then details of comorbidity and factors associated with the current DHS were collected by a semi-structured interview. Data were analyzed by performing descriptive methods of statistics. RESULTS: Deliberate self-poisoning with using toxic substances such as lead, and poison (44.8%) followed by drug intoxication such as opiate and methamphetamine (35.2%) and body and vessel cutting (20%) were the most prevalent types of DSH. Furthermore, results revealed that comorbidities such as physical illness (38.9%) and psychiatric disorders including depression (31.5%), psychotic symptoms (15%), bipolar disorder (5.6%), stress (5.6%), and anxiety (1.9%) were commonly prevalent. The most frequently reported factors associated with DSH were desires for self-punishing (42%), self-medication for emotional sufferings (33%), experiencing euphoric feelings (24%), and stress (20%), respectively. CONCLUSION: DSH is one of the critical health and treatment priorities, which are prevalent in emergency rooms of hospitals in Iran. Clients with comorbid diagnosis of DSH, especially drug use warrant specific attention in emergency rooms.

Prediction of Post-Traumatic Stress Symptoms via Comorbid Disorders and other Social and School Problems in Earthquake Exposed Turkish Adolescents / Predicción de síntomas de estrés post-traumático por trastornos comórbidos y otros problemas sociales y escolares en adolescentes expuestos a un terremoto en Turquía

On May 3rd, 2003, a strong earthquake hit the eastern part of Turkey at 03:27 a.m. and lasted 20 seconds. It destroyed a regional boarding school killing 83 students and 1 teacher. Disaster-exposed children are at risk for a variety of mental health, social, and academic problems. This research was designed to investigate the extent of comorbidity among adolescent earthquake survivors. One hundred and ninety-one adolescents were given the Child Post Traumatic Stress Reaction Index and the Behavior Assessment Systems one year after the earthquake. The adolescents were divided into PTSD (Post Traumatic Stress Disorder) positive and non PTSD groups. Multivariate ANOVAs were then conducted to test group and gender differences on the BASC subscales. Correlation analysis revealed some significant associations between the CPTSD RI and BASC subscales. Multiple stepwise regression analysis was used to predict the contribution of each of the BASC SRP A subscales. Depression was the strongest contributor, accounting for 23% of the total variance. The next most significant contributing variable was atypicality, at 6%. This was followed by sensation-seeking, with a 4% variance. Finally attitude to school added another 2% to the prediction for PTSD. These four variables, together, explained 35% of the variance in the CPTSD RI total score (r.585, r²=.35 p<.05). Those variables also correlated with the CPTSD RI subscales of re-experiencing, avoidance and hyperarousal. Cross- cultural implications were also discussed in reference to the disaster and other disorders.

El 3 de mayo de 2003 un fuerte terremoto de 20 segundos golpeó Turquía del este a las 3:27 de la madrugada, éste destruyó un internado regional en donde 83 estudiantes y 1 maestro fallecieron. Los niños expuestos a desastres están en riesgo sufrir una variedad de dificultades con respecto a su salud mental, así como problemas sociales y académicos. El propósito de este estudio fue evaluar el grado de comorbilidad entre los adolescentes sobrevivientes al terremoto. Un año después de la catástrofe 191 adolescentes completaron el Índice de Reacción de Desorden de Estrés Postraumático en Niños CPTSD y el Sistema de Evaluación de Conducta BASC. Estos adolescentes fueron divididos en grupos de PTSD (Desorden de Estrés Postraumático) positivo y grupos que no presentaban PTSD. De esta manera, se llevaron a cabo análisis de varianza ANOVA para probar las diferencias de grupo y de género en las subescalas BASC (Sistema de Evaluación de Conducta para Niños). El análisis de correlación reveló algunas asociaciones significativas entre el CPTSD RI y las subescalas BASC. Múltiples análisis de regresión stepwise (paso a paso) fueron utilizados para predecir la contribución de cada una de las subescalas BASC SRP A. La depresión fue el mayor contribuyente, lo que representa el 23% de la varianza total. La siguiente variable que contribuye significativamente fue atípica al 6%. Esto fue seguido por la búsqueda de sensaciones, con una variación del 4%. Por último, la actitud hacia la escuela añadió un 2% a la predicción para el PTSD. Estas cuatro variables juntas explicaron el 35% de la varianza de la puntuación total del CPTSD RI (r.585, r²=.35 p<.05). Estas variables también se correlacionan con las subescalas de RI CPTSD de re-experimentación, evitación e hiperexcitación. Las implicaciones transculturales también fueron discutidas en referencia a la catástrofe y otros trastornos.