Showing papers on "Psychiatric interview published in 2010"

Relationship between School Absenteeism and Depressive Symptoms among Adolescents with Juvenile Fibromyalgia

Abstract: Objective To describe school absences in adolescents with Juvenile Primary Fibromyalgia Syndrome (JPFS) and examine the relationship between school absenteeism, pain, psychiatric symptoms, and maternal pain history. Methods Adolescents with JPFS (N ¼ 102; mean age 14.96 years) completed measures of pain and depressive symptoms, and completed a psychiatric interview. Parents provided information about the adolescents’ school absences, type of schooling, and parental pain history. School attendance reports were obtained directly from schools. Results Over 12% of adolescents with JPFS were homeschooled. Those enrolled in regular school missed 2.9 days per month on average, with one-third of participants missing more than 3 days per month. Pain and maternal pain history were not related to school absenteeism. However, depressive symptoms were significantly associated with school absences. Conclusion Many adolescents with JPFS experience difficulties with regular school attendance. Long-term risks associated with school absenteeism and the importance of addressing psychological factors are discussed.

Non-participation in the second wave of the PART study on mental disorder and its effects on risk estimates.

Abstract: Background: In epidemiological studies, analyses are needed to investigate the consequences of non-response. Aims: To analyse the consequences of attrition in the second wave of the population-based PART study, which was performed three years after the first wave. Methods: Potential determinants for non-participation obtained from population registers and the first wave were analyzed. The relationships between potential determinants and reduced well-being or depressive mood in the first wave questionnaire were investigated separately for participants and non-participants in the second wave. Samples of respondents to the second wave questionnaire with reduced or not reduced well-being were summoned for interview regarding determinants of distress and disorder. The occurrence of potential determinants was compared between participants and non-participants in both groups Results: Low income, low education, non-Nordic origin, not being married and previous psychiatric diagnosis were associated with lower participation rates. These variables were similarly related to depressive mood and low psychological well-being in the first wave among participants and non-participants in the second wave. Potential determinants were not or only weakly related to participation in the interview groups. Conclusion: Although the true prevalence of distress and disorder is underestimated, the true associations between potential determinants and the outcomes seem reasonably well reproduced.

A Feasibility Study of the Use of Asynchronous Telepsychiatry for Psychiatric Consultations

Abstract: 838 Objective: This study examined the feasibility of conducting psychiatric consultations using asynchronous, or store-and-forward, videobased telepsychiatry. Methods: Video-recorded 20- to 30-minute assessments of 60 nonemergency, English-speaking adult patients in a medically underserved county in California were uploaded along with other patient data to a Webbased record. Two psychiatrists then used the record to provide psychiatric consultations to the referring primary care providers. Results: Eighty-five percent of patients received diagnoses of mood disorders, 32% diagnoses of substance use disorders, 53% diagnoses of anxiety disorders, and 5% other axis I diagnoses. Psychiatrists recommended short-term medication changes for 95% of the patients and provided guidelines for possible future changes. Conclusions: This study—the first study of asynchronous telepsychiatry to be published—demonstrated the feasibility of this approach. This type of assessment should not replace the face-to-face psychiatric interview, but it may be a very helpful additional process that improves access to care and expertise. (Psychiatric Services 61: 838–840, 2010)

Psychiatric characterization of children with genetic causes of hyperandrogenism.

Abstract: Objective: Very little is known about the mental health status in children with genetic causes of hyperandrogenism. This study sought to characterize psychiatric morbidity in this group. Design/methods: Children (8–18 years) with the diagnosis of classic congenital adrenal hyperplasia (CAH) or familial male precocious puberty (FMPP) underwent a semi-structured psychiatric interview, the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. According to sex and the literature, incidence of identified psychopathology was compared between the two endocrinological groups. We evaluated 72 patients: 54 CAH (21 females) and 18 FMPP. Results: Twenty-four (44.4%) CAH patients and 10 (55.6%) FMPP patients met the criteria for at least one lifetime psychiatric diagnosis. Attention-deficit hyperactivity disorder (ADHD) was present in 18.2% of CAH males, 44.4% of FMPP males, and one case (4.8%) in CAH females. A high rate of anxiety disorders was also found in all the three groups (17–21%). Relative to females with CAH, the FMPP patients exhibited higher rates of ADHD. Age at diagnosis and the treatment modalities were not associated with psychopathology. Rates of psychiatric disorder, specifically ADHD and anxiety disorders, were higher than in the general population. Conclusion: Although anxiety disorders may occur at an increased rate in children with chronic illness, androgens may contribute to higher risk for psychopathology in pediatric patients with genetic cause of excess androgen. Early diagnosis and treatment of childhood hyperandrogenism is essential for optimal development. The results suggest that assessment for psychiatric disorders should be part of the routine evaluation of these patients.

Psychosocial issue in children and adolescents with multiple sclerosis.

Abstract: In adult-onset multiple sclerosis (MS) cases, major depression, fatigue and psychological distress are common, whereas there is little information on these issues in children with the disease. The aim of this study was to assess psychosocial disorders in an Italian cohort of children and adolescent with MS. We evaluated 56 patients through self-assessment scales of depression (Children Depression Inventory) and fatigue (Fatigue Severity Scale), a psychiatric interview [Kiddie-SADS-Present and Lifetime Version (K-SADS-PL)] and an interview on school and everyday activities. Significant fatigue was found in 11 patients (20%). Twelve of the 39 patients who underwent the K-SADS-PL received a formal diagnosis of an affective disorder. Moreover, MS affected school activities in 28% of cases, daily living activities in 41% and social relationships in 28%. Our study confirms the critical role of psychosocial difficulties in children and adolescents with MS and provides a few cues to clinical management.

Psychosocial issue in children and adolescents with multiple

Abstract: In adult-onset multiple sclerosis (MS) cases, major depression, fatigue and psychological distress are common, whereas there is little information on these issues in children with the disease. The aim of this study was to assess psychosocial disorders in an Italian cohort of chil- dren and adolescent with MS. We evaluated 56 patients through self-assessment scales of depression (Children Depression Inventory) and fatigue (Fatigue Severity Scale), a psychiatric interview (Kiddie-SADS-Present and Life- time Version (K-SADS-PL)) and an interview on school and everyday activities. Significant fatigue was found in 11 patients (20%). Twelve of the 39 patients who underwent the K-SADS-PL received a formal diagnosis of an affective disorder. Moreover, MS affected school activities in 28% of cases, daily living activities in 41% and social rela- tionships in 28%. Our study confirms the critical role of psychosocial difficulties in children and adolescents with MS and provides a few cues to clinical management.

in patients with chronic fatigue syndrome

Abstract: Summary Objectives The aim of this study was to examine the accuracy of doctors at diagnosing co-morbid psychiatric disorders in patients with chronic fatigue syndrome (CFS). Design Case series comparing clinical diagnoses with a standardized structured psychiatric interview. Setting Secondary care specialist chronic fatigue syndrome clinic. Participants One hundred and thirty-five participants of a randomized controlled trial of non-pharmacological treatments at one centre in the PACE trial. Main outcome measures Current psychiatric diagnoses made by CFS specialist doctors, compared with current psychiatric diagnoses made independently using a structured psychiatric interview. Results Clinicians identified 59 (44%, 95% CI 39‐56%) of patients as suffering from a co-morbid psychiatric disorder compared to 76 (56%, CI 53‐69%) by structured interview. Depressive and anxiety disorders were most common. Clinicians were twice as likely to miss diagnoses (30 patients, 22%) than misdiagnose them (13, 10%). Psychiatrists were less likely to miss diagnoses than other clinicians, but were as likely to misdiagnose them. Conclusions Doctors assessing patients in a chronic fatigue syndrome clinic miss psychiatric diagnoses more often than misdiagnosing them. Missed diagnoses are common. CFS clinic doctors should be trained to diagnose psychiatric disorders. DECLARATIONS Competing interests PDW has done independent consultancy work for the Department for Work and Pensions and a re-insurance company. MS has done independent consultancy work for insurance companies and lawyers. No other authors had competing interests

Academic psychiatry's responsibility for increasing the recognition of mood disorders and risk for suicide in primary care.

Abstract: PURPOSE OF REVIEW: The authors seek solutions to better meet the healthcare needs of depressed patients in primary care by improving the recognition of depression, other mood disorders and of a risk for suicide. RECENT FINDINGS: For 25 years academic psychiatry and primary care have known that only 10-50% of depressed patients are adequately treated, primarily because of the failure to recognize depression. There are substantial negative consequences including suicide. Suicide occurs during depression so the recognition of depression is the critical first step to preventing suicide. Recently noted is that one barrier to recognition is the traditional, comprehensive, psychiatric interview taught in academic departments of psychiatry that is impractical in primary care settings because it takes too much time. Some brief, initial psychiatric techniques have been developed but these typically have been introduced in primary care training programs and not by departments of psychiatry. SUMMARY: A verbal four-question, 90s screen for depression may be acceptable for routine use in primary care because it typically requires only seconds to a few minutes. Introduction of such a screening instrument to medical students on psychiatry and primary care clerkships could increase the recognition of depression and reduce death by suicide. Language: en

Quality of life in patients operated for pelvic fractures caused by suicide attempt by jumping

Abstract: Background and Aims: Jumping from great height is an aggressive method of suicide attempt where the frequent combination of psychiatric disorder and somatic injuries makes treatment difficult. Our aim was to evaluate survival rate and get patient-reported outcome in patients operated for a pelvic or acetabular fracture sustained when jumping from a height as a suicide attempt. Patients and Methods: During the period 2003-2004, 12 patients (11 women) of whom eight were below 30 years of age, were prospectively included. At two years HRQoL (Health-Related Quality of Life) questionnaires (SF-36 and LiSat-11) were used to describe outcome, and at four years a structured psychiatric interview SCID-I (Structured Clinical Interview for DSM-IV Axis I Disorders) was done. Results: At four years all patients were alive. One patient had made a new suicide attempt. Eight patients gave adequate reply on SF-36 and LiSat-11 at two years. In all domains patients scored lower than a norm group with the relatively lowest values in physical domains. Younger patients assessed life as better when compared with middle aged patients. Conclusions: This study showed a very low recurrence rate into suicidal behaviour in a group of jumpers and all patients were alive at four years after a suicidal attempt by jumping. The high proportion of psychiatric disorder in these patients highlights the need for a combined treatment effort between orthopaedic and psychiatric expertise. Language: en

Minor Psychiatric Morbidity in Young Saudi Mothers Using Mini International Neuropsychiatric Interview (MINI)

Abstract: Objective: To determine the prevalence of postpartum psychiatric disorders in young mothers using a brief structured psychiatric interview, the Mini International Neuropsychiatric Interview (MINI). Study Design: A cross-sectional study. Place and Duration of Study: The Primary Health Care Centres (PHCCs) in Al-Ahsa region, Saudi Arabia, during the period 2008 to 2009. Methodology: Young primigravid mothers (in their teen age) were interviewed using MINI. Psychiatric morbidity was analyzed in relation to the different sociodemographic, psychiatric and obstetric characteristics. The distribution and frequency of the MINI subscales were presented in number and percentage. To quantify the risk, Univariate analysis was employed with reporting of crude Odds Ratio (OR) and 95% Confidence Intervals (CI); p-value of < 0.05 was considered significant. Results: The prevalence of psychiatric disorders was 22.6% with preponderance of anxiety disorders due to increased prevalence of generalized anxiety disorder and social phobia. Postpartum anxiety disorders were significantly associated with urban residency, poor husband support, past history of psychiatric illness, anemia, caesarean mode of delivery and female baby gender. Conclusion: These results highlighted importance of addressing screening for psychiatric morbidity particularly anxiety disorders in the implementation of perinatal care for the pregnant Saudi adolescents.

Feasibility of using risk factors to screen for psychological disorder during routine breast care nurse consultations.

Abstract: This study investigated using risk factors to psychosocial problems to screen for psychological disorders among 100 women with early-stage breast cancer. The National Health and Medical Research Council produced psychosocial clinical practice guidelines for health professionals working with women with breast cancer. They identified risk factors to psychosocial problems in breast cancer. The Breast Cancer-Vulnerability Index (BC-VI), which we developed, is composed of these empirically derived risk factors. This study investigated whether the breast care nurse-administered BC-VI correctly identifies women who had mood and/or anxiety disorders, in comparison with a psychiatric interview. We recruited 100 women with early-stage breast cancer after surgery and before adjuvant treatment. They completed questionnaires and were interviewed using the Composite International Diagnostic Interview. The breast care nurses rated women on the BC-VI using information gathered during clinical consultations. Results indicated that the BC-VI was correlated with diagnoses of anxiety and depressive disorders. However, cutoff scores for the BC-VI were not sufficiently sensitive or specific to use to identify those with clinical disorders. However, this was also the case for the included screening questionnaires. This article discusses the implications of these results and offers suggestions for future research.

Injury Patterns and Psychological Traits of Patients With Self-Inflicted Wounds Produced by Punching Glass

Abstract: BACKGROUND:: Self-inflicted injuries are among the preventable forms of hand injury. Psychologic factors underlying these injuries have not been studied sufficiently. This study aims to reveal the extent of injury and the morbidity as well as the psychologic factors in a population of patients who intentionally injured themselves by punching glass. METHODS:: Patients seen and treated for glass punching injuries during a 4.5-year period were reviewed. The demographic data included the extent of injury, postoperative hospitalization time, and full recovery time. Their psychologic traits were analyzed by two questionnaires (Symptom Distress Check List and State-Trait Anger Expression Inventory) and through a psychiatric interview. The results were compared with a sex- and age-matched control group with accidental hand injuries. RESULTS:: The study group consisted of 36 patients. Mean age was 24.7 years. Most were men (n = 28), not married (n = 28), and living with their families. Half of them were unemployed. Twelve had only skin lacerations. The remaining 24 patients had a total of 45 tendon, 15 nerve, and 9 artery injuries. On an average, 46 days were required for full recovery. A second attempt of self-infliction was not reported. Twenty-one patients underwent questionnaires and psychiatric interview. The study group felt significantly higher levels of psychologic distress and hostility (p = 0.018 and p = 0.002, respectively). They also had higher levels of anger in daily life (p = 0.002). Clinical psychiatric evaluation failed to reveal any significant psychiatric disorder. CONCLUSION:: Self-inflicted hand injuries increase the workload of emergency services and clinics involved in the treatment. Prevention is very difficult, especially when alcohol is not an underlying cause. A typical patient has hostile and disobedient characteristics and who easily expresses his anger. Happily, having suffered enough during their treatment these patients do not attempt a second self-infliction. Language: en

Stratégies diagnostiques et thérapeutiques face aux hallucinations de l’enfant et de l’adolescent

Abstract: Hallucinations are a common symptom in pediatric populations Because spontaneous rapid recovery often occurs, routine medication with antipsychotic drugs should be avoided An adequate initial etiological assessment requires a medical examination, a psychiatric interview, and a meeting with key adult informants Laboratory testing and imaging may also be useful The risk of self-injury or harming others must be systematically assessed and should determine the choice between prescribing a nonspecific anxiolytic medication or hospitalizing the child Treatment should combine psychotherapy and psychoeducation, and antipsychotics should be given in case of prodromal psychotic presentation In the years to come, randomized controlled trials should define the exact role that repetitive transcranial magnetic stimulation might play as a treatment of hallucinations in children and adolescents Language: fr

Gender and presence of profound psychological traumas versus comorbidity of panic disorder and depression in difficult and aspirin-induced asthma

Abstract: Summary aim. The author examined psychiatrically a group of 106 patients with difficult asthma and 100 patients with aspirin-induced asthma. The special interest of the study was the link between different types of traumas that the patients from both groups had throughout their lives and comorbidity of panic and depressive symptoms that indicate severe and persistent course of common psychiatric problem. Methods. 106 consecutive adults with confirmed, physician-diagnosed difficult asthma and 100 patients with aspirin-induced asthma underwent psychiatric interview and assessment using M.I.N.I 5.0, Beck Depression Inventory (BDI) and Panic and Agoraphobia Scale (PAS). Psychiatric assessment was performed by experienced liaison psychiatrist according to IcD-10 and DSM-IV diagnosis. In difficult asthma group there were 78 women (74%) and 28 men (26%). The average age was 51.3 (SD=14.5) for women and 47.5 (SD=12.7) for men. In aspirin induced asthma group there were 66 women (66%) and 34 men (34%). The average age was 52.7 (SD=12.3) for women and 48.8 (SD=13.0) for men. results . In both groups of asthmatic patients women were majority (74% with difficult asthma and 66% with aspirin-induced asthma) with higher level of panic and depressive symptoms than men. Also comorbidity of these symptoms distinguishes the group of women as more at risk of intense psychiatric vulnerability. Conclusions . It is possible that psychological traumas affect the development, course and severity of complex psychiatric symptoms in asthmatic patients. It may play a special role in etiology of difficult asthma. asthma / panic disorder / depression /comorbidity / gender / trauma

Relationship disorders and cognitive functioning in young children.

Abstract: The aim of this study was to investigate the cognitive functioning of young children with or without relationship disorders with their mother. Mother-infant dyads were recruited during the first three postpartum days. Parent Infant Relationship Global Assessment Scale (PIRGAS) scores and mother-child relationship disorders were decided when children were 41-49 months of age by integrating the data obtained from psychiatric interview with mothers, Clinical Problem Solving Procedure (CPSP) and home observation. Cognitive functioning of young children was evaluated with Stanford-Binet Intelligence Scale. The young children without relationship problems/disorders had higher intelligence quotient (IQ) scores even after controlling for the effect of independent variables on cognitive functioning. These findings suggest that there is a link between the quality of the mother-child relationship and cognitive functioning in young children. Therefore, physicians should assess the interactions of children with their mothers even if they are brought for reasons other than relationship problems.

Prevalence of mental morbidity amongst prisoners

Abstract: Jails and prisons hold many people that society does not want to have around and it would be wise to keep them there, despite the fact that the legal and correctional system have failed to bring any positive changes in them. Prisoners with mental illness frequently endure violence, exploitation and extortion at the hands of other inmates and neglect and mistreatment by jail staff. To know the prevalence of mental morbidity among prisoners. The study was carried out in the district jail, Rohtak. A study sample of 150 male prisoners above sixteen was selected by random sampling technique ensuring proportionate representation to convicts as well as the non-convicts. Indian Psychiatric Interview Schedule (IPIS) was used for the purpose of screening the subjects suspected for psychiatric disorders and those who screened positive were administered Structured Clinical Interview for DSM-IV AXIS-I disorder (SCID-I) and AXIS-II disorder (SCID-II). 56% convicts belong to the age group of 30 to 50 years while 52% non-convicts were in the age group of 21 to 30 years. Prevalence of mental morbidity was 70% among convicts and 93% among non-convicts. 20% of convicts and 80% of non-convicts had AXIS-1 disorders while 24.6% of convicts and 75.4% of non-convicts had AXIS-11 disorders. Key words: Mental morbidity, prisoners.

[Comorbidity of aspirin-induced asthma, panic disorder and depression versus gender and presence of profound psychological traumas].

Abstract: Aim The author examined psychiatrically a group of 100 ambulatory patients with asthma The special interest of the study was the careful analysis of the time, context and content of different psychological traumas that the patients had throughout their lives Methods 100 consecutive adults with confirmed, physician-diagnosed aspirin-induced asthma underwent psychiatric interview and assessment using MINI 50, Beck Depression Inventory (BDI) and Panic And Agoraphobia Scale (PAS) Psychiatric assessment was performed by an experienced liaison psychiatrist according to ICD-10 and DSM-IV diagnosis There were 66 women (66%) and 34 men (34%) The average age was 527 (SD = 123) for women and 488 (SD = 130) for men Results In the group of 100 patients with asthma, women were a majority (66%) with higher level of anxiety and depressive symptoms than men It may be due to specific trauma of suffering and/or death of an emotionally close person, which occurred in adulthood This kind of trauma may have an impact on the aetiology of both panic disorder and depression Women are more exposed to this sort of trauma due to their social role Conclusions It is possible, that psychological trauma affects the development, course and severity of anxiety and depressive symptoms in asthmatic patients