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Open Access
Article
Publication date: 22 February 2011

Justin B. Dickerson

Episodic mood disorders are often associated with alcohol dependence. Few studies have explored the contribution of episodic mood disorders to length of stay among those…

Abstract

Episodic mood disorders are often associated with alcohol dependence. Few studies have explored the contribution of episodic mood disorders to length of stay among those hospitalized with alcohol dependence syndrome. Filling this research gap could improve care for patients while minimizing hospital utilization costs. This study was a cross-sectional analysis of the National Hospital Discharge Survey. ICD-9-CM diagnosis codes were used to identify those admitted to a private or non-profit hospital with alcohol dependence syndrome, and a co-morbid diagnosis of an episodic mood disorder (n=358). Descriptive statistics were used to highlight differences in key demographic and hospital variables between those with and without episodic mood disorders. Negative binomial regression was used to associate episodic mood disorders with hospital length of stay. Incidence rate ratios were calculated. Co-morbid episodic mood disorders ([.beta]=0.31, P=0.001), referral to a hospital by a physician ([.beta]=0.35, P=0.014), and increasing age ([.beta]= 0.01, P=0.001) were associated with longer hospital stays. Hospital patients with an admitting diagnosis of alcohol dependence syndrome were 36% more likely to have a longer hospital stay if they also had a co-morbid diagnosis of an episodic mood disorder (IRR=1.36, CI=1.14-1.62). Patients admitted to a hospital with alcohol dependence syndrome should be routinely screened for episodic mood disorders. Opportunities exist for enhanced transitional care between acute, ambulatory, and community-based care settings to lower hospital utilization.

Details

Mental Illness, vol. 3 no. 1
Type: Research Article
ISSN: 2036-7465

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Book part
Publication date: 21 April 2010

Kathryn Burrows

Purpose – This chapter explores the changing definition of bipolar disorder, examining how debates within psychiatry actually construct the definition of mental illness…

Abstract

Purpose – This chapter explores the changing definition of bipolar disorder, examining how debates within psychiatry actually construct the definition of mental illness, thereby creating the appearance of an emerging epidemic with increasing prevalence.

Method – I review the recent psychiatric and epidemiological research to reveal that the intellectual and scientific debates that occur in the psychological laboratory and in survey research are in fact falsely increasing the figures that show that an epidemic of bipolar is emerging.

Findings – For centuries, bipolar disorder was equated with severe psychosis and had a prevalence rate between 0.4% and 1.6%. As spectrum and subthreshold conceptions of bipolar disorder become established in official psychiatric diagnostic manuals, however, estimates of the prevalence of bipolar spectrum disorders have risen to almost 25%. I demonstrate that nearly all of this increase is a result of changes in the scientific and intellectual definition of bipolar disorders among psychiatric professionals, and that rates of symptoms are not in fact increasing.

Contribution to field – The arbitrariness of diagnostic thresholds naturally leads researchers to argue for lower thresholds. This allows more individuals who were previously considered psychiatrically normal to be reclassified as psychiatrically disordered. Lowering diagnostic thresholds increases the risk of confusing normal elation or sadness with disordered states, increasing the potential of false-positive diagnoses and the false impression of rising rates of disorder.

Details

Understanding Emerging Epidemics: Social and Political Approaches
Type: Book
ISBN: 978-1-84855-080-3

Open Access
Article
Publication date: 30 September 2015

Toru Uehara and Yoko Ishige

This study aims to examine the association of frontal functioning with subclinical bipolar spectrum by a newly developed convenient method. We investigated subclinical…

Abstract

This study aims to examine the association of frontal functioning with subclinical bipolar spectrum by a newly developed convenient method. We investigated subclinical bipolar tendency and frontal lobe activation during word productions using multi-channel near infrared spectroscopy. Participants: 44 healthy university students (mean ages 20.5 years old, and 29 female) gave their written informed consent, and we strictly protected privacy and anonymity was carefully preserved. A 13-items self-report questionnaire (Mood Disorders Questionnaire; MDQ) and a 16-channel near-infrared spectroscopy were used to compare frontal activations between two samples divided by median (4 points) of the total MDQ scores and to analyze correlations between relative changes of cerebral blood volume and bipolarity levels. There was no case suspected as bipolar disorders by MDQ screening (mean 3.4, max 10). Significant differences in lower activations were noted in the right and left pre-frontal cortex (PFC) with higher bipolarity scores using the specific software to analyze the NIRS waveform (P<0.05). Total MDQ were correlated significantly with frontal activation negatively in many channels; therefore, we conducted multiple linear regression to select significant frontal activations using the MDQ as a dependent variable. Stepwise method revealed that activation in left lateral PFC was negatively associated to bipolar tendency, and this regression model was significant (R2=0.10, F=4.5, P=0.04). Differences in frontal functioning suggest that subclinical bipolar tendencies might be related to left lateral PFC activations. It should be confirmed whether the identical pattern can be identified for clinical subjects with bipolar disorders.

Details

Mental Illness, vol. 7 no. 2
Type: Research Article
ISSN: 2036-7465

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Article
Publication date: 14 August 2017

Alice Bennett and Darren Johnson

In light of the clinical importance of understanding co-morbidity within offender populations, the purpose of this paper is to examine the prevalence and comorbidities of…

Abstract

Purpose

In light of the clinical importance of understanding co-morbidity within offender populations, the purpose of this paper is to examine the prevalence and comorbidities of clinical disorder (Axis I) and personality disorder (Axis II) within a sample of high risk, male offenders located in a high secure, prison-based personality disorder treatment service.

Design/methodology/approach

The study utilised clinical assessment data for both Axis I diagnoses (Structured Clinical Interview for DSM-IV) and Axis II diagnoses (International Personality Disorder Examination) of 115 personality disordered offenders who met the criteria for the treatment service between 2004 and 2015.

Findings

Co-morbidity between Axis I and Axis II diagnoses was high, with 81 per cent of the sample having co-morbid personality disorder and clinical disorder diagnosis. The most prevalent Axis I disorder was substance misuse, and Axis II was antisocial, borderline, and paranoid personality disorder. Following χ2 analysis, Cluster A personality disorder demonstrated co-morbidity with both mood disorder and schizophrenia/other psychotic disorder. Paranoid, schizoid, narcissistic, and avoidant personality disorder demonstrated a level of co-morbidity with Axis I disorders. There was no association found between the clinical disorders of substance use and anxiety with any personality disorder within this sample.

Practical implications

In part these results suggest that certain Axis II disorders may increase the risk of lifetime Axis I disorders.

Originality/value

The findings of no co-morbidity between the clinical disorders of substance use and anxiety with any personality disorder within sample are inconsistent to previous findings.

Details

Journal of Forensic Practice, vol. 19 no. 3
Type: Research Article
ISSN: 2050-8794

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Article
Publication date: 1 December 2007

Kiriakos Xenitidis, Elena Paliokosta, Stefanos Maltezos and Vangelis Pappas

The general public and professionals from a range of backgrounds have increasingly become interested in autism spectrum disorders. This interest is particularly relevant…

Abstract

The general public and professionals from a range of backgrounds have increasingly become interested in autism spectrum disorders. This interest is particularly relevant to learning disability practitioners. Both autism and learning disabilities are independently associated with increased risk of mental health problems. Thus, when a person has learning disabilities and an autism spectrum disorder, a comprehensive assessment for mental health problems is of paramount importance. This paper provides an overview of the assessment of mental health problems in adults and children with neurodevelopmental disorders. The general assessment principles are outlined followed by assessment issues related to specific conditions such as psychoses, mood disorders and attention deficit hyperactivity disorder. Finally conclusions on the clinical implications are drawn.

Details

Advances in Mental Health and Learning Disabilities, vol. 1 no. 4
Type: Research Article
ISSN: 1753-0180

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Article
Publication date: 15 May 2017

Yasmina Frem, Marta Torrens, Antonia Domingo-Salvany and Gail Gilchrist

The purpose of this paper is to examine gender differences in lifetime substance use and non-substance use (non-SUD) psychiatric disorders among illicit drug users and…

Abstract

Purpose

The purpose of this paper is to examine gender differences in lifetime substance use and non-substance use (non-SUD) psychiatric disorders among illicit drug users and determine factors associated with non-SUD psychiatric disorders independently for males and for females.

Design/methodology/approach

Secondary analysis of five cross-sectional studies conducted in Barcelona, Spain during 2000-2006. Lifetime DSM-IV substance use and non-SUD psychiatric diagnoses were assessed using the Spanish Psychiatric Research Interview for Substance and Mental disorders (PRISM) among 629 people who use substances (68 per cent male) recruited from treatment (n=304) and out of treatment (n=325) settings. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using binary logistic regression.

Findings

The prevalence of any lifetime psychiatric (non-SUD) disorder was 41.8 per cent, with major depression (17 per cent) and antisocial personality disorder (17 per cent) being the most prevalent disorders. After adjusting for age and study, the odds of having any lifetime non-SUD (OR 2.10; 95%CI 1.48, 2.96); any mood disorder (OR 2.13; 95%CI 1.46, 3.11); any anxiety disorder (OR 1.86; 95%CI 1.19; 2.92); any eating disorder (OR 3.09; 95%CI 1.47, 6.47); or borderline personality disorder (OR 2.30; 95%CI 1.36, 3.84) were greater for females than males. Females were less likely than males to meet criteria for antisocial personality disorder (OR 0.59; 95%CI 0.36, 0.96) and attention deficit disorder (OR 0.37; 95%CI 0.17, 0.78).

Research limitations/implications

Psychiatric disorders are common among people who use substances, with gender differences reported for specific disorders. Gender-sensitive integrated treatment approaches are required to prevent and to address comorbidity psychiatric disorders among this population.

Originality/value

This secondary analysis of five cross-sectional studies included a large sample size allowing sufficient power to examine the differences between men and women. An additional strength of the methodology is the use of the gold standard PRISM which was used to assess disorders.

Open Access
Book part
Publication date: 19 November 2020

Zsuzsa Kaló

Sex and gender are regarded as critical structural determinants of mental health and mental illness. Mental illness is a complex phenomenon, and risky behaviour and…

Abstract

Sex and gender are regarded as critical structural determinants of mental health and mental illness. Mental illness is a complex phenomenon, and risky behaviour and substance use commonly occur simultaneously or subsequent to one another. A gendered vulnerability in biological, environmental, and behavioural risk factors has been registered in the development and escalation of mental illness. Studies have found that women who use drugs experience greater physical and mental health repercussions than men. Women who use drugs present higher rates of depression and anxiety, suicidal tendencies, isolation and general psychological distress. This chapter addresses the most common mental illnesses associated with women who use drugs: depression, anxiety, trauma-related disorders, and eating disorders.

Details

The Impact of Global Drug Policy on Women: Shifting the Needle
Type: Book
ISBN: 978-1-83982-885-0

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Article
Publication date: 1 November 2019

Sajjad Rezaei

Aggression is a destructive experience in terms of social and public health. The purpose of this paper is to determine the role of depressive mood, premenstrual dysphoric…

Abstract

Purpose

Aggression is a destructive experience in terms of social and public health. The purpose of this paper is to determine the role of depressive mood, premenstrual dysphoric disorder (PMDD) and premenstrual syndrome (PMS) in adolescent girls’ aggression.

Design/methodology/approach

In a cross-sectional study, 510 girl students were selected by multistage cluster sampling from Lahijan and Sangar high schools (Northern Iran) in the 2017–2018 academic year, and each of them responded to the short version of Beck Depression Inventory (BDI-13), Premenstrual Symptoms Screening Tool and Ahvaz Aggression Inventory. Data were analyzed by point-biserial and Pearson’s correlation coefficients, univariate analysis of covariance in the form of 2 × 3 factorial design and Hochberg’s GT2 post hoc test.

Findings

The questionnaires of 475 students were returned correctly (survey validity=93 percent). The results of ANCOVA after adjustment for confounding variables such as age and physical illness history revealed that the existence of main effect for depressive mood (F=31.50, df=1, p<0.0001) and PMS and PMDD diagnoses (F=11.39, df=2, p<0.0001) were associated with increased aggression. However, there was no significant interaction effect on aggression levels (p>0.05). Additionally, post hoc tests revealed no significant differences between the diagnosis of PMS and PMDD in terms of aggression (p>0.05).

Research limitations/implications

The present study has some limitations. Depressive mood and diagnoses of PMS and PMDD were defined through relying on the self-report data and cut points suggested by the questionnaires. Obviously, change of measurement tools or even cut points reduces the results reliability and repeatability. Furthermore, the research plan does not allow us to infer causal relations and does not provide information about the direction of the relationship between depression symptoms, PMS and PMDD diagnoses, and aggression. Finally, the present study is relied on high schools’ data, and the results cannot be generalized to other adolescent girls.

Originality/value

Despite the limitations of this study, its findings offer new insights into the factors influencing the perpetration of aggression in Iranian adolescent girls. Depressed adolescent girls and those receiving a PMS or PMDD diagnosis are more likely to develop aggression. These findings can be used in high schools to design educational and health-based interventions in order to reduce and prevent anger and resentment in adolescent girls.

Details

Journal of Aggression, Conflict and Peace Research, vol. 11 no. 4
Type: Research Article
ISSN: 1759-6599

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Article
Publication date: 15 March 2011

Andrew McVicar and John Clancy

Principles of epigenesis that provide a foundation for research into chronic medical disorders are increasingly being applied in the context of mental health. The purpose…

Abstract

Purpose

Principles of epigenesis that provide a foundation for research into chronic medical disorders are increasingly being applied in the context of mental health. The purpose of this paper is to consider recent research evidence for epigenetic influences in the pathogenesis of depression, and the putative links with stress biology during exposure to chronic stress, with the aim of placing this into a context of potential new therapeutics.

Design/methodology/approach

Substantive reviews published during the last ten years were identified in a search of the Pubmed database in September 2010 using the terms “epigenetics” or “epigenesis” with “mental health”, “mood disorder”, “depression”, stress', “chronic stress” or “environment”, supplemented by hand‐searching of citations in the reviews.

Findings

Epigenetic mechanisms are both heritable and acquired, and their impact on the underlying genome helps explain individual vulnerability and patterns of occurrence of depression.

Originality/value

The paper shows that this relatively new field of research is in its infancy, and the influence of adverse environments (i.e. stressors) on genetic/epigenetic predisposition has promise for the advent of novel therapeutics based on epigenetic manipulation.

Details

Journal of Public Mental Health, vol. 10 no. 1
Type: Research Article
ISSN: 1746-5729

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Article
Publication date: 27 September 2010

Henry Kwok, Eileena Chui and Alexander Tang

Psychotropic medications are often used to treat problem behaviours in people with intellectual disability which not only occur frequently but also tend to persist over…

Abstract

Psychotropic medications are often used to treat problem behaviours in people with intellectual disability which not only occur frequently but also tend to persist over time. This study examined the pattern of prescription of such medications to manage problem behaviours for adults with intellectual disabilities in a specialist psychiatric unit in Hong Kong. Individuals aged 18 or above with problem behaviours and receiving psychotropic medication for treatment in hospital, outpatient and community settings were studied. Their demographic and clinical information was collected. The type and dosage of medications were retrieved from the computer database and analysed. Those with psychotic disorder and mood (affective disorder) were excluded. After screening, 236 patients met the inclusion criteria. People with moderate intellectual disability accounted for most of the cohort (46%). Autism spectrum disorder was the commonest psychiatric diagnosis (35%) and aggression the commonest problem behaviour (52%). Antipsychotics, mood stabilisers and antidepressants were prescribed to 96%, 20% and 13% of the subjects respectively. The profile of problem behaviour in the Chinese population with intellectual disability is consistent with the findings reported in the world literature. Antipsychotic drugs are the most commonly prescribed class of psychotropic medication used to treat such behaviours. Although the current evidence is not strong enough to support a clear‐cut recommendation on the use of medications, the dichotomous notion of ‘prescription’ or ‘no prescription’ for problem behaviours may be simplistic.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 4 no. 3
Type: Research Article
ISSN: 2044-1282

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