Anxiety Disorders in Old Age: Psychiatric Comorbidities, Quality of Life, and Prevalence According to Age, Gender, and Country.

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Canuto, Alessandra; Weber, Kerstin; Baertschi, Marc; Andreas, Sylke; Volkert, Jana; Dehoust, Maria Christina; Sehner, Susanne; Suling, Anna; Wegscheider, Karl; Ausín, Berta; Crawford, Mike J; Da Ronch, Chiara; Grassi, Luigi; Hershkovitz, Yael; Muñoz, Manuel; Quirk, Alan; Rotenstein, Ora; Santos-Olmo, Ana Belén; Shalev, Arieh; Strehle, Jens; Wittchen, Hans-Ulrich; Schulz, Holger; Härter, Martin

2018-02-01

Previous estimates of the prevalence of anxiety disorders in late life vary greatly due to the lack of reliable diagnostic tools. This MentDis_ICF65+ study assessed 12-month prevalence rates of anxiety disorders and age- and gender-related differences in comorbidities, as well as impact on quality of life. The study used a cross-sectional multicenter survey. The study sample comprised 3,142 men and women aged 65 to 84 years, living in five European countries and Israel. Anxiety disorders were assessed using computer-assisted face-to-face interviews with an age-appropriate diagnostic interview (CIDI65+). The prevalence of anxiety disorders was 17.2%. Agoraphobia was the most frequent disorder (4.9%), followed by panic disorder (3.8%), animal phobia (3.5%), general anxiety disorder (3.1%), post-traumatic stress disorder (1.4%), social phobia (1.3%), and obsessive-compulsive disorder (0.8%). The prevalence rate of any anxiety disorder dropped by 40% to 47% in adults aged 75-84 years compared with those aged 65-74 years. Women were twice as likely to present with agoraphobia or general anxiety disorder as men. Only panic disorder and phobia were associated with comorbid major depression. The negative relationship with quality of life was limited to agoraphobia and generalized anxiety disorder. The age-appropriate CIDI65+ led to higher prevalence rates of anxiety disorders in the elderly, yet to weaker associations with comorbidities and impaired quality of life compared with previous studies. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Prevalence of attention deficit hyperactivity disorder and comorbid psychiatric and behavioral problems among primary school students in western Saudi Arabia

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Faten N. AlZaben

2018-01-01

Full Text Available Objectives: To determine the prevalence of attention deficit hyperactivity disorder (ADHD, subtypes of ADHD, and psychiatric, academic, and behavioral comorbidity in public primary school students in Jeddah, Saudi Arabia. Methods: This is a cross-sectional study. A simple random sample of 6 primary government schools in Jeddah, Saudi Arabia, was identified (3 male, 3 female, and a random sample of classes in each of grades 1-6 were selected. Between July and November 2016, teachers in these classes were asked to complete the Vanderbilt ADHD scale on all students in their classes. Results: A total of 929 students were screened. The overall prevalence of ADHD was 5% (5.3% in girls, 4.7% in boys. The most prevalent subtype of ADHD was combined type (2.7%, followed by hyperactive type (1.2%, and inattentive type (1.1%. The highest prevalence of ADHD overall was in grade 3 (7.1% and the lowest prevalence in grade 6 (3.4%. Among students with ADHD, prevalence of comorbid psychiatric, academic, and behavioral problems was widespread (56.5% oppositional defiant disorder/conduct disorder, 54.4% impaired academic performance, 44.4% classroom behavioral problems, 41.3% depression/anxiety. Comorbid problems were especially prevalent in combined ADHD subtype and in boys. Conclusions: Attention deficit hyperactivity disorder is common in primary school children in Jeddah, and is associated with widespread psychiatric, academic, and behavioral problems, especially in boys. These findings have implications for the diagnosis and treatment of this serious neurobehavioral disorder.

Prevalence of comorbid retinal disease in patients with glaucoma at an academic medical center

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Griffith JF

2015-07-01

Full Text Available Joseph F Griffith,1 Jeffrey L Goldberg2 1Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, 2Shiley Eye Center, University of California San Diego, La Jolla, CA, USA Background: Patients with various retinal diseases and patients who have undergone retinal procedures and surgeries have an increased risk of developing ocular hypertension and glaucoma. Little is known about the epidemiology of comorbid retinal diseases in glaucoma patients. This study evaluated the prevalence of retinal comorbidities in a population of patients with five types of glaucoma.Methods: A longitudinal, retrospective study was conducted using International Classification of Disease (ICD-9 billing records from 2003 to 2010 at an academic medical center. Patients were classified as having primary open-angle glaucoma (POAG, low tension open-angle glaucoma (NTG, pigmentary open-angle glaucoma, chronic-angle closure glaucoma (CACG, or pseudoexfoliation glaucoma (PXG if they had at least three clinic visits with the same ICD-9 code. Patients were classified as having a retinal comorbidity if they had two visits with the same code. Variables were analyzed with the independent t-test, χ2 test, analysis of variance, or Fisher’s exact test.Results: A total of 5,154 patients had glaucoma, and 14.8% of these had a retinal comorbidity. The prevalence of comorbid retinal disease was higher in patients with POAG (15.7% than in those with NTG (10.7%, PXG (10.1%, or pigmentary open-angle glaucoma (3.7%; P<0.05. Two hundred and two patients had diabetic retinopathy, with POAG patients (4.5% having a higher prevalence than those with CACG (1.4% or PXG (0.6%; P<0.001. There were 297 patients who had macular degeneration and both POAG (2.0% and PXG patients (2.9% had a higher prevalence of nonexudative macular degeneration than those with CACG (0%; P<0.01. Patients with comorbid retinal disease had a higher prevalence of blindness and low vision than those without comorbid

Neuropathologic comorbidity and cognitive impairment in the Nun and Honolulu-Asia Aging Studies.

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White, Lon R; Edland, Steven D; Hemmy, Laura S; Montine, Kathleen S; Zarow, Chris; Sonnen, Joshua A; Uyehara-Lock, Jane H; Gelber, Rebecca P; Ross, G Webster; Petrovitch, Helen; Masaki, Kamal H; Lim, Kelvin O; Launer, Lenore J; Montine, Thomas J

2016-03-15

To examine frequencies and relationships of 5 common neuropathologic abnormalities identified at autopsy with late-life cognitive impairment and dementia in 2 different autopsy panels. The Nun Study (NS) and the Honolulu-Asia Aging Study (HAAS) are population-based investigations of brain aging that included repeated cognitive assessments and comprehensive brain autopsies. The neuropathologic abnormalities assessed were Alzheimer disease (AD) neuropathologic changes, neocortical Lewy bodies (LBs), hippocampal sclerosis, microinfarcts, and low brain weight. Associations with screening tests for cognitive impairment were examined. Neuropathologic abnormalities occurred at levels ranging from 9.7% to 43%, and were independently associated with cognitive impairment in both studies. Neocortical LBs and AD changes were more frequent among the predominantly Caucasian NS women, while microinfarcts were more common in the Japanese American HAAS men. Comorbidity was usual and very strongly associated with cognitive impairment. Apparent cognitive resilience (no cognitive impairment despite Braak stage V) was strongly associated with minimal or no comorbid abnormalities, with fewer neocortical AD lesions, and weakly with longer interval between final testing and autopsy. Total burden of comorbid neuropathologic abnormalities, rather than any single lesion type, was the most relevant determinant of cognitive impairment in both cohorts, often despite clinical diagnosis of only AD. These findings emphasize challenges to dementia pathogenesis and intervention research and to accurate diagnoses during life. © 2016 American Academy of Neurology.

Vestibular vertigo and comorbid cognitive and psychiatric impairment: the 2008 National Health Interview Survey.

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Bigelow, Robin T; Semenov, Yevgeniy R; du Lac, Sascha; Hoffman, Howard J; Agrawal, Yuri

2016-04-01

Patients with vestibular disease have been observed to have concomitant cognitive and psychiatric dysfunction. We evaluated the association between vestibular vertigo, cognitive impairment and psychiatric conditions in a nationally representative sample of US adults. We performed a cross-sectional analysis using the 2008 National Health Interview Survey (NHIS), which included a Balance and Dizziness Supplement, and questions about cognitive function and psychiatric comorbidity. We evaluated the association between vestibular vertigo, cognitive impairment (memory loss, difficulty concentrating, confusion) and psychiatric diagnoses (depression, anxiety and panic disorder). We observed an 8.4% 1-year prevalence of vestibular vertigo among US adults. In adjusted analyses, individuals with vestibular vertigo had an eightfold increased odds of 'serious difficulty concentrating or remembering' (OR 8.3, 95% CI 4.8 to 14.6) and a fourfold increased odds of activity limitation due to difficulty remembering or confusion (OR 3.9, 95% CI 3.1 to 5.0) relative to the rest of the US adults. Individuals with vestibular vertigo also had a threefold increased odds of depression (OR 3.4, 95% CI 2.9 to 3.9), anxiety (OR 3.2, 95% CI 2.8 to 3.6) and panic disorder (OR 3.4, 95% CI 2.9 to 4.0). Our findings indicate that vestibular impairment is associated with increased risk of cognitive and psychiatric comorbidity. The vestibular system is anatomically connected with widespread regions of the cerebral cortex, hippocampus and amygdala. Loss of vestibular inputs may lead to impairment of these cognitive and affective circuits. Further longitudinal research is required to determine if these associations are causal. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Prevalence of different comorbidities in COPD patients by gender and GOLD stage.

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Dal Negro, R W; Bonadiman, L; Turco, P

2015-01-01

Several comorbidities frequently affect COPD progression. Aim of the study was to assess the prevalence of main comorbidities by gender and disease severity in a cohort of COPD patients referring for the first time to a specialist institution. The study was a non-interventional, cross-sectional investigation carried out via automatic and anonymous selection from the institutional data base over the period 2012-2015. Inclusion criteria were: subjects of both sex aged ≥40 years; diagnosis of COPD according to GOLD guidelines 2014; the availability of a complete clinical record file. Variables collected were: lung function; smoking history; BMI; the Charlson Comorbidity Index (CCI); number and kind of comorbidities for each patient. At least one comorbidity of clinical relevance was found in 78.6 % of patients, but at least two in 68.8 %, and three or more were found in 47.9 % of subjects. Mean CCI was 3.4 ± 1.6sd. The overall prevalence was 2.6 comorbidities per patient, but 2.5 in males, and 3.0 in females, respectively (p Cognition disorders, dementia and signs of degenerative brain disorders were more frequently found in men, while depression in females. Finally, lung cancer was at the first place in men, but at the second in females. All comorbidities increased their prevalence progressively up to the last stage of COPD severity, except the cardio-vascular and the metabolic ones which dropped in the IV GOLD stage, presumably due to the high mortality rate in this severe COPD stage. The gender-dependency of comorbidities was confirmed in general terms, even if lung cancer proved a dramatic increase almost independently of sex.

Prevalence, incidence, and autoimmune comorbidities of celiac disease

DEFF Research Database (Denmark)

Grode, Louise; Bech, Bodil H; Jensen, Thomas Møller

2018-01-01

AIM: The aim of this study was to describe and identify potential trends with respect to prevalence, incidence, age, sex, and autoimmune comorbidity of celiac disease (CD). PATIENTS AND METHODS: A Danish nationwide cohort study of CD using data from The National Patient Register. Patients...

The Economic Burden of Visual Impairment and Comorbid Fatigue: A Cost-of-Illness Study (From a Societal Perspective).

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Schakel, Wouter; van der Aa, Hilde P A; Bode, Christina; Hulshof, Carel T J; van Rens, Ger H M B; van Nispen, Ruth M A

2018-04-01

To investigate the burden of visual impairment and comorbid fatigue in terms of impact on daily life, by estimating societal costs (direct medical costs and indirect non-health care costs) accrued by these conditions. This cost-of-illness study was performed from a societal perspective. Cross-sectional data of visually impaired adults and normally sighted adults were collected through structured telephone interviews and online surveys, respectively. Primary outcomes were fatigue severity (FAS), impact of fatigue on daily life (MFIS), and total societal costs. Cost differences between participants with and without vision loss, and between participants with and without fatigue, were examined by (adjusted) multivariate regression analyses, including bootstrapped confidence intervals. Severe fatigue (FAS ≥ 22) and high fatigue impact (MFIS ≥ 38) was present in 57% and 40% of participants with vision loss (n = 247), respectively, compared to 22% (adjusted odds ratio [OR] 4.6; 95% confidence interval [CI] [2.7, 7.6]) and 11% (adjusted OR 4.8; 95% CI [2.7, 8.7]) in those with normal sight (n = 233). A significant interaction was found between visual impairment and high fatigue impact for total societal costs (€449; 95% CI [33, 1017]). High fatigue impact was associated with significantly increased societal costs for participants with visual impairment (mean difference €461; 95% CI [126, 797]), but this effect was not observed for participants with normal sight (€12; 95% CI [-527, 550]). Visual impairment is associated with an increased prevalence of high fatigue impact that largely determines the economic burden of visual impairment. The substantial costs of visual impairment and comorbid fatigue emphasize the need for patient-centered interventions aimed at decreasing its impact.

[Body dysmorphic disorder in cosmetic surgery - prevalence, psychiatric comorbidity and outcome].

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Hundscheid, T; van der Hulst, R R W J; Rutten, B P F; Leue, C

2014-01-01

Patients suffering from body dysmorphic disorder (bdd) are preoccupied with a slight or imagined defect in appearance. First of all, to review the literature on the prevalence of bdd in cosmetic surgery and thereafter to review the literature on psychiatric comorbidity and the outcome of surgical interventions. We based our search strategy on Embase, Medline and PubMed, using the search terms 'body dysmorphic disorder', 'cosmetic surgery', 'prevalence', 'comorbidity' and 'outcome'. Our search covered English and Dutch literature published after the introduction of bdd in dsm-iii-r and before 1 November, 2013. A study of the relevant articles enabled us to access additional articles mentioned in these texts. Our initial search strategy turned out to be too narrow. It was therefore broadened to include 'body dysmorphic disorder', 'cosmetic surgery', and 'prevalence'. Eventually we included 23 original articles. In 11 of these the prevalence of bdd varied from 3.2 to 53.6%. Twelve articles on psychiatric comorbidity revealed predominantly mood and anxiety disorders on axis I and cluster C personality disorders on axis II. Only two studies reported on the outcome of cosmetic surgery performed on bdd patients; surgical interventions, however, seemed to result in new preoccupations with the prolongation of psychiatric comorbidity. bdd is a common psychiatric disorder that can sometimes lead to cosmetic surgery. However, pre-operative screening of bdd patients is vital so that efficient psychiatric treatment can be initiated and patients are not subjected to surgical interventions which may be ineffective or even harmful.

Psychiatric comorbidity and psychosocial impairment among patients with vertigo and dizziness.

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Lahmann, Claas; Henningsen, Peter; Brandt, Thomas; Strupp, Michael; Jahn, Klaus; Dieterich, Marianne; Eckhardt-Henn, Annegret; Feuerecker, Regina; Dinkel, Andreas; Schmid, Gabriele

2015-03-01

Vertigo and dizziness are often not fully explained by an organic illness, but instead are related to psychiatric disorders. This study aimed to evaluate psychiatric comorbidity and assess psychosocial impairment in a large sample of patients with a wide range of unselected organic and non-organic (ie, medically unexplained) vertigo/dizziness syndromes. This cross-sectional study involved a sample of 547 patients recruited from a specialised interdisciplinary treatment centre for vertigo/dizziness. Diagnostic evaluation included standardised neurological examinations, structured clinical interview for major mental disorders (SCID-I) and self-report questionnaires regarding dizziness, depression, anxiety, somatisation and quality of life. Neurological diagnostic workup revealed organic and non-organic vertigo/dizziness in 80.8% and 19.2% of patients, respectively. In 48.8% of patients, SCID-I led to the diagnosis of a current psychiatric disorder, most frequently anxiety/phobic, somatoform and affective disorders. In the organic vertigo/dizziness group, 42.5% of patients, particularly those with vestibular paroxysmia or vestibular migraine, had a current psychiatric comorbidity. Patients with psychiatric comorbidity reported more vertigo-related handicaps, more depressive, anxiety and somatisation symptoms, and lower psychological quality of life compared with patients without psychiatric comorbidity. Almost half of patients with vertigo/dizziness suffer from a psychiatric comorbidity. These patients show more severe psychosocial impairment compared with patients without psychiatric disorders. The worst combination, in terms of vertigo-related handicaps, is having non-organic vertigo/dizziness and psychiatric comorbidity. This phenomenon should be considered when diagnosing and treating vertigo/dizziness in the early stages of the disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

Patterns of comorbidity in community-dwelling older people hospitalised for fall-related injury: A cluster analysis

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Finch Caroline F

2011-08-01

Full Text Available Abstract Background Community-dwelling older people aged 65+ years sustain falls frequently; these can result in physical injuries necessitating medical attention including emergency department care and hospitalisation. Certain health conditions and impairments have been shown to contribute independently to the risk of falling or experiencing a fall injury, suggesting that individuals with these conditions or impairments should be the focus of falls prevention. Since older people commonly have multiple conditions/impairments, knowledge about which conditions/impairments coexist in at-risk individuals would be valuable in the implementation of a targeted prevention approach. The objective of this study was therefore to examine the prevalence and patterns of comorbidity in this population group. Methods We analysed hospitalisation data from Victoria, Australia's second most populous state, to estimate the prevalence of comorbidity in patients hospitalised at least once between 2005-6 and 2007-8 for treatment of acute fall-related injuries. In patients with two or more comorbid conditions (multicomorbidity we used an agglomerative hierarchical clustering method to cluster comorbidity variables and identify constellations of conditions. Results More than one in four patients had at least one comorbid condition and among patients with comorbidity one in three had multicomorbidity (range 2-7. The prevalence of comorbidity varied by gender, age group, ethnicity and injury type; it was also associated with a significant increase in the average cumulative length of stay per patient. The cluster analysis identified five distinct, biologically plausible clusters of comorbidity: cardiopulmonary/metabolic, neurological, sensory, stroke and cancer. The cardiopulmonary/metabolic cluster was the largest cluster among the clusters identified. Conclusions The consequences of comorbidity clustering in terms of falls and/or injury outcomes of hospitalised patients

Severe MUPS in a sick-listed population: a cross-sectional study on prevalence, recognition, psychiatric co-morbidity and impairment

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Koopmans Petra C

2009-12-01

Full Text Available Abstract Background Medically unexplained physical symptoms (MUPS have a high prevalence in the general population and are associated with psychiatric morbidity. There are indications that MUPS are an important determinant of frequent and long-term disability. The primary objective was to assess the prevalence of MUPS in sick-listed-employees and its associations with depressive disorders, anxiety disorders, health anxiety, distress and functional impairment. Secondary objectives were to investigate the classification of the occupational health physicians (OHPs, their opinions about the causes as well as the attributions of the employee. Methods In a cross-sectional study of 489 sick-listed employees from 5 OHP group practices, MUPS, depressive disorders, anxiety disorders, health anxiety, distress and functional impairment were assessed with the Patient Health Questionnaire (PHQ, the Whitely Index (WI, the Four- Dimensional Symptom Questionnaire (4DSQ and the Short-Form 36 Health Survey (SF-36. We used a cut off score of 15 on the PHQ for the categorisation of severe MUPS. The opinions of the OHPs were evaluated by means of a separate questionnaire with regard to the presence of employees physical symptoms, and the symptoms attributions, and the diagnoses of the OHPs. Results Severe MUPS had a prevalence of 15.1% in this population of sick-listed employees. These employees had 4-6 times more depressive and anxiety disorders, and were more impaired. Female gender and PHQ-9 scores were determinants of severe MUPS. Most of the time the OHPs diagnosed employees with severe MUPS as having a mental disorder. The employees attributed their physical symptoms in 66% to mental or to both mental and physical causes. Conclusion The prevalence of severe MUPS is higher in long-term sick-listed employees than in the non-sick- listed working population and at least equals the prevalence in the general practice population. Severe MUPS are associated with

Benign paroxysmal positional vertigo and comorbid conditions.

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Cohen, Helen S; Kimball, Kay T; Stewart, Michael G

2004-01-01

To determine the prevalence of comorbid disease in patients with benign paroxysmal positional vertigo (BPPV) and the relationship of comorbid disease to symptoms of vertigo, disequilibrium, and anxiety. Patients who had posterior semicircular canal BPPV and who had been referred for vestibular rehabilitation at a tertiary care center completed a health status questionnaire and the Vertigo Symptom Scale, answered questions about level of vertigo, and were tested on computerized dynamic posturography. Subjects had high rates of diabetes, mild head trauma, and probable sinus disease. Balance was generally impaired, worse in diabetics and subjects with significant vestibular weakness. Subjects who smoked or had had mild head trauma had higher levels of anxiety. Comorbid conditions, particularly diabetes, mild head trauma, and sinus disease, are unusually prevalent in BPPV patients. Message: Patients with comorbid disease are at risk for having increased vertigo, anxiety, and disequilibrium compared to other patients. Copyright 2004 S. Karger AG, Basel

Facial emotion perception impairments in schizophrenia patients with comorbid antisocial personality disorder.

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Tang, Dorothy Y Y; Liu, Amy C Y; Lui, Simon S Y; Lam, Bess Y H; Siu, Bonnie W M; Lee, Tatia M C; Cheung, Eric F C

2016-02-28

Impairment in facial emotion perception is believed to be associated with aggression. Schizophrenia patients with antisocial features are more impaired in facial emotion perception than their counterparts without these features. However, previous studies did not define the comorbidity of antisocial personality disorder (ASPD) using stringent criteria. We recruited 30 participants with dual diagnoses of ASPD and schizophrenia, 30 participants with schizophrenia and 30 controls. We employed the Facial Emotional Recognition paradigm to measure facial emotion perception, and administered a battery of neurocognitive tests. The Life History of Aggression scale was used. ANOVAs and ANCOVAs were conducted to examine group differences in facial emotion perception, and control for the effect of other neurocognitive dysfunctions on facial emotion perception. Correlational analyses were conducted to examine the association between facial emotion perception and aggression. Patients with dual diagnoses performed worst in facial emotion perception among the three groups. The group differences in facial emotion perception remained significant, even after other neurocognitive impairments were controlled for. Severity of aggression was correlated with impairment in perceiving negative-valenced facial emotions in patients with dual diagnoses. Our findings support the presence of facial emotion perception impairment and its association with aggression in schizophrenia patients with comorbid ASPD. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Prevalence of Comorbid Psychiatric Disorders in Children and Adolescents With Attention Deficit Hyperactivity Disorder

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Riahi

2015-08-01

Full Text Available Background Attention deficit hyperactivity disorder (ADHD is often associated with other psychological problems. Objectives The present study aimed to study the prevalence of comorbid psychiatric disorders in children and adolescents with ADHD who admitted to Golestan Hospital in Ahvaz. Patients and Methods This was a descriptive/analytic cross-sectional study carried out on 118 outpatient children and adolescents who were selected by convenient sampling. The data were collected using the questionnaire, designed by authors, and were analyzed through descriptive statistics and chi-square test. Results The prevalence of comorbid disorders were as follows: anxiety disorders (48.3%; depression (20.33%; bipolar disorder (17.79%; obsessive-compulsive (47.45%; tic and tourette (35.59%, oppositional defiant disorder (43.22%; conduct disorder (11.01%; urinary incontinence (58.47%; communication disorder (9.32%; and learning disorder (21.18%. There was no significant difference between females and males with respect to the prevalence of comorbid disorders. Conclusions Similar to previous studies, we found some comorbid psychiatric disorders with ADHD. The treatment of the disorder can be improved, by more attention to comorbid psychiatric disorders, early diagnosis of them, and using distinct and specific treatment for everyone.

Prevalence, comorbidity and impact of irritable bowel syndrome in Norway.

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Vandvik, Per Olav; Lydersen, Stian; Farup, Per G

2006-06-01

To study the prevalence of irritable bowel syndrome (IBS) and its comorbidity in a Norwegian adult population. In 2001, 11,078 inhabitants (aged 30-75 years) in Oppland County were invited to take part in a public health survey. A total of 4622 subjects (42%) completed the questionnaires on symptoms of IBS (Rome II criteria), comorbidity, health-care visits and medications. The impact of comorbidity on global health, working disability and use of health-care resources in subjects with IBS was explored by stepwise logistic regression. The population prevalence of IBS was 388/4622 (8.4% (95% CI: 7.6-9.4%)) with a female predominance and an age-dependent decrease. The proportion who had consulted for IBS ranged from 51% among 30-year-olds to 79% in 75-year-olds (p=0.05). IBS was associated with musculoskeletal complaints (OR = 2.4-3.4 for six different items), fibromyalgia (OR = 3.6 [2.7-4.8]), mood disorder (OR = 3.3 (2.6-4.3)), reduced global health (OR = 2.6 (2.1-3.2)), working disability (OR = 1.6 (1.2-2.1)), more frequent health-care visits and use of medications (OR 1.7-2.3). When controlling for comorbidity, reduced global health (OR = 1.5 (1.1-2.0)) and use of alternative health care (OR = 1.7 (1.3-2.4)) remained associated with IBS. Severity of abdominal pain/discomfort was a predictor of having to seek a physician for IBS (OR = 1.3 (1.2-1.5)). Symptoms of IBS were reported by 8% of Norwegian adults and had resulted in consultations with physicians for the majority in the long run. Subjects with IBS in the community were characterized by frequent somatic and psychiatric comorbidity. Their observed reduced health, working disability and increased use of health resources were largely explained by comorbid symptoms and disorders.

A systematic review of the incidence and prevalence of comorbidity in multiple sclerosis

DEFF Research Database (Denmark)

Marrie, Ruth Ann; Cohen, Jeffrey; Stuve, Olaf

2015-01-01

BACKGROUND: Comorbidity is an area of increasing interest in multiple sclerosis (MS). OBJECTIVE: The objective of this review is to estimate the incidence and prevalence of comorbidity in people with MS and assess the quality of included studies. METHODS: We searched the PubMed, SCOPUS, EMBASE...

[Addictive internet use as a comorbid disorder among clients of an adolescent psychiatry - prevalence and psychopathological symptoms].

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Müller, Kai W; Ammerschläger, Marcella; Freisleder, Franz Joseph; Beutel, Manfred E; Wölfling, Klaus

2012-09-01

Excessive and addictive internet use fulfilling criteria of nonsubstance related addiction disorder is increasingly being discussed by scientists and clinicians alike. Its prevalence of about 3 % among minors points to a relatively frequent phenomenon that can lead to functional impairment and distress. However, there is still no evidence concerning its prevalence among underaged patients in psychiatric treatment. 81 patients between the age of 8 and 17 years were screened by a standardized instrument for internet addiction (AICA-S) to assess the prevalence of internet addiction among minors being treated in psychiatric inpatient settings. Their clinical symptoms were examined using Youth Self-Report and Child Behavior Checklist. 11.3 % of the patients fulfilled the criteria of addictive internet use. These patients were older and more often affected by anxiety and depression than patients without internet addiction. Data suggest that internet addiction is a relevant factor among minors in psychiatric institutions. Those with comorbid internet addiction show distinct patterns of psychopathology and may require disorder-specific treatment.

Prevalence and Polysomnographic Correlates of Insomnia Comorbid with Medical Disorders

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Budhiraja, Rohit; Roth, Thomas; Hudgel, David W.; Budhiraja, Pooja; Drake, Christopher L.

2011-01-01

Study Objectives: To determine the prevalence and polysomnographic correlates of insomnia in subjects with self-reported medical disorders. Design: Prospective cross-sectional study. Participants: Community-based sample of 3282 men and women aged 18 to 65 years old, with a subset who underwent polysomnography. Measurements: Self-reported measures of sleep habits and current health, and polysomnographic sleep variables. Results: The prevalence of insomnia was 21.4%. The adjusted odds of insomnia were 2.2 times as high in persons with any medical disorders as in those without medical disorders. Specifically, odds of insomnia were higher in people with heart disease (OR = 1.6 [95% CI: 1.2-23], P = 0.004), hypertension (1.5 [12-18], P insomnia increased with increasing number of medical disorders. However, polysomnographic sleep was not significantly different in persons with or without medical disorders for most disorders assessed. Conclusion: This large population-based study suggests that insomnia is highly prevalent in diverse chronic medical disorders. However, polysomnographic evidence of disturbed sleep is present in only a subset of comorbid insomnia populations. Citation: Budhiraja R; Roth T; Hudgel DW; Budhiraja P; Drake CL. Prevalence and polysomnographic correlates of insomnia comorbid with medical disorders. SLEEP 2011;34(7):859-867. PMID:21731135

Prevalence of CHD-related metabolic comorbidity of diabetes mellitus in Northern Chinese adults: the REACTION study.

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Gao, Nannan; Yuan, Zhongshang; Tang, Xulei; Zhou, Xiaoming; Zhao, Meng; Liu, Lu; Ji, Jiadong; Xue, Fuzhong; Ning, Guang; Zhao, Jiajun; Zhang, Haiqing; Gao, Ling

2016-03-01

To gain more precise understanding of the epidemiology of comorbidities with diabetes and to clarify the correlation with coronary heart disease (CHD) in Chinese population. Based on REACTION study, 18,696 participants aged over 40 years were included in the cross-sectional analysis. Prevalence and patterns of comorbid diseases were demonstrated, and their impact on CHD was also analyzed by logistic regression. Diabetes was more prevalent in patients with older age and lower education level, with relatively low awareness (36.3%), treatment (27.9%) and control (34.7%) rate. The proportion of diabetics with additional condition was 88.8%; 53.2% had more than two comorbidities. Compared with patients with comorbidities, diabetics only had the highest controlled HbA1c rate (37.9%). Dyslipidemia (71.97%) was the most common comorbidity, followed by hypertension (58.19%), and hypothyroidism (21.24%). A strong gradient existed between the number of comorbidities and CHD versus "diabetes only" group; the odds ratio was 1.38, 2.48 and 3.01 for diabetics with one, two and three additional diseases, respectively. Low glycemic control and high prevalence of diabetes comorbidities are common in China, which increases the risk of CHD. Full-scale and individualized guidelines for diabetics should be planned. Copyright © 2016 Elsevier Inc. All rights reserved.

Social phobia: diagnosis and epidemiology, neurobiology and pharmacology, comorbidity and treatment

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Brunello, Nicoletta; den Boer, Johan A.; Judd, Lewis L.; Kasper, Siegfried; Kelsey, Jeffrey E.; Lader, Malcolm; Lecrubier, Yves; Lepine, Jean-Pierre; Lydiard, R. B.; Mendlewicz, Julien; Montgomery, Stuart A.; Racagni, Giorgio; Stein, Murray B.; Wittchen, Hans-Ulrich

2013-01-01

Social phobia is a common disorder associated with significant psychosocial impairment, representing a substantial public health problem largely determined by the high prevalence, and the lifelong chronicity. Social phobia starts in early childhood or adolescence and is often comorbid with depression, other anxiety disorders, alcohol and substance abuse or eating disorders. This cascade of comorbidity, usually secondary to social phobia, increases the disability associated with the condition....

Does comorbid bipolar disorder increase neuropsychological impairment in children and adolescents with ADHD?

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Joana C. Narvaez

2014-03-01

Full Text Available Objective: To assess differences in executive functioning between children and adolescents with attention-deficit/hyperactivity disorder (ADHD comorbid or not with bipolar disorder (BD, and to study the neuropsychological profile of subjects with the comorbidity in a clinical sample from a developing country. Method: Case-control study comparing 23 participants with BD + ADHD and 85 ADHD-only subjects aged 6 to 17 years old. Both groups were drug-free. Executive function domains were assessed with the Stroop Test, the Wisconsin Card Sorting Test, and the Continuous Performance Test II. Results: The group with juvenile BD + ADHD showed a significantly worse performance on the Stroop task, including time in color (p = 0.002, time in color-word (p < 0.001, interference, number or errors in color and color-word (p = 0.001, and number of errors in word cards (p = 0.028. No between-group differences were found in other tests. Conclusions: Our findings suggest that ADHD-only and ADHD + BD do not show differences in inhibitory control and set-shifting domains. However, children and adolescents with BD and comorbid ADHD show greater impairment in processing speed and interference control. This suggests a potentially higher impairment in the dorsolateral prefrontal cortex and may be a potential neuropsychological signature of juvenile BD comorbid with ADHD.

Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases

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Gabriel, Sherine E; Michaud, Kaleb

2009-01-01

Epidemiology is the study of the distribution and determinants of disease in human populations. Over the past decade there has been considerable progress in our understanding of the fundamental descriptive epidemiology (levels of disease frequency: incidence and prevalence, comorbidity, mortality, trends over time, geographic distributions, and clinical characteristics) of the rheumatic diseases. This progress is reviewed for the following major rheumatic diseases: rheumatoid arthritis (RA), juvenile rheumatoid arthritis, psoriatic arthritis, osteoarthritis, systemic lupus erythematosus, giant cell arteritis, polymyalgia rheumatica, gout, Sjögren's syndrome, and ankylosing spondylitis. These findings demonstrate the dynamic nature of the incidence and prevalence of these conditions – a reflection of the impact of genetic and environmental factors. The past decade has also brought new insights regarding the comorbidity associated with rheumatic diseases. Strong evidence now shows that persons with RA are at a high risk for developing several comorbid disorders, that these conditions may have atypical features and thus may be difficult to diagnose, and that persons with RA experience poorer outcomes after comorbidity compared with the general population. Taken together, these findings underscore the complexity of the rheumatic diseases and highlight the key role of epidemiological research in understanding these intriguing conditions. PMID:19519924

Prevalence of Attention Deficit Hyperactivity Disorder among School Children and Associated Co-morbidities - A Hospital Based Descriptive Study.

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Rimal, H; Pokharel, A

Attention Deficit Hyperactivity Disorder is the most common neuro- developmental disorders of childhood characterized by the core symptoms including inattentiveness and distractibility and frequently involve impairments in executive functioning, increased impulsivity, and restlessness. Objective To find out the prevalence of Attention Deficit Hyperactivity Disorder among school aged children Presented to Pediatric clinic and also to investigate associated comorbidities. Method This study was conducted at Nobel Medical College Teaching Hospital, Biratnagar during April 2014 - March 2015. Attention Deficit Hyperactivity Disorder was diagnosed by the developmental Pediatrician after taking relevant history and the clinical assessment using Attention Deficit Hyperactivity Disorder rating scale with diagnostic criteria consistent with Diagnostic Statistical Manual - IV classification. Spence anxiety scale child and parent rated version and Strength and Difficulty Questionnaire were also used. Result Result showed the yearly prevalence of Attention Deficit Hyperactivity Disorder being 41(11.7%) with male: female ratio of 4:1. The study reported that Attention Deficit Hyperactivity Disorder combined type was the commonest type that was 26(63%) cases followed by Inattentive type 9(22%) cases and 6(15%) were hyperactive type. The mean age for Attention Deficit Hyperactivity Disorder was 7 years and 5 months. The most common co-morbidities were sleep problem 12(29.3%), Learning difficulty 10(24.4%), Anxiety disorder 10(24.4), Oppositional Defiant Disorder 9(22%), Autism Spectrum Disorder 5(12%), speech delay 6(14.6%), and 4(10%) had associated tics. There was abnormal SDQ prevalence of 29.3% across the area of emotional distress. The mean abnormal SDQ score in total difficulty area 8 (20.7%), socializing with peer 9(22%), behavioral difficulty 11(26.8%), hyperactivity/inattention 23(56.1%) and impact of difficulties in young person's life being 5(12.2%). Conclusion There is

Prevalence of Comorbidities and Risk Factors for Comorbidities in Patients with Spondyloarthritis in Latin America: A Comparative Study with the General Population and Data from the ASAS-COMOSPA Study

NARCIS (Netherlands)

Bautista-Molano, Wilson; Landewé, Robert; Burgos-Vargas, Rubén; Maldonado-Cocco, José; Moltó, Anna; van den Bosch, Filip; Valle-Oñate, Rafael; Dougados, Maxime; van der Heijde, Désirée

2018-01-01

Increased risk of comorbidities has been reported in spondyloarthritis (SpA). The objective of this study was to determine the prevalence and risk of developing comorbidities in patients with SpA in 3 Latin American (LA) countries, and to compare that prevalence with the general population. Data

Prevalence and comorbidity of tic disorder in Israeli adolescents: results from a national mental health survey.

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Steinberg, Tamar; Tamir, Inbal; Zimmerman-Brenner, Sharon; Friling, Michal; Apter, Alan

2013-02-01

Tic disorders are common causes of morbidity in Israel but their prevalence in this country needs further study. To assess the prevalence of mental disorders in Israeli youth including tic disorders, as part of the Israel Survey of Mental Health among Adolescents (ISMEHA). The ISMEHA was conducted in a representative sample of 957 adolescents aged 14-17 and their mothers during 2004-2005. We interviewed the adolescents and their mothers in their homes and collected demographic information about the use of services. We also administered a psychiatric interview, the Development and Well-Being Assessment inventory (DAWBA), which included a question on tic disorder. The prevalence of tic disorders was calculated based on the adolescents' and maternal reports. The relationships among demographic data, comorbidity rates, help-seeking behaviors and tic disorder are presented. The prevalence of tics was 1.3% according to maternal reports and 4.4% according to adolescents' reports. The prevalence correlated with externalizing disorders and learning disabilities. A higher prevalence of tics was found in the Arab population compared with Jewish adolescents. The prevalence of tic disorders in Israel, as measured by a direct question in this epidemiological study, and associated comorbidities concurs with previous reports. The complexities of prevalence estimations, comorbidities, demographic correlates, and help-seeking behaviors are discussed.

Social phobia : diagnosis and epidemiology, neurobiology and pharmacology, comorbidity and treatment

NARCIS (Netherlands)

Brunello, N; den Boer, JA; Judd, LL; Kasper, S; Kelsey, JE; Lader, M; Lecrubier, Y; Lepine, JP; Lydiard, RB; Mendlewicz, J; Montgomery, SA; Racagni, G; Stein, MB; Wittchen, HU

2000-01-01

Social phobia is a common disorder associated with significant psychosocial impairment, representing a substantial public health problem largely determined by the high prevalence, and the lifelong chronicity. Social phobia starts in early childhood or adolescence and is often comorbid with

Review of literature of attention-deficit/hyperactivity disorder with comorbid eating disorders

OpenAIRE

Nazar,Bruno Palazzo; Pinna,Camilla Moreira de Sousa; Coutinho,Gabriel; Segenreich,Daniel; Duchesne,Monica; Appolinario,José Carlos; Mattos,Paulo

2008-01-01

OBJECTIVE: According to studies of prevalence, up to 70% of adults with attention deficit/hyperactivity disorder have at least one psychiatric comorbidity, which leads to diagnostic and therapeutic difficulties as well as more severe functional impairment. There is a paucity of data on the comorbidity of attention deficit/hyperactivity disorder and eating disorders. The objective of this study was to review the literature regarding the attention deficit/hyperactivity disorder/eating disorders...

Prevalence and co-morbidity among anxiety disorders in a national cohort of psychiatrically referred children and adolescents

DEFF Research Database (Denmark)

Esbjørn, Barbara Hoff; Hoeyer, Mette; Dyrborg, Jørgen

2010-01-01

The paper provides prevalence estimates of anxiety disorders as well as homotypic (e.g., other anxiety disorders) and heterotypic (e.g., mood, externalizing) co-morbidity in a national sample of children and adolescents referred to the psychiatric system in Denmark. Data were gathered from a data...... as routine to increase the precision in recognizing and reporting on childhood anxiety disorders.......The paper provides prevalence estimates of anxiety disorders as well as homotypic (e.g., other anxiety disorders) and heterotypic (e.g., mood, externalizing) co-morbidity in a national sample of children and adolescents referred to the psychiatric system in Denmark. Data were gathered from...... a database containing 83% of all youth referred from 2004 to 2007 (N=13,241). A prevalence of 5.7% of anxiety disorder was found in the sample. Homotypic co-morbidity was found in only 2.8%, whereas heterotypic co-morbidity was found in 42.9% of the cohort. A total of 73.6% had a principal anxiety disorder...

The Prevalence of Ocular Allergy and Comorbidities in Chinese School Children in Shanghai

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Yanqing Feng

2017-01-01

Full Text Available Objective. To investigate the prevalence and features of ocular allergy (OA and comorbidities among school children in Shanghai, China. Methods. This was a population-based cross-sectional study. Each participant completed an ISAAC-based questionnaire. The prevalence of OA symptoms, allergic rhinitis (AR asthma, atopic dermatitis (AD, and sensitization to mites, pollen, and food was analyzed. Results. A total of 724 and 942 completed questionnaires from the 7–9-year-old (young group and the 12–14-year-old (teen group groups were analyzed, respectively. The overall prevalence of OA symptoms was 28%. However, more young students (10.6% reported mild to severe daily life interference caused by OA than the teens (5.7%. The young group had higher prevalence of diagnosed allergic conjunctivitis (10.2%. The overall prevalence of AR symptom, diagnosed asthma, and diagnosed AD was 40.4%, 11.6%, and 16.7%, respectively. Young children had higher prevalence of diagnosed AR and AD than the teens. There were gender associated differences in the prevalence of AR and asthma among young children, but not among the teens. The comorbidities associated with OA was also analyzed. Sensitization to mites, food, and pollen was associated with higher prevalence of allergic conditions. Conclusions. OA together with other allergic conditions affected a significant number of children in Shanghai.

The Prevalence of Comorbid Personality Disorders in Treatment-Seeking Problem Gamblers: A Systematic Review and Meta-Analysis.

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Dowling, Nicki A; Cowlishaw, S; Jackson, A C; Merkouris, S S; Francis, K L; Christensen, D R

2015-12-01

The aim of this study was to systematically review and meta-analyze the prevalence of comorbid personality disorders among treatment-seeking problem gamblers. Almost one half (47.9%) of problem gamblers displayed comorbid personality disorders. They were most likely to display Cluster B disorders (17.6%), with smaller proportions reporting Cluster C disorders (12.6%) and Cluster A disorders (6.1%). The most prevalent personality disorders were narcissistic (16.6%), antisocial (14.0%), avoidant (13.4%), obsessive-compulsive (13.4%), and borderline (13.1%) personality disorders. Sensitivity analyses suggested that these prevalence estimates were robust to the inclusion of clinical trials and self-selected samples. Although there was significant variability in reported rates, subgroup analyses revealed no significant differences in estimates of antisocial personality disorder according to problem gambling severity, measure of comorbidity employed, and study jurisdiction. The findings highlight the need for gambling treatment services to conduct routine screening and assessment of co-occurring personality disorders and to provide treatment approaches that adequately address these comorbid conditions.

What Can ADHD without Comorbidity Teach Us about Comorbidity?

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Takeda, Toshinobu; Ambrosini, Paul J.; deBerardinis, Rachel; Elia, Josephine

2012-01-01

Neuropsychiatric comorbidity in ADHD is frequent, impairing and poorly understood. In this report, characteristics of comorbid and comorbid-free ADHD subjects are investigated in an attempt to identify differences that could potentially advance our understanding of risk factors. In a clinically-referred ADHD cohort of 449 youths (ages 6-18), age,…

Prevalence and onset of comorbidities in the CDKL5 disorder differ from Rett syndrome.

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Mangatt, Meghana; Wong, Kingsley; Anderson, Barbara; Epstein, Amy; Hodgetts, Stuart; Leonard, Helen; Downs, Jenny

2016-04-14

Initially described as an early onset seizure variant of Rett syndrome, the CDKL5 disorder is now considered as an independent entity. However, little is currently known about the full spectrum of comorbidities that affect these patients and available literature is limited to small case series. This study aimed to use a large international sample to examine the prevalence in this disorder of comorbidities of epilepsy, gastrointestinal problems including feeding difficulties, sleep and respiratory problems and scoliosis and their relationships with age and genotype. Prevalence and onset were also compared with those occurring in Rett syndrome. Data for the CDKL5 disorder and Rett syndrome were sourced from the International CDKL5 Disorder Database (ICDD), InterRett and the Australian Rett syndrome Database (ARSD). Logistic regression (multivariate and univariate) was used to analyse the relationships between age group, mutation type and the prevalence of various comorbidities. Binary longitudinal data from the ARSD and the equivalent cross-sectional data from ICDD were examined using generalized linear models with generalized estimating equations. The Kaplan-Meier method was used to estimate the failure function for the two disorders and the log-rank test was used to compare the two functions. The likelihood of experiencing epilepsy, GI problems, respiratory problems, and scoliosis in the CDKL5 disorder increased with age and males were more vulnerable to respiratory and sleep problems than females. We did not identify any statistically significant relationships between mutation group and prevalence of comorbidities. Epilepsy, GI problems and sleep abnormalities were more common in the CDKL5 disorder than in Rett syndrome whilst scoliosis and respiratory problems were less prevalent. This study captured a much clearer picture of the CDKL5 disorder than previously possible using the largest sample available to date. There were differences in the presentation of

Prevalence of comorbidities according to predominant phenotype and severity of chronic obstructive pulmonary disease

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Camiciottoli G

2016-09-01

Full Text Available Gianna Camiciottoli,1,2 Francesca Bigazzi,1 Chiara Magni,1 Viola Bonti,1 Stefano Diciotti,3 Maurizio Bartolucci,4 Mario Mascalchi,5 Massimo Pistolesi1 1Section of Respiratory Medicine, Department of Clinical and Experimental Medicine, 2Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, 3Department of Electrical, Electronic, and Information Engineering “Guglielmo Marconi,” University of Bologna, Cesena, 4Department of Diagnostic Imaging, Careggi University Hospital, 5Radiodiagnostic Section, Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy Background: In addition to lung involvement, several other diseases and syndromes coexist in patients with chronic obstructive pulmonary disease (COPD. Our purpose was to investigate the prevalence of idiopathic arterial hypertension (IAH, ischemic heart disease, heart failure, peripheral vascular disease (PVD, diabetes, osteoporosis, and anxious depressive syndrome in a clinical setting of COPD outpatients whose phenotypes (predominant airway disease and predominant emphysema and severity (mild and severe diseases were determined by clinical and functional parameters. Methods: A total of 412 outpatients with COPD were assigned either a predominant airway disease or a predominant emphysema phenotype of mild or severe degree according to predictive models based on pulmonary functions (forced expiratory volume in 1 second/vital capacity; total lung capacity %; functional residual capacity %; and diffusing capacity of lung for carbon monoxide % and sputum characteristics. Comorbidities were assessed by objective medical records. Results: Eighty-four percent of patients suffered from at least one comorbidity and 75% from at least one cardiovascular comorbidity, with IAH and PVD being the most prevalent ones (62% and 28%, respectively. IAH prevailed significantly in predominant airway disease, osteoporosis prevailed

Prevalence of comorbidities in the Middle East respiratory syndrome coronavirus (MERS-CoV: a systematic review and meta-analysis

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Alaa Badawi

2016-08-01

Full Text Available The Middle East respiratory syndrome coronavirus (MERS-CoV is associated with life-threatening severe illnesses and a mortality rate of approximately 35%, particularly in patients with underlying comorbidities. A systematic analysis of 637 MERS-CoV cases suggests that diabetes and hypertension are equally prevalent in approximately 50% of the patients. Cardiac diseases are present in 30% and obesity in 16% of the cases. These conditions down-regulate the synthesis of proinflammatory cytokines and impair the host's innate and humoral immune systems. In conclusion, protection against MERS-CoV and other respiratory infections can be improved if public health vaccination strategies are tailored to target persons with chronic disorders.

Prevalence and causes of hearing impairment in Africa.

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Mulwafu, W; Kuper, H; Ensink, R J H

2016-02-01

To systematically assess the data on the prevalence and causes of hearing impairment in Africa. Systematic review on the prevalence and causes of hearing loss in Africa. We undertook a literature search of seven electronic databases (EMBASE, PubMed, Medline, Global Health, Web of Knowledge, Academic Search Complete and Africa Wide Information) and manually searched bibliographies of included articles. The search was restricted to population-based studies on hearing impairment in Africa. Data were extracted using a standard protocol. We identified 232 articles and included 28 articles in the final analysis. The most common cut-offs used for hearing impairment were 25 and 30 dB HL, but this ranged between 15 and 40 dB HL. For a cut-off of 25 dB, the median was 7.7% for the children- or school-based studies and 17% for population-based studies. For a cut-off of 30 dB HL, the median was 6.6% for the children or school-based studies and 31% for population-based studies. In schools for the deaf, the most common cause of hearing impairment was cryptogenic deafness (50%) followed by infectious causes (43%). In mainstream schools and general population, the most common cause of hearing impairment was middle ear disease (36%), followed by undetermined causes (35%) and cerumen impaction (24%). There are very few population-based studies available to estimate the prevalence of hearing impairment in Africa. Those studies that are available use different cut-offs, making comparison difficult. However, the evidence suggests that the prevalence of hearing impairment is high and that much of it is avoidable or treatable. © 2015 John Wiley & Sons Ltd.

The Decreasing Prevalence of Nonrefractive Visual Impairment in Older Europeans

DEFF Research Database (Denmark)

Delcourt, Cécile; Le Goff, Mélanie; von Hanno, Therese

2018-01-01

TOPIC: To estimate the prevalence of nonrefractive visual impairment and blindness in European persons 55 years of age and older. CLINICAL RELEVANCE: Few visual impairment and blindness prevalence estimates are available for the European population. In addition, many of the data collected...... in European population-based studies currently are unpublished and have not been included in previous estimates. METHODS: Fourteen European population-based studies participating in the European Eye Epidemiology Consortium (n = 70 723) were included. Each study provided nonrefractive visual impairment...... and blindness prevalence estimates stratified by age (10-year strata) and gender. Nonrefractive visual impairment and blindness were defined as best-corrected visual acuity worse than 20/60 and 20/400 in the better eye, respectively. Using random effects meta-analysis, prevalence rates were estimated according...

An epidemiological study of prevalence and comorbidity of obsessive compulsive disorder symptoms (SOCD) and stress in Pakistani Adults.

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Ashraf, Farzana; Malik, Sadia; Arif, Amna

2017-01-01

To investigate the prevalence and comorbidity of subclinical obsessive compulsive disorder (SOCD) symptoms and stress across gender, marital and employment statuses. A cross-sectional research was conducted from December, 2016 to March 2017 at two universities of cosmopolitan city Lahore. Two self-report scales measuring SOCD symptoms and stress were used to collect data from 377 adults selected through simple random sampling technique, proportionately distributed across gender, marital and employment status. From the total sample, 52% reported low level of stress and 48% faced high level of stress. Significant differences in prevalence were observed across marital and employment statuses whereas for men and women, it was observed same (24%). Comorbidity of high level of SOCD symptoms and high level of stress was seen 34%. Significant prevalence and comorbidity exists between SOCD symptoms and stress and more studies addressing diverse population are needed.

Comorbid Diagnosis of Psychotic Disorders in Borderline Personality Disorder: Prevalence and Influence on Outcome

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C. W. Slotema

2018-03-01

Full Text Available BackgroundA diagnosis of psychotic disorder is traditionally considered incompatible with borderline personality disorder (BPD, even though patients sometimes fulfill the diagnostic criteria for both disorders. How often this happens is barely known, as is the influence of comorbid psychotic disorders on the outcome of BPD. Since studies on isolated auditory verbal hallucinations in patients with BPD indicate that these perceptual symptoms have severe consequences and are associated with suicidal behavior and hospitalization, patients with comorbid psychotic disorders are unlikely to fare better.ObjectiveTo examine the point prevalence of psychotic disorders in patients with BPD, their association with the outcome of BPD, and their predictive value for outcome.MethodsIn a cross-sectional design, 84 female outpatients diagnosed with BPD were interviewed with the aid of the MINI-International Neuropsychiatric Interview to establish the point prevalence of comorbid psychotic and other comorbid disorders. After termination of their treatment at a specialized outpatient clinic, the type of referral was considered to be a “good” outcome when they were referred to their general practitioner or to basic psychiatric care for noncomplex patients, and a “poor” outcome when referred to a specialized psychiatric department or to a psychiatric district team for patients with severe psychiatric disorders.ResultsPsychotic disorders were present in 38% of the patients with BPD. With a prevalence of 20%, psychotic disorder not otherwise specified (NOS was the most common subtype; the least common types were schizophrenia (2%, substance-induced psychotic disorder (2%, and brief psychotic disorder (1%. Among six types of comorbid disorders, only psychotic disorders were associated with a poor outcome; they were also predictors for a poor outcome, along with comorbid mood disorders, eating disorders, and somatoform disorders, as well as the severity of BPD

Chinese Registry of rheumatoid arthritis (CREDIT): II. prevalence and risk factors of major comorbidities in Chinese patients with rheumatoid arthritis.

Science.gov (United States)

Jin, Shangyi; Li, Mengtao; Fang, Yongfei; Li, Qin; Liu, Ju; Duan, Xinwang; Liu, Yi; Wu, Rui; Shi, Xiaofei; Wang, Yongfu; Jiang, Zhenyu; Wang, Yanhong; Yu, Chen; Wang, Qian; Tian, Xinping; Zhao, Yan; Zeng, Xiaofeng

2017-11-15

Rheumatoid arthritis patients are at higher risk of developing comorbidities. The main objective of this study was to evaluate the prevalence of major comorbidities in Chinese rheumatoid arthritis patients. We also aimed to identify factors associated with these comorbidities. Baseline demographic, clinical characteristics and comorbidity data from RA patients enrolled in the Chinese Registry of rhEumatoiD arthrITis (CREDIT) from Nov 2016 to August 2017 were presented and compared with those from five other registries across the world. Possible factors related to three major comorbidities (cardiovascular disease, fragility fracture and malignancy) were identified using multivariate logistic regression analyses. A total of 13,210 RA patients were included (80.6% female, mean age 52.9 years and median RA duration 4.0 years). Baseline prevalence rates of major comorbidities were calculated: CVD, 2.2% (95% CI 2.0-2.5%); fragility fracture, 1.7% (95% CI 1.5-1.9%); malignancy, 0.6% (95% CI 0.5-0.7%); overall major comorbidities, 4.2% (95% CI 3.9-4.6%). Advanced age was associated with all comorbidities. Male gender and disease duration were positively related to CVD. Female sex and longer disease duration were potential risk factors for fragility fractures. Ever use of methotrexate (MTX) was negatively related to baseline comorbidities. Patients with rheumatoid arthritis in China have similar prevalence of comorbidities with other Asian countries. Advanced age and long disease duration are possible risk factors for comorbidities. On the contrary, MTX may protect RA patients from several major comorbidities, supporting its central role in the management of rheumatoid arthritis.

Prevalence, Comorbidity and Course of Trauma Reactions in Young Burn-Injured Children

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De Young, Alexandra C.; Kenardy, Justin A.; Cobham, Vanessa E.; Kimble, Roy

2012-01-01

Background: Infants, toddlers and preschoolers are the highest risk group for burn injury. However, to date this population has been largely neglected. This study examined the prevalence, onset, comorbidity and recovery patterns of posttrauma reactions in young children with burns. Methods: Parents of 130 unintentionally burned children (1-6…

Prevalence of Comorbidities, Overweight and Obesity in an International Sample of People with Multiple Sclerosis and Associations with Modifiable Lifestyle Factors.

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Claudia Helena Marck

Full Text Available Multiple sclerosis (MS is a chronic neurological disorder, often affecting young people. Comorbid disorders such as depression, anxiety and hypertension are common and can affect disease course, treatment, and quality of life (QOL of people with MS (PwMS. The associations between comorbidities, body mass index (BMI and health outcomes are not well studied in MS, although research shows most PwMS are overweight. Most data on the prevalence of comorbidities and obesity in PwMS comes from North American populations. This study describes the prevalence of comorbidities, overweight and obesity and associations with modifiable factors in an international sample of PwMS recruited online through social media, MS societies and websites. The online survey consisted of validated and researcher-devised instruments to assess self-reported health outcomes and lifestyle behaviors. Of the 2399 respondents, 22.5% were overweight, 19.4% were obese and 67.2% reported at least one comorbidity, with back pain (36.2%, depression (31.7%, anxiety (29.1% and arthritis (13.7% most prevalent and most limiting in daily activities. Obesity and most comorbid disorders were significantly more prevalent in North America. Obese participants were more likely to have comorbidities, especially diabetes (OR 4.8 and high blood pressure (OR 4.5 but also depression (OR 2.2. Being overweight, obese, or a former, or current smoker was associated with an increase in the number of comorbidities; while healthy diet, physical activity (borderline significant and moderate alcohol consumption were associated with decreased number of comorbidities. Increasing number of comorbidities was related to worse QOL, increased odds of disability and prior relapse. Obese PwMS had higher odds of disability and lower QOL. The associations between BMI, comorbidities and health outcomes are likely to be bi-directional and associated with lifestyle behaviors. Preventing and treating comorbid disorders and

Prevalence of Comorbidities, Overweight and Obesity in an International Sample of People with Multiple Sclerosis and Associations with Modifiable Lifestyle Factors.

Science.gov (United States)

Marck, Claudia Helena; Neate, Sandra Leanne; Taylor, Keryn Louise; Weiland, Tracey Joy; Jelinek, George Alexander

2016-01-01

Multiple sclerosis (MS) is a chronic neurological disorder, often affecting young people. Comorbid disorders such as depression, anxiety and hypertension are common and can affect disease course, treatment, and quality of life (QOL) of people with MS (PwMS). The associations between comorbidities, body mass index (BMI) and health outcomes are not well studied in MS, although research shows most PwMS are overweight. Most data on the prevalence of comorbidities and obesity in PwMS comes from North American populations. This study describes the prevalence of comorbidities, overweight and obesity and associations with modifiable factors in an international sample of PwMS recruited online through social media, MS societies and websites. The online survey consisted of validated and researcher-devised instruments to assess self-reported health outcomes and lifestyle behaviors. Of the 2399 respondents, 22.5% were overweight, 19.4% were obese and 67.2% reported at least one comorbidity, with back pain (36.2%), depression (31.7%), anxiety (29.1%) and arthritis (13.7%) most prevalent and most limiting in daily activities. Obesity and most comorbid disorders were significantly more prevalent in North America. Obese participants were more likely to have comorbidities, especially diabetes (OR 4.8) and high blood pressure (OR 4.5) but also depression (OR 2.2). Being overweight, obese, or a former, or current smoker was associated with an increase in the number of comorbidities; while healthy diet, physical activity (borderline significant) and moderate alcohol consumption were associated with decreased number of comorbidities. Increasing number of comorbidities was related to worse QOL, increased odds of disability and prior relapse. Obese PwMS had higher odds of disability and lower QOL. The associations between BMI, comorbidities and health outcomes are likely to be bi-directional and associated with lifestyle behaviors. Preventing and treating comorbid disorders and obesity in

Prevalence of Comorbidity in Patients With Young-Onset Alzheimer Disease Compared With Late-Onset: A Comparative Cohort Study.

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Gerritsen, Adrie A J; Bakker, Christian; Verhey, Frans R J; de Vugt, Marjolein E; Melis, René J F; Koopmans, Raymond T C M

2016-04-01

With the lack of a cure for Alzheimer disease (AD), the identification of comorbidity is important to reduce the possibility of excess disability. Although comorbidity in patients with late-onset AD (LO-AD) is common, for people with young-onset AD (YO-AD), it is unclear how often comorbidity occurs. Furthermore, it is uncertain whether comorbidity in patients with YO-AD differs from that in patients with LO-AD. The aim of this study was to explore the prevalence, types of morbidity, and morbidity profiles in patients with YO-AD compared with those of patients with LO-AD. Explorative cohort study from 2 separate Dutch cohorts (Needs in Young-onset Dementia [NeedYD] and the Clinical Course of Cognition and Comorbidity-Dementia Study [4C-Dementia study]). Participants were recruited in 2007 and 2008 from (1) the memory clinics of 3 Dutch Alzheimer centers, (2) the memory clinics of general hospitals, (3) mental health services in the southern part of the Netherlands, and (4) young-onset dementia specialized day care facilities. A comparison group of community-dwelling, elderly patients with AD was selected from the 4C-Dementia study. Patients in this study were recruited in 2010 and 2011 from the aforementioned Alzheimer centers. The prevalence rates of comorbidity were compared between 177 patients with YO-AD and 155 patients with LO-AD. Comorbidity was classified using the International Classification of Diseases, 10th Revision (ICD-10). The total amount of comorbidity was established by counting the number of existing diseases (ICD categories or chapters) and comorbidity was also dichotomized as present or absent. Furthermore, a hierarchical cluster analysis was performed to study clusters of comorbidity. Compared with LO-AD, patients with YO-AD showed less (P < .001) overall comorbidity (58.2% vs 86.5%) and had lower prevalence rates of diabetes, obesity, and circulatory diseases; however, the prevalence rates of diseases of the nervous system in YO-AD (6

The prevalence, age distribution and comorbidity of personality disorders in Australian women.

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Quirk, Shae E; Berk, Michael; Pasco, Julie A; Brennan-Olsen, Sharon L; Chanen, Andrew M; Koivumaa-Honkanen, Heli; Burke, Lisa M; Jackson, Henry J; Hulbert, Carol; A Olsson, Craig; Moran, Paul; Stuart, Amanda L; Williams, Lana J

2017-02-01

We aimed to describe the prevalence and age distribution of personality disorders and their comorbidity with other psychiatric disorders in an age-stratified sample of Australian women aged ⩾25 years. Individual personality disorders (paranoid, schizoid, schizotypal, histrionic, narcissistic, borderline, antisocial, avoidant, dependent, obsessive-compulsive), lifetime mood, anxiety, eating and substance misuse disorders were diagnosed utilising validated semi-structured clinical interviews (Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Non-patient Edition and Structured Clinical Interview for DSM-IV Axis II Personality Disorders). The prevalence of personality disorders and Clusters were determined from the study population ( n = 768), and standardised to the Australian population using the 2011 Australian Bureau of Statistics census data. Prevalence by age and the association with mood, anxiety, eating and substance misuse disorders was also examined. The overall prevalence of personality disorders in women was 21.8% (95% confidence interval [CI]: 18.7, 24.9). Cluster C personality disorders (17.5%, 95% CI: 16.0, 18.9) were more common than Cluster A (5.3%, 95% CI: 3.5, 7.0) and Cluster B personality disorders (3.2%, 95% CI: 1.8, 4.6). Of the individual personality disorders, obsessive-compulsive (10.3%, 95% CI: 8.0, 12.6), avoidant (9.3%, 95% CI: 7.1, 11.5), paranoid (3.9%, 95% CI: 3.1, 4.7) and borderline (2.7%, 95% CI: 1.4, 4.0) were among the most prevalent. The prevalence of other personality disorders was low (⩽1.7%). Being younger (25-34 years) was predictive of having any personality disorder (odds ratio: 2.36, 95% CI: 1.18, 4.74), as was being middle-aged (odds ratio: 2.41, 95% CI: 1.23, 4.72). Among the strongest predictors of having any personality disorder was having a lifetime history of psychiatric disorders (odds ratio: 4.29, 95% CI: 2.90, 6.33). Mood and anxiety disorders were the most common comorbid

Prevalence of comorbidities in the Middle East respiratory syndrome coronavirus (MERS-CoV): a systematic review and meta-analysis.

Science.gov (United States)

Badawi, Alaa; Ryoo, Seung Gwan

2016-08-01

The Middle East respiratory syndrome coronavirus (MERS-CoV) is associated with life-threatening severe illnesses and a mortality rate of approximately 35%, particularly in patients with underlying comorbidities. A systematic analysis of 637 MERS-CoV cases suggests that diabetes and hypertension are equally prevalent in approximately 50% of the patients. Cardiac diseases are present in 30% and obesity in 16% of the cases. These conditions down-regulate the synthesis of proinflammatory cytokines and impair the host's innate and humoral immune systems. In conclusion, protection against MERS-CoV and other respiratory infections can be improved if public health vaccination strategies are tailored to target persons with chronic disorders. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Prevalence of cognitive impairment in major depression and bipolar disorder.

Science.gov (United States)

Douglas, Katie M; Gallagher, Peter; Robinson, Lucy J; Carter, Janet D; McIntosh, Virginia Vw; Frampton, Christopher Ma; Watson, Stuart; Young, Allan H; Ferrier, I Nicol; Porter, Richard J

2018-05-01

The current study examines prevalence of cognitive impairment in four mood disorder samples, using four definitions of impairment. The impact of premorbid IQ on prevalence was examined, and the influence of treatment response. Samples were: (i) 58 inpatients in a current severe depressive episode (unipolar or bipolar), (ii) 69 unmedicated outpatients in a mild to moderate depressive episode (unipolar or bipolar), (iii) 56 outpatients with bipolar disorder, in a depressive episode, and (iv) 63 outpatients with bipolar disorder, currently euthymic. Cognitive assessment was conducted after treatment in Studies 1 (6 weeks of antidepressant treatment commenced on admission) and 2 (16-week course of cognitive behaviour therapy or schema therapy), allowing the impact of treatment response to be assessed. All mood disorder samples were compared with healthy control groups. The prevalence of cognitive impairment was highest for the inpatient depression sample (Study 1), and lowest for the outpatient depression sample (Study 2). Substantial variability in rates was observed depending on the definition of impairment used. Correcting cognitive performance for premorbid IQ had a significant impact on the prevalence of cognitive impairment in the inpatient depression sample. There was minimal evidence that treatment response impacted on prevalence of cognitive impairment, except in the domain of psychomotor speed in inpatients. As interventions aiming to improve cognitive outcomes in mood disorders receive increasing research focus, the issue of setting a cut-off level of cognitive impairment for screening purposes becomes a priority. This analysis demonstrates important differences in samples likely to be recruited depending on the definition of cognitive impairment and begins to examine the importance of premorbid IQ in determining who is impaired. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Sleep problems and daily functioning in children with ADHD: An investigation of the role of impairment, ADHD presentations, and psychiatric comorbidity

DEFF Research Database (Denmark)

Virring, Anne; Lambek, Rikke; Jennum, Poul Jørgen

2017-01-01

, the Weiss Functional Impairment Rating Scale, and the ADHD Rating Scale. RESULTS: We found a moderate, positive correlation between sleep problems and impaired functioning in both children with ADHD and in typically developed children. ADHD presentations did not differ significantly with respect to sleep......OBJECTIVE: Little systematic information is available regarding how sleep problems influence daytime functioning in children with ADHD, as the role of ADHD presentations and comorbidity is unclear. METHOD: In total, 397 children were assessed with the Children's Sleep Habits Questionnaire...... problem profile, but having a comorbid internalizing or autistic disorder lead to higher sleep problem score. CONCLUSION: Sleep problems and impaired daily functioning were more common in children with ADHD, but the overall association between sleep problems and impaired daily functioning was similar...

Impaired health-related quality of life in Addison's disease--impact of replacement therapy, comorbidities and socio-economic factors.

Science.gov (United States)

Kluger, Nicolas; Matikainen, Niina; Sintonen, Harri; Ranki, Annamari; Roine, Risto P; Schalin-Jäntti, Camilla

2014-10-01

Patients with Addison's disease (AD) on conventional replacement therapy have impaired health-related quality of life (HRQoL). It is possible that lower hydrocortisone (HC) doses recommended by current guidelines could restore HRQoL. We compared HRQoL in AD patients treated according to current HC recommendations to that of the age- and gender-standardized general population. We assessed HRQoL in a cross-sectional setting with the 15D instrument in a Finnish AD cohort (n = 107) and compared the results with those of a large sample of general population (n = 5671). We examined possible predictors of HRQoL in AD. Within the patient group, HRQoL was also assessed by SF-36. Mean HC dose was 22 mg/d, corresponding to 12 ± 4 mg/m2. HRQoL was impaired in AD compared with the general population (15D score; 0·853 vs 0·918, P < 0·001). Within single 15D dimensions, discomfort and symptoms, vitality and sexual activity were most affected. Stepwise regression analysis demonstrated that Patient's Association membership (P = 0·02), female gender (P < 0·01), presence of other autoimmune or inflammatory comorbidity (P < 0·02), lower education (P < 0·02) and longer disease duration (P < 0·05) independently predicted impaired HRQoL, whereas replacement regimens, autoimmune-related comorbidities, total number of comorbidities or level of healthcare follow-up did not. In AD, HRQoL was impaired also as assessed by SF-36. HRQoL is significantly impaired in AD compared with the general population despite use of recommended HC doses. Patient's Association membership was the most significant predictor of impaired HRQoL. This finding should be explored in more detail in the future. © 2014 John Wiley & Sons Ltd.

Cognitive-behavioral screening reveals prevalent impairment in a large multicenter ALS cohort.

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Murphy, Jennifer; Factor-Litvak, Pam; Goetz, Raymond; Lomen-Hoerth, Catherine; Nagy, Peter L; Hupf, Jonathan; Singleton, Jessica; Woolley, Susan; Andrews, Howard; Heitzman, Daragh; Bedlack, Richard S; Katz, Jonathan S; Barohn, Richard J; Sorenson, Eric J; Oskarsson, Björn; Fernandes Filho, J Americo M; Kasarskis, Edward J; Mozaffar, Tahseen; Rollins, Yvonne D; Nations, Sharon P; Swenson, Andrea J; Koczon-Jaremko, Boguslawa A; Mitsumoto, Hiroshi

2016-03-01

To characterize the prevalence of cognitive and behavioral symptoms using a cognitive/behavioral screening battery in a large prospective multicenter study of amyotrophic lateral sclerosis (ALS). Two hundred seventy-four patients with ALS completed 2 validated cognitive screening tests and 2 validated behavioral interviews with accompanying caregivers. We examined the associations between cognitive and behavioral performance, demographic and clinical data, and C9orf72 mutation data. Based on the ALS Cognitive Behavioral Screen cognitive score, 6.5% of the sample scored below the cutoff score for frontotemporal lobar dementia, 54.2% scored in a range consistent with ALS with mild cognitive impairment, and 39.2% scored in the normal range. The ALS Cognitive Behavioral Screen behavioral subscale identified 16.5% of the sample scoring below the dementia cutoff score, with an additional 14.1% scoring in the ALS behavioral impairment range, and 69.4% scoring in the normal range. This investigation revealed high levels of cognitive and behavioral impairment in patients with ALS within 18 months of symptom onset, comparable to prior investigations. This investigation illustrates the successful use and scientific value of adding a cognitive-behavioral screening tool in studies of motor neuron diseases, to provide neurologists with an efficient method to measure these common deficits and to understand how they relate to key clinical variables, when extensive neuropsychological examinations are unavailable. These tools, developed specifically for patients with motor impairment, may be particularly useful in patient populations with multiple sclerosis and Parkinson disease, who are known to have comorbid cognitive decline. © 2016 American Academy of Neurology.

Prevalence of Cognitive Impairment Among Peritoneal Dialysis Patients, Impact on Peritonitis and Role of Assisted Dialysis.

Science.gov (United States)

Shea, Yat Fung; Lam, Man Fai; Lee, Mi Suen Connie; Mok, Ming Yee Maggie; Lui, Sing-Leung; Yip, Terence P S; Lo, Wai Kei; Chu, Leung Wing; Chan, Tak-Mao

2016-01-01

♦ Chronic renal failure and aging are suggested as risk factors for cognitive impairment (CI). We studied the prevalence of CI among peritoneal dialysis (PD) patients using Montreal Cognitive Assessment (MoCA), its impact on PD-related peritonitis in the first year, and the potential role of assisted PD. ♦ One hundred fourteen patients were newly started on PD between February 2011 and July 2013. Montreal Cognitive Assessment was performed in the absence of acute illness. Data on patient characteristics including demographics, comorbidities, blood parameters, dialysis adequacy, presence of helpers, medications, and the number PD-related infections were collected. ♦ The age of studied patients was 59±15.0 years, and 47% were female. The prevalence of CI was 28.9%. Patients older than 65 years old (odds ratio [OR] 4.88, confidence interval [CI] 1.79 - 13.28 p = 0.002) and with an education of primary level or below (OR 4.08, CI 1.30 - 12.81, p = 0.016) were independent risk factors for CI in multivariate analysis. Patients with PD-related peritonitis were significantly older (p peritonitis among self-care PD patients (OR 2.20, CI 0.65 - 7.44, p = 0.20). When we compared patients with MoCA-defined CI receiving self-care and assisted PD, there were no statistically significant differences between the 2 groups in terms of age, MoCA scores, or comorbidities. There were also no statistically significant differences in 1-year outcome of PD-related peritonitis rates or exit-site infections. ♦ Cognitive impairment is common among local PD patients. Even with CI, peritonitis rate in self-care PD with adequate training is similar to CI patients on assisted PD. Copyright © 2016 International Society for Peritoneal Dialysis.

High prevalence of seasonal affective disorder among persons with severe visual impairment

DEFF Research Database (Denmark)

Madsen, Helle Østergaard; Dam, Henrik; Hageman, Ida

2016-01-01

BACKGROUND: Light severely affects the occurrence of seasonal affective disorder (SAD). AIMS: To compare the prevalence of SAD in persons with severe visual impairment and persons with full sight, and in persons with severe visual impairment with or without light perception. METHOD: This cross......-sectional study assessed the Global Seasonality Score (GSS) and the prevalence of SAD among 2781 persons with visual impairment and 4099 persons with full sight using the Seasonal Pattern Assessment Questionnaire (SPAQ). RESULTS: Respondents with visual impairment had significantly higher GSS and prevalence...... of SAD compared with full sight controls, Pvisual impairment and SPAQ-defined SAD parameters...

Prevalence and comorbidity of major depressive disorder in young black and white women

NARCIS (Netherlands)

Franko, DL; Thompson, D; Barton, BA; Dohm, FA; Kraemer, HC; Iachan, R; Crawford, PB; Schreiber, GB; Daniels, [No Value; Striegel-Moore, RH

Objective This study reports the prevalence and comorbidity of depression in two large samples of black and white young adult women. Method Clinical interviews of participants in a follow-up study of the National Heart, Lung, and Blood Institute Growth and Health Study (NGHS-Wave II; N = 378) were

Prevalence of overweight and obesity and their cardiometabolic comorbidities in Hispanic adults living in Puerto Rico.

Science.gov (United States)

Pérez, Cynthia M; Sánchez, Hesmy; Ortiz, Ana P

2013-12-01

This study characterized the prevalence of overweight and obesity and assessed their cardiometabolic comorbidities in the population aged 21-79 years living in the San Juan metropolitan area of Puerto Rico. We analyzed data from a household survey conducted in Puerto Rico between 2005 and 2007 that used a representative sample of 840 non-institutionalized adults living in the San Juan metropolitan area. Body mass index categories were classified as normal weight, overweight and obese. Poisson regression model with robust variance was used to estimate the prevalence ratio to assess the association of each cardiometabolic comorbidity (hypertension, dyslipidemia, diabetes, prediabetes, systemic inflammation, prothrombotic state, and coronary heart disease) with overweight and obesity. Age-standardized prevalence of overweight and obesity was 35.9 and 41.5%, respectively, figures higher than the combined prevalence for the U.S. adult population (68.8%) but similar to all mainland Hispanics (78.8%). Men were more likely to be overweight than women (40.4 vs. 33.4%), whereas more women than men were obese (43.7 vs. 37.6%). Prevalence of all cardiometabolic comorbidities was significantly (p < 0.05) higher among overweight and obese adults than those of normal weight after adjusting for age, sex, years of education, smoking status, alcohol consumption and physical activity. A considerable proportion of adults in this population are overweight or obese. In view of the wide-ranging effects that overweight and obesity have on health, preventive actions to avert the rise of excess body weight as well as the design of lifestyle interventions are largely needed in this population.

Prevalence of co-morbidity and its relationship to treatment among unselected patients with Hodgkin's disease and non-Hodgkin's lymphoma, 1993-1996

NARCIS (Netherlands)

van Spronsen, DJ; Janssen-Heijnen, MLG; Breed, WPM; Coebergh, JWW

A population-based series of patients with cancer is likely to comprise more patients with serious co-morbidity than clinical trials because of restrictive eligibility criteria for the latter. Since co-morbidity may influence decision-making, we studied the age-specific prevalence of co-morbidity

Motor impairment in children with Neurofibromatosis type 1: Effect of the comorbidity with language disorders.

Science.gov (United States)

Iannuzzi, Stéphanie; Albaret, Jean-Michel; Chignac, Céline; Faure-Marie, Nathalie; Barry, Isabelle; Karsenty, Caroline; Chaix, Yves

2016-02-01

There is a body of evidence demonstrating comorbidity of motor and cognitive deficit in «idiopathic» developmental disorders. These associations are also found in developmental disorders secondary to monogenic disorders as in Neurofibromatosis type 1 for which the principal complication during childhood is learning disabilities. The comparison of motor impairment between developmental disorders either idiopathic or secondary as in NF1 could help us to better understand the cause of the combined language/motor deficit in these populations. The aim of this current study was to investigate motor impairment in children with NF1 for which oral language had been specified and then to compare the motors skills of the NF1 group to motor performance of children with Specific Language Disorder (SLD). Two groups of 49 children between 5 and 12years old were included and compared, the NF1 group and the SLD (Specific Language Disorder) group. Each child completed evaluation involving cognitive, language and motor assessment. In NF1 group, motor impairment was more frequent and more severe and concerned specifically balance rather than manual dexterity or ball skills, compared to a group of children with SLD. This motor impairment was independent of language status in the NF1 group. These results as well as other studies on the same topic could suggest that in NF1 children, fine motor skills impairment would be dependent on the existence of comorbidity with language disorders. Also, that gross motor skills impairment, and more precisely the balance deficit would be characteristic of NF1. This issue encourages studies of procedural learning that can involve the fronto-striatal or the fronto-cerebellar loops according to the type of motor tasks and the stage of learning. Copyright © 2015 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

[ADH/D and impulsiveness: Prevalence of impulse control disorders and other comorbidities, in 81 adults with attention deficit/hyperactivity disorder (ADH/D)].

Science.gov (United States)

Porteret, R; Bouchez, J; Baylé, F J; Varescon, I

2016-04-01

Attention deficit hyperactivity disorder (ADH/D) is a neuropsychological developmental disorder characterized by pervasive and impairing symptoms of inattention, hyperactivity, and impulsivity. Whereas it is well known in children, there is still little information about ADH/D in adults, including prevalence. Indeed, there are actually no epidemiological studies in France, despite the considerable impact of this disorder in a patient's professional and affective life. Moreover, ADH/D rarely stays isolated, and many comorbidities often complicate the diagnostic investigation. It is well known that the so-called ADH/D is composed of two main categories of symptoms (Attentional Disorder/Hyperactiviy Disorder), but Impulsiveness also remains a major symptom. The aim of this study was to evaluate not only the prevalence of Impulse Control Disorders (ICD) but also psychological and addictive comorbidities among adult patients with ADH/D. A total of 100 patients from specialized consultations of adult ADH/D were evaluated in this study, but only 81 were included after presenting all the clinical criteria of ADH/D. We used the DSM IV-T-R for ADH/D, the Minnesota Impulsive Disorders Interview a semi-structured clinical interview assessing impulse control disorders (ICD) (compulsive buying, trichotillomania, compulsive sexual behaviour, kleptomania, pyromania and intermittent explosive disorder), and the Mini International Neuropsychiatric Interview in order to evaluate psychiatric and addictive comorbidities. More than 90 % of the patients met the early apparition criteria of ADH/D (before 7years). More than half of the patients presented a mixed type of ADH/D (both inattentive and hyperactive-impulsive forms): 55.6 % vs 44.4 % for the inattentive type. The vast majority of patients showed a complete form (with a total of 6 or more symptoms out of 9, of inattentive and/or impulsive-hyperactivity category): 93.8 % and only 6.2 % presented a sub-syndromic form of ADH/D (with

Posttraumatic stress disorder: prevalences, comorbidities and quality of life in a community sample of young adults

OpenAIRE

Medeiros, Letícia Galery; Silva, Ricardo Azevedo da; Souza, Luciano Dias de Mattos; Silva, Giovanna Del Grande da; Pinheiro, Ricardo Tavares; Jansen, Karen

2015-01-01

Objectives To verify the prevalence of current posttraumatic stress disorder (PTSD) in young adults, the occurrence of comorbidities and its association with quality of life. Methods This is a cross-sectional population-based study. The targeted population consisted on individuals aged 18 to 24 years old, who lived in the urban area of Pelotas-RS, Brazil. Cluster sampling was applied. PTSD and its comorbidities were assessed using the Mini International Neuropsychiatric Interview (MINI 5.0), ...

Associations between Pathological Gambling and Psychiatric Comorbidity among Help-Seeking Populations in Hong Kong

Directory of Open Access Journals (Sweden)

Daniel T. L. Shek

2012-01-01

Full Text Available Problem gambling is complex and often comorbid with other mental health problems. Unfortunately, gambling studies on comorbid psychiatric disorders among Chinese communities are extremely limited. The objectives of this study were to (a determine the prevalence of comorbid psychiatric disorders among treatment-seeking pathological gamblers; (b compare the demographic profiles and clinical features of pathological gamblers with and without comorbid psychiatric disorders; (c explore the associations between pathological gambling and psychiatric disorders and their temporal relationship. Participants (N=201 who sought gambling counseling were examined by making Axis-I diagnoses including mood disorders, schizophrenia spectrum disorders, substance use disorders, anxiety disorders, and adjustment disorder. Results showed that 63.7% of participants had lifetime comorbid psychiatric disorder. The most common comorbid psychiatric mental disorders were mood disorders, adjustment disorder, and substance use disorders. Pathological gamblers with psychiatric comorbidities were significantly more severe in psychopathology, psychosocial functioning impairment, and gambling problems than those without the disorders.

ADHD severity as it relates to comorbid psychiatric symptomatology in children with Autism Spectrum Disorders (ASD).

Science.gov (United States)

Mansour, Rosleen; Dovi, Allison T; Lane, David M; Loveland, Katherine A; Pearson, Deborah A

2017-01-01

Comorbid diagnoses identified in pediatric samples have been correlated with a range of outcomes, including greater levels of emotional, behavioral, and educational impairment and the need for more intensive treatment. Given that previous research has documented high levels of comorbid Attention-Deficit/Hyperactivity Disorder (ADHD) in children with Autism Spectrum Disorders (ASD), this study closely examines the relationship between parent-reported ADHD symptoms (i.e., Conners' Parent Rating Scale, Revised [CPRS-R]) and the prevalence of additional comorbid psychiatric diagnoses in a pediatric ASD sample (n=99). Regression analyses revealed that greater severity of ADHD symptomatology was significantly related to a greater number of comorbid psychiatric diagnoses, as identified using the Diagnostic Interview for Children and adolescents, 4th Edition (DICA-IV). Additionally, more severe ADHD symptoms were also associated with higher levels of symptom severity on Child Behavior Checklist (CBCL) syndrome subscales. Interestingly, increasing severity of ASD symptomatology, as measured by the Autism Diagnostic Interview, Revised (ADI-R), was not associated with a higher prevalence of comorbid psychiatric diagnoses or CBCL syndrome severity. Our study concluded that higher levels of ADHD severity-not ASD severity-were associated with a higher prevalence of comorbid psychiatric symptomatology in school-age children with ASD. These findings may encourage clinicians to thoroughly assess ADHD symptomatology in ASD children to better inform treatment planning. Copyright © 2016 Elsevier Ltd. All rights reserved.

Psychiatric comorbidity in patients with conversion disorder and prevalence of dissociative symptoms.

Science.gov (United States)

Yayla, Sinan; Bakım, Bahadır; Tankaya, Onur; Ozer, Omer Akil; Karamustafalioglu, Oguz; Ertekin, Hulya; Tekin, Atilla

2015-01-01

The 1st objective of the current study was to investigate the frequency and types of dissociative symptoms in patients with conversion disorder (CD). The 2nd objective of the current study was to determine psychiatric comorbidity in patients with and without dissociative symptoms. A total of 54 consecutive consenting patients primarily diagnosed with CD according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria who were admitted to the psychiatric emergency outpatient clinic of Sisli Etfal Research and Teaching Hospital (Istanbul, Turkey) were included in the study. The Structured Clinical Interview for DSM-IV Axis I Disorders, Structured Interview for DSM-IV Dissociative Disorders, and Dissociative Experiences Scale were administered. Study groups consisted of 20 patients with a dissociative disorder and 34 patients without a diagnosis of any dissociative disorder. A total of 37% of patients with CD had any dissociative diagnosis. The prevalence of dissociative disorders was as follows: 18.5% dissociative disorder not otherwise specified, 14.8% dissociative amnesia, and 3.7% depersonalization disorder. Significant differences were found between the study groups with respect to comorbidity of bipolar disorder, past hypomania, and current and past posttraumatic stress disorder (ps = .001, .028, .015, and .028, respectively). Overall comorbidity of bipolar disorder was 27.8%. Psychiatric comorbidity was higher and age at onset was earlier among dissociative patients compared to patients without dissociative symptoms. The increased psychiatric comorbidity and early onset of conversion disorder found in patients with dissociative symptoms suggest that these patients may have had a more severe form of conversion disorder.

Gender Differences in Anxiety Disorders: Prevalence, Course of Illness, Comorbidity and Burden of Illness

OpenAIRE

McLean, Carmen P.; Asnaani, Anu; Litz, Brett T.; Hofmann, Stefan G.

2011-01-01

Women have consistently higher prevalence rates of anxiety disorders, but less is known about how gender affects age of onset, chronicity, comorbidity, and burden of illness. Gender differences in DSM-IV anxiety disorders were examined in a large sample of adults (N = 20,013) in the United States using data from the Collaborative Psychiatric Epidemiology Studies (CPES). The lifetime and 12-month male:female prevalence ratios of any anxiety disorder were 1:1.7 and 1:1.79, respectively. Women h...

Treatment seeking adults with autism or ADHD and co-morbid Substance Use Disorder: Prevalence, risk factors and functional disability

NARCIS (Netherlands)

Sizoo, Bram; van den Brink, Wim; Koeter, Maarten; Gorissen van Eenige, Marielle; van Wijngaarden-Cremers, Patricia; van der Gaag, Rutger Jan

2010-01-01

Background: Little is known about Autism Spectrum Disorder (ASD) in adults, especially not about ASD with co-morbid Substance Use Disorder (SUD). We wanted to examine how adults with ASD compare to adults with ADHD on prevalence and risk factors for co-morbid SUD, and on disability levels associated

Chemical Intolerance in Primary Care Settings: Prevalence, Comorbidity, and Outcomes

Science.gov (United States)

Katerndahl, David A.; Bell, Iris R.; Palmer, Raymond F.; Miller, Claudia S.

2012-01-01

PURPOSE This study extends previous community-based studies on the prevalence and clinical characteristics of chemical intolerance in a sample of primary care clinic patients. We evaluated comorbid medical and psychiatric disorders, functional status, and rates of health care use. METHODS A total of 400 patients were recruited from 2 family medicine clinic waiting rooms in San Antonio, Texas. Patients completed the validated Quick Environmental Exposure and Sensitivity Inventory (QEESI) to assess chemical intolerance; the Primary Care Evaluation of Mental Disorders (PRIME-MD) screen for possible psychiatric disorders; the Dartmouth–Northern New England Primary Care Cooperative Information Project (Dartmouth COOP) charts for functional status; and the Healthcare Utilization Questionnaire. RESULTS Overall, 20.3% of the sample met criteria for chemical intolerance. The chemically intolerant group reported significantly higher rates of comorbid allergies and more often met screening criteria for possible major depressive disorder, panic disorder, generalized anxiety disorder, and alcohol abuse disorder, as well as somatization disorder. The total number of possible mental disorders was correlated with chemical intolerance scores (P intolerance were significantly more likely to have poorer functional status, with trends toward increased medical service use when compared with non–chemically intolerant patients. After controlling for comorbid psychiatric conditions, the groups differed significantly only regarding limitations of social activities. CONCLUSIONS Chemical intolerance occurs in 1 of 5 primary care patients yet is rarely diagnosed by busy practitioners. Psychiatric comorbidities contribute to functional limitations and increased health care use. Chemical intolerance offers an etiologic explanation. Symptoms may resolve or improve with the avoidance of salient chemical, dietary (including caffeine and alcohol), and drug triggers. Given greater medication

Prevalence of comorbidity in primary care patients with type 2 diabetes and its association with elevated HbA1c: A cross-sectional study in Croatia.

Science.gov (United States)

Bralić Lang, Valerija; Bergman Marković, Biserka

2016-01-01

To the authors' knowledge, there are few valid data that describe the prevalence of comorbidity in type 2 diabetes mellitus (T2DM) patients seen in family practice. This study aimed to investigate the prevalence of comorbidities and their association with elevated (≥ 7.0%) haemoglobin A1c (HbA1c) using a large sample of T2DM patients from primary care practices. A cross-sectional study in which multivariate logistic regression was applied to explore the association of comorbidities with elevated HbA1c. Primary care practices in Croatia. Altogether, 10 264 patients with diabetes in 449 practices. Comorbidities and elevated HbA1c. In total 7979 (77.7%) participants had comorbidity. The mean number of comorbidities was 1.6 (SD 1.28). Diseases of the circulatory system were the most common (7157, 69.7%), followed by endocrine and metabolic diseases (3093, 30.1%), and diseases of the musculoskeletal system and connective tissue (1437, 14.0%). After adjustment for age and sex, the number of comorbidities was significantly associated with HbA1c. The higher the number of comorbidities, the lower the HbA1c. The prevalence of physicians' inertia was statistically significantly and negatively associated with the number of comorbidities (Mann-Whitney U test, Z = -12.34; p < 0.001; r = -0.12). There is a high prevalence of comorbidity among T2DM patients in primary care. A negative association of number of comorbidities and HbA1c is probably moderated by physicians' inertia in treatment of T2DM strictly according to guidelines. There is a high prevalence of comorbidity among T2DM patients in primary care. Patients with breast cancer, obese patients, and those with dyslipidaemia and ischaemic heart disease were more likely to have increased HbA1c. The higher the number of comorbidities, the lower the HbA1c.

Quality of life and functional impairment in obsessive-compulsive disorder: a comparison of patients with and without comorbidity, patients in remission, and healthy controls.

Science.gov (United States)

Huppert, Jonathan D; Simpson, H Blair; Nissenson, Kore J; Liebowitz, Michael R; Foa, Edna B

2009-01-01

Several studies have demonstrated that obsessive-compulsive disorder (OCD) is associated with interference in quality of life (QOL) and functional impairment. However, these studies did not compare individuals in remission to individuals who continue to have the disorder, predominantly used comparisons with norms and not with a matched normal sample, and did not always consider the impact of comorbidity. We administered multiple measures that assess QOL and functional impairment to 66 OCD patients who had previously consented for a clinical trial and to 36 age and sex matched individuals who denied any psychiatric history. Results confirm that OCD was associated with significantly lower QOL and functional impairment compared to healthy controls (HCs) in areas of work, social life, and family life. Individuals with OCD and other comorbid psychiatric diagnoses showed the poorest QOL and functioning, with comorbid depression accounting for much of the variance. The levels of QOL and functioning in individuals in remission tended to lie in between HCs and individuals with current OCD: their QOL or functioning did not differ significantly from HCs nor did they consistently differ significantly from those who had current OCD. These results suggest that individuals who are in remission have improved levels of QOL and functioning, whereas individuals with OCD are significantly impaired, and individuals with OCD and comorbid disorders are the most impaired. Treatment strategies should be focused on achieving remission of all symptoms to have the greatest impact on functioning and QOL. Published 2008 Wiley-Liss, Inc.

Brief Report: Children with ADHD without Co-Morbid Autism Do Not Have Impaired Motor Proficiency on the Movement Assessment Battery for Children

Science.gov (United States)

Papadopoulos, Nicole; Rinehart, Nicole; Bradshaw, John L.; McGinley, Jennifer L.

2013-01-01

Motor proficiency was investigated in a sample of children with Attention Deficit Hyperactivity Disorder-Combined type (ADHD-CT) without autism. Accounting for the influence of co-morbid autistic symptoms in ADHD motor studies is vital given that motor impairment has been linked to social-communication symptoms in children who have co-morbid ADHD…

Prevalence and causes of visual impairment and blindness among 9980 Scandinavian adults

DEFF Research Database (Denmark)

Buch, Helena; Vinding, Troels; La Cour, Morten

2004-01-01

To investigate the age-specific prevalence and causes of visual impairment and blindness in an epidemiologic study of an adult Scandinavian population.......To investigate the age-specific prevalence and causes of visual impairment and blindness in an epidemiologic study of an adult Scandinavian population....

Cognitive Impairment and Depression in a Population of Patients with Chronic Kidney Disease in Colombia: A Prevalence Study

Directory of Open Access Journals (Sweden)

Carlos Edgardo Rodríguez-Angarita

2016-05-01

Full Text Available Background: Growth of the elderly population is linked to the increase of comorbid conditions such as chronic kidney disease (CKD, depression, and cognitive impairment (CI. Cognitive impairment can vary from minimal deficits in the normal aging, to mild cognitive impairment with a prevalence ranging from 1 to 29 % in people ≥ 65 years of age, up to severe impairment with a prevalence of 6 to 42 %. The CI induced by depression usually affects the functional performance of the elderly. Objective: The objective of the study is to describe the prevalence of CI and depression in patients ≥ 55 years with CKD stages 3 and 4, attending a secondary prevention program during 2012–2013. Design: The design of the study is a cross-sectional study of simple random sampling, and 308 patients were invited to participate. Setting: Patients were being treated in a CKD secondary prevention program in Bogotá, Colombia, during 2012–2013. Patients: Participants were over 54 years diagnosed with CKD in stages 3 to 4 according to the K/DOQI classification. Measurements: CI was assessed using NEUROPSI and modified Lawton Scale; depression was measured with Yesavage Geriatric Depression Scale and the MINI International Neuropsychiatric Interview. Methods: Through an interview with the subjects, information regarding age, occupation, civil status, educational level, and clinical baseline variables was collected. Clinical assessment with specific instruments was performed by a multidisciplinary team composed of nephrologists, a psychiatrist, a neurologist, and a neuropsychologist. Results: Two hundred and fifty-one patients agreed to participate. The average age was 76.3 (SD = 7.9 years, 67 % were males, and 86.5 % had CKD stage 3. Overall prevalence of CI was 51 % (95 % CI 44.7 to 57.2, and the prevalence of major depression reached 8 % (95 % CI 4.5 to 11.3; 4.8 % of the patients ( n = 12 had both CI and depression. Limitations: A limitation of the study is its

Impairments in component processes of executive function and episodic memory in alcoholism, HIV infection, and HIV infection with alcoholism comorbidity

Science.gov (United States)

Fama, Rosemary; Sullivan, Edith V.; Sassoon, Stephanie A.; Pfefferbaum, Adolf; Zahr, Natalie M.

2016-01-01

Background Executive functioning and episodic memory impairment occur in HIV infection (HIV) and chronic alcoholism (ALC). Comorbidity of these conditions (HIV+ALC) is prevalent and heightens risk for vulnerability to separate and compounded deficits. Age and disease-related variables can also serve as mediators of cognitive impairment and should be considered, given the extended longevity of HIV-infected individuals in this era of improved pharmacological therapy. Methods HIV, ALC, HIV+ALC, and normal controls (NC) were administered traditional and computerized tests of executive function and episodic memory. Test scores were expressed as age- and education-corrected Z-scores; selective tests were averaged to compute Executive Function and Episodic Memory Composite scores. Efficiency scores were calculated for tests with accuracy and response times. Results HIV, ALC, and HIV+ALC had lower scores than NC on Executive Function and Episodic Memory Composites, with HIV+ALC even lower than ALC and HIV on the Episodic Memory Composite. Impairments in planning and free recall of visuospatial material were observed in ALC, whereas impairments in psychomotor speed, sequencing, narrative free recall, and pattern recognition were observed in HIV. Lower decision-making efficiency scores than NC occurred in all three clinical groups. In ALC, age and lifetime alcohol consumption were each unique predictors of Executive Function and Episodic Memory Composite scores. In HIV+ALC, age was a unique predictor of Episodic Memory Composite score. Conclusions Disease-specific and disease-overlapping patterns of impairment in HIV,ALC, and HIV+ALC have implications regarding brain systems disrupted by each disease and clinical ramifications regarding the complexities and compounded damping of cognitive functioning associated with dual diagnosis that may be exacerbated with aging. PMID:27759882

Prevalence, comorbidity and heritability of hoarding symptoms in adolescence: a population based twin study in 15-year olds.

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Volen Z Ivanov

Full Text Available Hoarding Disorder (HD is often assumed to be an 'old age' problem, but many individuals diagnosed with HD retrospectively report first experiencing symptoms in childhood or adolescence. We examined the prevalence, comorbidity and etiology of hoarding symptoms in adolescence.To determine the presence of clinically significant hoarding symptoms, a population-based sample of 15-year old twins (N = 3,974 completed the Hoarding Rating Scale-Self Report. Co-occurring Obsessive Compulsive Disorder (OCD, Autism Spectrum Disorders (ASD and Attention Deficit Hyperactivity Disorder (ADHD were estimated from parental report. Model-fitting analyses divided hoarding symptom scores into additive genetic, shared, and non-shared environmental effects.The prevalence of clinically significant hoarding symptoms was 2% (95% CI 1.6-2.5%, with a significantly higher prevalence in girls than boys. Exclusion of the clutter criterion (as adolescents do not have control over their environment increased the prevalence rate to 3.7% (95% CI 3.1-4.3%. Excessive acquisition was reported by 30-40% among those with clinically significant hoarding symptoms. The prevalence of co-occurring OCD (2.9%, ASD (2.9% and ADHD (10.0% was comparable in hoarding and non-hoarding teenagers. Model-fitting analyses suggested that, in boys, additive genetic (32%; 95% CI 13-44% and non-shared environmental effects accounted for most of the variance. In contrast, among girls, shared and non-shared environmental effects explained most of the variance, while additive genetic factors played a negligible role.Hoarding symptoms are relatively prevalent in adolescents, particularly in girls, and cause distress and/or impairment. Hoarding was rarely associated with other common neurodevelopmental disorders, supporting its DSM-5 status as an independent diagnosis. The relative importance of genetic and shared environmental factors for hoarding differed across sexes. The findings are suggestive of

Disruptive Mood Dysregulation Disorder in a Community Mental Health Clinic: Prevalence, Comorbidity and Correlates.

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Freeman, Andrew J; Youngstrom, Eric A; Youngstrom, Jennifer K; Findling, Robert L

2016-03-01

The revision of the Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5) added a new diagnosis of disruptive mood dysregulation disorder (DMDD) to depressive disorders. This study examines the prevalence, comorbidity, and correlates of the new disorder, with a particular focus on its overlap with oppositional defiant disorder (ODD), with which DMDD shares core symptoms. Data were obtained from 597 youth 6-18 years of age who participated in a systematic assessment of symptoms offered to all intakes at a community mental health center (sample accrued from July 2003 to March 2008). Assessment included diagnostic, symptomatic, and functional measures. DMDD was diagnosed using a post-hoc definition from item-level ratings on the Schedule for Affective Disorders and Schizophrenia for School-Age Children that closely matches the DSM-5 definition. Caregivers rated youth on the Child Behavior Checklist. Approximately 31% of youth met the operational definition of DMDD, and 40% had Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) diagnoses of ODD. Youth with DMDD almost always had ODD (odds ratio [OR] = 53.84) and displayed higher rates of comorbidity with attention-deficit/hyperactivity disorder (ADHD) and conduct disorder than youth without DMDD. Caregivers of youth with DMDD reported more symptoms of aggressive behavior, rule-breaking, social problems, anxiety/depression, attention problems, and thought problems than all other youth without DMDD. Compared with youth with ODD, youth with DMDD were not significantly different in terms of categorical or dimensional approaches to comorbidity and impairment. The new diagnosis of DMDD might be common in community mental health clinics. Youth with DMDD displayed more severe symptoms and poorer functioning than youth without DMDD. However, DMDD almost entirely overlaps with ODD and youth with DMDD were not significantly different than youth with ODD. These findings raise concerns

Prevalence and Causes of Visual Impairment and Blindness in Shanxi Province, China.

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Li, Tong; Du, Liping; Du, Lingzhen

2015-01-01

To estimate the prevalence and causes of visual impairment and blindness in Shanxi Province, China. Data were obtained from the Second National Sampling Survey of Disability conducted in 2006. Blindness and visual impairment were defined as best corrected visual acuity Visual acuity (VA) was measured using a Standard Logarithmic Visual Acuity E chart (Snellen) for subjects aged 7 years and older. Participants younger than 7 years were examined using special experiments or the Childhood Graphical Visual Chart. The prevalence of visual impairment and blindness in Shanxi was estimated to be 0.6% (466/75,016) among persons up to 80 years old. The prevalence in rural areas (0.7%; 351/48,137) was significantly higher than that in urban areas (0.4%; 115/26,879) and was higher in females (0.8%; 298/36,933) than in males (0.4%; 168/38,083). The most common cause of visual impairment and blindness was cataract (44.9%), followed by retinopathy and choroidopathy (12.5%), hereditary and developmental disorders (10.3%), corneal disease (5.2%), and refractive error (4.9%). Prevalences of visual impairment and blindness in women and in rural areas were higher than in men and urban areas, and increased with age. Cataract was the most prevalent cause of visual impairment and blindness. Based on the findings from this study, we suggest that provision of support and welfare services should be organized.

Comorbid Depression and Anxiety in Childhood and Adolescent Anorexia Nervosa: Prevalence and Implications for Outcome

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Hughes, Elizabeth K.

2012-01-01

Background: Comorbid conditions are common in individuals with anorexia nervosa (AN) and can raise issues for diagnosis, prognosis, and treatment planning. Methods: First, reported prevalence rates for depression and anxiety in children and adolescents with AN were reviewed. Diagnostic issues and current understanding of the temporal onset and…

Prevalence of and risk factors for suicide attempts versus suicide gestures: analysis of the National Comorbidity Survey.

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Nock, Matthew K; Kessler, Ronald C

2006-08-01

Definitions and classification schemes for suicide attempts vary widely among studies, introducing conceptual, methodological, and clinical problems. We tested the importance of the intent to die criterion by comparing self-injurers with intent to die, suicide attempters, and those who self-injured not to die but to communicate with others, suicide gesturers, using data from the National Comorbidity Survey (n = 5,877). Suicide attempters (prevalence = 2.7%) differed from suicide gesturers (prevalence = 1.9%) and were characterized by male gender, fewer years of education, residence in the southern and western United States; psychiatric diagnoses including depressive, impulsive, and aggressive symptoms; comorbidity; and history of multiple physical and sexual assaults. It is possible and useful to distinguish between self-injurers on the basis of intent to die. Copyright 2006 APA, all rights reserved.

The Tribal Odisha Eye Disease Study (TOES) 1: prevalence and causes of visual impairment among tribal children in an urban school in Eastern India.

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Warkad, Vivekanand U; Panda, Lapam; Behera, Pradeep; Das, Taraprasad; Mohanta, Bikash C; Khanna, Rohit

2018-04-01

To estimate the prevalence and causes of visual impairment and other ocular comorbidities among tribal children in an urban school population in eastern India. In this cross-sectional study, vision screening tests were administered to tribal school children. Demographic data, including name, age, sex, home district, height, and weight of each child, and examination data, including unaided and pinhole visual acuity, external eye examination with a flashlight, slit-lamp examination, intraocular pressure (IOP) measurement, and undilated fundus photography, were collected. Children with visual acuity of less than 20/20, abnormal anterior or posterior segment findings, and IOP of >21 mm Hg were referred for further evaluation. Of 10,038 children (5,840 males [58.2%]) screened, 335 (median age, 9 years; range, 6-17 years) were referred. Refractive error was the most common cause of visual impairment (59.52%; 95% CI, 51.97-66.65) followed by amblyopia (17.2%; 95% CI, 12.3-23.6) and posterior segment anomaly (14.88%; 95% CI, 10.2-21.0). The prevalence of best-corrected visual acuity of 20/40 was 0.13%. The prevalence of blindness was 0.03%. Visual impairment among tribal children in this residential school is an uncommon but important disability. Copyright © 2018 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

Obesity in Mexico: prevalence, comorbidities, associations with patient outcomes, and treatment experiences

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DiBonaventura, Marco D; Meincke, Henrik; Le Lay, Agathe; Fournier, Janine; Bakker, Erik; Ehrenreich, Allison

2017-01-01

Marco D DiBonaventura,1 Henrik Meincke,2 Agathe Le Lay,2 Janine Fournier,2 Erik Bakker,3 Allison Ehrenreich1 1Kantar Health, New York, NY, USA; 2Novo Nordisk, Copenhagen, Denmark; 3Novo Nordisk, Mexico City, Mexico Objective: The goal of this study is to investigate obesity and its concomitant effects including the prevalence of comorbidities, its association with patient-reported outcomes and costs, and weight loss strategies in a sample of Mexican adults. Methods: Mexican adults (N=2,511) ...

Cognitive impairment in COPD: a systematic review.

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Torres-Sánchez, Irene; Rodríguez-Alzueta, Elisabeth; Cabrera-Martos, Irene; López-Torres, Isabel; Moreno-Ramírez, Maria Paz; Valenza, Marie Carmen

2015-01-01

The objectives of this study were to characterize and clarify the relationships between the various cognitive domains affected in COPD patients and the disease itself, as well as to determine the prevalence of impairment in the various cognitive domains in such patients. To that end, we performed a systematic review using the following databases: PubMed, Scopus, and ScienceDirect. We included articles that provided information on cognitive impairment in COPD patients. The review of the findings of the articles showed a significant relationship between COPD and cognitive impairment. The most widely studied cognitive domains are memory and attention. Verbal memory and learning constitute the second most commonly impaired cognitive domain in patients with COPD. The prevalence of impairment in visuospatial memory and intermediate visual memory is 26.9% and 19.2%, respectively. We found that cognitive impairment is associated with the profile of COPD severity and its comorbidities. The articles reviewed demonstrated that there is considerable impairment of the cognitive domains memory and attention in patients with COPD. Future studies should address impairments in different cognitive domains according to the disease stage in patients with COPD.

Cognitive impairment in COPD: a systematic review

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Irene Torres-Sánchez

2015-04-01

Full Text Available The objectives of this study were to characterize and clarify the relationships between the various cognitive domains affected in COPD patients and the disease itself, as well as to determine the prevalence of impairment in the various cognitive domains in such patients. To that end, we performed a systematic review using the following databases: PubMed, Scopus, and ScienceDirect. We included articles that provided information on cognitive impairment in COPD patients. The review of the findings of the articles showed a significant relationship between COPD and cognitive impairment. The most widely studied cognitive domains are memory and attention. Verbal memory and learning constitute the second most commonly impaired cognitive domain in patients with COPD. The prevalence of impairment in visuospatial memory and intermediate visual memory is 26.9% and 19.2%, respectively. We found that cognitive impairment is associated with the profile of COPD severity and its comorbidities. The articles reviewed demonstrated that there is considerable impairment of the cognitive domains memory and attention in patients with COPD. Future studies should address impairments in different cognitive domains according to the disease stage in patients with COPD.

Comorbidities and health status in individuals with and without COPD in five Latin American cities: the PLATINO study.

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López Varela, Maria Victorina; Montes de Oca, María; Halbert, Ronald; Muiño, Adriana; Tálamo, Carlos; Pérez-Padilla, Rogelio; Jardim, José Roberto B; Valdivia, Gonzalo; Pertuzé, Julio; Menezes, Ana María B

2013-11-01

Comorbidities are common in patients with chronic obstructive pulmonary disease (COPD), and have a significant impact on health status and prognosis. The PLATINO study provides data on self-reported comorbidities and perceived health status in COPD subjects. PLATINO is a population-based study on COPD prevalence in five Latin American cities. COPD diagnosis was defined by GOLD criteria (FEV1/FVCcerebrovascular disease, peptic ulcer and asthma. Health status was evaluated using the SF-12 questionnaire, derived from the question: «In general, would you say your health is excellent, very good, good, fair or poor?». A simple comorbidity score was calculated by adding the total number of comorbid conditions. Of a total population of 5314individuals, 759 had COPD. Reported comorbidities by decreasing frequency were: any cardiovascular disease, hypertension, peptic ulcer, heart disease, diabetes, cerebrovascular disease, asthma and lung cancer. COPD patients had a higher comorbidity score and prevalence of lung cancer (Pcerebrovascular disease (P=.0750). Factors associated with comorbidities were age, body mass index (BMI) and female gender. The number of comorbidities increased as the health status deteriorated. In the PLATINO population-based study, COPD individuals had an increased number of comorbidities. Age, female gender and higher BMI were the factors associated with comorbidity in these patients. Comorbid conditions were associated with impaired health status, independently of the COPD status. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

Antisocial personality disorder in incarcerated offenders: Psychiatric comorbidity and quality of life.

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Black, Donald W; Gunter, Tracy; Loveless, Peggy; Allen, Jeff; Sieleni, Bruce

2010-05-01

We determined the frequency of antisocial personality disorder (ASPD) in offenders. We examined demographic characteristics, psychiatric comorbidity, and quality of life in those with and without ASPD. We also looked at the subset with attention-deficit/hyperactivity disorder (ADHD). A random sample of 320 newly incarcerated offenders was assessed using the Mini International Neuropsychiatric Interview (MINI), the 36-item Short Form Health Survey (SF-36), and the Level of Service Inventory-Revised (LSI-R). ASPD was present in 113 subjects (35.3%). There was no gender-based prevalence difference. Offenders with ASPD were younger, had a higher suicide risk, and had higher rates of mood, anxiety, substance use, psychotic, somatoform disorders, borderline personality disorder, and ADHD. Quality of life was worse, and their LSI-R scores were higher, indicating a greater risk for recidivism. A subanalysis showed that offenders with ASPD who also had ADHD had a higher suicide risk, higher rates of comorbid disorders, and worse mental health functioning. ASPD is relatively common among both male and female inmates and is associated with comorbid disorders, high suicide risk, and impaired quality of life. Those with comorbid ADHD were more impaired than those without ADHD. ASPD occurs frequently in prison populations and is nearly as common in women as in men. These study findings should contribute to discussions of appropriate and innovative treatment of ASPD in correctional settings.

The Prevalence of Age-Related Eye Diseases and Visual Impairment in Aging: Current Estimates

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Klein, Ronald; Klein, Barbara E. K.

2013-01-01

Purpose. To examine prevalence of five age-related eye conditions (age-related cataract, AMD, open-angle glaucoma, diabetic retinopathy [DR], and visual impairment) in the United States. Methods. Review of published scientific articles and unpublished research findings. Results. Cataract, AMD, open-angle glaucoma, DR, and visual impairment prevalences are high in four different studies of these conditions, especially in people over 75 years of age. There are disparities among racial/ethnic groups with higher age-specific prevalence of DR, open-angle glaucoma, and visual impairment in Hispanics and blacks compared with whites, higher prevalence of age-related cataract in whites compared with blacks, and higher prevalence of late AMD in whites compared with Hispanics and blacks. The estimates are based on old data and do not reflect recent changes in the distribution of age and race/ethnicity in the United States population. There are no epidemiologic estimates of prevalence for many visually-impairing conditions. Conclusions. Ongoing prevalence surveys designed to provide reliable estimates of visual impairment, AMD, age-related cataract, open-angle glaucoma, and DR are needed. It is important to collect objective data on these and other conditions that affect vision and quality of life in order to plan for health care needs and identify areas for further research. PMID:24335069

Co-morbidities of vertiginous diseases.

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Warninghoff, Jan C; Bayer, Otmar; Ferrari, Uta; Straube, Andreas

2009-07-07

Co-morbidities of vertiginous diseases have so far not been investigated systematically. Thus, it is still unclear whether the different vertigo syndromes (e.g. benign paroxysmal positional vertigo (BPPV), Meniere's disease (MD), vestibular migraine and phobic vertigo (PPV)) have also different spectrums of co-morbidities. All patients from a cohort of 131 participants were surveyed using a standardised questionnaire about the co-morbidities hypertension, diabetes mellitus, BMI (body mass index), migraine, other headache, and psychiatric diseases in general and the likelihood of a depression in particular. We noted hypertension in 29.0% of the cohort, diabetes mellitus in 6.1%, migraine in 8.4%, other headache in 32.1%, psychiatric diseases in 16.0%, overweight and obesity in 33.6% and 13.7% respectively, as well as a clinical indication for depression in 15.9%. In general, we did not detect an increased prevalence of the co-morbidities diabetes mellitus, arterial hypertension, migraine, other headache and obesity compared to the general population. There was an increased prevalence of psychiatric co-morbidity in patients with PPV, and the prevalence of hypertension was elevated in patients with MD.

Co-morbidities of vertiginous diseases

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Ferrari Uta

2009-07-01

Full Text Available Abstract Background Co-morbidities of vertiginous diseases have so far not been investigated systematically. Thus, it is still unclear whether the different vertigo syndromes (e.g. benign paroxysmal positional vertigo (BPPV, Meniere's disease (MD, vestibular migraine and phobic vertigo (PPV have also different spectrums of co-morbidities. Methods All patients from a cohort of 131 participants were surveyed using a standardised questionnaire about the co-morbidities hypertension, diabetes mellitus, BMI (body mass index, migraine, other headache, and psychiatric diseases in general and the likelihood of a depression in particular. Results We noted hypertension in 29.0% of the cohort, diabetes mellitus in 6.1%, migraine in 8.4%, other headache in 32.1%, psychiatric diseases in 16.0%, overweight and obesity in 33.6% and 13.7% respectively, as well as a clinical indication for depression in 15.9%. Conclusion In general, we did not detect an increased prevalence of the co-morbidities diabetes mellitus, arterial hypertension, migraine, other headache and obesity compared to the general population. There was an increased prevalence of psychiatric co-morbidity in patients with PPV, and the prevalence of hypertension was elevated in patients with MD.

Impairments in Component Processes of Executive Function and Episodic Memory in Alcoholism, HIV Infection, and HIV Infection with Alcoholism Comorbidity.

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Fama, Rosemary; Sullivan, Edith V; Sassoon, Stephanie A; Pfefferbaum, Adolf; Zahr, Natalie M

2016-12-01

Executive functioning and episodic memory impairment occur in HIV infection (HIV) and chronic alcoholism (ALC). Comorbidity of these conditions (HIV + ALC) is prevalent and heightens risk of vulnerability to separate and compounded deficits. Age and disease-related variables can also serve as mediators of cognitive impairment and should be considered, given the extended longevity of HIV-infected individuals in this era of improved pharmacological therapy. HIV, ALC, HIV + ALC, and normal controls (NC) were administered traditional and computerized tests of executive function and episodic memory. Test scores were expressed as age- and education-corrected Z-scores; selective tests were averaged to compute Executive Function and Episodic Memory Composite scores. Efficiency scores were calculated for tests with accuracy and response times. HIV, ALC, and HIV + ALC had lower scores than NC on Executive Function and Episodic Memory Composites, with HIV + ALC even lower than ALC and HIV on the Episodic Memory Composite. Impairments in planning and free recall of visuospatial material were observed in ALC, whereas impairments in psychomotor speed, sequencing, narrative free recall, and pattern recognition were observed in HIV. Lower decision-making efficiency scores than NC occurred in all 3 clinical groups. In ALC, age and lifetime alcohol consumption were each unique predictors of Executive Function and Episodic Memory Composite scores. In HIV + ALC, age was a unique predictor of Episodic Memory Composite score. Disease-specific and disease-overlapping patterns of impairment in HIV, ALC, and HIV + ALC have implications regarding brain systems disrupted by each disease and clinical ramifications regarding the complexities and compounded damping of cognitive functioning associated with dual diagnosis that may be exacerbated with aging. Copyright © 2016 by the Research Society on Alcoholism.

Prevalence of CMMSE defined cognitive impairment among peritoneal dialysis patients and its impact on peritonitis.

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Shea, Yat Fung; Lam, Man-Fai; Lee, Mi Suen Connie; Mok, Ming Yee Maggie; Lui, Sing-Leung; Yip, Terence P S; Lo, Wai Kei; Chu, Leung Wing; Chan, Tak-Mao

2016-02-01

Peritoneal dialysis (PD) exchange procedure is complex. Patients with cognitive impairment (CI) may require assistance. We studied the prevalence of CI among PD patients, its impact on PD-related peritonitis and the outcome of assisted PD. Cantonese version of Mini-Mental State examination (CMMSE) was performed in 151 patients newly started on PD. Data on patient characteristics including demographics, co-morbidities, blood parameters, medications, and number of PD-related peritonitis in the first 6 months were collected. 151 subjects were recruited. The age of studied patients was 60 ± 15.0 years, and 45% were female. The prevalence of CI was 13.9% using education-adjusted cut-off of CMMSE. Patients older than 65-year-old, female, and lower education level were independent risk factors for CI (OR 9.27 p = 0.001, OR 14.84 p = 0.005, and OR 6.10 p = 0.009, respectively). Age greater than 65-year old is an independent risk factor for PD-related peritonitis but CI was not. Patients requiring assisted PD were of older age (p peritonitis (p = 0.07). CI is common among local PD patients. Overall, CI could not be identified as an independent risk factor for PD peritonitis. There is a higher prevalence of CI among assisted PD patients but helpers may not completely eliminate the risk of PD-related peritonitis.

Prevalence and comorbidity of eating disorders among a community sample of adolescents: 2-year follow-up.

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Rojo-Moreno, Luis; Arribas, Pilar; Plumed, Javier; Gimeno, Natalia; García-Blanco, Ana; Vaz-Leal, Francisco; Luisa Vila, María; Livianos, Lorenzo

2015-05-30

The previous literature about comorbidity between eating disorders (ED) and other DSM-IV psychiatric disorders in adolescence has employed cross-sectional studies with clinical samples, where the comorbid disorders were diagnosed retrospectively. The present study aims to overcome these limitations by the analysis of comorbidity in a community population during 2-year follow-up. A semi-structured interview was applied to a teenager sample. Firstly, a cross-sectional and non-randomized study on psychiatric morbidity was conducted with 993 teenagers between the ages of 12 and 16 from five schools. Secondly, 326 students between 14 and 17 years old of one school were reassessed 2 years later in order to detect ED new cases and find associations with previous psychiatric disorders. The ED prevalence was 3.6%. Cross-sectional analysis revealed that 62.9% of individuals with an ED had comorbid disorders: anxiety disorders (51.4%), Attention Deficit Hyperactivity Disorder (31.4%), oppositional defiant disorder (11.4%), and obsessive compulsive disorder (8.6%). Prospective longitudinal analysis showed an ED incidence rate of 2.76% over the course of 2 years. 22.2% of new cases had received previous psychiatric diagnoses, of which all were anxiety disorders. Thus, ED exhibited a high comorbidity rate among adolescent populations and anxiety disorders were the most common comorbid diagnosis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Comorbidities in Preschool Children at Family Risk of Dyslexia

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Gooch, Debbie; Hulme, Charles; Nash, Hannah M.; Snowling, Margaret J.

2014-01-01

Background: Comorbidity among developmental disorders such as dyslexia, language impairment, attention deficit/hyperactivity disorder and developmental coordination disorder is common. This study explores comorbid weaknesses in preschool children at family risk of dyslexia with and without language impairment and considers the role that…

The prevalence and causes of visual impairment in seven-year-old children.

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Ghaderi, Soraya; Hashemi, Hassan; Jafarzadehpur, Ebrahim; Yekta, Abbasali; Ostadimoghaddam, Hadi; Mirzajani, Ali; Khabazkhoob, Mehdi

2018-05-01

To report the prevalence and causes of visual impairment in seven-year-old children in Iran and its relationship with socio-economic conditions. In a cross-sectional population-based study, first-grade students in the primary schools of eight cities in the country were randomly selected from different geographic locations using multistage cluster sampling. The examinations included visual acuity measurement, ocular motility evaluation, and cycloplegic and non-cycloplegic refraction. Using the definitions of the World Health Organization (presenting visual acuity less than or equal to 6/18 in the better eye) to estimate the prevalence of vision impairment, the present study reported presenting visual impairment in seven-year-old children. Of 4,614 selected students, 4,106 students participated in the study (response rate 89 per cent), of whom 2,127 (51.8 per cent) were male. The prevalence of visual impairment according to a visual acuity of 6/18 was 0.341 per cent (95 per cent confidence interval 0.187-0.571); 1.34 per cent (95 per cent confidence interval 1.011-1.74) of children had visual impairment according to a visual acuity of 6/18 in at least one eye. Sixty-six (1.6 per cent) and 23 (0.24 per cent) children had visual impairment according to a visual acuity of 6/12 in the worse and better eye, respectively. The most common causes of visual impairment were refractive errors (81.8 per cent) and amblyopia (14.5 per cent). Among different types of refractive errors, astigmatism was the main refractive error leading to visual impairment. According to the concentration index, the distribution of visual impairment in children from low-income families was higher. This study revealed a high prevalence of visual impairment in a representative sample of seven-year-old Iranian children. Astigmatism and amblyopia were the most common causes of visual impairment. The distribution of visual impairment was higher in children from low-income families. Cost

Obstructive sleep apnea-hypopnea syndrome and cognitive impairments in the elderly

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Song Shuling

2017-01-01

Full Text Available Obstructive sleep apnea-hypopnea syndrome (OSAHS is a common sleep-related breathing disorder that is associated with significant morbidity and mortality. It has received increasing attention that neurocognitive deficits occur with a high frequency in OSAHS. However, it is rarely known that OSAHS impacts on cognition in the elderly in whom an increased prevalence of OSAHS is present. In this review we consider recent studies in the association between OSAHS and cognitive impairments, with specific interest in the older population. Firstly, we elucidate the characteristics of OSAHS and OSAHS-related cognitive impairments in the older patients. Many studies have showed that the prevalence of OSAHS increases with age and it is higher in the elderly than other population. Moreover, OSAHS is associated with higher incidence of comorbidities and increased risk of clinical deterioration in the elderly, especially the neurocognitive impairments which even can develop dementia. Subsequently, we discuss the possible reasons of cognitive impairments that caused or aggravated by OSAHS in the elderly. The intermittent hypoxia (IH-related disturbances of homeostasis such as oxidative stress, inflammation, and age-related changes such as the changes of sleep architecture, the declined expression level of anti-aging gene, medical comorbidities and polypharmacy, may be both contribute to the increased risk of cognitive impairments in the older patients with OSAHS.

Comorbidities in preschool children at family risk of dyslexia

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Gooch, Debbie; Hulme, Charles; Nash, Hannah M; Snowling, Margaret J

2015-01-01

Background Comorbidity among developmental disorders such as dyslexia, language impairment, attention deficit/hyperactivity disorder and developmental coordination disorder is common. This study explores comorbid weaknesses in preschool children at family risk of dyslexia with and without language impairment and considers the role that comorbidity plays in determining children’s outcomes. Method The preschool attention, executive function and motor skills of 112 children at family risk for dyslexia, 29 of whom also met criteria for language impairment, were assessed at ages 3 ½ and 4 ½. The performance of these children was compared to the performance of children with language impairment and typically developing controls. Results Weaknesses in attention, executive function and motor skills were associated with language impairment rather than family risk status. Individual differences in language and executive function are strongly related in the preschool period and preschool motor skills predicted unique variance (4%) in early reading skills over and above children’s language ability. Conclusion Comorbidity between developmental disorders can be observed in the preschool years: children with language impairment have significant and persistent weaknesses in motor skills and executive function compared to those without language impairment. Children’s early language and motor skills are predictors of children’s later reading skills. PMID:24117483

The Brave New World of Personality Disorder-Trait Specified: Effects of Additional Definitions on Coverage, Prevalence, and Comorbidity

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Clark, Lee Anna; Vanderbleek, Emily N.; Shapiro, Jaime L.; Nuzum, Hallie; Allen, Xia; Daly, Elizabeth; Kingsbury, Thomas J.; Oiler, Morgan; Ro, Eunyoe

2015-01-01

The alternative dimensional model for personality disorder (PD) in DSM-5, Section III (DSM-5-III) includes two main criteria: (A) personality-functioning impairment, and (B) personality-trait pathology; provides specific functioning-and-trait criteria for six PD-type diagnoses; and introduces PD-trait specified (PD-TS), which requires meeting the general PD criteria and not meeting criteria for any specific PD type. We termed this Simple PD-TS and developed two additional definitions: Mixed PD-TS, meeting criteria for one or two PD types and having five or more additional pathological traits; and Complex PD-TS, meeting criteria for three or more PD types. In a mixed sample of 165 outpatients and 215 community adults screened to be at high-risk for PD, we investigated the effect of these additional definitions on prevalence, coverage, comorbidity, and within-diagnosis heterogeneity, and conclude that eliminating the PD-type diagnoses and thus having PD-TS as the only PD diagnosis would be both more parsimonious and more useful clinically. PMID:26097740

Prevalence of Visual Impairment and Refractive Errors in Children of South Sinai, Egypt.

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Yamamah, Gamal Abdel Naser; Talaat Abdel Alim, Ahmed Ahmed; Mostafa, Yehia Salah El Din; Ahmed, Rania Ahmed Abdel Salam; Mohammed, Asmaa Mahmoud; Mahmoud, Asmaa Mohammed

2015-01-01

To assess the prevalence and causes of visual impairment in children of South Sinai, and to evaluate outcomes of rehabilitation programs. Population-based, cross-sectional analysis of 2070 healthy school children screened for visual impairment from 2009 through 2010 in cities of South Sinai and their surrounding Bedouin settlements. Visual acuity (VA) was tested using Snellen charts followed by cycloplegic autorefractometry for cases with presenting VA ≤ 6/9. Appropriate eyeglasses were prescribed and VA re-evaluated. This study included 1047 boys and 1023 girls, mean age 10.7 ± 3.1 years. Visual impairment (uncorrected VA ≤ 6/9) was detected in 29.4% of children, while 2.0% had moderate-severe visual impairment (uncorrected VA ≤ 6/24). There were statistically significant differences in prevalence of visual impairment between the studied cities (p visual impairment was significantly higher among girls (p children showed significantly lower prevalences of visual impairment. Only age was a reliable predictor of visual impairment (odds ratio 0.94, p children who received spectacles (p children had some form of visual impairment, 90.32% of which comprised refractive errors (mainly astigmatism) which were significantly corrected with eyeglasses. VA screening and correction of refractive errors are of the utmost importance for ensuring better visual outcomes and improved school performance.

Speech sound disorder at 4 years: prevalence, comorbidities, and predictors in a community cohort of children.

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Eadie, Patricia; Morgan, Angela; Ukoumunne, Obioha C; Ttofari Eecen, Kyriaki; Wake, Melissa; Reilly, Sheena

2015-06-01

The epidemiology of preschool speech sound disorder is poorly understood. Our aims were to determine: the prevalence of idiopathic speech sound disorder; the comorbidity of speech sound disorder with language and pre-literacy difficulties; and the factors contributing to speech outcome at 4 years. One thousand four hundred and ninety-four participants from an Australian longitudinal cohort completed speech, language, and pre-literacy assessments at 4 years. Prevalence of speech sound disorder (SSD) was defined by standard score performance of ≤79 on a speech assessment. Logistic regression examined predictors of SSD within four domains: child and family; parent-reported speech; cognitive-linguistic; and parent-reported motor skills. At 4 years the prevalence of speech disorder in an Australian cohort was 3.4%. Comorbidity with SSD was 40.8% for language disorder and 20.8% for poor pre-literacy skills. Sex, maternal vocabulary, socio-economic status, and family history of speech and language difficulties predicted SSD, as did 2-year speech, language, and motor skills. Together these variables provided good discrimination of SSD (area under the curve=0.78). This is the first epidemiological study to demonstrate prevalence of SSD at 4 years of age that was consistent with previous clinical studies. Early detection of SSD at 4 years should focus on family variables and speech, language, and motor skills measured at 2 years. © 2014 Mac Keith Press.

Prevalence of comorbid substance use disorder during long-term central stimulant treatment in adult ADHD.

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Torgersen, Terje; Gjervan, Bjørn; Rasmussen, Kirsten; Vaaler, Arne; Nordahl, Hans M

2013-03-01

Central stimulant (CS) therapy is a cornerstone in treatment of adult attention-deficit/hyperactivity disorder (ADHD). Substance use disorder (SUD) is a common comorbid disorder of ADHD and might complicate the treatment. Our main objectives were to investigate the prevalence of SUD during CS treatment, and identify variables associated with SUD during the treatment. The collection of data was based on a naturalistic, retrospective approach using the medical records of a cohort of all adult ADHD patients (N = 117) starting treatment with CS in a specific catchment area in the period 1997 to May 2005. A logistic regression model was applied to identify possible predictors of SUD during CS treatment. The study showed no onset of SUD during the CS treatment in the group of patients without comorbid SUD at baseline (mean CS treatment length 41.1 months). In the group of patients with comorbid SUD at baseline, 58.5 % had one or more relapses of SUD during treatment (mean CS treatment length 27.9 months). Younger age and comorbid antisocial personality disorder were associated with relapse. In a logistic regression analysis, cannabis abstinence for more than 12 months was a negative predictor for relapse of SUD. CS treatment does not precipitate onset of SUD in adults without previous SUD.

Increased Clinical and Neurocognitive Impairment in Children with Autism Spectrum Disorders and Comorbid Bipolar Disorder

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Weissman, Adam S.; Bates, Marsha E.

2010-01-01

Bipolar (BD) symptomatology is prevalent in children with autism spectrum disorders (ASD) and may lead to increased impairment. The current study compared clinical and neurocognitive impairment in children (7-13 years) diagnosed with ASD (n=55), BD (n=34), ASD + BD (n=23), and a non-clinical control group (n=27). Relative to the ASD group, the ASD…

Cognitive Impairment Associated with Cancer

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Pendergrass, J. Cara; Harrison, John E.

2018-01-01

This brief review explores the areas of cognitive impairment that have been observed in cancer patients and survivors, the cognitive assessment tools used, and the management of the observed cognitive changes. Cognitive changes and impairment observed in patients with cancer and those in remission can be related to the direct effects of cancer itself, nonspecific factors or comorbid conditions that are independent of the actual disease, and/or the treatments or combination of treatments administered. Attention, memory, and executive functioning are the most frequently identified cognitive domains impacted by cancer. However, the prevalence and extent of impairment remains largely unknown due to marked differences in methodology, definitions of cognitive impairment, and the assessment measures used. Assessment of cognitive functioning is an important and necessary part of a comprehensive oncological care plan. Research is needed to establish a better understanding of cognitive changes and impairments associated with cancer so that optimal patient outcomes can be achieved. PMID:29497579

Clinical outcomes associated with comorbid posttraumatic stress disorder among patients with bipolar disorder.

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Passos, Ives C; Jansen, Karen; Cardoso, Taiane de A; Colpo, Gabriela D; Zeni, Cristian P; Quevedo, Joao; Kauer-Sant'Anna, Márcia; Zunta-Soares, Giovanna; Soares, Jair C; Kapczinski, Flavio

2016-05-01

To assess clinical outcomes associated with the presence of a lifetime history of comorbid posttraumatic stress disorder in subjects with bipolar disorder. This cross-sectional study of 284 subjects with bipolar disorder (DSM-IV) assessed the association between lifetime comorbid posttraumatic stress disorder (DSM-IV) and clinical characteristics. Participants were included from January 2006 to June 2009. We assessed age at onset, number of mood episodes, presence of rapid cycling, first drug use, suicide attempts, hospitalizations, functional impairment, and quality of life. Diagnostic, clinical, and functional assessments were carried out using the Structured Clinical Interview for DSM-IV Axis I Disorders, patient edition (SCID-I/P), the Functioning Assessment Short Test, and the World Health Organization Quality of Life scale. The number of manic episodes as assessed by SCID-I/P was the primary outcome. The prevalence of lifetime comorbid posttraumatic stress disorder was 19.7% (56 subjects). Subjects with bipolar disorder and posttraumatic stress disorder had an accelerated course of illness, with a lower age at onset of manic/hypomanic episodes (P = .009) and earlier initiation of illicit drug use (P = .008). In addition, they were more likely to be younger when they received the diagnosis of bipolar disorder (P = .036) and had a higher number of manic/hypomanic episodes (P = .01). Quality of life was worse in all domains among subjects who presented the comorbidity, and rates of functional impairment were higher. Comorbid posttraumatic stress disorder was associated with increased morbidity and accelerated illness progression among subjects with bipolar disorder. © Copyright 2016 Physicians Postgraduate Press, Inc.

[Symptoms of depression in children and adolescents in relation to psychiatric comorbidities].

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Baji, Ildikó; Gádoros, Júlia; Kiss, Enikô; Mayer, László; Kovács, Eszter; Benák, István; Vetró, Agnes

2012-01-01

The lifetime prevalence of MDD before adolescence is 4-5%, while the symptoms concern 13-20% of the adolescents. In the development of suicidal behaviour the most important risk factors are the use of psychoactive drugs and smoking. Psychiatric comorbidities are aggravating significantly the major depression. The comorbidities are high among major depression, anxiety and disruptive disorders. We examined 649 children being in a depressive episode diagnosed by ISCA-D semi-structured interview, 45,9% of them were girls, and 54,1% were boys, the mean age was 11,7 years ( SD=2,00). The participants were enrolled into three groups according to their comorbidities: group with only depression without comorbidities, group with anxiety comorbidity, and group with disruptive comorbidity. We compared the three groups according to the frequency of their depressive symptoms. Anxiety comorbidities increase the incidence of depressive symptoms. Among the criteria symptoms irritability where the most frequent symptom independently from the comorbidities, the depressed mood is the most frequent within the anxiety group, while anhedonia occurred with a moderate frequency in each groups. In the anxiety group the vegetative symptoms, while in the disruptive group the psychomotor agitation and the feeling of worthlessness are the most frequent symptoms. Comorbidities are increasing the incidence of the suicide symptoms. The incidence of impaired decision making was high in each group, the comorbidities didn't influence it's frequency. Among depressed boys irritability and feelings of worthlessness (low self-esteem) increase the presence of externalisation comorbidity. Among depressed girls guilt was significantly more frequent in the anxiety comorbidity group, and concentration problems are the most typical symptoms in the clear MDD group, without comorbidities.

Prevalence of cognitive impairment no dementia in a rural area of Northern China.

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Zhang, Ying; Shi, Zhihong; Liu, Mengyuan; Liu, Shuai; Yue, Wei; Liu, Shuling; Xiang, Lei; Lu, Hui; Liu, Ping; Wisniewski, Thomas; Wang, Jinhuan; Ji, Yong

2014-01-01

Few data are available on the prevalence of cognitive impairment no dementia (CIND) in rural China. The aim of this study was to estimate the prevalence of CIND in individuals aged 60 years and older in a large rural community, and to analyze the associated risk factors. A two-phase, door-to-door epidemiological study was used for residents aged 60 years and older in Ji County, a rural county near Tianjin in Northern China. In phase 1 of the study, the Mini-Mental State Examination and Clinical Dementia Rating were administered for screening purposes. In phase 2, the subjects who screened positive were further examined by neurologists. A total of 5,744 individuals underwent the home visit interview, where demographic variables and comorbidities were recorded; 5,550 individuals completed the two phases. CIND was diagnosed by the Aging, Demographics and Memory Study on CIND criteria. The odds ratio (OR) for each risk factor was calculated by logistic regression analysis. The prevalence of CIND among those aged 60 years and older was 23.3%. The prevalence of CIND was lower among those with a higher level of education or social involvement. CIND was more prevalent in females, older individuals, those with a past history of stroke, and those living without a partner. Significant risk factors were found by multivariate analyses: past history of stroke (OR = 1.889; 95% CI: 1.437-2.483); being female (OR = 1.546; 95% CI: 1.305-1.832); and having no partner (divorced, widowed or single; OR = 1.250; 95% CI: 1.042-1.499). In turn, level of education (OR = 0.560; 95% CI: 0.460-0.681) and engagement in social activities (OR = 0.339; 95% CI: 0.258-0.404) were protective factors. This is the first large-scale community-based epidemiological study assessing the prevalence of cognitive loss in the rural Chinese population. The total prevalence of CIND observed was 23.3%, which was higher than in other studies in Western and Asian countries. Living without a partner, female gender

Prevalence and correlates of comorbid depression in a nonclinical online sample with DSM-5 internet gaming disorder.

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Wang, Hee Ryung; Cho, Hyun; Kim, Dai-Jin

2018-01-15

We investigated the prevalence and correlates of comorbid depression among patients with internet gaming disorder using the Internet Gaming Disorder scale (IGD-9) and the Patient Health Questionnaire-9 (PHQ-9) among nonclinical online survey respondents. Korean adolescents and adults from 14 to 39 years of age were selected. We compared internet gaming use patterns and sociodemographic and clinical variables between patients with internet gaming disorder who had depression and those without depression. In 2016, 7200 people participated in an online survey. Respondents with internet gaming disorder that was comorbid with depression were older, more often female, had greater Internet Addiction Test total scores, Alcohol Use Disorder Identification Test total scores, Generalized Anxiety Disorder Scale-7 total scores, Fagerstrom Test for Nicotine Dependence total scores, and higher Dickman Dysfunctional Impulsivity Instrument dysfunctional subscale scores than those without depression. The binary logistic regression analysis revealed that female gender, problematic alcohol use, anxiety, and a past history of psychiatric counseling or treatment due to internet gaming use were significant predictors for comorbid depression among participants with internet gaming disorder. Depression was a common comorbidity of internet gaming disorder. Internet gaming disorder with comorbid depression was related to more serious psychiatric phenomenology and a greater psychiatric burden. Copyright © 2017. Published by Elsevier B.V.

The prevalence of Usher syndrome and other retinal dystrophy-hearing impairment associations.

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Rosenberg, T; Haim, M; Hauch, A M; Parving, A

1997-05-01

The study was undertaken to procure population-based prevalence data on the various types of Usher syndrome and other retinal dystrophy-hearing impairment associations. The medical files on 646 patients with a panretinal pigmentary dystrophy aged 20-49 years derived from the Danish Retinitis Pigmentosa (RP) register were scrutinised. The data were supplemented by a prior investigation on hearing ability in a part of the study population. After exclusion of patients with possibly extrinsic causes of hearing impairments, 118 patients, including 89 cases of Usher syndrome were allocated to one of five clinically defined groups. We calculated the following prevalence rates: Usher syndrome type I: 1.5/100,000, Usher syndrome type II: 2.2/100,000, and Usher syndrome type III: 0.1/100,000 corresponding to a 2:3 ratio between Usher syndrome type I and II. The overall prevalence rate of Usher syndrome was estimated to 5/100,000 in the Danish population, devoid of genetic isolates. The material comprised 11 cases with retinal dystrophy, hearing impairment, and additional syndromic features. Finally, 18 subjects with various retinal dystrophy-hearing impairment associations without syndromic features were identified, corresponding to a prevalence rate of 0.8/100,000. This group had a significant overrepresentation of X-linked RP, including two persons harboring a mutation in the retinitis pigmentosa GTP-ase regulator (RPGR) gene.

Diabetes + Hypertension (comorbidity)

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Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This data set provides de-identified population data for diabetes and hypertension comorbidity prevalence in Allegheny County.

Characterisation of Physical Frailty and Associated Physical and Functional Impairments in Mild Cognitive Impairment

Directory of Open Access Journals (Sweden)

Ma Shwe Zin Nyunt

2017-12-01

Full Text Available ObjectiveTo characterize the physical frailty phenotype and its associated physical and functional impairments in mild cognitive impairment (MCI.MethodParticipants with MCI (N = 119, normal low cognition (NLC, N = 138, and normal high cognition (NHC, N = 1,681 in the Singapore Longitudinal Ageing Studies (SLAS-2 were compared on the prevalence of physical frailty, low lean body mass, weakness, slow gait, exhaustion and low physical activity, and POMA balance and gait impairment and fall risk.ResultsThere were significantly higher prevalence of frailty in MCI (18.5%, than in NLC (8.0% and NHC (3.9%, and pre-frailty in MCI (54.6%, NLC (52.9% than in NHC (48.0%. Age, sex, and ethnicity-adjusted OR (95% CI of association with MCI (versus NHC for frailty were 4.65 (2.40–9.04 and for pre-frailty, 1.67 (1.07–2.61. Similar significantly elevated prevalence and adjusted ORs of association with MCI were observed for frailty-associated physical and functional impairments. Further adjustment for education, marital status, living status, comorbidities, and GDS significantly reduced the OR estimates. However, the OR estimates remained elevated for frailty: 3.86 (1.83–8.17, low body mass: 1.70 (1.08–2.67, slow gait: 1.84 (1.17–2.89, impaired gait: 4.17 (1.98–8.81, and elevated fall risk 3.42 (1.22–9.53.ConclusionTwo-thirds of MCI were physically frail or pre-frail, most uniquely due to low lean muscle mass, slow gait speed, or balance and gait impairment. The close associations of frailty and physical and functional impairment with MCI have important implications for improving diagnostic acuity of MCI and targetting interventions among cognitively frail individuals to prevent dementia and disability.

Common comorbidities in women and men with epilepsy and the relationship between number of comorbidities and health plan paid costs in 2010.

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Wilner, A N; Sharma, B K; Soucy, A; Thompson, A; Krueger, A

2014-03-01

The objectives of this observational study were to determine the prevalence of the most common comorbidities in women and men with epilepsy and to demonstrate the relationship of these comorbidities to health plan paid costs. Data for 6621 members with epilepsy (52% women, 48% men) from eight commercial health plans were analyzed. The presence of comorbidities in people with epilepsy was identified by searching health insurance claims for 29 prespecified comorbidity-specific diagnosis codes. More women (50%) than men (43%) with epilepsy had one or more of the 29 comorbidities (pwomen and their relative prevalences were psychiatric diagnosis (16%), hypertension (12%), asthma (11%), hyperlipidemia (11%), headache (7%), diabetes (6%), urinary tract infection (5%), hypothyroidism (5%), anemia (5%), and migraine (4%). For men, the top 10 comorbidities and their relative prevalences were psychiatric diagnosis (15%), hyperlipidemia (12%), hypertension (12%), asthma (8%), diabetes (5%), headache (4%), cancer (4%), coronary artery disease (3%), anemia (3%), and gastroesophageal reflux disease (3%). Seven of the top 10 comorbidities were common to both women and men. Psychiatric diagnosis was the only comorbidity among the top five comorbidities for all age groups. The presence of one comorbidity approximately tripled the health-care cost for that member compared with the cost for members who had no comorbidities. Additional comorbidities generally further increased costs. The increase in health-care cost per member per month ($) with increase in number of comorbidities was greater for men than for women (p<0.05). Copyright © 2014 Elsevier Inc. All rights reserved.

Developmental Coordination Disorder, an umbrella term for motor impairments in children: nature and co-morbid disorders

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Laurence eVaivre-Douret

2016-04-01

Full Text Available Background:Developmental Coordination Disorder (DCD defines a heterogeneous class of children exhibiting marked impairment in motor coordination as a general group of deficits in fine and gross motricity (subtype mixed group common to all research studies, and with a variety of other motor disorders that have been little investigated. No consensus about symptoms and aetiology has been established. Methods: Data from 58 children aged 6 to 13 years with DCD were collected on DSM-IV criteria, similar to DSM- 5 criteria. They had no other medical condition and inclusion criteria were strict (born full-term, no medication, no occupational /physical therapy. Multivariate statistical methods were used to evidence relevant interactions between discriminant features in a general DCD subtype group and to highlight specific co-morbidities. The study examined age-calibrated standardized scores from completed assessments of psychological, neuropsychological and neuropsychomotor functions, and more specifically the presence of minor neurological dysfunctions (MND including neurological soft signs (NSS, without evidence of focal neurological brain involvement. These were not considered in most previous studies. Results: Findings show the salient DCD markers for the mixed subtype (imitation of gestures, digital perception, digital praxia, manual dexterity, upper and lower limb coordination, versus surprising co-morbidities, with 33% of MND with mild spasticity from phasic stretch reflex (PSR, not associated with the above impairments but rather with sitting tone (p= .004 and dysdiadochokinesia (p= .011. PSR was not specific to a DCD subtype but was related to increased impairment of coordination between upper and lower limbs and manual dexterity. Our results highlight the major contribution of an extensive neuro-developmental assessment (mental and physical. Discussion: The present study provides important new evidence in favour of a complete physical

Prevalence, correlates, and comorbidity of DSM-IV obsessive-compulsive personality disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions.

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Grant, Jon E; Mooney, Marc E; Kushner, Matt G

2012-04-01

Although recognized for over 100 years, there is a relative dearth of empirical research on obsessive compulsive personality disorder (OCPD). The goal of the current study is to present nationally representative findings on prevalence, sociodemographic correlates, and comorbidity of OCPD among men and women. The current study uses nationally representative data to examine sociodemographic correlates and comorbidity of OCPD. Face-to-face interviews were conducted with 43,093 adults in the United States. The prevalence of lifetime OCPD was 7.8%, with rates the same for men and women. OCPD was significantly less common in younger adults and in Asians and Hispanics but was significantly more common in individuals with a high school education or less. When sociodemographic variables and other comorbidities were controlled for, current associations remained significant for all mood and anxiety disorders as well as lifetime personality disorders among both men and women. OCPD is a prevalent personality disorder in the US population and is equally represented in men and women. The results highlight the need for further research to identify common pathophysiological elements common to OCPD and associated disorders. Copyright © 2012 Elsevier Ltd. All rights reserved.

Prevalence of visual impairment in El Salvador: inequalities in educational level and occupational status

Directory of Open Access Journals (Sweden)

Anna Rius

2014-11-01

Full Text Available OBJECTIVE: To examine the prevalence of blindness, visual impairment, and related eye diseases and conditions among adults in El Salvador, and to explore socioeconomic inequalities in their prevalence by education level and occupational status, stratified by sex. METHODS: Based upon the Rapid Assessment of Avoidable Blindness (RAAB methodology, this nationwide sample comprised 3 800 participants (3 399 examined ≥ 50 years old from 76 randomly selected clusters of 50 persons each. The prevalence of blindness, visual impairment and related eye diseases and conditions, including uncorrected refractive error (URE, was calculated for categories of education level and occupational status. Multiple logistic regression models were fitted to calculate odds ratios (ORs and 95% confidence intervals (CIs and stratified by sex. RESULTS: Age-adjusted prevalence was 2.4% (95% CI: 2.2-2.6 for blindness (men: 2.8% (95% CI: 2.5-3.1; women: 2.2% (95% CI: 1.9-2.5 and 11.8% (95% CI: 11.6-12.0 for moderate visual impairment (men: 10.8% (95% CI: 10.5-11.1; women: 12.6% (95% CI: 12.4-12.8. The proportion of visual impairment due to cataract was 43.8% in men and 33.5% in women. Inverse gradients of socioeconomic inequalities were observed in the prevalence of visual impairment. For example, the age-adjusted OR (AOR was 3.4 (95% CI: 2.0-6.4 for visual impairment and 4.3 (95% CI: 2.1-10.4 for related URE in illiterate women compared to those with secondary education, and 1.9 (95% CI: 1.1-3.1 in cataract in unemployed men. CONCLUSIONS: Blindness and visual impairment prevalence is high in the El Salvador adult population. The main associated conditions are cataract and URE, two treatable conditions. As socioeconomic and gender inequalities in ocular health may herald discrimination and important barriers to accessing affordable, good-quality, and timely health care services, prioritization of public eye health care and disability policies should be put in place

Prevalence of visual impairment in El Salvador: inequalities in educational level and occupational status.

Science.gov (United States)

Rius, Anna; Guisasola, Laura; Sabidó, Meritxell; Leasher, Janet L; Moriña, David; Villalobos, Astrid; Lansingh, Van C; Mujica, Oscar J; Rivera-Handal, José Eduardo; Silva, Juan Casrlos

2014-11-01

To examine the prevalence of blindness, visual impairment, and related eye diseases and conditions among adults in El Salvador, and to explore socioeconomic inequalities in their prevalence by education level and occupational status, stratified by sex. Based upon the Rapid Assessment of Avoidable Blindness (RAAB) methodology, this nationwide sample comprised 3 800 participants (3 399 examined) ≥ 50 years old from 76 randomly selected clusters of 50 persons each. The prevalence of blindness, visual impairment and related eye diseases and conditions, including uncorrected refractive error (URE), was calculated for categories of education level and occupational status. Multiple logistic regression models were fitted to calculate odds ratios (ORs) and 95% confidence intervals (CIs) and stratified by sex. Age-adjusted prevalence was 2.4% (95% CI: 2.2-2.6) for blindness (men: 2.8% (95% CI: 2.5-3.1); women: 2.2% (95% CI: 1.9-2.5)) and 11.8% (95% CI: 11.6-12.0) for moderate visual impairment (men: 10.8% (95% CI: 10.5-11.1); women: 12.6% (95% CI: 12.4-12.8)). The proportion of visual impairment due to cataract was 43.8% in men and 33.5% in women. Inverse gradients of socioeconomic inequalities were observed in the prevalence of visual impairment. For example, the age-adjusted OR (AOR) was 3.4 (95% CI: 2.0-6.4) for visual impairment and 4.3 (95% CI: 2.1-10.4) for related URE in illiterate women compared to those with secondary education, and 1.9 (95% CI: 1.1-3.1) in cataract in unemployed men. Blindness and visual impairment prevalence is high in the El Salvador adult population. The main associated conditions are cataract and URE, two treatable conditions. As socioeconomic and gender inequalities in ocular health may herald discrimination and important barriers to accessing affordable, good-quality, and timely health care services, prioritization of public eye health care and disability policies should be put in place, particularly among women, the unemployed, and

DSM-III-R generalized anxiety disorder in the National Comorbidity Survey.

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Wittchen, H U; Zhao, S; Kessler, R C; Eaton, W W

1994-05-01

Nationally representative general population data are presented on the current, 12-month, and lifetime prevalence of DSM-III-R generalized anxiety disorder (GAD) as well as on risk factors, comorbidity, and related impairments. The data are from the National Comorbidity Survey, a large general population survey of persons aged 15 to 54 years in the noninstitutionalized civilian population of the United States. DSM-III-R GAD was assessed by lay interviewers using a revised version of the Composite International Diagnostic Interview. Generalized anxiety disorder was found to be a relatively rare current disorder with a current prevalence of 1.6% but was found to be a more frequent lifetime disorder affecting 5.1% of the US population aged 15 to 45 years. Generalized anxiety disorder was twice as common among women as among men. Multivariate logistic regression analysis showed that being older than 24 years, separated, widowed, divorced, unemployed, and a homemaker are significant correlates of GAD. Consistent with studies in treatment samples, we found that GAD was frequently associated with a wide spectrum of other mental disorders, with a lifetime comorbidity among 90.4% of the people who had a history of GAD. Contrary to the traditional view that GAD is a mild disorder, we found that the majority of people with GAD, whether they were comorbid or not, reported substantial interference with their life, a high degree of professional help seeking, and a high use of medication because of their GAD symptoms. Although lifetime GAD is highly comorbid, the proportion of current GAD that is not accompanied by any other current diagnosis is high enough to indicate that GAD should be considered an independent disorder rather than exclusively a residual or prodrome of other disorders.

Monocular and binocular visual impairment in the UK Biobank study: prevalence, associations and diagnoses.

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McKibbin, Martin; Farragher, Tracey M; Shickle, Darren

2018-01-01

To determine the prevalence of, associations with and diagnoses leading to mild visual impairment or worse (logMAR >0.3) in middle-aged adults in the UK Biobank study. Prevalence estimates for monocular and binocular visual impairment were determined for the UK Biobank participants with fundus photographs and spectral domain optical coherence tomography images. Associations with socioeconomic, biometric, lifestyle and medical variables were investigated for cases with visual impairment and matched controls, using multinomial logistic regression models. Self-reported eye history and image grading results were used to identify the primary diagnoses leading to visual impairment for a sample of 25% of cases. For the 65 033 UK Biobank participants, aged 40-69 years and with fundus images, 6682 (10.3%) and 1677 (2.6%) had mild visual impairment or worse in one or both eyes, respectively. Increasing deprivation, age and ethnicity were independently associated with both monocular and binocular visual impairment. No primary diagnosis for the recorded level of visual impairment could be identified for 49.8% of eyes. The most common identifiable diagnoses leading to visual impairment were cataract, amblyopia, uncorrected refractive error and vitreoretinal interface abnormalities. The prevalence of visual impairment in the UK Biobank study cohort is lower than for population-based studies from other industrialised countries. Monocular and binocular visual impairment are associated with increasing deprivation, age and ethnicity. The UK Biobank dataset does not allow confident identification of the causes of visual impairment, and the results may not be applicable to the wider UK population.

Monocular and binocular visual impairment in the UK Biobank study: prevalence, associations and diagnoses

Science.gov (United States)

Farragher, Tracey M; Shickle, Darren

2018-01-01

Objective To determine the prevalence of, associations with and diagnoses leading to mild visual impairment or worse (logMAR >0.3) in middle-aged adults in the UK Biobank study. Methods and analysis Prevalence estimates for monocular and binocular visual impairment were determined for the UK Biobank participants with fundus photographs and spectral domain optical coherence tomography images. Associations with socioeconomic, biometric, lifestyle and medical variables were investigated for cases with visual impairment and matched controls, using multinomial logistic regression models. Self-reported eye history and image grading results were used to identify the primary diagnoses leading to visual impairment for a sample of 25% of cases. Results For the 65 033 UK Biobank participants, aged 40–69 years and with fundus images, 6682 (10.3%) and 1677 (2.6%) had mild visual impairment or worse in one or both eyes, respectively. Increasing deprivation, age and ethnicity were independently associated with both monocular and binocular visual impairment. No primary diagnosis for the recorded level of visual impairment could be identified for 49.8% of eyes. The most common identifiable diagnoses leading to visual impairment were cataract, amblyopia, uncorrected refractive error and vitreoretinal interface abnormalities. Conclusions The prevalence of visual impairment in the UK Biobank study cohort is lower than for population-based studies from other industrialised countries. Monocular and binocular visual impairment are associated with increasing deprivation, age and ethnicity. The UK Biobank dataset does not allow confident identification of the causes of visual impairment, and the results may not be applicable to the wider UK population. PMID:29657974

Prevalence of Mild Cognitive Impairment and Dementia in Saudi Arabia: A Community-Based Study.

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Alkhunizan, Muath; Alkhenizan, Abdullah; Basudan, Loay

2018-01-01

The age of the population in Saudi Arabia is shifting toward elderly, which can lead to an increased risk of mild cognitive impairment (MCI) and dementia. The aim of this study is to determine the prevalence of cognitive impairment (MCI and dementia) among elderly patients in a community-based setting in Riyadh, Saudi Arabia. In this cross-sectional study, we included patients aged 60 years and above who were seen in the Family Medicine Clinics affiliated with King Faisal Specialist Hospital and Research Centre. Patients with delirium, active depression, and patients with a history of severe head trauma in the past 3 months were excluded. Patients were interviewed during their regular visit by a trained physician to collect demographic data and to administer the validated Arabic version of the Montreal Cognitive Assessment (MoCA) test. One hundred seventy-one Saudi patients were recruited based on a calculated sample size for the aim of this study. The mean age of included sample was 67 ± 6 years. The prevalence of cognitive impairment was 45%. The prevalence of MCI was 38.6% and the prevalence of dementia was 6.4%. Age, low level of education, hypertension, and cardiovascular disease were risk factors for cognitive impairment. Prevalence of MCI and dementia in Saudi Arabia using MoCA were in the upper range compared to developed and developing countries. The high rate of risk factors for cognitive impairment in Saudi Arabia is contributing to this finding.

Prevalence of visual impairment and blindness in Upper Egypt: a gender-based perspective.

Science.gov (United States)

Mousa, Ahmed; Courtright, Paul; Kazanjian, Arminee; Bassett, Ken

2014-06-01

To estimate the prevalence, causes of and risk factors for vision loss in Upper Egypt. In this cross-sectional study, four villages in Upper Egypt were randomly selected; within these four villages, households were randomly selected and within the selected households all residents aged ≥ 40 years were enumerated and enrolled. Door-to-door eye examinations of household members were conducted. Data on relevant demographic and socioeconomic characteristics were collected. The prevalence and causes of vision loss and associated risk factors were assessed. Sex differences in prevalence and determinants were also evaluated. The prevalence of best eye presenting visual impairment, severe visual impairment, and blindness were 23.9%, 6.4%, and 9.3% respectively. The prevalence of blindness among women significantly exceeded that among men (11.8% vs. 5.4%, respectively, p = 0.021). The prevalence of cataract was 22.9% (higher in women, 26.5% than men 17.2%, p = 0.018). The prevalence of trachomatous trichiasis was 9.7% (higher among women, 12.5%, than men, 5.4%, p = 0.012). The principal causes of blindness were cataract (60%), uncorrected refractive errors (16%) and corneal opacities (12%). Age, sex, family size, illiteracy, unemployment, water source and sanitation methods and living conditions were the major risk factors for vision loss. The prevalence of visual impairment remains high in Egypt, particularly among women. Risk factors for blindness may differ between men and women. There is a need for qualitative investigations to better understand the causes behind the excess in prevalence of blindness among women.

[Prevalence and Comorbidity of Self-Reported Diagnosis of Burnout Syndrome in the General Population].

Science.gov (United States)

Maske, Ulrike E; Riedel-Heller, Steffi G; Seiffert, Ingeburg; Jacobi, Frank; Hapke, Ulfert

2016-01-01

To determine the prevalence and comorbid mental disorders of self-reported diagnosis of burnout syndrome in the general population of Germany. In the German Health Interview and Examination Survey (DEGS1) self-reported diagnosis of a burnout syndrome made by a physician or psychotherapist was assessed in a standardized interview (N = 7987). For N = 4483 mental disorders were determined with the Composite International Diagnostic Interview (CIDI). Weighted lifetime and 12-month prevalences were calculated. Lifetime prevalence of diagnosed burnout syndrome was 4.2 % (women 5.2 %, men 3.3 %), 12-month prevalence was 1.5 % (women 1.9 %, men 1.1 %). Highest prevalences were found in 40 - 59 year olds, in people with middle and high socio economic status and in women with low and men with high social support. Among the 12-month cases, 70.9 % had at least one DSM-IV disorder. Associations were found for the diagnosis of burnout syndrome with somatoform, affective and anxiety disorders. The diagnosis of burnout syndrome is less frequently given and reported than expected. People with a burnout diagnosis often have a manifest mental disorder. © Georg Thieme Verlag KG Stuttgart · New York.

Theory of mind in social anxiety disorder, depression, and comorbid conditions.

Science.gov (United States)

Washburn, Dustin; Wilson, Gillian; Roes, Meighen; Rnic, Katerina; Harkness, Kate Leslie

2016-01-01

Social anxiety disorder is characterized by marked interpersonal impairment, particularly when presenting with comorbid major depression. However, the foundational social-cognitive skills that underlie interpersonal impairment in comorbid and non-comorbid manifestations of SAD has to date received very little empirical investigation. In a sample of 119 young adults, the current study examined differences in theory of mind (ToM), defined as the ability to decode and reason about others' mental states, across four groups: (a) non-comorbid SAD; (b) non-comorbid Lifetime MDD; (c) comorbid SAD and Lifetime MDD; and (d) healthy control. The non-comorbid SAD group was significantly less accurate at decoding mental states than the non-comorbid MDD and control groups. Further, both the comorbid and non-comorbid SAD groups made significantly more 'excessive' ToM reasoning errors than the non-comorbid MDD group, suggesting a pattern of over-mentalizing. Findings are discussed in terms of their implications for understanding the social cognitive foundations of social anxiety. Copyright © 2015 Elsevier Ltd. All rights reserved.

Social phobia in Brazilian university students: prevalence, under-recognition and academic impairment in women.

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Baptista, Carlos Alberto; Loureiro, Sonia Regina; de Lima Osório, Flávia; Zuardi, Antonio Waldo; Magalhães, Pedro V; Kapczinski, Flávio; Filho, Alaor Santos; Freitas-Ferrari, Maria Cecília; Crippa, José Alexandre S

2012-02-01

Despite the fact that public speaking is a common academic activity and that social phobia has been associated with lower educational achievement and impaired academic performance, little research has examined the prevalence of social phobia in college students. The aim of this study was to evaluate the prevalence of social phobia in a large sample of Brazilian college students and to examine the academic impact of this disorder. The Social Phobia Inventory (SPIN) and the MINI-SPIN, used as the indicator of social phobia in the screening phase, were applied to 2319 randomly selected students from two Brazilian universities. For the second phase (diagnostic confirmation), four psychiatrists and one clinical psychologist administered the SCID-IV to subjects with MINI-SPIN scores of 6 or higher. The prevalence of social phobia among the university students was 11.6%. Women with social phobia had significantly lower grades than those without the disorder. Fear of public speaking was the most common social fear. Only two of the 237 students with social phobia (0.8%) had previously received a diagnosis of social phobia and were under treatment. Social phobia comorbidities were not evaluated in this study. The methods of assessment employed by the universities (written exams) may mask the presence of social phobia. This was not a population-based study, and thus the results are not generalizable to the entire population with social phobia. Preventive strategies are recommended to reduce the under-recognition and the adverse impact of social phobia on academic performance and overall quality of life of university students. Copyright © 2011 Elsevier B.V. All rights reserved.

The prevalence of visual impairment and blindness in underserved rural areas: a crucial issue for future.

Science.gov (United States)

Hashemi, H; Yekta, A; Jafarzadehpur, E; Doostdar, A; Ostadimoghaddam, H; Khabazkhoob, M

2017-08-01

PurposeTo determine the prevalence of visual impairment and blindness in underserved Iranian villages and to identify the most common cause of visual impairment and blindness.Patients and methodsMultistage cluster sampling was used to select the participants who were then invited to undergo complete examinations. Optometric examinations including visual acuity, and refraction were performed for all individuals. Ophthalmic examinations included slit-lamp biomicroscopy and ophthalmoscopy. Visual impairment was determined according to the definitions of the WHO and presenting vision.ResultsOf 3851 selected individuals, 3314 (86.5%) participated in the study. After using the exclusion criteria, the present report was prepared based on the data of 3095 participants. The mean age of the participants was 37.6±20.7 years (3-93 years). The prevalence of visual impairment and blindness was 6.43% (95% confidence interval (CI): 3.71-9.14) and 1.18% (95% CI: 0.56-1.79), respectively. The prevalence of visual impairment varied from 0.75% in participants aged less than 5 years to 38.36% in individuals above the age of 70 years. Uncorrected refractive errors and cataract were the first and second leading causes of visual impairment; moreover, cataract and refractive errors were responsible for 35.90 and 20.51% of the cases of blindness, respectively.ConclusionThe prevalence of visual impairment was markedly high in this study. Lack of access to health services was the main reason for the high prevalence of visual impairment in this study. Cataract and refractive errors are responsible for 80% of visual impairments which can be due to poverty in underserved villages.

Bipolar disorder with comorbid anxiety disorders: impact of comorbidity on treatment outcome in cognitive-behavioral therapy and psychoeducation

OpenAIRE

Hawke, Lisa D; Velyvis, Vytas; Parikh, Sagar V

2013-01-01

Background Comorbid anxiety disorders are extremely prevalent in bipolar disorder (BD) and have substantial impact on the course of illness. Limited evidence regarding treatment factors has led to a renewal of research efforts examining both the impact of treatments on comorbid anxiety and the impact of comorbid anxiety on treatments. The current study examines the impact of comorbid anxiety disorders on response to two psychosocial interventions for BD. Methods A sample of 204 patients with ...

Gender Differences in Anxiety Disorders: Prevalence, Course of Illness, Comorbidity and Burden of Illness

Science.gov (United States)

McLean, Carmen P.; Asnaani, Anu; Litz, Brett T.; Hofmann, Stefan G.

2011-01-01

Women have consistently higher prevalence rates of anxiety disorders, but less is known about how gender affects age of onset, chronicity, comorbidity, and burden of illness. Gender differences in DSM-IV anxiety disorders were examined in a large sample of adults (N = 20,013) in the United States using data from the Collaborative Psychiatric Epidemiology Studies (CPES). The lifetime and 12-month male:female prevalence ratios of any anxiety disorder were 1:1.7 and 1:1.79, respectively. Women had higher rates of lifetime diagnosis for each of the anxiety disorders examined, except for social anxiety disorder which showed no gender difference in prevalence. No gender differences were observed in the age of onset and chronicity of the illness. However, women with a lifetime diagnosis of an anxiety disorder were more likely than men to also be diagnosed with another anxiety disorder, bulimia nervosa, and major depressive disorder. Furthermore, anxiety disorders were associated with a greater illness burden in women than in men, particularly among European American women and to some extend also among Hispanic women. These results suggest that anxiety disorders are not only more prevalent but also more disabling in women than in men. PMID:21439576

Prevalence of Attention-Deficit/Hyperactivity Disorder (ADHD symptomatology and psychiatric comorbidity among adolescents diagnosed with ADHD in childhood

Directory of Open Access Journals (Sweden)

Stephen Walker

2011-03-01

Full Text Available Objectives: Given the paucity of research on adolescent ADHD, this study aimed to establish the prevalence of DSM-IV ADHD in a cohort of South African adolescents who had been diagnosed with the disorder in childhood. It also aimed to establish the prevalence of psychiatric comorbidities and adjustment difficulties in this sample. Method: Data regarding age of diagnosis, current ADHD status, current ADHD-related pharmacological management, current psychopathology and current adjustment were gathered from 64 adolescents and their guardians via self-report questionnaire. Descriptive statistics were calculated with regard to current ADHD status, comorbid psychopathology and adjustment difficulties, as well as current ADHD-related medication. Results: According to parent reports, 59.38% of the sample met DSM-IV criteria for ADHD Inattentive subtype, while 37.50% met the criteria for ADHD Hyperactive/Impulsive subtype. Approximately sixty-four percent (64.06% of the adolescents were still using stimulant medication. Based on the adolescent self-report, 43.75% of the sample reported clinically significant symptoms of psychopathology or maladjustment. Furthermore, 39.28% of the adolescents met the diagnostic criteria for at least one psychiatric comorbidity. Conclusion: ADHD did persist into adolescence in the current sample. A significant psychopathological and maladjustment load appears evident amongst adolescents previously diagnosed with ADHD despite continuous pharmacological management of the condition.

Coding of significant comorbidities and complications for stroke in rehabilitation.

Science.gov (United States)

Murray, Joanne; Pfeiffer, Rhonda; Scholten, Ingrid

2017-09-01

Comorbidities and complications of stroke have implications for level of care and hospital resources. It is critical, therefore, that hospital morbidity data accurately reflect the prevalence of these additional diagnoses. This study aimed to measure and describe the concordance between stroke clinicians/researchers and medical record coders when recording stroke and related diagnoses. Diagnoses recorded prospectively, according to defined criteria by a clinical research team, were compared with the coding of stroke comorbidities and complications as per the Australian Coding Standards (ACS) from the separations of 100 inpatients from three rehabilitation facilities in South Australia. Percentage agreement, kappa coefficient, sensitivity and specificity values were calculated. Kappa coefficients for agreement of prospective diagnoses with coding ranged from 0.08 to 0.819. The diagnoses with the highest agreement were stroke, aspiration pneumonia (nil cases), aphasia and dysphagia. The diagnoses with the lowest agreement were apraxia, cognitive impairment, constipation and dehydration. Not all stroke comorbidities are represented accurately in hospital morbidity datasets. Education of stroke clinicians about the current ACS may clarify expectations about medical record documentation for coding purposes which in turn may result in more accurate morbidity data and therefore costings for the rehabilitation sector.

Co-morbid disorders in Tourette syndrome

DEFF Research Database (Denmark)

Debes, Nanette Marinette Monique

2013-01-01

in persons with TS. Both in clinical cohorts and in population-based cohorts the prevalence of co-morbidities is high. The presence of co-morbid ADHD and/or OCD has an impact on psychosocial, educational, and neuropsychological consequences of TS and it is associated with higher rates of other co......-morbid disorders, like rage, anxiety, and conduct disorders. The symptoms of a co-morbid disorder might appear prior to the time that tics reach clinical attention. The TS phenotype probably changes during the course of the disease. The exact aetiology of the co-occurrence of co-morbid disorders and TS...

Severe obesity and comorbid condition impact on the weight-related quality of life of the adolescent patient.

Science.gov (United States)

Zeller, Meg H; Inge, Thomas H; Modi, Avani C; Jenkins, Todd M; Michalsky, Marc P; Helmrath, Michael; Courcoulas, Anita; Harmon, Carroll M; Rofey, Dana; Baughcum, Amy; Austin, Heather; Price, Karin; Xanthakos, Stavra A; Brandt, Mary L; Horlick, Mary; Buncher, Ralph

2015-03-01

To assess links between comorbid health status, severe excess weight, and weight-related quality of life (WRQOL) in adolescents with severe obesity and undergoing weight-loss surgery (WLS) to inform clinical care. Baseline (preoperative) data from Teen Longitudinal Assessment of Bariatric Surgery, a prospective multicenter observational study of 242 adolescents with severe obesity (MedianBMI = 50.5 kg/m(2); Meanage = 17.1; 75.6% female; 71.9% white) undergoing WLS, were used to examine the impact of demographics, body mass index (BMI), presence/absence of 16 comorbid conditions, and a cumulative comorbidity load (CLoad) index on WRQOL scores (Impact of Weight on Quality of Life-Kids). WRQOL was significantly lower than reference samples of healthy weight, overweight, and obese samples. Of 16 comorbid conditions, the most prevalent were dyslipidemia (74.4%), chronic pain (58.3%), and obstructive sleep apnea (56.6%). Male subjects had a greater CLoad (P = .01) and BMI (P = .01), yet less impairment in total WRQOL (P conditions (eg, stress urinary incontinence) also emerged as contributors to lower WRQOL. WRQOL impairment is substantial for adolescents with severe obesity undergoing WLS, with predictors varying by sex. These patient-data highlight targets for education, support, and adjunctive care referrals before WLS. Furthermore, they provide a comprehensive empirical base for understanding heterogeneity in adolescent WRQOL outcomes after WLS, as weight and comorbidity profiles change over time. Copyright © 2015 Elsevier Inc. All rights reserved.

PSYCHIATRIC COMORBIDITY IN PATIENTS WITH OPIOID DEPENDENCE

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Shihab Kattukulathil

2018-02-01

Full Text Available BACKGROUND Opioid dependence is a major public health problem in Kerala. Presence of psychiatric disorder among opioid dependent patients worsens the scenario. To date no attempts have been made to analyse the magnitude and pattern of comorbid psychiatric disorders in the state. MATERIALS AND METHODS We assessed 30 patients with ICD-10 diagnosis of opioid dependence syndrome for the presence of comorbid psychiatric disorders using structured clinical interview for DSM IV Axis 1 disorder (SCID-1. Patients with opioid withdrawal state, delirium and acute medical emergencies were excluded. RESULTS 56.7% of our subjects had a comorbid psychiatric disorder. Major depressive disorder was the most common one (n=7, 23.3%. Prevalence of other disorders were generalised anxiety disorder (n=6, 20%, bipolar affective disorder (n=3, 10% and schizophrenia (n=1, 3.3%. CONCLUSION Comorbid Psychiatric disorders are highly prevalent in opioid dependence. There is a need for further large sample studies in the areas of comorbidities and in the integrated strategies for the identification and management of both opioid dependence and comorbid psychiatric disorders.

Assessment of cognitive impairment in patients with Parkinson's disease: prevalence and risk factors

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Wang Q

2014-02-01

Full Text Available Qiumei Wang,1 Zhenxin Zhang,2 Ling Li,2 Hongbo Wen,2 Qun Xu3,4 1Department of Geriatrics, 2Department of Neurology, 3School of Basic Medicine, Peking Union Medical College Hospital, 4Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing, People's Republic of China Background: Although Parkinson's disease (PD is clinically characterized by motor symptoms, cognitive impairment is one of the most disabling non-motor symptoms. Despite it attracting increasing attention worldwide, less is known about its prevalence in the Chinese population. The objective of this study was to assess cognitive impairment and related risk factors in Chinese PD patients. Methods: We collected the demographic, diagnostic, and treatment information of 901 PD patients from 42 centers throughout the People's Republic of China, then administered a battery of neuropsychological tests, to assess motor, cognitive, and neuropsychiatric symptoms. Results: Overall, 193 of 901 (21.4% PD patients met the criteria for dementia (PD-D, and 206 (22.8% met the criteria for mild cognitive impairment (PD-MCI. Visuospatial dysfunction and attention/executive impairment predominated. Increased severity of cognitive impairment was associated with greater motor impairment. Patients with psychiatric symptoms, such as depression and hallucinations, were more likely to have dementia. Potentially, the younger-aged and more educated are shown less cognitive impairment, but age at onset, and levodopa equivalent dose, were not associated with the presence of cognitive dysfunction. Conclusion: The prevalence and profile of cognitive impairment in Chinese PD patients, as well as the risk factors, are similar as those reported for other races, but the frequency of nonamnestic cognitive domains differs. Keywords: cognitive impairment, risk factor, prevalence, Parkinson's disease

Prevalence of eye disease and visual impairment in Île de la Gonave, Haïti.

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Tousignant, B; Brûlé, J

2017-08-01

Epidemiological data describing the prevalence of blindness and visual impairment in Haiti are sparse. The Haitian National Committee for the Prevention of Blindness (CNPC) estimates the prevalence of blindness at 1 %. Other regional data estimate moderate and severe visual impairment at 5% and 22%, respectively. IRIS Mundial (IM) is a non-governmental organization collaborating with the CNPC to develop eye care infrastructure in Haiti. To estimate the prevalence and causes of blindness and visual impairment on the Haitian island of Gonâve, to assist in planning of relevant eye care infrastructure. Results from eye exams carried out by a team from IM in January 2013 have been compiled and analyzed. In all, 1724 patients were examined (38% men, 62% women). In the best eye, 87% of patients had visual acuity, 6% had moderate visual impairment, and 7% had severe visual impairment. Moreover, 1% of patients had high myopia, 1% high hyperopia, 1% high astigmatism, and 32% were presbyopic. Clinically significant binocular cataracts were found in 1.5 % of patients, while 2 % were diagnosed with probable glaucoma. Our data give a glimpse of the prevalence of visual impairment and ocular disease on Gonâve Island in Haiti. Uncorrected refractive error, cataracts, and glaucoma are confirmed as prevalent conditions in this population and their presence should guide the planning of relevant eye care interventions.

The Prevalence and Causes of Visaual Impairment and Blindness in a Rural Population in the North of Iran

Science.gov (United States)

HASHEMI, Hassan; REZVAN, Farhad; YEKTA, AbbasAli; OSTADIMOGHADDAM, Hadi; SOROUSH, Sara; DADBIN, Nooshin; KHABAZKHOOB, Mehdi

2015-01-01

Background: Visual impairment is a very important public health problem. In Iran, reports of visual impairment and blindness have been published from the urban population while the prevalence of visual impairment in the rural population has not been reported. The purpose of this study to determine the prevalence and causes of visual impairment, in a rural population in district of based on age and sex Methods: In a cross-sectional population-based study, using random cluster sampling, 13 of the 83 villages of Khaf County in the north east of Iran were selected. Eye examinations were performed in a Mobile Eye Clinic (Nooravaran Salamat, 2011) and included optometric examinations such as measuring uncorrected and corrected visual acuity along with non-cycloplegic refraction. Results: The prevalence of visual impairment, low vision, and blindness was 6.3% (95% CI 5.3–7.3), 3.4% (95% CI 2.6–4.1), and 3.0% (95% CI 2.3–3.6), respectively. The prevalence of visual impairment ranged from 1.8% in the participant younger than 20 years of age to 28% in the subjects aged 60 and over (Pimpairment and low vision was significantly higher in women. The most prevalent causes of visual impairment were uncorrected refractory error (54.5%) and cataract (17.6%). Conclusion: The prevalence of visual impairment was significantly higher in the rural population of this study when compared to previous reports from Iran. It seems that provision of therapeutic facilities like cataract surgery and availability of eyeglasses in villages can considerably reduce the prevalence of visual impairment. PMID:26258099

The Prevalence of Mild Cognitive Impairment in Diverse Geographical and Ethnocultural Regions: The COSMIC Collaboration.

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Perminder S Sachdev

Full Text Available Changes in criteria and differences in populations studied and methodology have produced a wide range of prevalence estimates for mild cognitive impairment (MCI.Uniform criteria were applied to harmonized data from 11 studies from USA, Europe, Asia and Australia, and MCI prevalence estimates determined using three separate definitions of cognitive impairment.The published range of MCI prevalence estimates was 5.0%-36.7%. This was reduced with all cognitive impairment definitions: performance in the bottom 6.681% (3.2%-10.8%; Clinical Dementia Rating of 0.5 (1.8%-14.9%; Mini-Mental State Examination score of 24-27 (2.1%-20.7%. Prevalences using the first definition were 5.9% overall, and increased with age (P < .001 but were unaffected by sex or the main races/ethnicities investigated (Whites and Chinese. Not completing high school increased the likelihood of MCI (P ≤ .01.Applying uniform criteria to harmonized data greatly reduced the variation in MCI prevalence internationally.

Prevalence of oral health status in visually impaired children

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KVKK Reddy

2011-01-01

Full Text Available Introduction: The epidemiological investigation was carried out among 228 children selected from two schools of similar socioeconomic strata in and around Chennai city. Materials and Methods: The study population consisted of 128 visually impaired and 100 normal school going children in the age group of 6-15 years. The examination procedure and criteria were those recommended by W.H.O. in 1997. Results: The mean DMFT/deft was 1.1 and 0.17,0.87 and 0.47 in visually impaired and normal children, respectively. Oral hygiene levels in both groups were: mean value in good category was 0.19 and 0.67, in fair category was 0.22 and 0.1, and in poor category 0.40 and 0.23 in visually impaired children and normal children, respectively. Trauma experienced children were 0.29 and 0.13 in visually impaired children and normal children, respectively. Conclusion: The conclusions drawn from this study were that there was a greater prevalence of dental caries, poorer oral hygiene, and higher incidence of trauma in visually impaired children.

Prevalence and Axis I Comorbidity of Full and Partial Posttraumatic Stress Disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions

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Pietrzak, Robert H.; Goldstein, Risë B.; Southwick, Steven M.; Grant, Bridget F.

2010-01-01

The present study used data from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions (n=34,653) to examine lifetime Axis I psychiatric comorbidity of posttraumatic stress disorder (PTSD) in a nationally representative sample of U.S. adults. Lifetime prevalences±standard errors of PTSD and partial PTSD were 6.4%±0.18 and 6.6%±0.18, respectively. Rates of PTSD and partial PTSD were higher among women (8.6%±0.26 and 8.6%±0.26) than men (4.1%±0.19 and 4.5%±0.21). Respondents with both PTSD and partial PTSD most commonly reported unexpected death of someone close, serious illness or injury to someone close, and sexual assault as their worst stressful experiences. PTSD and partial PTSD were associated with elevated lifetime rates of mood, anxiety, and substance use disorders, and suicide attempts. Respondents with partial PTSD generally had intermediate odds of comorbid Axis I disorders and psychosocial impairment relative to trauma controls and full PTSD. PMID:21168991

The prevalence of diabetes mellitus and impaired glucose tolerance ...

African Journals Online (AJOL)

The prevalence of diabetes mellitus and impaired glucose tolerance (IGT) was determined in 479 urbanised South African blacks (141 men and 338 women) of Zulu descent selected by cluster sampling in a suburb of Durban. All subjects underwent a modified glucose tolerance test whereby fasting and 2-hour postglucose ...

Sex differences in prevalence and comorbidity of alcohol and drug use disorders: results from wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions.

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Goldstein, Risë B; Dawson, Deborah A; Chou, S Patricia; Grant, Bridget F

2012-11-01

The present study examined sex differences in lifetime Axis I and II psychiatric comorbidity of DSM-IV alcohol use disorders (AUDs) and drug use disorders (DUDs) among general population U.S. adults. Using data from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions, Wave 2 lifetime prevalences of each disorder comorbid with alcohol abuse, alcohol dependence, drug abuse, and drug dependence were compared between men and women. Sex-specific associations of alcohol, any drug, and cannabis- and cocaine-specific abuse and dependence with each comorbid disorder were examined using logistic regression, first with adjustment for sociodemographic variables and then with additional adjustment for all other psychiatric disorders. Prevalences of most comorbid disorders differed significantly by sex among respondents with each AUD and DUD. However, after adjustment for sociodemographic characteristics and additional co-occurring psychiatric diagnoses, there were few sex differences in unique comorbid associations of specific AUDs and DUDs with specific psychiatric disorders. Rates of psychiatric disorders comorbid with AUDs and DUDs indicate large burdens of morbidity in both sexes, highlighting the need for careful assessment and appropriate treatment of both substance use and mental health disorders. The unique comorbid associations with AUDs and DUDs identified in this study further indicate the need for prospective etiological research to characterize these associations, their underlying mechanisms, and the possible sex specificity of those mechanisms.

Reduced prevalence of cognitive impairment in families with exceptional longevity

DEFF Research Database (Denmark)

Cosentino, Stephanie; Schupf, Nicole; Christensen, Kaare

2013-01-01

with exceptional longevity are protected against cognitive impairment consistent with Alzheimer disease. DESIGN Cross-sectional analysis. SETTING Multisite study in New York, Massachusetts, Pennsylvania, and Denmark. PARTICIPANTS A total of 1870 individuals (1510 family members and 360 spouse controls) recruited...... through the Long Life Family Study. MAIN OUTCOME AND MEASURE Prevalence of cognitive impairment based on a diagnostic algorithm validated using the National Alzheimer's Coordinating Center data set. RESULTS The cognitive algorithm classified 546 individuals (38.5%) as having cognitive impairment...... consistent with Alzheimer disease. Long Life Family Study probands had a slightly but not statistically significant reduced risk of cognitive impairment compared with spouse controls (121 of 232 for probands vs 45 of 103 for spouse controls; odds ratio = 0.7; 95% CI, 0.4-1.4), whereas Long Life Family Study...

Prevalence and causes of hearing impairment in Fundong Health District, North-West Cameroon.

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Ferrite, Silvia; Mactaggart, Islay; Kuper, Hannah; Oye, Joseph; Polack, Sarah

2017-04-01

To estimate the prevalence and causes of hearing impairment in Fundong Health District, North-West Cameroon. We selected 51 clusters of 80 people (all ages) through probability proportionate to size sampling. Initial hearing screening was undertaken through an otoacoustic emission (OAE) test. Participants aged 4+ years who failed this test in both ears or for whom an OAE reading could not be taken underwent a manual pure-tone audiometry (PTA) screening. Cases of hearing impairment were defined as those with pure-tone average ≥41 dBHL in adults and ≥35 dBHL in children in the better ear, or children under age 4 who failed the OAE test in both ears. Each case with hearing loss was examined by an ear, nose and throat nurse who indicated the main likely cause. We examined 3567 (86.9%) of 4104 eligible people. The overall prevalence of hearing impairment was 3.6% (95% confidence interval [CI]: 2.8-4.6). The prevalence was low in people aged 0-17 (1.1%, 0.7-1.8%) and 18-49 (1.1%, 0.5-2.6%) and then rose sharply in people aged 50+ (14.8%, 11.7-19.1%). Among cases, the majority were classified as moderate (76%), followed by severe (15%) and profound (9%). More than one-third of cases of hearing impairment were classified as unknown (37%) or conductive (37%) causes, while sensorineural causes were less common (26%). Prevalence of hearing impairment in North-West Cameroon is in line with the WHO estimate for sub-Saharan Africa. The majority of cases with known causes are treatable, with impacted wax playing a major role. © 2017 John Wiley & Sons Ltd.

Developing a successful treatment for co-morbid insomnia and sleep apnoea.

Science.gov (United States)

Sweetman, Alexander M; Lack, Leon C; Catcheside, Peter G; Antic, Nick A; Chai-Coetzer, Ching Li; Smith, Simon S; Douglas, James A; McEvoy, R Doug

2017-06-01

Insomnia and sleep apnoea are the two most common sleep disorders, found in 6% and 23-50% of the general population respectively. These disorders also frequently co-occur, with 39-58% of sleep apnoea patients reporting symptoms indicative of co-morbid insomnia. When these disorders co-occur, clinicians are faced with difficult treatment decisions, patients experience the additive detrimental impacts of both disorders, and the effectiveness of discrete treatments for each disorder may be impaired. A common finding is that co-morbid insomnia and sleep apnoea (COMISA) is more difficult to treat than either disorder presenting alone. Co-morbid insomnia reduces the initial acceptance of, and later adherence to, continuous positive airway pressure (CPAP) therapy for obstructive sleep apnoea. This has resulted in recent recommendations that treatment approaches should initially target COMISA patients' insomnia to remove this barrier to CPAP treatment, and improve patient outcomes. However, no randomised controlled trial outcomes investigating this treatment approach currently exist. The current article aims to review and integrate recent research examining the prevalence, characteristics, and theoretical mechanistic relationships between co-occurring insomnia and OSA, and discuss previous treatment attempts. Copyright © 2016 Elsevier Ltd. All rights reserved.

Comorbidity of Personality Disorders and Adult Attention Deficit Hyperactivity Disorder (ADHD)--Review of Recent Findings.

Science.gov (United States)

Matthies, Swantje; Philipsen, Alexandra

2016-04-01

Children suffering from attention deficit hyperactivity disorder (ADHD) may remit until adulthood. But, more than 60-80% have persisting ADHD symptoms. ADHD as an early manifesting neurodevelopmental disorder is considered a major risk factor for the development of comorbid psychiatric disorders in later life. Particularly, personality disorders are oftentimes observed in adult patients suffering from ADHD. If ADHD and personality disorders share common etiological mechanisms and/or if ADHD as a severely impairing condition influences psychological functioning and learning and leads to unfavorable learning histories is unclear. The development of inflexible and dysfunctional beliefs on the basis of real and perceived impairments or otherness due to the core symptoms of ADHD is intuitively plausible. Such beliefs are a known cause for the development of personality disorders. But, why some personality disorders are more frequently found in ADHD patients as for example antisocial and borderline personality disorder remains subject of debate. Because of the high prevalence of ADHD and the high impact of personality disorders on daily functioning, it is important to take them into account when treating patients with ADHD. Research on the developmental trajectories leading to personality disorders in adult ADHD patients might open the door for targeted interventions to prevent impairing comorbid clinical pictures.

Compulsive Buying Behavior: Characteristics of Comorbidity with Gambling Disorder.

Science.gov (United States)

Granero, Roser; Fernández-Aranda, Fernando; Steward, Trevor; Mestre-Bach, Gemma; Baño, Marta; Del Pino-Gutiérrez, Amparo; Moragas, Laura; Aymamí, Neus; Gómez-Peña, Mónica; Mallorquí-Bagué, Núria; Tárrega, Salomé; Menchón, José M; Jiménez-Murcia, Susana

2016-01-01

Compulsive buying behavior (CBB) has begun to be recognized as a condition worthy of attention by clinicians and researchers. Studies on the commonalities between CBB and other behavioral addictions such as gambling disorder (GD) exist in the literature, but additional research is needed to assess the frequency and clinical relevance of the comorbidity of CBB and GD. The aim of the study was to estimate the point-prevalence of CBB+GD in a clinical setting. Data corresponded to n = 3221 treatment-seeking patients who met criteria for CBB or GD at a public hospital unit specialized in treating behavioral addictions. Three groups were compared: only-CBB (n = 127), only-GD (n = 3118) and comorbid CBB+GD (n = 24). Prevalence for the co-occurrence of CBB+GD was 0.75%. In the stratum of patients with GD, GD+CBB comorbidity obtained relatively low point prevalence (0.77%), while in the subsample of CBB patients the estimated prevalence of comorbid GD was relatively high (18.9%). CBB+GD comorbidity was characterized by lower prevalence of single patients, higher risk of other behavioral addictions (sex, gaming or internet), older age and age of onset. CBB+GD registered a higher proportion of women compared to only-GD (37.5 vs. 10.0%) but a higher proportion of men compared to only-CBB (62.5 vs. 24.4%). Compared to only-GD patients, the simultaneous presence of CBB+GD was associated with increased psychopathology and dysfunctional levels of harm avoidance. This study provides empirical evidence to better understand CBB, GD and their co-occurrence. Future research should help delineate the processes through which people acquire and develop this comorbidity.

Compulsive Buying Behavior: Characteristics of Comorbidity with Gambling Disorder

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Roser eGranero

2016-04-01

Full Text Available Compulsive buying behavior (CBB has begun to be recognized as a condition worthy of attention by clinicians and researchers. Studies on the commonalities between CBB and other behavioral addictions such as gambling disorder (GD exist in the literature, but additional research is needed to assess the frequency and clinical relevance of the comorbidity of CBB and GD. The aim of the study was to estimate the point-prevalence of CBB+GD in a clinical setting. Data corresponded to n=3,221 treatment-seeking patients who met criteria for CBB or GD at a public hospital unit specialized in treating behavioral addictions. Three groups were compared: only-CBB (n=127, only-GD (n=3,118 and comorbid CBB+GD (n=24. Prevalence for the co-occurrence of CBB+GD was 0.75%. In the stratum of patients with GD, GD+CBB comorbidity obtained relatively low point prevalence (0.77%, while in the subsample of CBB patients the estimated prevalence of comorbid GD was relatively high (18.9%. CBB+GD comorbidity was characterized by lower prevalence of single patients, higher risk of other behavioral addictions (sex, gaming or internet, older age and age of onset. CBB+GD registered a higher proportion of women compared to only-GD (37.5% vs. 10.0% but a higher proportion of men compared to only-CBB (62.5% vs. 24.4%. Compared to only-GD patients, the simultaneous presence of CBB+GD was associated with increased psychopathology and dysfunctional levels of harm avoidance. This study provides empirical evidence to better understand CBB, GD and their co-occurrence. Future research should help delineate the processes through which people acquire and develop this comorbidity.

Prevalence of Physical Impairment Among the Elderlly Persons of the Tehran City in 1385

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Afsoon Nodehi Moghadam

2007-01-01

Full Text Available Objectives: Musculoskeletal pain is common in elderly people with prevalence range from 10% to 71%. Musculoskeletal pain is found to be a strong risk factor for disability in elderly woman. The purpose of this study is to examine the prevalence of physical impairment of elderly people. Methods & Materials: A physiotherapist has evaluated elderly persons files in four physiotherapy centers during 1384-85. Results: Knee osteoarthritis and low back pain respectively were the most common causes of physical impairment in elderly women. Prevalence of knee osteoarthritis is increasing. This increase is likely due to several factors: advancing age of population, increasing injuries and rapidly advancing rates of obesity. Age–related change of intervertebral disks, decreased back muscle strength and decreased bone mineral density may lead to low back pain. Conclusion: Knee osteoarthritis and low back pain are the most commom causes of physical impairment.

Social Anxiety Disorder and Mood Disorders Comorbidity

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Zerrin Binbay

2012-03-01

Full Text Available Social Anxiety Disorder is a common disorder leading functional impairment. The comorbidity between mood disorders with social anxiety disorder is relatively common. This comorbidity impacts the clinical severity, resistance and functionality of patients. The systematic evaluation of the comorbidity in both patient groups should not be ignored and be carefully conducted. In general, social anxiety disorder starts at an earlier age than mood disorders and is reported to be predictor for subsequent major depression. The absence of comorbidity in patients with social anxiety disorder is a predictor of good response to treatment. In bipolar disorder patients with comorbid social anxiety disorder, there is an increased level of general psychopathology. Besides, they have poor outcome and increased risk of suicide. In this article, comorbidity between these two disorders has been evaluated in detail.

Prevalence of Comorbidities in Rheumatoid Arthritis and Evaluation of Their Monitoring in Clinical Practice: The Spanish Cohort of the COMORA Study.

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Balsa, Alejandro; Lojo-Oliveira, Leticia; Alperi-López, Mercedes; García-Manrique, María; Ordóñez-Cañizares, Carmen; Pérez, Lorena; Ruiz-Esquide, Virginia; Corrales, Alfonso; Narváez, Javier; Rey-Rey, José; Rodríguez-Lozano, Carlos; Ojeda, Soledad; Muñoz-Fernández, Santiago; Nolla, Joan M; García-Torrón, José; Gamero, Fernando; García-Vicuña, Rosario; Hernández-Cruz, Blanca; Campos, José; Rosas, José; García-Llorente, José Francisco; Gómez-Centeno, Antonio; Cáliz, Rafael; Sanmartí, Raimon; Bermúdez, Alberto; Abasolo-Alcázar, Lydia; Fernández-Nebro, Antonio; Rodríguez-Rodríguez, Luis; Marras, Carlos; González-Gay, Miguel Ángel; Hmamouchi, Ihsane; Martín-Mola, Emilio

2017-07-12

To describe the prevalence of comorbidities in patients with RA in Spain and discuss their management and implications using data from the Spanish cohort of the multinational study on COMOrbidities in Rheumatoid Arthritis (COMORA). This is a national sub-analysis of the COMORA study. We studied the demographics and disease characteristics of 200 adults patients diagnosed with RA (1987 ACR), and routine practices for screening and preventing the following selected comorbidities: cardiovascular, infections, cancer, gastrointestinal, pulmonary, osteoporosis and depression. Patients had a mean age of 58 years and a mean RA duration of 10 years. Mean DAS28 score was 3.3 and approximately 25% of patients were in remission (DAS28 20% (51%), hypercholesterolemia (46%) or hypertension (41%) and smoking (25%) were the most common CV risk factors. For prostate, colon and skin cancers, only 9%, 10% and 18% of patients, respectively, were optimally monitored. Infections were also inadequately managed, with 7% and 17% of patients vaccinated against influenza and pneumococcal, respectively, as was osteoporosis, with 47% of patients supplemented with vitamin D and 56% with a bone densitometry performed. In Spain, the prevalence of comorbidities and CV risk factors in RA patients with established and advanced disease is relatively high, and their management in clinical daily practice remains suboptimal. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Prevalence of motor-skill impairment in preterm children who do not develop cerebral palsy: a systematic review.

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Williams, Jacqueline; Lee, Katherine J; Anderson, Peter J

2010-03-01

Motor skill impairment is a common negative outcome in children born preterm who do not develop cerebral palsy (CP). This study aimed to conduct a systematic review of current data to provide an accurate estimate of the prevalence of non-CP motor impairment in preterm children at school age. We searched the Medline, PubMed, and PsycInfo databases and relevant journals to identify all studies published post-1990 that reported the prevalence of motor impairment in school-aged children born preterm (children was 40.5/100. and for moderate motor impairment the estimate was 19.0/100. There was also a trend for lower motor impairment levels in samples born before 1990 compared with those born after 1990. Children born preterm are at increased risk of motor impairment, with prevalence three to four times greater than in the general population. This highlights the need for improved surveillance and intervention strategies in this group of children.

Prevalence and causes of blindness and visual impairment in the ...

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Public information systems, epidemiological data and funding for blindness programmes are often lacking and have hampered comprehensive blindness control programmes in the rural communities, a fact that underscores the importance of this study. Aim: To estimate the prevalence and causes of visual impairment and ...

Prevalence, comorbidities and outpatient treatment of anorexia and bulimia nervosa in German children and adolescents.

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Jaite, Charlotte; Hoffmann, Falk; Glaeske, Gerd; Bachmann, Christian J

2013-06-01

This study aimed at investigating the prevalence, psychiatric comorbidity and outpatient treatment in a sample of German children and adolescents with eating disorders (EDs). Data of a large German statutory health insurance company were analysed and outpatients aged between 10 and 21 years with an ED diagnosis in 2009 were identified. Of 248,558 insured children and adolescents, 1,404 patients (79.9 % females, mean age: 16.7; SD: 3.3 years) matched the inclusion criteria. The large majority of patients with anorexia nervosa (AN) and bulimia nervosa (BN) were females (94.7 and 92.7 %), on which we focus in the following analyses. The prevalence in females was 0.28 % (AN) and 0.20 % (BN). Psychiatric comorbidity was diagnosed in 59.8 % (AN) and 64.1 % (BN) of patients, respectively. Most patients were treated with psychotherapy (AN: 75.7 %, BN: 78.5 %), 16.4 % (AN) and 20.2 % (BN) of our patients received pharmacotherapy with either antidepressants or antipsychotics. 23.5 % (AN) and 21.1 % (BN) received no treatment with psychotherapy, antidepressants or antipsychotics. This naturalistic study suggests that in young ED outpatients, EDs seem to be underdiagnosed and treatment does not necessarily comply with current guidelines. Therefore, dissemination of state-of-the-art knowledge on diagnosis and treatment in children and adolescents with EDs constitutes an important educational goal.

Current comorbidity among consecutive adolescent psychiatric outpatients with DSM-IV mood disorders.

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Karlsson, Linnea; Pelkonen, Mirjami; Ruuttu, Titta; Kiviruusu, Olli; Heilä, Hannele; Holi, Matti; Kettunen, Kirsi; Tuisku, Virpi; Tuulio-Henriksson, Annamari; Törrönen, Johanna; Marttunen, Mauri

2006-06-01

To compare selected characteristics (age, sex, age of onset for depression, impairment, severity of depression, somatic comorbidity, and treatment status) of adolescents with currently comorbid and non-comorbid depression. A sample of 218 consecutive adolescent (13-19 years) psychiatric outpatients with depressive disorders, and 200 age- and sex-matched school-attending controls were interviewed for DSM-IV Axis I and Axis II diagnoses. Current comorbidity, most commonly with anxiety disorders, was equally frequent (>70%) in outpatients and depressed controls. Younger age (OR 0.20; 95% CI 0.08, 0.51) and male gender (OR 0.02; 95% CI 0.09, 0.55) were associated with concurrent disruptive disorders. Current comorbidity with substance use disorders (SUD) was independent of age (OR 1.13; 95% CI 0.51, 2.49) and sex (OR 0.51; 95% CI 0.22, 1.17). Personality disorders associated with older age (OR 2.06; 95% CI 1.10, 3.86). In multivariable logistic regression analysis, impairment (GAF comorbidity (OR 3.13; 95% CI 1.53, 6.45), while severity of depression and lifetime age of onset for depression were not. Adolescent depression presents with age- and sex-dependent patterns of multiple co-occurring problem areas. While many clinical characteristics of adolescent depression are not affected by comorbidity, comorbidity associates with increased impairment.

Migraine and its psychiatric comorbidities.

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Minen, Mia Tova; Begasse De Dhaem, Olivia; Kroon Van Diest, Ashley; Powers, Scott; Schwedt, Todd J; Lipton, Richard; Silbersweig, David

2016-07-01

Migraine is a highly prevalent and disabling neurological disorder associated with a wide range of psychiatric comorbidities. In this manuscript, we provide an overview of the link between migraine and several comorbid psychiatric disorders, including depression, anxiety and post-traumatic stress disorder. We present data on psychiatric risk factors for migraine chronification. We discuss the evidence, theories and methods, such as brain functional imaging, to explain the pathophysiological links between migraine and psychiatric disorders. Finally, we provide an overview of the treatment considerations for treating migraine with psychiatric comorbidities. In conclusion, a review of the literature demonstrates the wide variety of psychiatric comorbidities with migraine. However, more research is needed to elucidate the neurocircuitry underlying the association between migraine and the comorbid psychiatric conditions and to determine the most effective treatment for migraine with psychiatric comorbidity. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Prevalence and correlates of body dysmorphic disorder in a community sample of adolescents.

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Schneider, Sophie C; Turner, Cynthia M; Mond, Jonathan; Hudson, Jennifer L

2017-06-01

Body dysmorphic disorder typically begins in adolescence, yet little is known about the prevalence and correlates of the disorder in this age group. The current study aimed to explore the presenting features of adolescents meeting probable criteria for body dysmorphic disorder in a large community sample, and compare levels of comorbid psychopathology, quality of life and mental health service use between adolescents with probable body dysmorphic disorder and those without. Questionnaires were completed at school by 3149 adolescents: 63% male, aged 12-18 years ( M = 14.58). These assessed Diagnostic and Statistical Manual of Mental Disorders (4th ed.) body dysmorphic disorder criteria, past mental health service use and symptoms of body dysmorphic disorder, anxiety, depression, obsessive-compulsive disorder and eating disorders. In male participants, additional measures assessed quality of life, muscularity concerns, emotional symptoms, peer problems, conduct problems and hyperactivity. The prevalence of probable body dysmorphic disorder was 1.7%; there was no sex difference in prevalence, but older adolescents reported higher prevalence than younger adolescents. Probable body dysmorphic disorder participants reported substantially elevated levels of psychopathology, quality of life impairment and mental health service use compared to non-body dysmorphic disorder participants. The prevalence of body dysmorphic disorder in adolescents is similar to adult samples, and probable body dysmorphic disorder is associated with comorbidity, distress and functional impairment in a community sample. Further research is required to better understand the presentation of body dysmorphic disorder in adolescents, and to improve diagnosis and treatment.

Prevalence of impaired glucose tolerance and insulin resistance among obese children and adolescents

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Robabeh Ghergherechi

2010-07-01

Full Text Available Robabeh Ghergherechi1, Ali Tabrizi21Department of Pediatrics Endocrinology, Tabriz University of Medical Sciences, Tabriz, Iran; 2Students’ Research Committee, Tabriz University of Medical Sciences, Tabriz, IranPurpose: Obesity is one of the most important nutritional disorders in the world which has an obvious relationship with the incidence of metabolic diseases. Obesity prevalence has increased among children and adolescents during recent decades, leading to a rise in Type 2 diabetes mellitus (DM II prevalence in these two age brackets. Hence, the aim of this study was to assess impaired glucose tolerance and insulin resistance, and gather metabolic findings in obese children and adolescents.Methods and materials: We studied 110 obese children and adolescents (body mass index > 95th percentile for age and gender 4–18 years of age referred to the endocrine clinic of the Children’s Hospital at Tabriz University in a descriptive cross-sectional study. ­Fasting glucose, insulin, and lipid profile in all subjects were determined. Oral glucose tolerance test after eating 75 g/kg glucose was performed. Homeostatic model assessment was used to ­estimate insulin resistance.Results: Impaired glucose tolerance and insulin resistance prevalence in 68 obese adolescents was 14.7% and 31.8%, respectively. Impaired glucose tolerance and insulin resistance was not seen in 23.8% of 42 obese children. No case of DM II was seen. There was a significant statistical difference in glucose (P = 0.003 and insulin (P < 0.001 level at minute 120 in individuals with impaired glucose tolerance compared to obese children and adolescents without impaired glucose tolerance. Rate of insulin resistance in patients with impaired glucose tolerance was greater and had a significant statistical difference (P = 0.03.Conclusion: Obesity has a close relationship with increased risk of impaired glucose tolerance and insulin resistance in children and adolescents. Oral glucose

Auditory hallucinations in adults with hearing impairment: a large prevalence study.

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Linszen, M M J; van Zanten, G A; Teunisse, R J; Brouwer, R M; Scheltens, P; Sommer, I E

2018-03-20

Similar to visual hallucinations in visually impaired patients, auditory hallucinations are often suggested to occur in adults with hearing impairment. However, research on this association is limited. This observational, cross-sectional study tested whether auditory hallucinations are associated with hearing impairment, by assessing their prevalence in an adult population with various degrees of objectified hearing impairment. Hallucination presence was determined in 1007 subjects aged 18-92, who were referred for audiometric testing to the Department of ENT-Audiology, University Medical Center Utrecht, the Netherlands. The presence and severity of hearing impairment were calculated using mean air conduction thresholds from the most recent pure tone audiometry. Out of 829 participants with hearing impairment, 16.2% (n = 134) had experienced auditory hallucinations in the past 4 weeks; significantly more than the non-impaired group [5.8%; n = 10/173; p impairment, with rates up to 24% in the most profoundly impaired group (p impairment in the best ear. Auditory hallucinations mostly consisted of voices (51%), music (36%), and doorbells or telephones (24%). Our findings reveal that auditory hallucinations are common among patients with hearing impairment, and increase with impairment severity. Although more research on potential confounding factors is necessary, clinicians should be aware of this phenomenon, by inquiring after hallucinations in hearing-impaired patients and, conversely, assessing hearing impairment in patients with auditory hallucinations, since it may be a treatable factor.

Prevalence and Evolution of Renal Impairment in People Living With HIV in Rural Tanzania.

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Mapesi, Herry; Kalinjuma, Aneth V; Ngerecha, Alphonce; Franzeck, Fabian; Hatz, Christoph; Tanner, Marcel; Mayr, Michael; Furrer, Hansjakob; Battegay, Manuel; Letang, Emilio; Weisser, Maja; Glass, Tracy R

2018-04-01

We assessed the prevalence, incidence, and predictors of renal impairment among people living with HIV (PLWHIV) in rural Tanzania. In a cohort of PLWHIV aged ≥15 years enrolled from January 2013 to June 2016, we assessed the association between renal impairment (estimated glomerural filtration rate impairment at enrollment. Of 921 patients with normal renal function at baseline, 117 (12.7%) developed renal impairment during a median follow-up (interquartile range) of 6.2 (0.4-14.7) months. The incidence of renal impairment was 110 cases per 1000 person-years (95% confidence interval [CI], 92-132). At enrollment, logistic regression identified older age (adjusted odds ratio [aOR], 1.79; 95% CI, 1.52-2.11), hypertension (aOR, 1.84; 95% CI, 1.08-3.15), CD4 count impairment. Cox regression model confirmed older age (adjusted hazard ratio [aHR], 1.85; 95% CI, 1.56-2.20) and CD4 count impairment. Our study found a low prevalence of renal impairment among PLWHIV despite high usage of tenofovir and its association with age, hypertension, low CD4 count, and advanced WHO stage. These important and reassuring safety data stress the significance of noncommunicable disease surveillance in aging HIV populations in sub-Saharan Africa.

Prevalence, Causes and Social Factors of Visual Impairment among Chinese Adults: Based on a National Survey.

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Guo, Chao; Wang, Zhenjie; He, Ping; Chen, Gong; Zheng, Xiaoying

2017-09-08

Visual impairment has become a global challenge, especially for developing countries. This study aims to estimate the prevalence, causes and social factors of visual impairment among Chinese adults. Data were from a nationally representative population-based cross-sectional study. The study population were 1,909,199 non-institutionalized adults aged 18 years and older in mainland China. In the survey, low vision and blindness were checked by ophthalmologists according to the WHO best-corrected visual acuity (BCVA) criteria. Population weighted numbers and prevalence of low vision and blindness with 95% confidence intervals (CIs) were estimated where appropriate. Multivariable logistic regression analysis was used to identify the social factors of visual impairment. The weighted prevalence of visual impairment was 17.17 (95% CI, 16.84-17.50) per 1000 Chinese adults aged 18 years and older. Cataract (57.35%), disorders of choroid and retina (9.80%), and disorders of cornea (6.49%) contributed more than 70 percent to the visual impairment in Chinese adults. Older age groups, young or middle-aged male adults, female elders, illiterate, rural dwellers, non-eastern residents, singles, unemployment, and from family with lower income were associated with visual impairment. More efforts are warranted to enhance treatment and rehabilitation among people with eye disorders to prevent visual impairment.

Comorbidities are frequent in patients with gastroesophageal reflux disease in a tertiary health care hospital

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Joaquim Prado P Moraes-Filho

2009-01-01

Full Text Available INTRODUCTION: Several aspects of gastroesophageal reflux disease (GERD have been studied, but the frequency of comorbidities is not yet fully understood. OBJECTIVES: To study the prevalence of GERD comorbidities in a tertiary care hospital. METHODS: We prospectively studied 670 consecutive adult patients from the outpatient department of our facility. A diagnosis was established using clinical, endoscopic and/or pHmetry-related findings. Each patient's medical file was reviewed with respect to the presence of other medical conditions and diagnoses. RESULTS: Of the 670 patients, 459 (68.6% were female, and the mean age was 55.94 (17-80 years. We registered 316 patients (47.1% with the erosive form of GERD and 354 patients (52.9% with the non-erosive form. A total of 1,664 instances of comorbidities were recorded in 586 patients (87.5%, with the most common being arterial hypertension (21%, hypercholesterolemia (9%, obesity (9%, type II diabetes mellitus (5% and depression (4%. Two or more comorbidities were present in 437 individuals (64.8%. The occurrence of comorbidities increased with age and was higher in patients with the non-erosive form of GERD. CONCLUSIONS: In a tertiary referral population, comorbidities were very common, and these may have worsened the already impaired health-related quality of life of these patients. Clinicians caring for GERD patients in this setting must be aware of the likelihood and nature of comorbid disorders and their impact on disease presentation and patient management.

Prevalence of hearing impairment in a rural midwestern cohort: estimates from the Keokuk county rural health study, 1994 to 1998.

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Flamme, Gregory A; Mudipalli, V Ranjit; Reynolds, Stephen J; Kelly, Kevin M; Stromquist, Ann M; Zwerling, Craig; Burmeister, Leon F; Peng, Shu-Chen; Merchant, James A

2005-06-01

The current paper estimates the prevalence of hearing problems in a rural population, analyzes the prevalence of hearing problems across age groups, and compares the prevalence of hearing problems in this population with results obtained in other populations. Data were obtained from a random sample of the residents of a rural county, stratified by farm, rural non-farm, and town residence. Hearing test results were obtained from participants between the ages of 8 and 92 years (N = 1972; 47% male). Pure-tone thresholds were classified as normal or impaired using a number of metrics, including speech intelligibility index values. Selected comparisons of crude rates were made with previous population-based studies of hearing loss prevalence. Nearly all (99%) of the participants in this study had significant hearing impairment. Atypical hearing impairment is most prevalent at 6 kHz. In males, this excess impairment shifts to lower frequencies with age but monotonically decreases in females. Notched configurations were most common among those between 30 and 59 years old. In females, the prevalence of hearing impairments sufficient to interfere with speech understanding begins to rapidly increase in the 6th decade (4th decade in males). Comparisons with prior population-based studies in the United States and Great Britain identified few significant differences. Significant hearing impairment is common in rural populations. The high prevalence in this population is similar to that found in other population-based studies. Future studies are needed to examine (1) the risk factors for hearing impairment, (2) the natural course of hearing problems across the life span, and (3) the effect of programs for the prevention of hearing impairment and rehabilitation for persons with existing hearing impairments.

Comorbidity of Anxiety and Depression in Children and Adolescents: 20 Years After

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Cummings, Colleen M.; Caporino, Nicole E.; Kendall, Philip C.

2014-01-01

Brady and Kendall (1992) concluded that although anxiety and depression in youth are meaningfully linked, there are important distinctions, and additional research was needed. Since then, studies of anxiety-depression comorbidity in youth have increased exponentially. Following a discussion of comorbidity, we review existing conceptual models and propose a multiple pathways model to anxiety-depression comorbidity. Pathway 1 describes youth with a diathesis for anxiety, with subsequent comorbid depression resulting from anxiety-related impairment. Pathway 2 refers to youth with a shared diathesis for anxiety and depression, who may experience both disorders simultaneously. Pathway 3 describes youth with a diathesis for depression, with subsequent comorbid anxiety resulting from depression-related impairment. Additionally, shared and stratified risk factors contribute to the development of the comorbid disorder, either by interacting with disorder-related impairment or by predicting the simultaneous development of the disorders. Our review addresses descriptive and developmental factors, gender differences, suicidality, assessments, and treatment-outcome research as they relate to comorbid anxiety and depression, and to our proposed pathways. Research since 1992 indicates that comorbidity varies depending on the specific anxiety disorder, with Pathway 1 describing youth with either social phobia or separation anxiety disorder and subsequent depression, Pathway 2 applying to youth with co-primary generalized anxiety disorder and depression, and Pathway 3 including depressed youth with subsequent social phobia. The need to test the proposed multiple pathways model and to examine (a) developmental change and (b) specific anxiety disorders is highlighted. PMID:24219155

Prevalence and Prescription of Antidepressants in Depression with Somatic Comorbidity in Asia: The Research on East Asian Psychotropic Prescription Patterns Study

Institute of Scientific and Technical Information of China (English)

Chao Chen; Tian-Mei Si; Yu-Tao Xiang; Gabor S Ungvari; Chuan-Yue Wang; Yan-Ling He; Ee-Heok Kua

2015-01-01

Background:Depression is often comorbid with chronic somatic diseases.Few previous studies have investigated the prevalence of somatic diseases in depression or the prescription pattern of antidepressants in comorbidly depressed patients in Asia.This study aimed to investigate the prevalence of somatic comorbidity (SC) in depression and compared the prescriptions of antidepressants in depressed patients with and without SC.Methods:A total of 2320 patients treated with antidepressants in 8 Asian countries were examined,and a diagnosis was based on the International Classification of Disease,10th revision.We listed 17 common chronic somatic diseases.Patients' socio-demographic and clinical characteristics and psychotropic drug prescriptions were recorded using a standardized protocol and data collection procedure.Results:Of the patients examined,1240 were diagnosed with depression and 30％ of them (n =375) had SC.The most common comorbid condition was diabetes (23.7％).The patients with SC were more likely to seek help at a general hospital (74.7％ vs.47.2％),and had a higher incidence of symptoms involving sadness,disturbed sleep,and poor appetite.Noradrenergic and specific serotonergic antidepressant was prescribed more for patients with SC than for those without SC (30.4％ vs.22.9％).Conclusions:SC is common in depressed Asian patients.It is important to strengthen the recognition of depression,especially in general hospitals and when patients report some somatic discomfort.It is also a matter of urgency to establish evidence-based guidelines for the use of new antidepressants in depressed patients with SC.

Comorbid Mild Cognitive Impairment and Depressive Symptoms Predict Future Dementia in Community Older Adults: A 24-Month Follow-Up Longitudinal Study.

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Makizako, Hyuma; Shimada, Hiroyuki; Doi, Takehiko; Tsutsumimoto, Kota; Hotta, Ryo; Nakakubo, Sho; Makino, Keitaro; Suzuki, Takao

2016-10-18

Older adults with mild cognitive impairment (MCI) are non-demented, but demonstrate cognitive dysfunction, and have significantly higher risk of progressing to dementia. A better understanding of more sensitive risk factors, such as combination of cognitive and psychological status, for progression of MCI to dementia may be crucial for prevention of development of dementia. To examine MCI, depressive symptoms, and comorbid MCI and depressive symptoms as risk factors for development of dementia. A total of 3,663 community-dwelling older people were included in this prospective longitudinal study. MCI was determined by age- and education-adjusted objective cognitive impairment using computerized comprehensive cognitive measures including memory, attention/executive function, and processing speed. Depressive symptoms were measured using the 15-item Geriatric Depression Scale (GDS) and defined by a GDS score of 6 or more. During the 24-month follow-up period, 72 participants (2.0%) developed dementia. Baseline MCI was significantly associated with an increased risk of incident dementia (hazard ratio [HR], 3.2; 95% confidence interval [CI], 1.8-5.5) but depressive symptoms were not (2.0; 1.0-4.2) after adjusting for age, sex, education, prescribed medications, and walking speed. Participants with comorbid MCI and depressive symptoms at baseline had a higher risk of developing dementia (HR, 4.8; 2.3-10.5). Although MCI and depressive symptoms may be associated with increased risk for incident dementia independently, comorbid MCI and depressive symptoms have a significantly greater impact on dementia development among community-dwelling older adults.

Psychiatric comorbidity in forensic psychiatry.

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Palijan, Tija Zarković; Muzinić, Lana; Radeljak, Sanja

2009-09-01

For the past several years a numerous studies in the field of forensic psychiatry confirmed a close relationship between violent offenders and comorbid substance abuse. The comorbid substance abuse in violent offenders was usually unrecognized and misdiagnosed. Furthermore, comorbidity in forensic psychiatry describes the co-occurrence of two or more conditions or psychiatric disorder known in the literature as dual diagnosis and defined by World Health Organization (WHO). In fact, many violent offenders have multiple psychiatric diagnoses. Recent studies have confirmed causal relationship between major psychiatric disorders and concomitant substance abuse (comorbidity) in 50-80% of forensic cases. In general, there is a high level of psychiatric comorbidity in forensic patients with prevalence of personality disorders (50-90%), mood disorders (20-60%) and psychotic disorders (15-20%) coupled with substance abuse disorders. Moreover, the high prevalence of psychiatric comorbidities could be found in mentally retarded individuals, as well as, in epileptic patients. Drugs and alcohol abuse can produce serious psychotoxic effects that may lead to extreme violent behavior and consequently to serious criminal offence such as physical assault, rape, armed robbery, attempted murder and homicide, all due to an altered brain function and generating psychotic-like symptoms. Studies have confirmed a significant statistical relevance in causal relationship between substance abuse and violent offences. In terms of forensic psychiatry, the comorbidity strongly contributes in the process of establishing psychiatric diagnosis of diminished mental capacity or insanity at the time of the offence in the course of clinical assessment and evaluation of violent offenders. Today, the primary focus of forensic psychiatry treatment services (in-patient or community) is management of the violent offenders with psychiatric comorbidity which requires a multilevel, evidence based approach to

Cognition and Comorbidity Behavior in Hospitalized Patients Suffering from Stroke. Seychelles 2010-2011

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Armando Carlos Roca Socarras

2012-10-01

Full Text Available Background: cognitive impairment and high comorbidity are common health problems in patients with cerebrovascular disease. Objective: to describe the behavior of cognitive impairment and comorbidity in hospitalized patients suffering from stroke. Method: descriptive study of 77 patients with ischemic stroke admitted from April 2010 to December 2011, in Seychelles General Hospital. The behavior of this disease in relation to variables such as age, presence of chronic noncommunicable diseases, cognitive impairment, educational level, affected cerebral hemisphere and time of evolution was analyzed. Results: 68,9 % of patients presented cognitive impairment, their average age was 74,2 (± 9,19 years old compared to 62,4 (± 14,2 years old for those with no cognitive impairment. We found a higher frequency of chronic noncommunicable diseases in cognitively impaired patients with a Charlson comorbidity index of 2,11 (± 0,97. 18 patients with cognitive impairment and 23 patients with no cognitive impairment were diagnosed with depression. Conclusions: more than half of hospitalized patients experienced cognitive impairment and in most cases previous to cerebrovascular disease. Male patients predominated. There was an increase in age, severity of depression, as well as in the frequency of chronic noncommunicable diseases, and myocardial infarction of considerable size, in respect to patients with no cognitive impairment.

Prevalence of undetected cognitive impairment and depression in residents of an elderly care home.

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Al-Jawad, M; Rashid, A K; Narayan, K A

2007-12-01

The elderly population in Malaysia is growing rapidly. Some of the most vulnerable are in residential care. Research is needed into the characteristics of this population to aid clinicians and policy makers in addressing the needs of this group. This observational, cross-sectional study aims to determine prevalence of undetected cognitive impairment and depression in elderly care home residents in Malaysia. One hundred and sixty-seven people over 60 years of age living in a state run residential home were interviewed. Validated assessment tools were used to measure dependency, cognitive impairment and depression. The prevalence of probable dementia is 36.5%, with increasing prevalence with age and level of dependence. Prevalence of depression is 67.0% (major depression 13.2%), with more depression in males and in the Indian population. None of the identified cases had been previously investigated or treated for dementia or depression.

Latent class analysis of comorbidity patterns among women with generalized and localized vulvodynia: preliminary findings

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Nguyen RHN

2013-04-01

Full Text Available Ruby HN Nguyen,1 Christin Veasley,2 Derek Smolenski1,3 1Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, 2National Vulvodynia Association, Silver Spring, MD, 3National Center for Telehealth and Technology, Defense Centers of Excellence, Department of Defense, Tacoma, WA, USA Background: The pattern and extent of clustering of comorbid pain conditions with vulvodynia is largely unknown. However, elucidating such patterns may improve our understanding of the underlying mechanisms involved in these common causes of chronic pain. We sought to describe the pattern of comorbid pain clustering in a population-based sample of women with diagnosed vulvodynia. Methods: A total of 1457 women with diagnosed vulvodynia self-reported their type of vulvar pain as localized, generalized, or both. Respondents were also surveyed about the presence of comorbid pain conditions, including temporomandibular joint and muscle disorders, interstitial cystitis, fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, endometriosis, and chronic headache. Age-adjusted latent class analysis modeled extant patterns of comorbidity by vulvar pain type, and a multigroup model was used to test for the equality of comorbidity patterns using a comparison of prevalence. A two-class model (no/single comorbidity versus multiple comorbidities had the best fit in individual and multigroup models. Results: For the no/single comorbidity class, the posterior probability prevalence of item endorsement ranged from 0.9% to 24.4%, indicating a low probability of presence. Conversely, the multiple comorbidity class showed that at least two comorbid conditions were likely to be endorsed by at least 50% of women in that class, and irritable bowel syndrome and fibromyalgia were the most common comorbidities regardless of type of vulvar pain. Prevalence of the multiple comorbidity class differed by type of vulvar pain: both

Specific learning disorder: prevalence and gender differences.

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Kristina Moll

Full Text Available Comprehensive models of learning disorders have to consider both isolated learning disorders that affect one learning domain only, as well as comorbidity between learning disorders. However, empirical evidence on comorbidity rates including all three learning disorders as defined by DSM-5 (deficits in reading, writing, and mathematics is scarce. The current study assessed prevalence rates and gender ratios for isolated as well as comorbid learning disorders in a representative sample of 1633 German speaking children in 3rd and 4th Grade. Prevalence rates were analysed for isolated as well as combined learning disorders and for different deficit criteria, including a criterion for normal performance. Comorbid learning disorders occurred as frequently as isolated learning disorders, even when stricter cutoff criteria were applied. The relative proportion of isolated and combined disorders did not change when including a criterion for normal performance. Reading and spelling deficits differed with respect to their association with arithmetic problems: Deficits in arithmetic co-occurred more often with deficits in spelling than with deficits in reading. In addition, comorbidity rates for arithmetic and reading decreased when applying stricter deficit criteria, but stayed high for arithmetic and spelling irrespective of the chosen deficit criterion. These findings suggest that the processes underlying the relationship between arithmetic and reading might differ from those underlying the relationship between arithmetic and spelling. With respect to gender ratios, more boys than girls showed spelling deficits, while more girls were impaired in arithmetic. No gender differences were observed for isolated reading problems and for the combination of all three learning disorders. Implications of these findings for assessment and intervention of learning disorders are discussed.

Depressive symptomatology in severe dementia in a European sample: prevalence, associated factors and prescription rate of antidepressants.

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Giebel, Clarissa M; Sutcliffe, Caroline; Renom-Guiteras, Anna; Arve, Seija; Hallberg, Ingalill Rahm; Soto, Maria; Zabalegui, Adelaida; Hamers, Jan; Saks, Kai; Challis, David

2015-04-01

Depression is a common comorbid disorder of dementia. This study explores the prevalence of and factors associated with depressive symptomatology, and antidepressant prescription rates in severe dementia across eight European countries. In total, 414 people with severe dementia completed measures of cognition and quality of life (QoL), whilst carers completed proxy measures of activities of daily living (ADLs), depression, neuropsychiatric symptoms, QoL and comorbidity. Findings indicated that 30% of the sample had depression, whilst the highest and lowest prevalence of depression was reported in Germany and Finland, respectively. Lower QoL, the presence of pain and more frequent neuropsychiatric symptoms were associated with depressive symptomatology, whilst no significant relationship between impairment of ADLs, comorbidity, and depression emerged. Spain and Estonia had the highest and lowest rates of antidepressant prescribing, respectively, whilst Germany had the highest discrepancy between depressive symptomatology and prescription. The study highlights variations across countries in the prevalence of depressive symptomatology in severe dementia and prescription of antidepressants. Information about factors associated with depressive symptomatology may help to better identify and manage depression.

Clinical Profile and Comorbidity of Obsessive-Compulsive Disorder among Children and Adolescents: A Cross-Sectional Observation in Bangladesh

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Md. Hafizur Rahman Chowdhury

2016-01-01

Full Text Available Obsessive compulsive disorder (OCD is a common disorder characterised by persistent and unwanted intrusive thoughts, images, and urges and repetitive behaviours or mental acts and can cause pervasive impairments. In Bangladesh, the prevalence of OCD among children is 2% which is higher than in previous reporting. This study was aimed at looking into the type, frequency, and severity of symptoms of OCD and comorbidity among children and adolescents. A consecutive 60 OCD cases from a child mental health service with age range of 5–18 years were recruited and divided into below and above 12 years of age group. The assessment was carried out using standardized Bangla version of Development and Wellbeing Assessment and Children’s Yale-Brown Obsessive Compulsive Scale was administered. Of the obsession, contamination was the highest followed by doubt, and of the compulsion, washing/cleaning was the highest followed by checking, repeating, and ordering rituals. More than half of the subjects had severe OCD and comorbidity was present in 58% subjects. Specific phobia, social phobia, major depressive disorder, and tic disorder were more prevalent. These symptoms and comorbidity profile can serve the baseline data for a country like Bangladesh and further large scale study would better generalize the study results.

Risk Factor and Comorbidity of Migraine

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Woro Riyadina

2015-06-01

Full Text Available Background: Migraine is a chronic daily headache which interfere a quality of life. The purpose of this research is to obtain the prevalence, risk factors, and comorbidity of migraine. Methods: A cross sectional study involving 4771 subjects in 5 villages in the district of Central Bogor, Bogor City 2011–2012. Data collection was performed using WHO STEPS (interview, measurement, physical examination, and laboratory test. Results: In this study, the migraine prevalence was 22.43%, with significant risk factors were sex, age, and stress (p < 0.05. Comorbidity of migraine was coronary heart diseases (p < 0.05. There was no significant correlation between migraine with marital status, level of education, smoking, hypertension, obesity, total cholesterol, LDL, HDL, trigliseride level, and diabetes mellitus (p > 0.05. Conclusions: Risk factors which have significant association with migraine are sex, age, and stress, whereas coronary heart disease existed as a comorbidity with migraine.

Co-morbid disorders and sexual risk behavior in Nigerian adolescents with bipolar disorder

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Bakare Muideen O

2009-06-01

Full Text Available Abstract Background Adolescent onset bipolar disorder often presents with co-morbid disorders of which psychoactive substance use disorders are notable. Mania symptoms and co-morbid psychoactive substance use disorders prone adolescents with bipolar disorder to impulsivity, impaired judgment, and risk taking behavior which often includes sexual risk behavior. There are dearth of information on pattern of co-morbid disorders and sexual risk behavior in adolescent onset bipolar disorder in Nigeria. This study assessed the prevalence and pattern of co-morbid disorders and determined associated factors of sexual risk behavior among adolescents with bipolar disorder. Methods Socio-demographic information was obtained from the adolescents using socio-demographic questionnaire. Clinical interview, physical examination and laboratory investigations were employed to establish co-morbid disorders in these adolescents during the outpatient follow up visits over a one year period. Results A total of forty six (46 adolescents with bipolar disorder were followed up over a one year period. Twenty two (47.8% of the adolescents had co-morbid disorders with cannabis use disorders, alcohol use disorders, conduct disorder with or without other psychoactive substance use accounting for 23.9%, 8.7%, 13.0% respectively and HIV infection, though a chance finding accounting for 2.2%. Twenty one (45.7% of the adolescents had positive history of sexual risk behavior, which was significantly associated with presence of co-morbid disorders (p = 0.003, level of religion activities in the adolescents (p = 0.000, and marital status of the parents (p = 0.021. Conclusion When planning interventions for children and adolescents with bipolar disorder, special attention may need to be focused on group of adolescents with co-morbid disorders and propensity towards impulsivity and sexual risk behavior. This may help in improving long term outcome in this group of adolescents.

Cross-sectional study on prevalence, causes and avoidable causes of visual impairment in Maori children.

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Chong, Cheefoong; Dai, Shuan

2013-08-02

To provide information and comparison pertaining to visual impairment of Maori children with other children in New Zealand in particular: prevalence of blindness, causes of visual impairment, and avoidable causes of visual impairment. Retrospective data collection utilising the WHO/PBL eye examination record for children with blindness and low vision at Blind and Low Vision Education Network New Zealand (BLENNZ), Homai. Individuals not of Maori ethnicity or over the age of 16 were excluded from the study. 106 blind and 64 low-vision Maori children were studied. The main cause of blindness in Maori children is cortical visual impairment. Twenty-eight percent of causes of blindness in this population are potentially avoidable with non-accidental injury as the main cause. The prevalence of blindness and low vision in children amounts to 0.05% and 0.03%, respectively. The prevalence and causes of childhood blindness are comparable to the other ethnic groups in New Zealand. The main difference lies in avoidable causes of blindness, which appeared to be much higher in the Maori population. The leading cause of avoidable blindness in Maori children is caused by non-accidental injuries.

Ethnic variation in the prevalence of visual impairment in people attending diabetic retinopathy screening in the United Kingdom (DRIVE UK.

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Sobha Sivaprasad

Full Text Available To provide estimates of visual impairment in people with diabetes attending screening in a multi-ethnic population in England (United Kingdom.The Diabetic Retinopathy In Various Ethnic groups in UK (DRIVE UK Study is a cross-sectional study on the ethnic variations of the prevalence of DR and visual impairment in two multi-racial cohorts in the UK. People on the diabetes register in West Yorkshire and South East London who were screened, treated or monitored between April 2008 to July 2009 (London or August 2009 (West Yorkshire were included in the study. Data on age, gender, ethnic group, visual acuity and diabetic retinopathy were collected. Ethnic group was defined according to the 2011 census classification. The two main ethnic minority groups represented here are Blacks ("Black/African/Caribbean/Black British" and South Asians ("Asians originating from the Indian subcontinent". We examined the prevalence of visual impairment in the better eye using three cut-off points (a loss of vision sufficient for driving (approximately <6/9 (b visual impairment (<6/12 and (c severe visual impairment (<6/60, standardising the prevalence of visual impairment in the minority ethnic groups to the age-structure of the white population.Data on visual acuity and were available on 50,331 individuals 3.4% of people diagnosed with diabetes and attending screening were visually impaired (95% confidence intervals (CI 3.2% to 3.5% and 0.39% severely visually impaired (0.33% to 0.44%. Blacks and South Asians had a higher prevalence of visual impairment (directly age standardised prevalence 4.6%, 95% CI 4.0% to 5.1% and 6.9%, 95% CI 5.8% to 8.0% respectively compared to white people (3.3%, 95% CI 3.1% to 3.5%. Visual loss was also more prevalent with increasing age, type 1 diabetes and in people living in Yorkshire.Visual impairment remains an important public health problem in people with diabetes, and is more prevalent in the minority ethnic groups in the UK.

Prevalence, sleep characteristics, and comorbidities in a population at high risk for obstructive sleep apnea: A nationwide questionnaire study in South Korea.

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Jun-Sang Sunwoo

Full Text Available To determine the prevalence, sleep characteristics, and comorbidities associated with a high risk for obstructive sleep apnea (OSA in the Korean adult population.We analyzed data from 2,740 subjects who responded to a nationwide questionnaire survey of sleep characteristics. Those who qualified under two or more symptom categories of the Berlin questionnaire were defined as "at high risk for OSA". We investigated their socio-demographic information, sleep habits, and medical and psychiatric comorbidities. Logistic regression analyses were performed to identify factors and consequences significantly associated with a high risk for OSA.The prevalence of a high risk for OSA was 15.8% (95% confidence interval [CI] 14.5-17.2%. Multiple logistic regression analysis showed that old age (≥ 70 years, odds ratio [OR] 2.68 and body mass index ≥ 25 kg/m2 (OR 10.75 were significantly related with a high risk for OSA, whereas regular physical activity (OR 0.70 had a protective effect. Subjective sleep characteristics associated with a high risk for OSA were perceived insufficient sleep (OR 1.49, excessive daytime sleepiness (OR 1.88, and insomnia (OR 3.70. In addition, hypertension (OR 5.83, diabetes mellitus (OR 2.54, hyperlipidemia (OR 2.85, and anxiety (OR 1.63 were comorbid conditions independently associated with a high risk for OSA.This is the first study to demonstrate the prevalence of a high risk for OSA in a nationwide representative sample of the Korean adult population. These findings elucidate the epidemiology and clinical characteristics of those at high risk for OSA.

Functional Impairments in Children with ADHD: Unique Effects of Age and Comorbid Status

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Booster, Genery D.; DuPaul, George J.; Eiraldi, Ricardo; Power, Thomas J.

2012-01-01

Objective: Children with ADHD and comorbid disorders display poorer overall functioning compared with children with ADHD alone, though little research has examined the differential impact of externalizing versus internalizing comorbidities. Method: This study examined the impact of internalizing and externalizing comorbidities on the academic and…

Using the System of Least Prompts to Teach Personal Hygiene Skills to a High School Student with Comorbid Visual Impairment and Autism Spectrum Disorder

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Probst, Kristi M.; Walker, Virginia L.

2017-01-01

Introduction: This study evaluated the effectiveness of a workshop and follow-up coaching sessions on the implementation of the system of least prompts procedure by classroom team members and explored whether this intervention resulted in personal hygiene skill acquisition by a male high school student with comorbid visual impairment and autism…

PREVALENCE, MECHANISMS, AND MANAGEMENT OF CANCER-RELATED COGNITIVE IMPAIRMENT

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Janelsins, Michelle C.; Kesler, Shelli R.; Ahles, Tim A.; Morrow, Gary R.

2014-01-01

This review summarizes the current literature on cancer-related cognitive impairment (CRCI) with a focus on prevalence, mechanisms, and possible interventions for CRCI in those who receive adjuvant chemotherapy for non-central nervous system tumors and is primarily focused on breast cancer. CRCI is characterized as deficits in areas of cognition including memory, attention, concentration, and executive function. Development of CRCI can impair quality of life and impact treatment decisions. CRCI is highly prevalent; these problems can be detected in up to 30% of patients prior to chemotherapy; up to 75% of patients report some form of CRCI during treatment, and CRCI is still present in up to 35% of patients many years following completion of treatment. While the trajectory of CRCI is becoming better understood, the mechanisms underlying the development of CRCI are still obscure; however, host characteristics, immune dysfunction, neural toxicity, and genetics may play key roles in the development and trajectory of CRCI. Intervention research is limited, though strategies to maintain function are being studied with promising preliminary findings. This review highlights key research being conducted in these areas, both in patient populations and in animals, which will ultimately result in better understanding and effective treatments for CRCI. PMID:24716504

Are Trauma and Post-Traumatic Stress Disorder Connected to Psychiatric Comorbidity in Danish Pre-schoolers?

DEFF Research Database (Denmark)

Schandorph Løkkegaard, Sille; Bonnemann Egebæk, Sarah Agnethe; Elklit, Ask

2017-01-01

This study examined the onset of seven psychiatric disorders and the amount of functional impairment in 80 preschool children (ages 1–6 years) following different kinds of traumatic events. Assessed via caregiver reports from an age-modified diagnostic interview, 46.3% of the children were...... identified as suffering from PTSD. Of those children, 78.3% had at least one comorbid disorder with oppositional defiant disorder, separation anxiety disorder, and major depression disorder being the most common. The prevalence of the disorders was significantly higher compared to the group of children...... without diagnosed PTSD. Furthermore, all the children displayed a wide range of symptomatology with profound functional impairment in different domains such as interpersonal relations with caregivers, siblings, and peers. These findings provide empirical support for assessing trauma related symptoms...

Prevalence of Cognitive Impairment and Depression among a Population Aged over 60 Years in the Metropolitan Area of Guadalajara, Mexico.

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Ortiz, Genaro G; Arias-Merino, Elva D; Flores-Saiffe, María E; Velázquez-Brizuela, Irma E; Macías-Islas, Miguel A; Pacheco-Moisés, Fermín P

2012-01-01

Background. Cognitive impairment is an important clinical issue among elderly patients with depression and has a more complex etiology because of the variable rate of neurodegenerative changes associated with depression. The aim of the present work was to examine the prevalence of cognitive impairment and depression in a representative sample of adults aged ≥60 years. Methods. The presented work was a cross-sectional study on the prevalence of cognitive impairment and depression. Door-to-door interview technique was assigned in condition with multistage probability random sampling to obtain subjects that represent a population of the Guadalajara metropolitan area (GMA), Mexico. Cognitive function and depression were assessed by applying standardized Mini-Mental State Examination of Folstein (MMSE) and the Geriatric Depression Scale (GDS), respectively. Results. Prevalence of cognitive impairment was 13.8% (14.5% women, 12.6% men); no significant differences by gender and retired or pensioner were found. Prevalence of depression was 29.1% (33.6% women, 21.1% men); no significant differences by retired or pensioner were found. Cognitive impairment was associated with depression (OR  =  3.26, CI 95%, 2.31-4.60). Prevalence of cognitive impairment and depression is associated with: being woman, only in depression being older than 75 years being married, and a low level of education. Conclusion. Cognitive impairment and depression are highly correlated in adults aged ≥60.

ADHD characteristics: I. Concurrent co-morbidity patterns in children & adolescents

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Ambrosini Paul

2008-07-01

Full Text Available Abstract Objective 342 Caucasian subjects with attention deficit/hyperactivity disorder (ADHD were recruited from pediatric and behavioral health clinics for a genetic study. Concurrent comorbidity was assessed to characterize the clinical profile of this cohort. Methods Subjects 6 to 18 years were diagnosed with the Schedule for Affective Disorders & Schizophrenia for School aged Children (K-SADS-P IVR. Results The most prevalent diagnoses co-occurring with ADHD were Oppositional Defiant Disorder (ODD (40.6%, Minor Depression/Dysthymia (MDDD (21.6%, and Generalized Anxiety Disorder (GAD (15.2%. In Inattentive ADHD (n = 106, 20.8% had MDDD, 20.8% ODD, and 18.6% GAD; in Hyperactive ADHD (n = 31 41.9% had ODD, 22.2% GAD, and 19.4% MDDD. In Combined ADHD, (n = 203, 50.7% had ODD, 22.7% MDDD and 12.4% GAD. MDDD and GAD were equally prevalent in the ADHD subtypes but, ODD was significantly more common among Combined and Hyperactive ADHD compared to Inattentive ADHD. The data suggested a subsample of Irritable prepubertal children exhibiting a diagnostic triad of ODD, Combined ADHD, and MDDD may account for the over diagnosing of Bipolar Disorder. Conclusion Almost 2/3rd of ADHD children have impairing comorbid diagnoses; Hyperactive ADHD represents less than 10% of an ADHD sample; ODD is primarily associated with Hyperactive and Combined ADHD; and, MDDD may be a significant morbidity for ADHD youths from clinical samples.

Impact of Comorbidities on Mortality in Patients with Idiopathic Pulmonary Fibrosis.

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Michael Kreuter

Full Text Available Comorbidities significantly influence the clinical course of idiopathic pulmonary fibrosis (IPF. However, their prognostic impact is not fully understood. We therefore aimed to determine the impact of comorbidities, as individual and as whole, on survival in IPF.The database of a tertiary referral centre for interstitial lung diseases was reviewed for comorbidities, their treatments, their frequency and survival in IPF patients.272 patients were identified of which 12% had no, 58% 1-3 and 30% 4-7 comorbidities, mainly cardiovascular, pulmonary and oncologic comorbidities. Median survival according to the frequency of comorbidities differed significantly with 66 months for patients without comorbidities, 48 months when 1-3 comorbidities were reported and 35 months when 4-7 comorbidities were prevalent (p = 0.004. A multivariate Cox proportional hazard analyses identified other cardiac diseases and lung cancer as significant predictors of death, gastro-oesophageal reflux disease (GERD and diastolic dysfunction had a significant positive impact on survival. A significant impact of comorbidities associated therapies on survival was not discovered. This included the use of proton pump inhibitors at baseline, which was not associated with a survival benefit (p = 0.718. We also established a predictive tool for highly prevalent comorbidities, termed IPF comorbidome which demonstrates a new relationship of IPF and comorbidities.Comorbidities are frequent in IPF patients. Some comorbidities, especially lung cancer, mainly influence survival in IPF, while others such as GERD may inherit a more favourable effect. Moreover, their cumulative incidence impacts survival.

Prevalence and factors associated with childhood visual impairment in Ethiopia

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Bezabih L

2017-11-01

Full Text Available Lidiya Bezabih,1 Tilaye Workneh Abebe,1 Robera Olana Fite2 1Department of Public Health, College of Health Sciences, Adama General Hospital and Medical College, Adama, 2Department of Nursing, College of Medicine and Health Sciences, Wolaita Sodo University, Wolaita Sodo, Ethiopia Background: Visual impairment is a significant loss of vision. It has an impact on the prosperity of different countries. It has been difficult to plan preventive measures against visual impairment due to the scarcity of data about the extent of the problem.Objectives: The study was aimed at assessing the prevalence and identifying factors associated with visual impairment among school-age children in Ethiopia.Materials and methods: A cross-sectional study design was used in four randomly selected schools found in Addis Ababa from May 15 to June 14, 2016. A total of 804 school-age students were selected using the simple random sampling method. Bivariable logistic regression and multivariable logistic regression were conducted. A p-value <0.05 was taken as a significant association.Results: A total of 718 students participated in the study, obtaining a response rate of 89.3%. In all, 7.24% of school-age children were visually impaired, of whom 3.9% had low vision and 3.34% had severe visual impairment. Factors associated with visual impairment were being female (adjusted odds ratio [AOR], 2.28; 95% confidence interval [CI], 1.06–3.50, being in the age group of 10–13 years (AOR, 2.94; 95% CI, 1.36–6.22, being in the age group of 14–18 years (AOR, 4.06; 95% CI, 2.17–11.95, being a private school student (AOR, 2.61; 95% CI, 1.81–4.41, watching television for 2–4 hours/day (AOR, 3.56; 95% CI, 1.37–7.34, watching television at <1 m (AOR, 7.65; 95% CI, 2.59–34.61, watching television at 1–2 m (AOR, 6.89; 95% CI, 1.74–25.27, mobile exposure for 2–4 hours/day (AOR, 2.61; 95% CI, 1.35–4.58, mobile exposure for >4 hours/day (AOR, 3.05; 95% CI, 1

Prevalence and predictive factors of sleep bruxism in children with and without cognitive impairment

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Cristina Batista Miamoto

2011-10-01

Full Text Available Studies have found a higher prevalence of sleep bruxism (SB in individuals with cognitive impairment. The aim of this study was to identify the prevalence and factors associated with the clinical manifestation of SB in children with and without cognitive impairment. The sample was made up of 180 individuals: Group 1 - without cognitive impairment; Group 2 - with Down syndrome; Group 3 - with cerebral palsy. Malocclusions were assessed based on the Dental Aesthetic Index (DAI; lip competence was assessed based on Ballard's description. The bio-psychosocial characteristics were assessed via a questionnaire and clinical exam. Statistical analysis involved the chi-square test (p < 0.05 and multivariate logistic regression. The prevalence of bruxism was 23%. There were no significant differences between the groups (p = 0.970. Individuals with sucking habits (OR [95% CI] = 4.44 [1.5 to 13.0], posterior crossbite (OR [95% CI] = 3.04 [1.2 to 7.5] and tooth wear facets (OR [95% CI] = 3.32 [1.2 to 8.7] had a greater chance of exhibiting SB. Sucking habits, posterior crossbite and tooth wear facets were identified as being directly associated with the clinical manifestations of bruxism.

Comorbidities of asthma in U.S. children.

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Mirabelli, Maria C; Hsu, Joy; Gower, W Adam

2016-07-01

Few epidemiologic population-based data are available to describe the wide range of health conditions that affect children with asthma. We conducted this study to identify common comorbidities of asthma during childhood and compare the prevalences of selected comorbidities among children with and without asthma. We analyzed weighted data from the 2012 National Health Interview Survey child sample, a sample of 10,954 U.S. children aged 3-17 years. Information about each child's health, including history of asthma and other health conditions, was provided by an adult proxy respondent. We conducted binomial regression to compare the prevalences of 41 selected health conditions among children with and without current asthma. An estimated 10.4% of children aged 3-17 years (n = 1202) were identified as having current asthma. Nearly all conditions considered were more common among children with than without asthma. Compared to children without asthma, children with asthma had higher prevalences of hay fever or respiratory allergies (prevalence difference [PD]: 30.5%; 95% CI: 26.6, 34.4), eczema or skin allergies (PD: 14.1%; 95% CI: 10.7, 17.5), sinusitis (PD: 11.3%; 95% CI: 8.4, 14.1), food or digestive allergies (PD: 10.4%; 95% CI: 7.7, 13.1), and difficulty with emotions, concentration, behavior, or getting along (PD: 7.9%; 95% CI: 4.7, 11.1). These results highlight the burden of comorbidities among children with asthma. Improved understanding of the impact of comorbidities among children with asthma may help develop best practices for the assessment, treatment, and control of coexisting health conditions. Published by Elsevier Ltd.

Understanding migraine and psychiatric comorbidity.

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Seng, Elizabeth K; Seng, Cynthia D

2016-06-01

This article describes recent trends in our understanding of the role of psychiatric disorders in the experience and treatment of migraine, and the role of migraine in the experience and treatment of psychiatric disorders. Although the majority of studies evaluating psychiatric comorbidity in migraine have focused on depression, anxiety, and bipolar disorders are highly associated with migraine and relevant for prognosis and treatment planning. Comorbid psychiatric disorders may be associated with poorer treatment response for some acute pharmacotherapies; however, people with comorbid migraine and mood or anxiety disorders can achieve large responses to preventive pharmacologic and behavioral therapies. Emerging research is developing and evaluating behavioral treatments designed to manage cooccurring migraine and mood or anxiety disorders. Stigma related to psychiatric disorders has been well characterized, and could exacerbate extant migraine-related stigma. Anxiety and mood disorders are prevalent in people with migraine, although not ubiquitous. Psychiatric comorbidity is associated with greater migraine symptoms and disability; however, people with comorbid depression or anxiety are amenable to preventive migraine treatment. Research regarding migraine treatment strategies optimized for people with comorbid psychiatric disorders is critical to advancing care and reducing stigma for this important subpopulation of people with migraine.

Comorbid autoimmune diseases in patients with vitiligo: A cross-sectional study.

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Gill, Liza; Zarbo, Allison; Isedeh, Prescilia; Jacobsen, Gordon; Lim, Henry W; Hamzavi, Iltefat

2016-02-01

Few large-scale studies have quantified the burden of comorbid autoimmune diseases in patients with vitiligo. We sought to determine the prevalence of comorbid autoimmune diseases in patients with vitiligo. We conducted a manual chart review on a cohort of 1873 patients with vitiligo seen between January 2002 and October 2012 at the Henry Ford Health System in Detroit, MI. Patients were excluded if they had fewer than 2 dermatology notes (N = 595) or if they were never given a diagnosis of vitiligo by a dermatologist (N = 180). Of 1098 patients with vitiligo, nearly 20% had at least 1 comorbid autoimmune disease. Compared with the general US population, we found a higher prevalence of thyroid disease (12.9%, P vitiligo. We observed a high prevalence of comorbid autoimmune diseases in patients with vitiligo and report several new associations. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Prevalence and Causes of Visual Impairment in Fundong District, North West Cameroon: Results of a Population-Based Survey.

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Oye, Joseph; Mactaggart, Islay; Polack, Sarah; Schmidt, Elena; Tamo, Violet; Okwen, Marvice; Kuper, Hannah

2017-12-01

To estimate the prevalence and causes of visual impairment in Fundong Health District, North West Cameroon. A total of 51 clusters of 80 people (all ages) were sampled with probability proportionate to size and compact segment sampling. Visual acuity (VA) was measured with a tumbling "E" chart. An ophthalmic nurse examined people with VAimpairments were assessed using clinical examination, and self-reported visual problems using the Washington Group Short Set. In total, 4080 people were enumerated of whom 3567 were screened (response rate 87%). The overall prevalence of visual impairment was 2.3% (95% CI 1.8-3.0%) and blindness was 0.6% (0.3-1.0%). The prevalence of both blindness and visual impairment increased rapidly with age, so that the vast majority of cases of visual impairment (84%) and blindness (82%) were in people aged 50+. Posterior segment disease and cataract were the main causes of blindness and visual impairment, with refractive error also an important cause of visual impairment. Cataract surgical coverage (proportion of all cataracts that had received surgery) was relatively high (87% of people at VAvisual impairment, 22% had a physical impairment or epilepsy and 30% had a hearing impairment. Self-reported difficulties in vision were relatively closely related to clinical measures of visual impairment. Ophthalmic programmes in Cameroon need to incorporate control of posterior segment diseases while also working to improve outcomes after cataract surgery.

Cognitive impairment in rural elderly population in ecuador

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Xavier Wong-Achi

2017-01-01

Full Text Available Introduction: The Mini-Cog is a simple and short test that identifies cognitive impairment. Its detection helps provide an early dementia diagnosis, rapid access to treatments, and even delay or reversion. Materials and Methods: This multicenter, observational, descriptive, and cross-sectional study included 214 patients. Patients enrolled in this study were community dwellers aged ≥55-year-old, without prior diagnosis of cognitive impairment or dementia, with adequate hearing and vision functions. It was conducted in primary care health centers localized in rural communities of Ecuador. Results: Ages ranged from 50 to 98 years and there was predominance of female gender: 66% versus 33%. The percentage of illiteracy was 26.4% (CI: 25.32–27.48, and 63% (CI: 62.1–63.94 of patients had complete primary educational level. The overall prevalence of cognitive impairment was 50.9% (95% CI: 48.5–53.3 and 47.2% (95% CI: 45.2–49.2 in patients with risk factors. We found several established risk factors associated with cognitive impairment onset, including social factors, physiological factors, and comorbidities. Conclusion: This is the first epidemiological research of CI in rural populations in this country using the Mini-Cog as a screening tool. Adopting public health measures for the prevention and control of those modifiable risk factors could reduce the prevalence of cognitive impairment and even its progression to dementia.

Generalized anxiety disorder: A comorbid disease.

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Nutt, David; Argyropoulos, Spilos; Hood, Sean; Potokar, John

2006-07-01

Generalized anxiety disorder (GAD) frequently occurs comorbidly with other conditions, including depression and somatic complaints. Comorbid GAD sufferers have increased psychologic and social impairment, request additional treatment, and have an extended course and poorer outcome than those with GAD alone; therapy should alleviate both the psychic and somatic symptoms of GAD without negatively affecting the comorbid condition. The ideal treatment would provide relief from both GAD and the comorbid condition, reducing the need for polypharmacy. Physicians need suitable tools to assist them in the detection and monitoring of GAD patients-the GADI, a new, self-rating scale, may meet this requirement. Clinical data have shown that various neurobiologic irregularities (e.g., in the GABA and serotonin systems) are associated with the development of anxiety. Prescribing physicians must take into account these abnormalities when choosing a drug. Effective diagnosis and treatment should improve patients' quality of life and their prognosis for recovery.

A Cross-sectional Study of Prevalence and Etiology of Childhood Visual Impairment in Auckland, New Zealand.

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Chong, Chee Foong; McGhee, Charles N J; Dai, Shuan

2014-01-01

Childhood visual impairment has significant individual and socioeconomic costs with global differences in etiology and prevalence. This study aimed to determine prevalence, etiology, and avoidable causes of childhood visual impairment in New Zealand. Retrospective data analysis from a national referral center, the Blind and Low Vision Education Network New Zealand, Auckland. The World Health Organization Program for Prevention of Blindness eye examination records for visually impaired children, 16 years or younger, registered with the Auckland Visual Resource Centre, were included. Data analyzed included demographics, etiology, visual acuity, visual fields, educational setting, and rehabilitation plan. Charts of 340 children were examined, of which 267 children (144 blind, 123 low vision) were included in the analysis, whereas the remaining 73 charts of children with no visual impairment were excluded. The calculated prevalence of blindness and low vision was 0.05% and 0.04%, respectively, in the Auckland region. Principal causes of blindness affecting 91 children (63.9%) were cerebral visual impairment in 61 children (42.4%), optic nerve atrophy in 18 children (12.5%), and retinal dystrophy in 13 children (9.0%). The main potentially avoidable causes of blindness in 27 children (19%) were neonatal trauma, asphyxia in 9 children (33%), and nonaccidental injury 6 children (22%). This first report of prevalence for childhood blindness and low vision in New Zealand is similar to data from Established Market Economy countries. The leading causes of blindness are also comparable to other high-income countries; however, proportions of avoidable causes differ significantly.

Prevalence of Cognitive Impairment and Depression among a Population Aged over 60 Years in the Metropolitan Area of Guadalajara, Mexico

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Genaro G. Ortiz

2012-01-01

Full Text Available Background. Cognitive impairment is an important clinical issue among elderly patients with depression and has a more complex etiology because of the variable rate of neurodegenerative changes associated with depression. The aim of the present work was to examine the prevalence of cognitive impairment and depression in a representative sample of adults aged ≥60 years. Methods. The presented work was a cross-sectional study on the prevalence of cognitive impairment and depression. Door-to-door interview technique was assigned in condition with multistage probability random sampling to obtain subjects that represent a population of the Guadalajara metropolitan area (GMA, Mexico. Cognitive function and depression were assessed by applying standardized Mini-Mental State Examination of Folstein (MMSE and the Geriatric Depression Scale (GDS, respectively. Results. Prevalence of cognitive impairment was 13.8% (14.5% women, 12.6% men; no significant differences by gender and retired or pensioner were found. Prevalence of depression was 29.1% (33.6% women, 21.1% men; no significant differences by retired or pensioner were found. Cognitive impairment was associated with depression (OR  =  3.26, CI 95%, 2.31–4.60. Prevalence of cognitive impairment and depression is associated with: being woman, only in depression being older than 75 years being married, and a low level of education. Conclusion. Cognitive impairment and depression are highly correlated in adults aged ≥60.

Prevalence of Non-Alcoholic Fatty Liver Disease in Morbidly Obese Patients Undergoing Sleeve Bariatric Surgery in Iran and Association With Other Comorbid Conditions

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Karimi-Sari

2015-04-01

Full Text Available Background Nonalcoholic fatty liver disease (NAFLD is one of the most common causes of chronic liver disease including simple steatosis to nonalcoholic steatohepatitis (NASH. NASH could progress to cirrhosis and liver cancer. The prevalence of NAFLD is increasing by increasing the prevalence of obesity. Objectives This study was designed to determine the prevalence of NASH in morbidly obese patients undergoing sleeve bariatric surgery and its correlation with other comorbidities. Patients and Methods In this analytical cross-sectional study, 114 morbidly obese patients undergoing sleeve gastrectomy were selected. Liver ultrasonography was performed for all patients before surgery and NAFLD existence and its grade was determined by hyperechoic texture and fatty infiltration. The liver enzymes and lipid profile were also measured. Prevalence of NAFLD in these patients and its correlation with other comorbid conditions (e.g. diabetes mellitus, hyperlipidemia, hypertension, hypothyroidism and ischemic heart disease were evaluated by SPSS software version 18. Results One hundred fourteen patients with a mean age of 33.96 ± 9.92 years and mean BMI of 43.61 ± 5.77 kg/m2 were enrolled (48 males and 66 females. The prevalence of NAFLD was 16.7%. NAFLD existence was associated with systolic blood pressure, hyperlipidemia, hemoglobin, hematocrit, triglyceride, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and potassium (P < 0.05. Conclusions According to high prevalence of NAFLD in morbidly obese patients undergoing sleeve gastrectomy in Iran, we suggest using gold standard diagnostic method to determine the exact NAFLD prevalence and evaluation of impact of sleeve surgery on NAFLD in short and long term follow-up periods.

The Prevalence of Visual Acuity Impairment among School Children at Arada Subcity Primary Schools in Addis Ababa, Ethiopia.

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Darge, Haile Fentahun; Shibru, Getahun; Mulugeta, Abiy; Dagnachew, Yinebeb Mezgebu

2017-01-01

Visual impairment and blindness are major public health problems in developing countries where there is no enough health-care service. To determine the prevalence of visual impairment among school children. A school-based cross-sectional study was conducted between 15 June 2015 and 30 November 2015 at Arada subcity primary schools, Addis Ababa, Ethiopia. Two schools were selected randomly, and 378 students were screened from grades 1 to 8 using systematic random sampling method. Snellen chart was used for visual acuity test. Students who had visual acuity of ≤6/12 were further examined by an ophthalmologist to diagnose the reason for low vision. Data was analyzed using SPSS version 20. A total of 378 students were screened, and 192 (50.8%) were females and the remaining 186 (49.2%) were males. The prevalence of visual impairment (VA) of ≤6/12 on either eye was 5.8%, VA visual acuity impairment. The prevalence of visual impairment among school children in the study area was 5.8% and school screening is recommended.

Prevalence and prognosis of Alzheimer's disease at the mild cognitive impairment stage

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Vos, S.J.B.; Verhey, F.; Frolich, L.; Kornhuber, J.; Wiltfang, J.; Maier, W.; Peters, O.; Ruther, E.; Nobili, F.; Morbelli, S.; Frisoni, G. B.; Drzezga, A.; Didic, M.; van Berckel, B.N.M.; Simmons, A.; Soininen, H.; Kloszewska, I.; Mecocci, P.; Tsolaki, M.; Vellas, B.; Lovestone, S.; Muscio, C.; Herukka, S.K.; Salmon, E.; Bastin, C.; Wallin, A.; Nordlund, A.; de Mendonca, A.; Silva, D.; Santana, I.; Lemos, R.; Engelborghs, S.; Van der Mussele, S.; Freund-Levi, Y.; Wallin, A.K.; Hampel, H.; van der Flier, W.M.; Scheltens, P.; Visser, P.J.

2015-01-01

Three sets of research criteria are available for diagnosis of Alzheimer's disease in subjects with mild cognitive impairment: the International Working Group-1, International Working Group-2, and National Institute of Aging-Alzheimer Association criteria. We compared the prevalence and prognosis of

Psychiatric comorbidity and acculturation stress among Puerto Rican substance abusers.

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Conway, Kevin P; Swendsen, Joel D; Dierker, Lisa; Canino, Glorisa; Merikangas, Kathleen R

2007-06-01

Although acculturation to the United States has been associated with an increase in substance, mood, and anxiety disorders in Latino populations, few studies have examined this concept relative to comorbidity among these syndromes. This study compares the prevalence and patterns of psychiatric comorbidity among Puerto Ricans with substance use disorders living in San Juan (Puerto Rico) to those who have migrated to New Haven (Connecticut) and examines the association between acculturation-related stress and the prevalence and patterns of psychiatric comorbidity among those who have migrated to New Haven. Lifetime levels of nearly all comorbid psychiatric disorders among respondents with substance use disorders were generally similar across sites. However, the risk of any co-occurring psychiatric disorder was higher among substance use disorder cases in New Haven who reported high levels of total acculturation stress and family-specific acculturation stress. These findings were generally accounted for by associations between affective disorders and high scores on these indicators of acculturation stress. The overall prevalence and patterns of psychiatric comorbidity are remarkably similar among Puerto Rican substance abusers whether they live in San Juan or have migrated to New Haven, thereby demonstrating robustness to differences in geographic location. Nevertheless, the degree of acculturation-related family stress is positively associated with co-occurring substance and psychiatric disorders, particularly affective disorders. Intervention in family strain related to the acculturation process may diminish the development of comorbid mental disorders and assist in implementing successful treatment of substance abuse.

Prevalence of and Comorbid Health Conditions Associated With Pediatric Prescription Opioid Use in the US.

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Banerjee, Souvik; Roland, Carl L; Willke, Richard; Mardekian, Jack; Garrison, Louis P

Prescription opioids are among the most effective analgesics to treat moderate to severe pain; however, little is known about the use of prescription opioids in children, particularly those receiving an extended-release formulation for the treatment of chronic pain. In this retrospective study, the authors determined the prevalence of prescription opioid use among 7-17-year-old children and associated comorbid health conditions from 2010 to 2013 using Truven Health MarketScan (MarketScan) and Optum Clinformatics DataMart (Optum). The primary end points were prevalence of using any prescription opioids, using only prescription short-acting opioids (SAOs), and at least one prescription of a long-acting opioid (LAO). The prevalence of prescription opioid use among children is non-negligible and has been trending downwards: 6.90% in 2010 and 5.93% in 2013 using MarketScan and a similar trend using Optum: 5.47% in 2010 and 4.51% in 2013. Very few children had claims for LAOs, with only 0.04% (4979 children) in MarketScan and 0.03% (1117 children) in Optum. Given the very small number of children, primarily in the 12-17 age group, who are prescribed LAOs, there is a need to focus on a better understanding of the patterns of SAO use in children.

Impact of comorbidities and drug therapy on development of renal impairment in a predominantly African American and Hispanic HIV clinic population

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M Keith Rawlings

2011-01-01

Full Text Available M Keith Rawlings1, Jennifer Klein1, Edna P Toubes Klingler1, Ejeanée Queen1, Lauren Rogers1, Linda H Yau2, Keith A Pappa2, Gary E Pakes21AIDS Arms Peabody Health Clinic, Dallas, Texas; 2GlaxoSmithKline, Research Triangle Park, North Carolina, USAPurpose: Renal impairment in human immunodeficiency virus (HIV-infected patients could potentially be caused by many factors. HIV-related renal impairment risks have been little studied in African Americans and Hispanics. We investigated the impact of HIV itself, highly active antiretroviral therapy (HAART, comorbidities, and non-HIV-related drug treatment on glomerular filtration rate in a predominantly African American/Hispanic HIV-infected population who had received HAART for at least one year. This study was a retrospective electronic medical record database evaluation of renal impairment risks in a largely African American/Hispanic HIV population obtaining medical care at an HIV clinic in Dallas, Texas.Methods: Proportional hazards models were used to investigate an association between an estimated glomerular filtration rate decrease >25% from baseline (ie, renal impairment and demographics, antiretroviral/nonantiretroviral medications, comorbidities (hypertension, diabetes mellitus, hepatitis C virus [HCV] infection, hepatitis B virus [HBV] infection, CD4+ counts, viral load, and duration patients were monitored at the clinic (time on study.Results: In total, 323 patients were evaluated: 82% males; 61% African American/12% Hispanic/19% Caucasian; mean age 37.9 years (standard deviation [SD] 8.5; 6% HBV-positive; 34% HCV-positive; 29% hypertensive; 3% diabetic; 52% tenofovir-treated; mean weight 75.4 kg (SD, 15.4; mean estimated glomerular filtration 114.5 mL/min/1.73 m2 (SD, 36.7 using the Modification of Diet in Renal Disease (MDRD calculation method; mean creatinine clearance (from which estimated glomerular filtration was extrapolated by the Cockcroft-Gault calculation method 120.6 mL/min/1

Comorbid mental disorders among adults in the mental health surveillance survey.

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Forman-Hoffman, Valerie L; Batts, Kathryn R; Hedden, Sarra L; Spagnola, Kathy; Bose, Jonaki

2018-03-09

To examine the prevalence and correlates of mental disorder comorbidity in the adult U.S. household population. Data are from a nationally representative sample of noninstitutionalized, civilian adults aged 18 years or older (n = 5653) who participated in the 2008-2012 Mental Health Surveillance Study. Mental disorders, including substance use disorders, were assessed by clinical interviewers using a semistructured diagnostic instrument. Analyses examined co-occurrence of mental disorders and associations with sociodemographic, functional impairment, and treatment correlates. Approximately one-third of adults (31.1%, or more than 15 million) with a past-year mental disorder had a co-occurring mental disorder. Correlates of comorbidity in adjusted models included being of young age, being of non-Hispanic white race/ethnicity, having low family income, and living in a large metropolitan area. Adults with comorbid mental disorders had lower mean levels of functioning and were more likely to report past-year treatment than adults with a single disorder; they also had higher estimates of past-year perceived unmet need for care (21.7% vs. 11.6%, P mental disorder have a co-occurring mental disorder. Elucidating factors associated with co-occurrence may lend clues to shared etiologies, help improve prevention efforts, facilitate early identification, and improve treatment regimens. Copyright © 2018 Elsevier Inc. All rights reserved.

Effects of comorbidity and early age of onset in young people with Bipolar Disorder on self harming behaviour and suicide attempts.

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Moor, Stephanie; Crowe, Marie; Luty, Sue; Carter, Janet; Joyce, Peter R

2012-02-01

The age of the first episode of illness in Bipolar Disorder has been shown to be an important predictor of outcome with early onset, particularly onset before puberty, associated with greater comorbidity, a poorer quality of life and greatest impairment in functioning. Baseline data from a psychotherapy study was used to examine the prevalence of other comorbid psychiatric conditions and the impact of onset at an early age on both self harming behaviour and suicide attempts in young people with Bipolar Disorder. This study of 100 adolescents and young adults (aged 15-36 years) with Bipolar Disorder showed that comorbid conditions were very common, even at the start of their bipolar illness. Comorbidity increased as the age of onset decreased with very early onset (self harmed and attempted suicide with high lethal intent. Self harming behaviour was predicted by having a lifetime diagnoses of Borderline Personality Disorder and Panic Disorder along with an early age of onset of Bipolar Disorder. In contrast, previous suicide attempts were predicted by greater comorbidity and not by very early (<13 years) age of onset. Copyright © 2011 Elsevier B.V. All rights reserved.

[Tuberculosis and diabetes co-morbidity: an unresolved problem].

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Ugarte-Gil, César; Moore, David A J

2014-01-01

Co-morbidity between tuberculosis and diabetes has been described since the early 20th century. In developed countries, where there has been a decrease of infectious diseases with an increase of non-communicable diseases, as well as those countries who still have a high prevalence of infectious diseases but an increase of non-communicable diseases, it is observed that the prevalence of co-morbidity between tuberculosis and diabetes is increasing, making clinical management and control at the public health level a new challenge for health systems. This review aims to show the current available evidence that can inform research lines being developed to understand the problem. In countries like Peru, where there is an epidemiological transition, further research could allow us to understand and describe in a better way the characteristics and impact of this co-morbidity.

Prevalence of Visual Impairment among 4- to 6-years-old Children in Khon Kaen City Municipality, Thailand.

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Wongwai, Phanthipha; Anupongongarch, Pacharapan; Suwannaraj, Sirinya; Asawaphureekorn, Somkiat

2016-08-01

To evaluate the prevalence of visual impairment of children aged four to six years in Khon Kaen City Municipality, Thailand. The visual acuity test was performed on 1,286 children in kindergarten schools located in Khon Kaen Municipality. The first test of visual acuity was done by trained teachers and the second test by the pediatric ophthalmologist. The prevalence of visual impairment of both tests was recorded including sensitivity, specificity, likelihood ratio, and predictive value of the test by teachers. The causes of visual impairment were also recorded. There were 39 children with visual impairment from the test by the teacher and 12 children from the test by the ophthalmologist. Myopia is the single cause of visual impairment. Mean spherical equivalence is 1.375 diopters (SD = 0.53). Median spherical equivalence is 1.375 diopters (minimum = 0.5, maximum =4). The detection of visual impairment by trained teachers had a sensitivity of 1.00 (95% CI 0.76-1.00), specificity of 0.98 (95% CI 0.97-0.99), likelihood ratio for a positive test 44.58 (95% CI 30.32-65.54), likelihood ratio for a negative test 0.04 (95% CI 0.003-0.60), positive predictive value of 0.31 (95% CI 0.19-0.47), and negative predictive value of 1.00 (95% CI 0.99-1.00). The prevalence of visual impairment among children aged four to six year old is 0.9%. Trained teachers can be examiners for screening purpose.

The impact of comorbid impulsive/compulsive disorders in problematic Internet use.

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Chamberlain, Samuel R; Ioannidis, Konstantinos; Grant, Jon E

2018-05-23

Background and aims Problematic Internet use (PIU) is commonplace but is not yet recognized as a formal mental disorder. Excessive Internet use could result from other conditions such as gambling disorder. The aim of the study was to assess the impact of impulsive-compulsive comorbidities on the presentation of PIU, defined using Young's Diagnostic Questionnaire. Methods A total of 123 adults aged 18-29 years were recruited using media advertisements, and attended the research center for a detailed psychiatric assessment, including interviews, completion of questionnaires, and neuropsychological testing. Participants were classified into three groups: PIU with no comorbid impulsive/compulsive disorders (n = 18), PIU with one or more comorbid impulsive/compulsive disorders (n = 37), and healthy controls who did not have any mental health diagnoses (n = 67). Differences between the three groups were characterized in terms of demographic, clinical, and cognitive variables. Effect sizes for overall effects of group were also reported. Results The three groups did not significantly differ on age, gender, levels of education, nicotine consumption, or alcohol use (small effect sizes). Quality of life was significantly impaired in PIU irrespective of whether or not individuals had comorbid impulsive/compulsive disorders (large effect size). However, impaired response inhibition and decision-making were only identified in PIU with impulsive/compulsive comorbidities (medium effect sizes). Discussion and conclusions Most people with PIU will have one or more other impulsive/compulsive disorders, but PIU can occur without such comorbidities and still present with impaired quality of life. Response inhibition and decision-making appear to be disproportionately impacted in the case of PIU comorbid with other impulsive/compulsive conditions, which may account for some of the inconsistencies in the existing literature. Large scale international collaborations are

Comorbidities in interstitial lung diseases

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George A. Margaritopoulos

2017-01-01

Full Text Available Fibrosing lung disorders include a large number of diseases with diverse behaviour. Patients can die because of the progression of their illness, remain stable or even improve after appropriate treatment has been instituted. Comorbidities, such as acute and chronic infection, gastro-oesophageal reflux, pulmonary hypertension, lung cancer, cardiovascular diseases, and obstructive sleep apnoea, can pre-exist or develop at any time during the course of the disease and, if unidentified and untreated, may impair quality of life, impact upon the respiratory status of the patients, and ultimately lead to disease progression and death. Therefore, early identification and accurate treatment of comorbidities is essential.

Suicidal behaviors in adolescents with ADHD: associations with depressive and other comorbidity, parent-child conflict, trauma exposure, and impairment.

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Daviss, W Burleson; Diler, Rasim S

2014-11-01

To examine potential predictors of lifetime suicidal behaviors (SBs) in adolescents with ADHD. Participants were 101 adolescents with ADHD aged 11 to 18 years, evaluated for lifetime SB and psychopathology with semistructured interviews, and for lifetime trauma exposure, parent-child conflict, ADHD symptoms, and functional impairment with child, parent, and teacher ratings. Controlling for the effects of age, female sex, and comorbid depressive and other disorders, lifetime SB (n = 28) remained significantly associated (p = .001) with parent-child conflict, and to a lesser extent (p function and breadth of exposure to victimization events. Measures related to past and current ADHD symptoms and signs were not associated with lifetime SB. Apart from depression, clinicians should pay particular attention to parent-child conflict, victimization trauma, and social impairment rather than levels of ADHD symptoms when weighing the likelihood of SB in youth with ADHD. © 2012 SAGE Publications.

Prevalence and diagnostic validity of motivational impairments and deficits in visuospatial short-term memory and working memory in ADHD subtypes.

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Dovis, Sebastiaan; Van der Oord, Saskia; Huizenga, Hilde M; Wiers, Reinout W; Prins, Pier J M

2015-05-01

Deficits in working memory (WM) and reinforcement sensitivity are thought to give rise to symptoms in the combined (ADHD-C) and inattentive subtype (ADHD-I) of ADHD. Children with ADHD are especially impaired on visuospatial WM, which is composed of short-term memory (STM) and a central executive. Although deficits in visuospatial WM and reinforcement sensitivity appear characteristic of children with ADHD on a group-level, the prevalence and diagnostic validity of these impairments is still largely unknown. Moreover, studies investigating this did not control for the interaction between motivational impairments and cognitive performance in children with ADHD, and did not differentiate between ADHD subtypes. Visuospatial WM and STM tasks were administered in a standard (feedback-only) and a high-reinforcement (feedback + 10 euros) condition, to 86 children with ADHD-C, 27 children with ADHD-I (restrictive subtype), and 62 typically developing controls (aged 8-12). Reinforcement sensitivity was indexed as the difference in performance between the reinforcement conditions. WM and STM impairments were most prevalent in ADHD-C. In ADHD-I, only WM impairments, not STM impairments, were more prevalent than in controls. Motivational impairments were not common (22% impaired) and equally prevalent in both subtypes. Memory and motivation were found to represent independent neuropsychological domains. Impairment on WM, STM, and/or motivation was associated with more inattention symptoms, medication-use, and lower IQ scores. Similar results were found for analyses of diagnostic validity. The majority of children with ADHD-C is impaired on visuospatial WM. In ADHD-I, STM impairments are not more common than in controls. Within both ADHD subtypes only a minority has an abnormal sensitivity to reinforcement.

Comorbidities of asthma during childhood : possibly important, yet poorly studied

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de Groot, E. P.; Duiverman, E. J.; Brand, P. L. P.

Asthma in adults is associated with comorbidities such as obesity, gastro-oesophageal reflux, dysfunctional breathing and mental disorders. Herein, we provide an overview of the current state of evidence on these comorbidities in childhood asthma. The prevalence, known mechanisms and possible

Cardiovascular disease risk factors in a Nigerian population with impaired fasting blood glucose level and diabetes mellitus.

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Oguoma, Victor M; Nwose, Ezekiel U; Ulasi, Ifeoma I; Akintunde, Adeseye A; Chukwukelu, Ekene E; Bwititi, Phillip T; Richards, Ross S; Skinner, Timothy C

2017-01-06

Diabetes is a risk factor for cardiovascular diseases (CVDs) and there are reports of increasing prevalence of prediabetes in Nigeria. This study therefore characterised CVDs risk factors in subjects with impaired fasting glucose (IFG) and diabetes. Data from 4 population-based cross-sectional studies on 2447 apparently healthy individuals from 18 - 89 years were analysed. Anthropometric, blood pressure and biochemical parameters were collected and classified. Individuals with IFG (prediabetes) and diabetes were merged each for positive cases of dyslipidaemia, high blood pressure (HBP) or obesity. Optimal Discriminant and Hierarchical Optimal Classification Tree Analysis (HO-CTA) were employed. Overall prevalence of IFG and diabetes were 5.8% (CI: 4.9 - 6.7%) and 3.1% (CI: 2.4 - 3.8%), respectively. IFG co-morbidity with dyslipidaemia (5.0%; CI: 4.1 - 5.8%) was the highest followed by overweight/obese (3.1%; CI: 2.5 - 3.8%) and HBP (1.8%; CI: 1.3 - 2.4%). The predicted age of IFG or diabetes and their co-morbidity with other CVD risk factors were between 40 - 45 years. Elevated blood level of total cholesterol was the most predictive co-morbid risk factor among IFG and diabetes subjects. Hypertriglyceridaemia was an important risk factor among IFG-normocholesterolaemic-overweight/obese individuals. The higher prevalence of co-morbidity of CVD risk factors with IFG than in diabetes plus the similar age of co-morbidity between IFG and diabetes highlights the need for risk assessment models for prediabetes and education of individuals at risk about factors that mitigate development of diabetes and CVDs.

Burden of comorbidities among Japanese patients with atrial fibrillation: a case study of dyspepsia

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Kinoshita Y

2013-05-01

Full Text Available Yoshikazu Kinoshita,1 Marco DiBonaventura,2 Bruno Rossi,3 Kazuya Iwamoto,4 Edward C Y Wang,5 Jean-Baptiste Briere51Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan; 2Health Sciences Practice, Kantar Health, New York, NY, USA; 3Market Access, 4Medical Affairs Cardiovascular and Neurology, 5Health Economics and Outcomes Research, Bayer Yakuhin Ltd, Osaka, JapanBackground: The aim of this study was to investigate the link between atrial fibrillation (AF and dyspepsia, as well as the contribution of dyspepsia to the overall burden of AF.Methods: The 2008, 2009, and 2010 Japan National Health and Wellness Survey (NHWS datasets were used in this study. The NHWS is an Internet-based survey administered to the adult population in Japan using a random stratified sampling framework to ensure demographic representativeness. The presence of dyspepsia was compared between those with and without AF. Among those with AF, the effect of dyspepsia on health status, work productivity, and activity impairment was examined, along with health care resource use using multivariable regression modeling and controlling for baseline differences.Results: Among patients with AF (n = 565, the three most commonly reported comorbidities were hypertension (38.76%, dyspepsia (37.35%, and overactive bladder (28.72%. Patients with AF had 48.59% greater odds of reporting dyspepsia than those without AF (P < 0.05. Patients with dyspepsia used more AF medications (2.05 versus 1.54 and had been diagnosed more recently (9.97 versus 10.58 years. Dyspepsia was associated with significantly worse physical health status (P < 0.05 and significantly more absenteeism, overall work impairment, activity impairment, physician visits, and emergency room visits (all P < 0.05.Conclusion: Patients with AF in Japan experience a number of comorbidities, with dyspepsia being the most common noncardiovascular comorbidity. Given the prevalence and

Ethnic variation in the prevalence of visual impairment in people attending diabetic retinopathy screening in the United Kingdom (DRIVE UK).

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Sivaprasad, Sobha; Gupta, Bhaskar; Gulliford, Martin C; Dodhia, Hiten; Mann, Samantha; Nagi, Dinesh; Evans, Jennifer

2012-01-01

To provide estimates of visual impairment in people with diabetes attending screening in a multi-ethnic population in England (United Kingdom). The Diabetic Retinopathy In Various Ethnic groups in UK (DRIVE UK) Study is a cross-sectional study on the ethnic variations of the prevalence of DR and visual impairment in two multi-racial cohorts in the UK. People on the diabetes register in West Yorkshire and South East London who were screened, treated or monitored between April 2008 to July 2009 (London) or August 2009 (West Yorkshire) were included in the study. Data on age, gender, ethnic group, visual acuity and diabetic retinopathy were collected. Ethnic group was defined according to the 2011 census classification. The two main ethnic minority groups represented here are Blacks ("Black/African/Caribbean/Black British") and South Asians ("Asians originating from the Indian subcontinent"). We examined the prevalence of visual impairment in the better eye using three cut-off points (a) loss of vision sufficient for driving (approximately ethnic groups to the age-structure of the white population. Data on visual acuity and were available on 50,331 individuals 3.4% of people diagnosed with diabetes and attending screening were visually impaired (95% confidence intervals (CI) 3.2% to 3.5%) and 0.39% severely visually impaired (0.33% to 0.44%). Blacks and South Asians had a higher prevalence of visual impairment (directly age standardised prevalence 4.6%, 95% CI 4.0% to 5.1% and 6.9%, 95% CI 5.8% to 8.0% respectively) compared to white people (3.3%, 95% CI 3.1% to 3.5%). Visual loss was also more prevalent with increasing age, type 1 diabetes and in people living in Yorkshire. Visual impairment remains an important public health problem in people with diabetes, and is more prevalent in the minority ethnic groups in the UK.

Exceptionally low prevalence of refractive error and visual impairment in schoolchildren from Lao People's Democratic Republic.

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Casson, Robert J; Kahawita, Shyalle; Kong, Aimee; Muecke, James; Sisaleumsak, Siphetthavong; Visonnavong, Vithoune

2012-10-01

Vientiane Province is an urbanizing region in Southeast Asia. We aimed to determine the prevalence of refractive error and visual impairment in primary school-aged children in this region. Prospective, cross-sectional survey. A total of 2899 schoolchildren from Vientiane Province, Lao People's Democratic Republic (Lao PDR). Ten districts from Vientiane were randomly selected and 2 primary schools were randomly selected from each district. All children aged 6 to 11 years at selected schools were eligible to participate. The examination included visual acuity (VA) testing, cycloplegic retinoscopy with subjective refinement if indicated, ocular motility testing, and anterior segment and fundus examinations in visually impaired children. Cycloplegic refraction and VA. There was an estimated total of 3330 children who were eligible to participate, and data were recorded from 2899 (87%) of these children. Complete refractive data were available on 2842 children (85% of eligible population). The mean spherical equivalent (SE) in the right eyes was +0.60 diopter (D) (95% confidence interval [CI], 0.49-0.72), and the mean SE in the left eyes was +0.59 (95% CI, 0.50-0.68). The prevalence of hyperopia was 2.8% (95% CI, 1.9-3.7; 88 subjects), and the prevalence of myopia was 0.8% (95% CI, 0.3-1.4; 24 subjects). The majority of children (98%; 95% CI, 97.0-99.0) had normal unaided binocular VA (at least 20/32 in their better eye). The overall prevalence of any visual impairment (presenting VA <20/32 in the better eye) was 1.9% (95% CI, 1.0-2.9; 55 subjects). In multivariate logistic regression analysis, age (P = 0.001) was a significant predictor, and female gender (P = 0.08) and Yao ethnicity (P = 0.09) were borderline significant predictors of the presence of any visual impairment. Visual impairment is not a public health concern in this primary school-aged population; however, visually impaired children in the community were not studied. From this baseline, future surveys

The Decreasing Prevalence of Nonrefractive Visual Impairment in Older Europeans: A Meta-analysis of Published and Unpublished Data.

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Delcourt, Cécile; Le Goff, Mélanie; von Hanno, Therese; Mirshahi, Alireza; Khawaja, Anthony P; Verhoeven, Virginie J M; Hogg, Ruth E; Anastosopoulos, Eleftherios; Cachulo, Maria Luz; Höhn, René; Wolfram, Christian; Bron, Alain; Miotto, Stefania; Carrière, Isabelle; Colijn, Johanna M; Buitendijk, Gabriëlle H S; Evans, Jennifer; Nitsch, Dorothea; Founti, Panayiota; Yip, Jennifer L Y; Pfeiffer, Norbert; Creuzot-Garcher, Catherine; Silva, Rufino; Piermarocchi, Stefano; Topouzis, Fotis; Bertelsen, Geir; Foster, Paul J; Fletcher, Astrid; Klaver, Caroline C W; Korobelnik, Jean-François

2018-03-13

To estimate the prevalence of nonrefractive visual impairment and blindness in European persons 55 years of age and older. Few visual impairment and blindness prevalence estimates are available for the European population. In addition, many of the data collected in European population-based studies currently are unpublished and have not been included in previous estimates. Fourteen European population-based studies participating in the European Eye Epidemiology Consortium (n = 70 723) were included. Each study provided nonrefractive visual impairment and blindness prevalence estimates stratified by age (10-year strata) and gender. Nonrefractive visual impairment and blindness were defined as best-corrected visual acuity worse than 20/60 and 20/400 in the better eye, respectively. Using random effects meta-analysis, prevalence rates were estimated according to age, gender, geographical area, and period (1991-2006 and 2007-2012). Because no data were available for Central and Eastern Europe, population projections for numbers of affected people were estimated using Eurostat population estimates for European high-income countries in 2000 and 2010. The age-standardized prevalence of nonrefractive visual impairment in people 55 years of age or older decreased from 2.22% (95% confidence interval [CI], 1.34-3.10) from 1991 through 2006 to 0.92% (95% CI, 0.42-1.42) from 2007 through 2012. It strongly increased with age in both periods (up to 15.69% and 4.39% in participants 85 years of age or older from 1991 through 2006 and from 2007 through 2012, respectively). Age-standardized prevalence of visual impairment tended to be higher in women than men from 1991 through 2006 (2.67% vs. 1.88%), but not from 2007 through 2012 (0.87% vs. 0.88%). No differences were observed between northern, western, and southern regions of Europe. The projected numbers of affected older inhabitants in European high-income countries decreased from 2.5 million affected individuals in 2000 to 1

Epidemiology and comorbidity of psoriasis in children.

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Augustin, M; Glaeske, G; Radtke, M A; Christophers, E; Reich, K; Schäfer, I

2010-03-01

Psoriasis is a common disease affecting all age groups. In contrast to adult psoriasis, only few studies on the epidemiology of childhood psoriasis have been published. Assessment of prevalence and comorbidities of juvenile psoriasis in Germany based on health insurance data. Data were collected from a database of about 1.3 million nonselected individuals from a German statutory health insurance organization which covers all geographical regions. Individuals with psoriasis were identified by ICD-10 codes applied to all outpatient and inpatient visits. The present analysis consists of all patients who were enlisted throughout the year 2005. The diagnosis of psoriasis was registered whenever there was at least one documented patient contact using code L40.* and subcodes. Comorbidities were also evaluated by ICD-10 diagnoses. In total, 33 981 patients with the diagnosis of psoriasis were identified. The prevalence in 2005 was 2.5%. The total rate of psoriasis in children younger than 18 years was 0.71%. The prevalence rates increased in an approximately linear manner from 0.12% at the age of 1 year to 1.2% at the age of 18 years. The overall rate of comorbidity in subjects with psoriasis aged under 20 years was twice as high as in subjects without psoriasis. Juvenile psoriasis was associated with increased rates of hyperlipidaemia, obesity, hypertension, diabetes mellitus, rheumatoid arthritis and Crohn disease. Psoriasis is a common disease in children. Like in adults, it is associated with significant comorbidity. Increased attention should be paid to the early detection and treatment of patients affected.

Shorter sleep duration is associated with social impairment and comorbidities in ASD.

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Veatch, Olivia J; Sutcliffe, James S; Warren, Zachary E; Keenan, Brendan T; Potter, Melissa H; Malow, Beth A

2017-07-01

Sleep disturbance, particularly insomnia, is common in children with autism spectrum disorders (ASD). Furthermore, disturbed sleep affects core symptoms and other related comorbidities. Understanding the causes and consequences of sleep disturbances in children with ASD is an important step toward mitigating these symptoms. To better understand the connection between sleep duration and ASD severity, we analyzed ASD-related symptoms using the Autism Diagnostic Interview-Revised (ADI-R), Autism Diagnostic Observation Schedule (ADOS), IQ scores, and parent reports of the average amount of time slept per night that were available in the medical histories of 2,714 children with ASD in the Simons Simplex Collection (SSC). The mean (SD) sleep duration was 555 minutes. Sleep duration and severity of core ASD symptoms were negatively correlated, and sleep duration and IQ scores were positively correlated. Regression results indicated that more severe social impairment, primarily a failure to develop peer relationships, is the core symptom most strongly associated with short sleep duration. Furthermore, increased severity for numerous maladaptive behaviors assessed on the Child Behavior Checklist, as well as reports of attention deficit disorder, depressive disorder, and obsessive compulsive disorder were associated with short sleep duration. Severity scores for social/communication impairment and restricted and repetitive behaviors (RRB) were increased, and IQ scores were decreased, for children reported to sleep ≤420 minutes per night (lower 5th percentile) compared to children sleeping ≥660 minutes (upper 95th percentile). Our results indicate that reduced amounts of sleep are related to more severe symptoms in children with ASD. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 1221-1238. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. © 2017 International Society for Autism

The influence of COPD on health-related quality of life independent of the influence of comorbidity.

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van Manen, Jeannette G; Bindels, Patrick J E; Dekker, Friedo W; Bottema, Bernardus J A M; van der Zee, Jaring S; Ijzermans, C Joris; Schadé, Egbert

2003-12-01

The goal of this study was to determine the influence of chronic obstructive pulmonary disease (COPD) on health-related quality of life (HRQL) independent of comorbidity. Patients with COPD in general practice, >/=40 years, were selected. To recruit controls, a random sample of persons without COPD and >/=40 years, was taken. HRQL was assessed with the SF-36 and comorbidity was determined by questionnaire. The influence of COPD on HRQL independent of comorbidity (represented by adjusted regression coefficients) was significant for physical functioning (-27.6), role functioning due to physical problems (-21.6), vitality (-14.4), and general health (-25.7), and was minor and not significant for social functioning (-5.6), mental health (-1.3), role functioning due to emotional problems (-2.7), and bodily pain (-2.5). Comorbidity contributed significantly to the HRQL of all domains (-7.6 to -27.1). COPD patients can be impaired in all domains of HRQL. However, impairments in physical functioning, vitality, and general health are related to COPD and to some extent to comorbidity, while impairments in social and emotional functioning do not seem to be related to COPD, but only to comorbidity.

A comparison of DSM-5 and ICD-11 PTSD prevalence, comorbidity and disability: an analysis of the Ukrainian Internally Displaced Person's Mental Health Survey.

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Shevlin, M; Hyland, P; Vallières, F; Bisson, J; Makhashvili, N; Javakhishvili, J; Shpiker, M; Roberts, B

2018-02-01

Recently, the American Psychiatric Association (DSM-5) and the World Health Organization (ICD-11) have both revised their formulation of post-traumatic stress disorder (PTSD). The primary aim of this study was to compare DSM-5 and ICD-11 PTSD prevalence and comorbidity rates, as well as the level of disability associated with each diagnosis. This study was based on a representative sample of adult Ukrainian internally displaced persons (IDPs: N = 2203). Post-traumatic stress disorder prevalence was assessed using the PTSD Checklist for DSM-5 and the International Trauma Questionnaire (ICD-11). Anxiety and depression were measured using the Generalized Anxiety Disorder Scale and the Patient Health Questionnaire-Depression. Disability was measured using the WHO Disability Assessment Schedule 2.0. The prevalence of DSM-5 PTSD (27.4%) was significantly higher than ICD-11 PTSD (21.0%), and PTSD rates for females were significantly higher using both criteria. ICD-11 PTSD was associated with significantly higher levels of disability and comorbidity. The ICD-11 diagnosis of PTSD appears to be particularly well suited to identifying those with clinically relevant levels of disability. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Prevalence of caries in intellectually impaired children at Sekolah Semangat Maju, Taiping, Perak, Malaysia

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Sanjit Singh

2009-07-01

Full Text Available Dental caries also known as tooth decay is a disease where a bacterial process damages the hard tooth structure. The aim of conducting this research was to obtain the prevalence of caries in the intellectually impaired children in Sekolah Semangat Maju, Taiping, Perak, Malaysia. The research was a descriptive research that utilized the survey technique. The population of the research was the students aged 7-17 years old from class 1 to class 5. The total sample for this research was 56 students. The students were examined for the presence of caries and the results were used to obtain the prevalence of caries in these subjects. The results from this study showed that the prevalence of caries based on the student’s medical diagnose was 68.42% for autism students, 57.14% for cerebral palsy students, 91.67% for Down’s syndrome students, 100.00% for mental retardation students and 42.86% for slow learner students. The conclusion from this research was that the overall prevalence of caries in intellectually impaired children at Sekolah Semangat Maju Taiping, Perak, Malaysia is 67.89%.

Lifetime Prevalence, Age of Risk, and Etiology of Comorbid Psychiatric Disorders in Tourette Syndrome

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Hirschtritt, Matthew E.; Lee, Paul C.; Pauls, David L.; Dion, Yves; Grados, Marco A.; Illmann, Cornelia; King, Robert A.; Sandor, Paul; McMahon, William M.; Lyon, Gholson J.; Cath, Danielle C.; Kurlan, Roger; Robertson, Mary M.; Osiecki, Lisa; Scharf, Jeremiah M.; Mathews, Carol A.

2015-01-01

Importance Tourette syndrome (TS) is characterized by high rates of psychiatric comorbidity; however, few studies have fully characterized these comorbidities. Furthermore, most studies have included relatively few participants (Tourette syndrome was associated with increased risk of anxiety (odds ratio [OR], 1.4; 95% CI, 1.0–1.9; P = .04) and decreased risk of substance use disorders (OR, 0.6; 95% CI, 0.3–0.9; P = .02) independent from comorbid OCD and ADHD; however, high rates of mood disorders among participants with TS (29.8%) may be accounted for by comorbid OCD (OR, 3.7; 95% CI, 2.9–4.8; P < .001). Parental history of ADHD was associated with a higher burden of non-OCD, non-ADHD comorbid psychiatric disorders (OR, 1.86; 95% CI, 1.32–2.61; P < .001). Genetic correlations between TS and mood (RhoG, 0.47), anxiety (RhoG, 0.35), and disruptive behavior disorders (RhoG, 0.48), may be accounted for by ADHD and, for mood disorders, by OCD. Conclusions and Relevance This study is, to our knowledge, the most comprehensive of its kind. It confirms the belief that psychiatric comorbidities are common among individuals with TS, demonstrates that most comorbidities begin early in life, and indicates that certain comorbidities may be mediated by the presence of comorbid OCD or ADHD. In addition, genetic analyses suggest that some comorbidities may be more biologically related to OCD and/or ADHD rather than to TS. PMID:25671412

The British Child and Adolescent Mental Health Survey 1999: the prevalence of DSM-IV disorders.

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Ford, Tamsin; Goodman, Robert; Meltzer, Howard

2003-10-01

To describe the prevalence of DSM-IV disorders and comorbidity in a large population-based sample of British children and adolescents. Using a one-phase design, 10,438 children were assessed using the Development and Well-Being Assessment (DAWBA), a structured interview with verbatim reports reviewed by clinicians so that information from parents, teachers, and children was combined in a manner that emulated the clinical process. The authors' analysis examined comorbidity and the influence of teacher reports. The overall prevalence of DSM-IV disorders was 9.5% (95% confidence interval 8.8-10.1%), but 2.1% of children were assigned "not otherwise specified" rather than operationalized diagnoses. After adjusting for the presence of a third disorder, there was no longer significant comorbidity between anxiety and conduct disorder or attention-deficit/hyperactivity disorder (ADHD), or between depression and oppositional defiant disorder. A comparison of the disorders in children with and without teacher reports suggested that the prevalence of conduct disorders and ADHD would be underestimated in the absence of teacher information. Roughly 1 in 10 children have at least one DSM-IV disorder, involving a level of distress or social impairment likely to warrant treatment. Comorbidity reported between some childhood diagnoses may be due to the association of both disorders with a third. Diagnoses of conduct disorder and ADHD may be missed if information is not sought from teachers about children's functioning in school.

Tourette syndrome in a longitudinal perspective. Clinical course of tics and comorbidities, coexisting psychopathologies, phenotypes and predictors.

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Groth, Camilla

2018-04-01

Tourette syndrome (TS) is a childhood onset neurodevelopmental disorder characterised by motor and vocal tics and frequent associated comorbidities. The developmental trajectory of tic shows tic-onset in the age of 4-6, peak in the age of 10-12 and decline during adolescence, although only few and small longitudinal studies form the basis of this evidence. Recent studies suggest that comorbid obsessive-compulsive disorder (OCD), attention deficit-hyperactivity disorder (ADHD) and coexisting psychopathologies tend to persist and become more dominant in adolescence. This large prospective follow-up study want to examine the clinical course of TS: tic and comorbidities during adolescence, the prevalence of coexisting psychopathologies, the tic-related impairment, development in phenotype expression and find predictors for the expected course of TS. 
Method: This study is examining a large clinical cohort recruited at the Danish National Tourette Clinic during the period 2005-2007 and 2011-2013. At baseline, 314 participants aged 5-19 years were included and at follow-up 6 years later 227 participated, aged 11-26. All participants were uniformly clinically examined at basis and follow-up with a clinical interview and validated measurements to assess comorbidities. The Yale Global Tic Severity Scale was used to asses tic severity and tic-related impairment. At follow-up a cross-sectional diagnostic evaluation was made with the Development and Well-Being Assessment to assess coexisting psychopathologies.
 Results: A significant decline in tic and the most frequent comorbidities OCD and ADHD was found although some variation existed and some subclinical and partial remissions persisted. Tic-related impairment was not reflected in the tic-decline as expected but influenced by several parameters. The phenotype expression was found to be dynamic but overall changed toward TS without comorbidities. Several predictors were found to predict the clinical course of TS in

Prevalence and causes of blindness and visual impairment among school children in south-western Nigeria.

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Ajaiyeoba, A I; Isawumi, M A; Adeoye, A O; Oluleye, T S

2005-01-01

The aim of the study was to assess the prevalence and identify the causes of blindness and visual impairment in school children of Ilesa-East Local Government Area of Osun State, Nigeria. A total of 1144 school children in primary and secondary schools were selected using a 2-stage random sampling method and examined to determine the prevalence and causes of blindness and visual impairment. A total of 17 (1.48%) children were blind or visually impaired. These comprised of 11 (0.96%) children who were visually impaired and 4 (0.3%) who were severely visually impaired. Only 2 (0.15%) school children were blind. The causes of visual impairment were refractive error 10 (0.87%) and immature cataract 1 (0.08%), causes of severe visual impairment included corneal opacities 2 (0.2%), amblyopia leading to squint 1 (0.08%) and 1 cataract 1 (0.08%). The causes of blindness in school children were corneal scars presumed to be due to vitamin A deficiency 1 (0.08%) and keratoconus 1 (0.08%). Causes of blindness and visual impairment in children attending regular schools in Nigeria were treatable. Prevention, early recognition and prompt treatment of these diseases by regular screening of school children would definitely reduce unnecessary visual handicap in Nigerian school children so that they can attain their full potential in the course of their education. Also, information from this study is relevant for the purpose of planning eye care programmes for the prevention of blindness in Nigerian school children. This will go a long way in the prevention of unnecessary blindness and visual impairment in school children.

Heterogeneity of executive functions among comorbid neurodevelopmental disorders

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Dajani, Dina R.; Llabre, Maria M.; Nebel, Mary Beth; Mostofsky, Stewart H.; Uddin, Lucina Q.

2016-01-01

Executive functions (EFs) are used to set goals, plan for the future, inhibit maladaptive responses, and change behavior flexibly. Although some studies point to specific EF profiles in autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) — prevalent and often highly comorbid neurodevelopmental disorders — others have not differentiated them. The objective of the current study was to identify distinct profiles of EF across typically developing (TD) children and children with ASD and ADHD. We employed a latent profile analysis using indicators of EF (e.g., working memory, inhibition, and flexibility) in a mixed group of 8–13 year-olds including TD children (n = 128), children with ASD without ADHD (n = 30), children with ADHD (n = 93), and children with comorbid ASD and ADHD (n = 66). Three EF classes emerged: “above average,” “average,” and “impaired.” EF classes did not reproduce diagnostic categories, suggesting that differences in EF abilities are present within the ASD and ADHD groups. Further, greater EF dysfunction predicted more severe socioemotional problems, such as anxiety/depression. These results highlight the heterogeneity of current diagnostic groups and identify an “impaired” EF group, consisting of children with both ASD and ADHD, which could specifically be targeted for EF intervention. PMID:27827406

Prevalence and Social Risk Factors for Hearing Impairment in Chinese Children—A National Survey

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Chunfeng Yun

2017-01-01

Full Text Available Hearing impairment may affect children’s communication skills, social development, and educational achievement. Little is known about the prevalence of hearing impairment among Chinese children. Data were taken from the 2006 second China National Survey on Disability (CNSD. Hearing impairment was defined as moderate (41–60 dB HL, severe (61–80 dB HL, profound (81–90 dB HL, or complete (>91 dB HL. Logistic regression was used to estimate the odds ratio (OR and 95% confidence intervals (CI. A weighted number of 567,915 hearing impairment children were identified, yielding a prevalence of 17.49 per 10,000 people (95% CI: 16.90–18.08, with prevention or treatment options possible for 64.6% of hearing impairment children. The main causes of hearing impairment were hereditary, tympanitis, and drug intoxication. Illiteracy in one or both parents (mother: OR = 1.388, 95% CI: 1.125–1.714, p < 0.0001; father: OR = 1.537, 95% CI: 1.152–2.049, p < 0.0001 relative to no school or primary school, annual family income lower than national average (OR = 1.323, 95% CI: 1.044–1.675, p = 0.0203, relative to higher than national average, household size larger than three people (OR = 1.432, 95% CI: 1.164–1.762, p = 0.0007, relative to smaller than three people and single-mother family (OR = 2.056, 95% CI: 1.390–3.042, p = 0.0176, relative to intact family were the independence risk factors for hearing impairment among Chinese children. Lower annual family income, male children, larger household size, single-mother family, and lower levels of maternal and paternal education were independent risk factors for hearing impairment for Chinese children. Further studies on hearing impairment prevention and the relationship between parental social factors and the risk of hearing impairment are needed.

Psychiatric comorbidity and quality of life in patients with alcohol dependence syndrome

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Sidharth Arya

2017-01-01

Full Text Available Context: There is a lack of literature on the relation between psychiatric comorbidities and their influence on quality of life in patients with alcohol dependence syndrome in the Indian settings. Aims: To study the relation between psychiatric comorbidity with quality of life in patients with alcohol dependence. Settings and Design: The study was carried out in a de-addiction centre of a tertiary care hospital upon randomly selected inpatients of alcohol dependence syndrome. Patients with other substance abuse except tobacco or those with severe physical impairment were excluded. Materials and Methods: Hundred in-patients were assessed between the period of August 2013 to July 2014, using a number of instruments including specially designed proforma for clinical and drinking variables, CIWA-Ar, SADD, M.I.N.I 5.0 and WHO QoL Bref. Statistics used: SPSS 19.0 was used for analysis. Significance was calculated using t-test for continuous variables and chi-square test for categorical variables. Results: Prevalence of psychiatric disorder was found to be 32% across all the tested patients, with anxiety (n = 13 and depressive disorder (n = 12 being most common. Presence of psychiatric comorbidity lead to significant lowering in overall quality, perception of general health, physical (42.12 vs 57.78, P = 0.001, psychological (40.19 vs 53.29, P = 0.002, social (43.97 vs 66.90, P = 0.000, and environment (50.47 vs 62.71, P = 0.001 domains. Conclusion: Comorbid psychiatric disorders have a significant negative impact on the quality of life in patients with alcohol dependence syndrome.

Comorbidities in Spondyloarthritis

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Anna Moltó

2018-03-01

Full Text Available Comorbidities in spondyloarthritis (SpA add to the burden of disease by contributing to disease activity, functional and work disability, and mortality. Thus, awareness of comorbidities in SpA is crucial to improve their screening and management and to ultimately improve outcomes in those affected. Osteoporosis has been reported to be the most prevalent comorbidity in SpA, and its risk is increased in these patients, compared with the general population; the risk of vertebral fractures requires further evaluation. Cardiovascular risk is also increased in this population, both due to an increase of the traditional cardiovascular risk factors in these patients, but also due to the presence of inflammation. The role of non-steroidal anti-inflammatory drugs in this increased risk needs further elucidation, but there is consensus on the need to encourage smoking cessation and to perform periodic evaluation of cardiovascular risk in these patients, particularly in the case of change in treatment course. Concerning the risk of cancer, no increased risk inherent to SpA seems to exist. However, an increased neoplastic risk can occur due to SpA treatments, e.g., P-UVA. Data are sparse on the risk of infections compared with rheumatoid arthritis, but there appears to be no risk in the absence of TNF-inhibitor exposure. Regardless of which comorbidity, a gap exists between recommendations for their management and actual implementation in clinical practice, suggesting that there is still a need for improvement in this area. Systematic screening for these comorbidities should improve both short- and long-term outcomes in SpA patients.

Prevalence of Cognitive Impairment and Depression among a Population Aged over 60 Years in the Metropolitan Area of Guadalajara, Mexico

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Ortiz, Genaro G.; Arias-Merino, Elva D.; Flores-Saiffe, María E.; Velázquez-Brizuela, Irma E.; Macías-Islas, Miguel A.; Pacheco-Moisés, Fermín P.

2012-01-01

Background. Cognitive impairment is an important clinical issue among elderly patients with depression and has a more complex etiology because of the variable rate of neurodegenerative changes associated with depression. The aim of the present work was to examine the prevalence of cognitive impairment and depression in a representative sample of adults aged ≥60 years. Methods. The presented work was a cross-sectional study on the prevalence of cognitive impairment and depression. Door-to-doo...

Comorbidity Between Attention Deficit/Hyperactivity Disorder and Obsessive-Compulsive Disorder Across the Lifespan: A Systematic and Critical Review

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Abramovitch, Amitai; Dar, Reuven; Mittelman, Andrew; Wilhelm, Sabine

2015-01-01

Abstract The concept of comorbidity between attention deficit/hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD) has been discussed for two decades. No review, however, has examined this question in light of the stark contrast in disorder-specific phenomenology and neurobiology. We review reported prevalence rates and the methodological, phenomenological, and theoretical issues concerning concomitant ADHD-OCD. Reported co-occurrence rates are highly inconsistent in the literature. Studies aimed at examining the potential for comorbidity have suffered from various methodological problems, including the existence of very few community samples, highly variable exclusionary criteria, and possible clinical misinterpretation of symptoms. Despite numerous studies suggesting an ADHD-OCD comorbidity, thus far etiological (i.e., genetic) backing has been provided only for a pediatric comorbidity. Additionally, inflated rates of ADHD-OCD co-occurrence may be mediated by the presence of tic disorders, and evidence of impaired neuronal maturational processes in pediatric OCD may lead to possibly transient phenotypical expressions that resemble ADHD symptomatology. Thus, clinicians are encouraged to consider the possibility that ADHD-like symptoms resulting from OCD-specific symptomatology may be misdiagnosed as ADHD. This suggestion may account for the lower co-occurrence rates reported in adolescents and adults and for the lack of a theoretical account for comorbidity in these age groups. Existing literature is summarized and critically reviewed, and recommendations are made for future research. PMID:26052877

Comorbidity in Emetophobia (Specific Phobia of Vomiting).

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Sykes, Mark; Boschen, Mark J; Conlon, Elizabeth G

2016-07-01

Emetophobia (fear of vomiting) is an anxiety disorder in which individuals report clinical levels of fear that they may vomit or be exposed to the vomit of others. The prevalence of comorbidity of emetophobia with other conditions has previously only been investigated using self-report instruments. Sixty-four adults with emetophobia participated in an online structured clinical diagnostic interview assessing the presence of emetophobia and other conditions. Higher comorbidity for depression, generalized anxiety disorder, panic disorder, social anxiety disorder and obsessive-compulsive disorder were found in participants compared with general population norms. Emetophobia is commonly comorbid with other anxiety and depressive disorders. Comorbidity rates, when assessed using a structured clinical interview, were lower than previously reported using self-report alone. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Message Emetophobia (specific phobia of vomiting) is a clinical fear of vomiting. Individuals with emetophobia show high comorbidity with other anxiety and mood disorders. The most common comorbid conditions were generalized anxiety disorder, panic disorder, hypochondriasis and obsessive-compulsive disorder. Clinicians should ensure that they assess for the presence of comorbid conditions when treating emetophobia. Copyright © 2015 John Wiley & Sons, Ltd.

The Prevalence of Nonalcoholic Fatty Liver Disease and Related Metabolic Comorbidities Was Associated with Age at Onset of Moderate to Severe Plaque Psoriasis: A Cross-Sectional Study.

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Xin Xu

Full Text Available Nonalcoholic fatty liver disease (NAFLD has been found to be highly prevalent in psoriatic patients. Adult onset psoriasis could be divided into either early or late onset psoriasis. The associations between NAFLD and related metabolic comorbidities and age at onset of psoriasis have not yet been investigated. Our study was to evaluate the associations between prevalence of NAFLD and related metabolic conditions and early, late, and childhood onset psoriasis. A cross-sectional observational study was conducted on patients with moderate to severe plaque psoriasis. Data on clinical characteristics of NAFLD and related metabolic diseases (diabetes, hypertriglyceridemia, hyperuricemia, and metabolic syndrome were collected. The prevalence of NAFLD in 439 patients (mean: 51±14 years, range: 18-85 years was 55.8%. NAFLD was frequently identified in early onset patients (74.2%, and this diagnosis was particularly common in patients currently younger than 40 (85.3%. Diabetes was the least prevalent component of metabolic syndrome in early onset patients with metabolic syndrome but the most often found component in late onset ones. Patients with childhood onset psoriasis had the lowest frequencies of all metabolic comorbidities except hyperuricemia among the three groups. In the multivariate analyses, early onset was independently and positively associated with NAFLD, hypertriglyceridemia and hyperuricemia and independently and negatively associated with diabetes among early and late onset patients. The results suggested prevalence of NAFLD and related metabolic comorbidities was associated with age at onset of moderate to severe plaque psoriasis. Early onset of psoriasis was independently associated with greater odds of NAFLD, hypertriglyceridemia, hyperuricemia and smaller odds of diabetes compared to late onset. Early onset patients have metabolic syndrome mainly related to lipid disorders and abnormal glucose metabolism was not often involved.

Visual impairment and blindness: an overview of prevalence and causes in Brazil

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Solange R. Salomão

2009-09-01

Full Text Available Our purpose is to provide a summary overview of blindness and visual impairment on the context of recent Brazilian ocular epidemiologic studies. Synthesis of data from two cross-sectional population-based studies - the São Paulo Eye Study and the Refractive Error in School Children Study is presented. 3678 older adults and 2441 school children were examined between July 2004 and December 2005. Prevalence of blindness in older adults using presenting visual acuity was 1.51% decreasing to 1. 07% with refractive correction. The most common causes of blindness in older adults were retinal disorders, followed by cataract and glaucoma. In school children, the prevalence of uncorrected visual impairment was 4.82% decreasing to 0.41% with refractive correction. The most common cause of visual impairment in school children was uncorrected refractive error. Visual impairment and blindness in Brazil is an important public health problem. It is a significant problem in older Brazilians, reinforcing the need to implement prevention of blindness programs for elderly people with emphasis on those without schooling. In school-children cost-effective strategies are needed to address a readily treatable cause of vision impairment - prescription and provision of glasses.Nosso objetivo é fazer uma revisão de cegueira e deficiência visual no contexto de recentes estudos epidemiológicos oculares brasileiros. É apresentada a síntese dos dados de dois estudos populacionais transversais - o Estudo Ocular de São Paulo e o Estudo de Erros Refrativos em Escolares. Entre julho de 2004 e dezembro de 2005 foram examinados 3678 adultos e 2441 escolares. A prevalência de cegueira em adultos mais velhos considerando a acuidade visual apresentada foi de 1, 51% diminuindo para 1, 07% com a correção refrativa. As causas mais comuns de cegueira em adultos mais velhos foram os distúrbios de retina, seguidos de catarata e glaucoma. Em escolares a prevalência de defici

Effectiveness and response predictors of omalizumab in a severe allergic asthma population with a high prevalence of comorbidities: the Australian Xolair Registry.

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Gibson, P G; Reddel, H; McDonald, V M; Marks, G; Jenkins, C; Gillman, A; Upham, J; Sutherland, M; Rimmer, J; Thien, F; Katsoulotos, G P; Cook, M; Yang, I; Katelaris, C; Bowler, S; Langton, D; Robinson, P; Wright, C; Yozghatlian, V; Burgess, S; Sivakumaran, P; Jaffe, A; Bowden, J; Wark, P A B; Yan, K Y; Kritikos, V; Peters, M; Hew, M; Aminazad, A; Bint, M; Guo, M

2016-09-01

Severe asthma is a high impact disease. Omalizumab targets the allergic inflammatory pathway; however, effectiveness data in a population with significant comorbidities are limited. To describe severe allergic asthma, omalizumab treatment outcomes and predictors of response among the Australian Xolair Registry participants. A web-based post-marketing surveillance registry was established to characterise the use, effectiveness and adverse effects of omalizumab (Xolair) for severe allergic asthma. Participants (n = 192) (mean age 51 years, 118 female) with severe allergic asthma from 21 clinics in Australia were assessed, and 180 received omalizumab therapy. They had poor asthma control (Asthma Control Questionnaire, ACQ-5, mean score 3.56) and significant quality of life impairment (Asthma-related Quality of Life Questionnaire score 3.57), and 52% were using daily oral corticosteroid (OCS). Overall, 95% had one or more comorbidities (rhinitis 48%, obesity 45%, cardiovascular disease 23%). The omalizumab responder rate, assessed by an improvement of at least 0.5 in ACQ-5, was high at 83%. OCS use was significantly reduced. The response in participants with comorbid obesity and cardiovascular disease was similar to those without these conditions. Baseline ACQ-5 ≥ 2.0 (P = 0.002) and older age (P = 0.05) predicted the magnitude of change in ACQ-5 in response to omalizumab. Drug-related adverse events included anaphylactoid reactions (n = 4), headache (n = 2) and chest pains (n = 1). Australian patients with severe allergic asthma report a high disease burden and have extensive comorbidity. Symptomatic response to omalizumab was high despite significant comorbid disease. Omalizumab is an effective targeted therapy for severe allergic asthma with comorbidity in a real-life setting. © 2016 Royal Australasian College of Physicians.

The prevalence and ingredient cost of chronic comorbidity in the Irish elderly population with medication treated type 2 diabetes: A retrospective cross-sectional study using a national pharmacy claims database

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O’Shea Miriam

2013-01-01

Full Text Available Abstract Background Comorbidity in patients with diabetes is associated with poorer health and increased cost. The aim of this study was to investigate the prevalence and ingredient cost of comorbidity in patients ≥ 65 years with and without medication treated type 2 diabetes using a national pharmacy claims database. Methods The Irish Health Service Executive Primary Care Reimbursement Service pharmacy claims database, which includes all prescribing to individuals covered by the General Medical Services scheme, was used to identify the study population (≥ 65 years. Patients with medication treated type 2 diabetes (T2DM were identified using the prescription of oral anti-hyperglycaemic agents alone or in combination with insulin as a proxy for disease diagnosis. The prevalence and ingredient prescribing cost of treated chronic comorbidity in the study population with and without medication treated T2DM were ascertained using a modified version of the RxRiskV index, a prescription based comorbidity index. The association between T2DM and comorbid conditions was assessed using logistic regression adjusting for age and sex. Bootstrapping was used to ascertain the mean annual ingredient cost of treated comorbidity. Statistical significance at p  Results In 2010, 43165 of 445180 GMS eligible individuals (9.7% were identified as having received medication for T2DM. The median number of comorbid conditions was significantly higher in those with T2DM compared to without (median 5 vs. 3 respectively; p  Conclusions Individuals with T2DM were more likely to have a higher number of treated comorbid conditions than those without and this was associated with higher ingredient costs. This has important policy and economic consequences for the planning and provision of future health services in Ireland, given the expected increase in T2DM and other chronic conditions.

Psychiatric Comorbidity and Physical Correlates in Alcohol-dependent Patients.

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Gauba, Deepak; Thomas, Pramod; Balhara, Yatan P S; Deshpande, Smita N

2016-01-01

To examine the prevalence and pattern of comorbidity in alcohol dependence and its relationship with physical and laboratory findings. Eighty males with alcohol dependence were examined using the Hindi version of Diagnostic Interview for Genetic Studies, the International Classification of Disease-10 th Edition Personality Disorder Examination, Alcohol Use Disorder Identification Test for alcohol use, global assessment of functioning, blood sampling electrocardiogram, and ultrasonogram. Eighty-seven percent had a comorbid Axis I or an Axis II psychiatric disorder, over 78% had nicotine dependence, and 56% had comorbid Axis II disorder, antisocial personality being the most common. Gamma glutamyl transpeptidase levels were significantly associated with comorbidity. High comorbidity of Axis I psychiatric disorders was found among persons with alcohol dependence. Axis II disorders were also present.

Disability and Comorbidity: Diagnoses and Symptoms Associated with Disability in a Clinical Population with Panic Disorder

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Caroline A. Bonham

2014-01-01

Full Text Available Background. Anxiety disorders are associated with considerable disability in the domains of (1 work, (2 social, and (3 family and home interactions. Psychiatric comorbidity is also known to be associated with disability. Methods. Data from the Cross-National Collaborative Panic Study was used to identify rates of comorbid diagnoses, anxiety and depression symptom ratings, and Sheehan disability scale ratings from a clinical sample of 1165 adults with panic disorder. Results. Comorbid diagnoses of agoraphobia, major depression, and social phobia were associated with disability across the three domains of work, social, and family and home interactions. The symptom of agoraphobic avoidance makes the largest contribution to disability but there is no single symptom cluster that entirely predicts impairment and disability. Limitations. The findings about the relative contributions that comorbid diagnoses make to disability only apply to a population with panic disorder. Conclusions. Although panic disorder is not generally considered to be among the serious and persistent mental illnesses, when it is comorbid with other diagnoses, it is associated with considerable impairment. In particular, the presence of agoraphobic avoidance should alert the clinician to the likelihood of important functional impairment. When measuring the functional impact of comorbid anxiety disorders, both the categorical and the dimensional approaches to diagnosis make valuable contributions.

Comorbid forms of psychopathology: key patterns and future research directions.

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Cerdá, Magdalena; Sagdeo, Aditi; Galea, Sandro

2008-01-01

The purpose of this review is to systematically appraise the peer-reviewed literature about clustered forms of psychopathology and to present a framework that can be useful for studying comorbid psychiatric disorders. The review focuses on four of the most prevalent types of mental health problems: anxiety, depression, conduct disorder, and substance abuse. The authors summarize existing empirical research on the distribution of concurrent and sequential comorbidity in children and adolescents and in adults, and they review existing knowledge about exogenous risk factors that influence comorbidity. The authors include articles that used a longitudinal study design and used psychiatric definitions of the disorders. A total of 58 articles met the inclusion criteria and were assessed. Current evidence demonstrates a reciprocal, sequential relation between most comorbid pairs, although the mechanisms that mediate such links remain to be explained. Methodological concerns include the inconsistency of measurement of the disorders across studies, small sample sizes, and restricted follow-up times. Given the significant mental health burden placed by comorbid disorders, and their high prevalence across populations, research on the key risk factors for clustering of psychopathology is needed.

Comorbidities associated with epilepsy and headaches

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Thalles P. Ferreira

2012-04-01

Full Text Available Comorbidities are often associated with chronic neurological diseases, such as headache and epilepsy. OBJECTIVES: To identify comorbidities associated with epilepsy and headaches, and to determine possible drug interactions. METHODS: A standardized questionnaire with information about type of epilepsy/headache, medical history, and medication was administered to 80 adult subjects (40 with epilepsy and 40 with chronic headache. RESULTS: Patients with epilepsy had an average of two comorbidities and those with headache of three. For both groups, hypertension was the most prevalent. On average, patients with epilepsy were taking two antiepileptic medications and those with headache were taking only one prophylactic medication. Regarding concomitant medications, patients with epilepsy were in use, on average, of one drug and patients with headache of two. CONCLUSIONS: Patients with chronic neurological diseases, such as epilepsy and headaches, have a high number of comorbidities and they use many medications. This may contribute to poor adherence and interactions between different medications.

Impact of deleting 5 DSM-IV personality disorders on prevalence, comorbidity, and the association between personality disorder pathology and psychosocial morbidity.

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Zimmerman, Mark; Chelminski, Iwona; Young, Diane; Dalrymple, Kristy; Martinez, Jennifer

2012-02-01

A high rate of comorbidity among the personality disorders has been consistently identified as a problem. To address the problem of excessive comorbidity, the DSM-5 Personality and Personality Disorders Work Group recommended reducing the number of specific personality disorder diagnoses from 10 to 5 by eliminating paranoid, schizoid, histrionic, narcissistic, and dependent personality disorders. No study has examined the impact of this change. The present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project examined the impact of eliminating these 5 personality disorders on the prevalence of personality disorders in a large sample of psychiatric outpatients presenting for treatment, comorbidity among the personality disorders, and association with psychosocial morbidity. From September 1997 to June 2008, 2,150 psychiatric patients presenting to the Rhode Island Hospital outpatient practice were evaluated with semistructured diagnostic interviews for DSM-IV Axis I and Axis II disorders and measures of psychosocial morbidity. More than one-quarter of the patients were diagnosed with one of the 10 DSM-IV personality disorders (28.6%, n = 614). When 5 personality disorders were excluded from consideration, then 25.8% (n = 555) were diagnosed with at least 1 of the 5 personality disorders proposed for retention in DSM-5, and the comorbidity rate dropped from 29.8% to 21.3%. Compared to patients without a personality disorder, the patients with either a retained or an excluded personality disorder had greater psychosocial morbidity. There was little difference in psychosocial morbidity between patients with a retained and an excluded personality disorder. The Personality and Personality Disorders Work Group's desired goal of reducing comorbidity would be achieved by deleting 5 personality disorders, although comorbidity would not be eliminated. The reduction of comorbidity could come with a cost of false-negative diagnoses

Prevalence of traumatic dental injuries among visually impaired children attending special schools of Chhattisgarh

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Harsha Munot; Alok Avinash; Nilotpol Kashyap; Rashmi Baranwal; Brij Kumar; Maylavarapu Krishna Sagar

2017-01-01

Background: Studies on dental trauma of the normal population have been carried out in the past; however, limited data are available on dental trauma of the handicapped population, especially visually impaired children in Chhattisgarh, India. Aim: The aim of this study is to determine the prevalence of traumatic dental injuries (TDIs) in visually impaired children in relation to age, cause, and place of injury. Materials and Methods: Epidemiological study was carried out among 400 children fr...

[Comorbidity -- mind and body interconnection based on the new findings].

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Kovacs, Gabor

2014-12-01

Comorbidity is a multicausal, multidimensional, multifaced phenomenon in medicine. There are many different definitions of the co-occurrence of two or more disorders, but Feinstein's is the most acceptable. Although epidemiological data show a high prevalence of comorbidity of somatic and psychiatric disorders, it is still underrecognized and undertreated. There are many unanswered questions related to comorbidity, including whether comorbidity is a valid phenomenon; whether the epidemiological results have validity; what is the linkage between somatic and psychological processes; which factors take part in the bidirectional manifestation; how do we treat the involved disorders; what is the right organization to manage the patients. The aim of the author was to review different aspects of comorbidity with the help of new knowledge. The starting point of the interpretation was the concept of identical biological substrates (pathophysiological endpoint) that generate the development of somatic and psychiatric disorders. The formation of these substrates is influenced by risk factors, which depend or not on the person (stressors vs genes). The effects of risk factors and biological substrates are parallel to each other, but one of them is a dominant agent. The author's concept ("dominance theory") is based on new discoveries of the biological mechanisms of psychiatric processes to help to understand the phenomenon of comorbidity and develop new therapies. It is very important to recognize, to diagnose and treat comorbidity because of the prevalence of excess mortality is high and the morbidity burden influences the patient' quality of life.

Prevalence and healthcare costs of obesity-related comorbidities: evidence from an electronic medical records system in the United States.

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Li, Qian; Blume, Steven W; Huang, Joanna C; Hammer, Mette; Ganz, Michael L

2015-01-01

This study estimated the economic burden of obesity-related comorbidities (ORCs) in the US, at both the person and population levels. The Geisinger Health System provided electronic medical records and claims between January 2004 and May 2013 for a sample of 153,561 adults (50% males and 97% white). Adults with A total of 21 chronic conditions, with established association with obesity in the literature, were identified by diagnosis codes and/or lab test results. The total healthcare costs were measured in each year. The association between annual costs and ORCs was assessed by a regression, which jointly considered all the ORCs. The per-person incremental costs of a single comorbidity, without any of the other ORCs, were calculated. The population-level economic burden was the product of each ORC's incremental costs and the annual prevalence of the ORC among 100,000 individuals. The prevalence of ORCs was stratified by obesity status to estimate the economic burden among 100,000 individuals with obesity and among those without. This study identified 56,895 adults (mean age = 47 years; mean BMI = 29.6 kg/m(2)). The annual prevalence of ORCs ranged from 0.5% for pulmonary embolism (PE) to 41.8% for dyslipidemia. The per-person annual incremental costs of a single ORC ranged from $120 for angina to $1665 for PE. Hypertensive diseases (HTND), dyslipidemia, and osteoarthritis were the three most expensive ORCs at the population level; each responsible for ≥$18 million annually among 100,000 individuals. HTND and osteoarthritis were much more costly among individuals with obesity than those without obesity. Data were from a small geographic region. ORCs are associated with substantial economic burden, especially for those requiring continuous treatments.

Prevalence and comorbidities of autism among children referred to ...

African Journals Online (AJOL)

Often, the co-morbidities constitute the upfront symptoms and therefore may it recognition and management difficult, aggravating as such the prognosis. The present study therefore aimed at studying the clinical profile of autism spectrum disorder (ASD) and the associated morbidities among children and adolescents in ...

Influence of comorbidities in idiopathic normal pressure hydrocephalus — research and clinical care. A report of the ISHCSF task force on comorbidities in INPH

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2013-01-01

Idiopathic normal pressure hydrocephalus (INPH) is a syndrome of ventriculomegaly, gait impairment, cognitive decline and incontinence that occurs in an elderly population prone to many types of comorbidities. Identification of the comorbidities is thus an important part of the clinical management of INPH patients. In 2011, a task force was appointed by the International Society for Hydrocephalus and Cerebrospinal Fluid Disorders (ISHCSF) with the objective to compile an evidence-based expert analysis of what we know and what we need to know regarding comorbidities in INPH. This article is the final report of the task force. The expert panel conducted a comprehensive review of the literature. After weighing the evidence, the various proposals were discussed and the final document was approved by all the task force members and represents a consensus of expert opinions. Recommendations regarding the following topics are given: I. Musculoskeletal conditions; II. Urinary problems; III. Vascular disease including risk factors, Binswanger disease, and white matter hyperintensities; IV. Mild cognitive impairment and Alzheimer disease including biopsies; V. Other dementias (frontotemporal dementia, Lewy body, Parkinson); VI. Psychiatric and behavioral disorders; VII. Brain imaging; VIII. How to investigate and quantify. The task force concluded that comorbidity can be an important predictor of prognosis and post-operative outcome in INPH. Reported differences in outcomes among various INPH cohorts may be partly explained by variation in the rate and types of comorbidities at different hydrocephalus centers. Identification of comorbidities should thus be a central part of the clinical management of INPH where a detailed history, physical examination, and targeted investigations are the basis for diagnosis and grading. Future INPH research should focus on the contribution of comorbidity to overall morbidity, mortality and long-term outcomes. PMID:23758953

Tinnitus Patients with Comorbid Headaches: The Influence of Headache Type and Laterality on Tinnitus Characteristics

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Berthold Langguth

2017-08-01

Full Text Available BackgroundBoth clinical experience and clinical studies suggest a relationship between tinnitus and headache. Here, we aimed to investigate the influence of comorbid headache type and headache laterality on tinnitus characteristics.MethodThe Tinnitus Research Initiative database was screened for patients of the Tinnitus Center of the University Regensburg who reported comorbid headaches. These patients were contacted to complete additional validated questionnaires. Based on these data, patients were categorized according to headache type and headache laterality, and their clinical characteristics were compared with tinnitus patients, who did not report comorbid headaches.ResultsData from 193 patients with tinnitus and comorbid headaches were compared with those from 765 tinnitus patients without comorbid headaches. Tinnitus patients with comorbid headache have higher scores in tinnitus questionnaires, a lower quality of life and more frequently comorbidities such as painful sensation to loud sounds, vertigo, pain (neck, temporomandibular, and general, and depressive symptoms when compared with tinnitus patients without headaches. Both headache laterality and headache type interact with the degree of comorbidity with higher impairment in patients with left-sided and bilateral headaches as well as in patients with migraine or cluster headache.ConclusionThe observed increased impairment in tinnitus patients with comorbid headache can be explained as an additive effect of both disorders on health-related quality of life. The more frequent occurrence of further comorbidities suggests a generally increased amplification of sensory signals in a subset of tinnitus patients with comorbid headaches.

[Internet addiction as a co-morbid disorder among patients of german addiction rehabilitation facilities: an exploratory investigation of clinical prevalence].

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Müller, Kai W; Koch, Andreas; Beutel, Manfred E; Dickenhorst, Ulrike; Medenwaldt, Jens; Wölfling, Klaus

2012-08-01

Excessive internet use is being discussed as a non-substance-related addiction disorder. Estimations of its prevalence show that 1% of the German general population is affected by internet addiction. However, it is still unclear, whether internet addiction as a co-morbid disorder is also common among patients of the general health care system, especially in patients being treated in inpatient addiction rehabilitation centers. It seems plausible that these patients have a heightened proneness to co-morbid internet addiction. In order to address this issue, a government-funded cooperation project was conducted. Within six months every new patient admitted to one of 15 rehabilitation facilities was screened for internet addiction. 4.2% of the patients fulfilled criteria for internet addiction. Male patients of younger age with main diagnosis of cannabis dependence or pathological gambling were found to be at higher risk. Internet addiction is more common among patients of the rehabilitation system than in the general population. Especially young, male patients in treatment for cannabis dependence or pathological gambling are at risk for co-morbid internet addiction. It is recommended that regular screening for internet addiction should be implemented in facilities with patients at risk in order to offer indicative treatment. © Georg Thieme Verlag KG Stuttgart · New York.

The Prevalence of Visual Acuity Impairment among School Children at Arada Subcity Primary Schools in Addis Ababa, Ethiopia

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Haile Fentahun Darge

2017-01-01

Full Text Available Background. Visual impairment and blindness are major public health problems in developing countries where there is no enough health-care service. Objective. To determine the prevalence of visual impairment among school children. Materials and Methods. A school-based cross-sectional study was conducted between 15 June 2015 and 30 November 2015 at Arada subcity primary schools, Addis Ababa, Ethiopia. Two schools were selected randomly, and 378 students were screened from grades 1 to 8 using systematic random sampling method. Snellen chart was used for visual acuity test. Students who had visual acuity of ≤6/12 were further examined by an ophthalmologist to diagnose the reason for low vision. Data was analyzed using SPSS version 20. Results. A total of 378 students were screened, and 192 (50.8% were females and the remaining 186 (49.2% were males. The prevalence of visual impairment (VA of ≤6/12 on either eye was 5.8%, VA < 6/18 on either eye was 1.1%, and VA < 6/18 on the better eye was 0.53%. In this study, color blindness [OR: 19.65, 95% CI (6.01–64.33] was significantly associated with visual acuity impairment. Conclusion. The prevalence of visual impairment among school children in the study area was 5.8% and school screening is recommended.

Are externalizing and internalizing difficulties of young children with spelling impairment related to their ADHD symptoms?

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Rietz, Chantal Sabrina; Hasselhorn, Marcus; Labuhn, Andju Sara

2012-08-01

Children with literacy difficulties often suffer from a variety of co-occurring externalizing and internalizing difficulties, as well as comorbid ADHD. Therefore, these externalizing and internalizing problems might be more related to comorbid ADHD, rather than being a correlate of literacy difficulties per se. In the present study, we investigated the occurrence of externalizing and internalizing difficulties in elementary school children (third grade) with and without spelling impairment. Taking the high rate of comorbidity between literacy difficulties and ADHD into account, we investigated whether co-occurring difficulties are associated with spelling impairment per se or with comorbid ADHD symptoms. Results indicated that these young children with spelling impairment showed more co-occurring difficulties compared with children without spelling impairment. Hierarchical regression analysis indicated that occurrence of externalizing symptoms is more strongly related to comorbid ADHD symptoms than to spelling impairment per se. The pattern of results concerning internalizing problems was not as distinct but showed a similar trend. Preferably, carers and educators should be aware of co-occurring socio-emotional and behavioural problems in children with spelling impairment. Particularly children with spelling impairment and comorbid ADHD symptoms seem to have an increased risk of encountering further co-occurring difficulties. Copyright © 2012 John Wiley & Sons, Ltd.

Prevalence of Dementia, Depression, and Mild Cognitive Impairment in a Rural Area of the Island of Crete, Greece.

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Tsolaki, Magda; Gkioka, Mara; Verykouki, Eleni; Galoutzi, Niki; Kavalou, Eirini; Pattakou-Parasyri, Vassiliki

2017-08-01

The studies on the prevalence of dementia, depression, and mild cognitive impairment (MCI) in Greece are sparse and show major variations of prevalence depending on geographical areas, nutritional habits, and the way of living. The aim of this door-to-door study was to find the prevalence of dementia, depression, and MCI in a rural Greek population. Four hundred and forty-three individuals older than 61years following the application of specific criteria were diagnosed with: normal cognition, depression, MCI with and without depression, and dementia with and without depression. Four diagnostic methods were used, 2 of which included Mungas correction for age and education. After Mungas adjustment, the results were as follows-depression: 33.9%; MCI: 15.3%; MCI with depression: 8.6%; dementia: 2.0%; and dementia with depression: 7.2%. Dementia is less prevalent compared to global data and other Greek areas. Mild cognitive impairment is more prevalent than dementia. High percentages of depression may be related to low education.

Generalized anxiety disorder: comorbidity, comparative biology and treatment.

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Nutt, David J; Ballenger, James C; Sheehan, David; Wittchen, Hans-Ulrich

2002-12-01

Generalized anxiety disorder (GAD) is a severe and chronic anxiety disorder characterized by uncontrollable worrying and somatic anxiety (tension, insomnia and hypervigilance). It is a common condition, with lifetime prevalence rates for DSM-IV GAD in the general population of approx. 5-6% being reported. In addition, like other anxiety disorders, GAD also shows comorbidity with depression and most of the other anxiety disorders. This article reviews data on the prevalence of GAD, its comorbidity with depression, and its social and economic impact. Proposed neurobiological mechanisms for GAD are discussed, since an understanding of these may help in the development of future therapies. Finally, current pharmacological and non-pharmacological treatment options for GAD are reviewed, with particular attention being paid to published clinical-trial data.

Prevalence of correctable visual impairment in primary school children in Qassim Province, Saudi Arabia.

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Aldebasi, Yousef H

2014-01-01

The worldwide prevalence of refractive errors (RE), which is a common cause of treatable visual impairment among children, varies widely. We assessed the prevalence of correctable visual impairment (uncorrected RE) in primary school children in Qassim, Saudi Arabia. A cross-sectional study was conducted in 21 primary schools. A total of 5176 children (mean age 9.5±1.8 years), 2573 boys (49.7%) and 2603 girls (50.3%), underwent a comprehensive eye examination. The examinations consisted of visual acuity, autorefraction, cover test, ocular motility, pupillary evaluation, anterior segment examination, cycloplegic auto-refraction and dilated fundus examination with direct ophthalmoscopy. The children were divided into groups based on their age and gender. The overall prevalence of RE in the better eye was 18.6% (n=963), and the prevalence of uncorrected RE 16.3% (n=846), with only 2.3% (n=127) of children wearing spectacles during examination. The prevalence of uncorrected myopia (5.8%) and myopic astigmatism (5.4%) was higher compared to that of hyperopic astigmatism (2.7%), mixed astigmatism (1.7%) and hyperopia (0.7%). The anisometropia prevalence was 3.6%. Risks for astigmatism, myopia and anisometropia were positively associated with age. In addition, myopia and anisometropia risks were also associated with female gender, while risk of astigmatism was correlated with male gender. Few children with vision reducing RE wore spectacles; an additional 16.3% of children could benefit from spectacle prescription. The prevalence of uncorrected RE in children is relatively high and represents an important public health problem in school-aged children in Qassim province. Performance of routine periodical vision screening throughout childhood may reverse this situation. Copyright © 2013 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

[Compulsive buying and psychiatric comorbidity].

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Mueller, Astrid; Mühlhans, Barbara; Silbermann, Andrea; Müller, Ulrike; Mertens, Christian; Horbach, Thomas; Mitchell, James E; de Zwaan, Martina

2009-08-01

Compulsive buying is an excessive behavior that has begun to receive attention from researchers in recent years. The current study provides an overview of research on compulsive buying and examines the psychiatric co-morbidity in a German female treatment seeking compulsive buying sample in comparison with age and gender-matched normal buying control groups. Thirty women suffering from compulsive buying disorder, 30 community controls, and 30 bariatric surgery candidates were assessed with the German versions of the Structured Clinical Interview for DSM-IV diagnoses (SCID). Women with compulsive buying disorder showed significantly higher prevalence rates of affective, anxiety, and eating disorders compared to community controls, and suffered significantly more often from affective and anxiety disorders compared to bariatric surgery candidates. The compulsive buying group presented with the highest rates of personality disorders, most commonly avoidant, depressive, obsessive-compulsive, and borderline personality disorder, and reported the highest prevalence rates of other impulse control disorders, especially for intermittent explosive disorder. The findings suggest an elevated psychiatric co-morbidity in patients with compulsive buying disorder.

Prevalência de manifestações clínico-laboratoriais e comorbidades na polimiosite segundo o gênero Prevalence of clinical and laboratory manifestations and comorbidities in polymyositis according to gender

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Fernando Henrique Carlos de Souza

2011-10-01

Full Text Available OBJETIVO: Analisar a distribuição e a influência do gênero na polimiosite (PM, quanto às manifestações clínico-laboratoriais, evolução e comorbidades. MÉTODOS: Estudo de coorte retrospectivo, unicêntrico, em que foram avaliados 75 pacientes consecutivos com PM (Bohan e Peter, 1975 entre 1990 e 2010. Os exames complementares referem-se ao início do diagnóstico da PM. RESULTADOS: Este estudo avaliou 52 mulheres e 23 homens (razão 2,3:1, a maioria de cor branca (84,0%, com média de idade de 42,7 ± 13,7 anos (16 a 67 anos, e duração média de doença de 6,9 ± 5,5 anos (0 a 20 anos. Aproximadamente 50% apresentaram recidiva da doença durante o acompanhamento, com 4,0% de óbitos. Apesar disso, dois terços encontravam-se em remissão no desfecho do estudo. Não houve diferença entre os gêneros quanto à distribuição das características demográficas, clínico-laboratoriais, evolução clínica e terapia medicamentosa instituída. Com relação às comorbidades, houve alta prevalência de hipertensão arterial sistêmica (38,7% e diabetes mellitus (17,3%, igualmente distribuídas entre os gêneros. Verificou-se alta prevalência de depressão e fibromialgia, porém apenas no gênero feminino. CONCLUSÕES: A prevalência de PM entre mulheres foi maior (razão 2,3:1. A prevalência de comorbidades foi alta na casuística estudada, cabendo-nos priorizar seus controles e, assim, oferecer melhor qualidade de vida aos pacientes.OBJECTIVE: To assess gender distribution in polymyositis (PM and its influence on disease, regarding clinical and laboratory manifestations, outcome and comorbidities. METHODS: Retrospective single-center cohort study assessing 75 consecutive patients with PM (Bohan and Peter, 1975 from 1990 to 2010. Complementary tests were related to early diagnosis of PM. RESULTS: The study assessed 52 women and 23 men (ratio 2.3:1, most of whom white (84.0%, with a mean age of 42.7 ± 13.7 years (16 to 67 years, and mean

Depression and cognitive impairment among newly admitted nursing home residents in the USA.

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Ulbricht, Christine M; Rothschild, Anthony J; Hunnicutt, Jacob N; Lapane, Kate L

2017-11-01

The objective of this study is to describe the prevalence of depression and cognitive impairment among newly admitted nursing home residents in the USA and to describe the treatment of depression by level of cognitive impairment. We identified 1,088,619 newly admitted older residents between 2011 and 2013 with an active diagnosis of depression documented on the Minimum Data Set 3.0. The prevalence of receiving psychiatric treatment was estimated by cognitive impairment status and depression symptoms. Binary logistic regression using generalized estimating equations provided adjusted odds ratios and 95% confidence intervals for the association between level of cognitive impairment and receipt of psychiatric treatment, adjusted for clustering of residents within nursing homes and resident characteristics. Twenty-six percent of newly admitted residents had depression; 47% of these residents also had cognitive impairment. Of those who had staff assessments of depression, anhedonia, impaired concentration, psychomotor disturbances, and irritability were more commonly experienced by residents with cognitive impairment than residents without cognitive impairment. Forty-eight percent of all residents with depression did not receive any psychiatric treatment. Approximately one-fifth of residents received a combination of treatment. Residents with severe cognitive impairment were less likely than those with intact cognition to receive psychiatric treatment (adjusted odds ratio = 0.95; 95% confidence interval: 0.93-0.98). Many newly admitted residents with an active diagnosis of depression are untreated, potentially missing an important window to improve symptoms. The extent of comorbid cognitive impairment and depression and lack of treatment suggest opportunities for improved quality of care in this increasingly important healthcare setting. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Comorbidity of intellectual disability confounds ascertainment of autism: implications for genetic diagnosis.

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Polyak, Andrew; Kubina, Richard M; Girirajan, Santhosh

2015-10-01

While recent studies suggest a converging role for genetic factors towards risk for nosologically distinct disorders including autism, intellectual disability (ID), and epilepsy, current estimates of autism prevalence fail to take into account the impact of comorbidity of these disorders on autism diagnosis. We aimed to assess the effect of comorbidity on the diagnosis and prevalence of autism by analyzing 11 years (2000-2010) of special education enrollment data on approximately 6.2 million children per year. We found a 331% increase in the prevalence of autism from 2000 to 2010 within special education, potentially due to a diagnostic recategorization from frequently comorbid features such as ID. The decrease in ID prevalence equaled an average of 64.2% of the increase of autism prevalence for children aged 3-18 years. The proportion of ID cases potentially undergoing recategorization to autism was higher (P = 0.007) among older children (75%) than younger children (48%). Some US states showed significant negative correlations between the prevalence of autism compared to that of ID while others did not, suggesting state-specific health policy to be a major factor in categorizing autism. Further, a high frequency of autistic features was observed when individuals with classically defined genetic syndromes were evaluated for autism using standardized instruments. Our results suggest that current ascertainment practices are based on a single facet of autism-specific clinical features and do not consider associated comorbidities that may confound diagnosis. Longitudinal studies with detailed phenotyping and deep molecular genetic analyses are necessary to completely understand the cause of this complex disorder. © 2015 Wiley Periodicals, Inc.

Comorbidity in US patients with multiple sclerosis

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Edwards NC

2018-02-01

Full Text Available Natalie C Edwards,1 Michael Munsell,2 Joseph Menzin,2 Amy L Phillips3 1Health Services Consulting Corporation (NCE, Boxborough, MA, USA; 2Boston Health Economics, Inc., Waltham, MA, USA; 3EMD Serono, Inc., Rockland, MA, USA Objective: To assess the trends in the prevalence of comorbidities in US patients with multiple sclerosis (MS, and the association of demographic characteristics with the presence of comorbidities. Study design: A retrospective analysis was conducted from a sample of 5 million patients from the IMS Health Real World Data Adjudicated Claims – US database.Methods: Comorbidity in patients with MS was assessed by year (2006–2014, and logistic regression models evaluated the association of age, sex, and region with select comorbidities.Results: The most common comorbidities from 2006 to 2014 were hyperlipidemia and hypertension (25.9%–29.7% of patients within an individual year, followed by gastrointestinal disease (18.4%–21.2% of patients and thyroid disease (12.9%–17.1% of patients. The proportion with a claim for hyperlipidemia increased from 2006 to 2009, was stable from 2009 to 2011, and then declined from 2011 to 2014. The proportion with a claim for hypertension generally increased from 2006 to 2013, then declined from 2013 to 2014. The proportion with a claim for gastrointestinal disease, thyroid disease, and anxiety generally increased from 2006 to 2014. Claims for comorbidities were statistically significantly more likely among older age groups (p<0.05, with the exception of anxiety and alcohol abuse, which were statistically significantly less likely among older age groups. Claims for gastrointestinal disease (OR=0.75, thyroid disease (OR=0.36, chronic lung disease (OR=0.76, arthritis (OR=0.71, anxiety (OR=0.63, and depression (OR=0.69 were statistically significantly less likely among males versus females (all p<0.05. Claims for hyperlipidemia (OR=1.39, hypertension (OR=1.25, diabetes (OR=1.31, and alcohol

Fourth revolution in psychiatry - Addressing comorbidity with chronic physical disorders.

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Gautam, Shiv

2010-07-01

The moral treatment of mental patients, Electro Convulsive therapy (ECT), and Psychotropic medications constitute the first, second, and third revolution in psychiatry, respectively. Addressing comorbidities of mental illnesses with chronic physical illnesses will be the fourth revolution in psychiatry. Mind and body are inseparable; there is a bidirectional relationship between psyche and soma, each influencing the other. Plausible biochemical explanations are appearing at an astonishing rate. Psychiatric comorbidity with many chronic physical disorders has remained neglected. Such comorbidity with cardiac, respiratory, Gastrointestinal, endocrinal, and neurological disorders, trauma, and other conditions like HIV and so on, needs to be addressed too. Evidence base of prevalence and causal relationship of psychiatric comorbidities in these disorders has been highlighted and strategies to meet the challenge of comorbidity have been indicated.

Multicenter European Prevalence Study of Neurocognitive Impairment and Associated Factors in HIV Positive Patients

DEFF Research Database (Denmark)

Haddow, Lewis J; Laverick, Rosanna; Daskalopoulou, Marina

2018-01-01

We conducted a cross-sectional study in 448 HIV positive patients attending five European outpatient clinics to determine prevalence of and factors associated with neurocognitive impairment (NCI) using computerized and pen-and-paper neuropsychological tests. NCI was defined as a normalized Z scor...

Executive function in posttraumatic stress disorder (PTSD) and the influence of comorbid depression

NARCIS (Netherlands)

Olff, Miranda; Polak, A Rosaura; Witteveen, Anke B; Denys, D.

BACKGROUND: Posttraumatic stress disorder (PTSD) has been associated with neurocognitive deficits, such as impaired verbal memory and executive functioning. Less is known about executive function and the role of comorbid depression in PTSD. Recently, studies have shown that verbal memory impairments

Prevalence of alcohol-impaired drivers based on random breath tests in a roadside survey in Catalonia (Spain).

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Alcañiz, Manuela; Guillén, Montserrat; Santolino, Miguel; Sánchez-Moscona, Daniel; Llatje, Oscar; Ramon, Lluís

2014-04-01

Sobriety checkpoints are not usually randomly located by traffic authorities. As such, information provided by non-random alcohol tests cannot be used to infer the characteristics of the general driving population. In this paper a case study is presented in which the prevalence of alcohol-impaired driving is estimated for the general population of drivers. A stratified probabilistic sample was designed to represent vehicles circulating in non-urban areas of Catalonia (Spain), a region characterized by its complex transportation network and dense traffic around the metropolis of Barcelona. Random breath alcohol concentration tests were performed during spring 2012 on 7596 drivers. The estimated prevalence of alcohol-impaired drivers was 1.29%, which is roughly a third of the rate obtained in non-random tests. Higher rates were found on weekends (1.90% on Saturdays and 4.29% on Sundays) and especially at night. The rate is higher for men (1.45%) than for women (0.64%) and it shows an increasing pattern with age. In vehicles with two occupants, the proportion of alcohol-impaired drivers is estimated at 2.62%, but when the driver was alone the rate drops to 0.84%, which might reflect the socialization of drinking habits. The results are compared with outcomes in previous surveys, showing a decreasing trend in the prevalence of alcohol-impaired drivers over time. Copyright © 2014 Elsevier Ltd. All rights reserved.

Comorbidity between obsessive-compulsive disorder and body dysmorphic disorder: prevalence, explanatory theories, and clinical characterization

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Frías Á

2015-08-01

Full Text Available Álvaro Frías,1,2 Carol Palma,1,2 Núria Farriols,1,2 Laura González2 1FPCEE Blanquerna, Universitat Ramon Llull, Barcelona, 2Adult Outpatient Mental Health Center, Hospital de Mataró – CSdM, Mataró, Spain Background: With the advent of the fifth edition of Diagnostic and Statistical Manual of Mental Disorders, body dysmorphic disorder (BDD has been subsumed into the obsessive-compulsive disorders and related disorders (OCDRD category. Objective: We aimed to determine the empirical evidence regarding the potential relationship between BDD and obsessive-compulsive disorder (OCD based on the prevalence data, etiopathogenic pathways, and clinical characterization of patients with both disorders. Method: A comprehensive search of databases (PubMed and PsycINFO was performed. Published manuscripts between 1985 and May 2015 were identified. Overall, 53 studies fulfilled inclusion criteria. Results: Lifetime comorbidity rates of BDD–OCD are almost three times higher in samples with a primary diagnosis of BDD than those with primary OCD (27.5% vs 10.4%. However, other mental disorders, such as social phobia or major mood depression, are more likely among both types of psychiatric samples. Empirical evidence regarding the etiopathogenic pathways for BDD–OCD comorbidity is still inconclusive, whether concerning common shared features or one disorder as a risk factor for the other. Specifically, current findings concerning third variables show more divergences than similarities when comparing both disorders. Preliminary data on the clinical characterization of the patients with BDD and OCD indicate that the deleterious clinical impact of BDD in OCD patients is greater than vice versa. Conclusion: Despite the recent inclusion of BDD within the OCDRD, data from comparative studies between BDD and OCD need further evidence for supporting this nosological approach. To better define this issue, comparative studies between BDD, OCD, and social phobia

Real-world burden of comorbidities in US patients with psoriasis.

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Shah, Kamal; Mellars, Lillian; Changolkar, Arun; Feldman, Steven R

2017-08-01

Understanding background comorbidity rates in psoriasis can provide perspective for adverse events associated with new therapies. We sought to assess the extent of comorbidities in psoriasis patients by use of the Truven Health Analytics MarketScan database. MarketScan, comprising commercial claims representative of a large US-insured population, had 1.22 million patients with ≥1 claim with a psoriasis diagnosis between January 1, 2008, and December 31, 2014. Patients ≥18 years of age who had ≥2 health claims in any diagnosis field for psoriasis (International Classification of Diseases, 9th Revision, Clinical Modification 696.1) with a psoriasis diagnosis (index) date between July 1, 2008, and June 30, 2014, were included to allow follow-up observation time. Prevalence and incidence of 24 comorbidities were assessed in 469,097 psoriasis patients; the most common comorbidities were hyperlipidemia (45.64% and 30.83%, respectively), hypertension (42.19% and 24.19%), depression (17.91% and 12.68%), type 2 diabetes mellitus (17.45% and 8.44%), and obesity (14.38% and 11.57%). A limitation of the study was that only a certain insured population was represented. Comorbidity rates align with those described in the literature and support the concept that psoriasis patients have high rates of cardiometabolic comorbidities. This analysis highlights the potential utility of very large insurance databases for determining comorbidity prevalence in psoriasis, which may aid health care providers in managing psoriasis. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Psoriasis and comorbidities: links and risks

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Ni C

2014-04-01

Full Text Available Catherine Ni, Melvin W Chiu Division of Dermatology, Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA Abstract: Psoriasis is a chronic inflammatory skin disease affecting approximately 2% of the population worldwide. In the past decade, many studies have drawn attention to comorbid conditions in psoriasis. This literature review examines the epidemiological evidence, pathophysiological commonalities, and therapeutic implications for different comorbidities of psoriasis. Cardiovascular disease, obesity, diabetes, hypertension, dyslipidemia, metabolic syndrome, nonalcoholic fatty liver disease, cancer, anxiety and depression, and inflammatory bowel disease have been found at a higher prevalence in psoriasis patients compared to the general population. Because of the wide range of comorbid conditions associated with psoriasis, comprehensive screening and treatment must be implemented to most effectively manage psoriasis patients. Keywords: cardiovascular, metabolic syndrome

High prevalence of cognitive impairment after intracerebral hemorrhage.

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Mélanie Planton

Full Text Available Cognitive impairment seems to be frequent in intracerebral hemorrhage (ICH survivors, but remains widely understudied. In this study, we investigated the frequency and patterns of vascular cognitive disorders (VCDs in patients with cerebral amyloid angiopathy (CAA-related and deep ICH compared to patients with mild cognitive impairment due to Alzheimer's disease (MCI-AD and healthy controls.We prospectively recruited 20 patients with CAA-related lobar ICH, 20 with deep ICH, 20 with MCI-AD and 17 healthy controls. Patients with cognitive decline pre-ICH were excluded from the analysis. Each participant underwent a comprehensive neuropsychological assessment and a structural brain MRI. Cognitive assessment was performed at a median delay of 4 months after the acute phase in ICH patients, and more than 6 months after the first complaint in MCI-AD patients. Cognitive profiles were compared between groups. The prevalence of VCDs in the ICH groups was estimated using the recent VASCOG criteria."Mild" and "major VCDs" were respectively observed in 87.5% and 2.5% of all ICH patients. Every patient in the CAA group had mild VCDs. No significant difference was observed in cognitive functioning between CAA-related and deep ICH patients. The most impaired process in the CAA group was naming, with a mean (±standard deviation z-score of -5.2 ±5.5, followed by processing speed (-4.1±3.3, executive functioning (-2.6 ±2.5, memory (-2.4 ±3.5 and attention (-0.9 ±1.3. This cognitive pattern was different from the MCI-AD patients, but the groups were only different in gestural praxis, and by construction, in memory processes.VCDs are frequent after ICH. Cognitive patterns of patients with deep or CAA-related ICH did not differ, but there was impaired performance in specific domains distinct from the effects of Alzheimer's disease.URL: http://www.clinicaltrials.gov. Unique identifier: NCT01619709.

Psychiatric comorbidities in autism spectrum disorders: findings from a Danish Historic Birth Cohort

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Abdallah, Morsi; Greaves-Lord, Kirstin; Grove, Jakob

2011-01-01

Several psychiatric comorbidities are common among patients with Autism Spectrum Disorders (ASD), which may worsen the clinical outcome and add to the substantial costs of care. The aim of this report is to estimate the psychiatric comorbidity rates within ASD utilizing a Danish Historic Birth...... Cohort (HBC). Overall, 72.5% of ASD cases had at least one other psychiatric comorbidity along with ASD which suggests a high prevalence of psychiatric comorbidities in individuals with ASD. Careful consideration and treatment of comorbidities may serve as a tool to understand and treat ASD better....

Executive function in posttraumatic stress disorder (PTSD) and the influence of comorbid depression

NARCIS (Netherlands)

Olff, Miranda; Polak, A. Rosaura; Witteveen, Anke B.; Denys, Damiaan

2014-01-01

Posttraumatic stress disorder (PTSD) has been associated with neurocognitive deficits, such as impaired verbal memory and executive functioning. Less is known about executive function and the role of comorbid depression in PTSD. Recently, studies have shown that verbal memory impairments may be

Prevalence and risk factors of visual impairment and blindness in Korea: the Fourth Korea National Health and Nutrition Examination Survey in 2008-2010.

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Rim, Tyler H T; Nam, Jae S; Choi, Moonjung; Lee, Sung C; Lee, Christopher S

2014-06-01

To describe the age, gender specific prevalence and risk factors of visual impairment and blindness in Korea. From 2008 to 2010, a total 14 924 randomly selected national representative participants of the Korea National Health and Nutrition Examination Survey underwent additional ophthalmologic examinations by the Korean Ophthalmologic Society. Best Corrected Distance Visual Acuity was measured using an international standard vision chart based on Snellen scale (Jin's vision chart). Independent risk factors for visual impairment were investigated using multivariate logistic regression analysis. The overall prevalence of visual impairment (≤20/40) of adults 40 years and older was 4.1% (95% CI, 3.6-4.6) based on the better seeing eye. The overall prevalence of blindness (≤20/200) for adults 40 years and older was 0.2% (95% CI, 0.1-0.3). Risk indicators of visual impairment were increasing age, low education status, living in rural area, being unemployed, being without spouse and the absence of private health insurance. The visually impaired were more likely to have eye diseases compared with the normal subjects, and they were less likely to utilize eye care. The prevalence of visual impairment was demonstrated to be higher while that of blindness was similar to previous population studies in Asia or U.S. Sociodemographic disparities are present in the prevalence of visual impairment and more targeted efforts are needed to promote vision screening in high risk groups. © 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Visual Impairment Is Associated With Depressive Symptoms-Results From the Nationwide German DEGS1 Study.

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Schuster, Alexander K; Tesarz, Jonas; Rezapour, Jasmin; Beutel, Manfred E; Bertram, Bernd; Pfeiffer, Norbert

2018-01-01

Visual impairment (VI) is associated with a variety of comorbidities including physical and mental health in industrial countries. Our aim is to examine associations between self-reported impairment and depressive symptoms in the German population. The point prevalence of self-reported VI in Germany was computed using data from the German Health Interview and Examination Survey for adults from 2008 to 2011 ( N  = 7.783, 50.5% female, age range 18-79 years). VI was surveyed by two questions, one for seeing faces at a distance of 4 m and one for reading newspapers. Depressive symptoms were evaluated with the Patient Health Questionnaire-9 questionnaire and 2-week prevalence was computed with weighted data. Depressive symptoms were defined by a value of ≥10. Logistic regression analysis was performed to analyze an association between self-reported VI and depressive symptoms. Multivariable analysis including adjustment for age, gender, socioeconomic status, and chronic diseases were carried out with weighted data. The 2-week prevalence of depressive symptoms was 20.8% (95% CI: 16.6-25.7%) for some difficulties in distance vision and 14.4% (95% CI: 7.5-25.9%) for severe difficulties in distance vision, while 17.0% (95% CI: 13.3-21.4%), respectively, 16.7% (95% CI: 10.7-25.1%) for near vision. Analysis revealed that depressive symptoms were associated with self-reported VI for reading, respectively, with low VI for distance vision. Multivariable regression analysis including potential confounders confirmed these findings. Depressive symptoms are a frequent finding in subjects with difficulties in distance and near vision with a prevalence of up to 24%. Depressive comorbidity should therefore be evaluated in subjects reporting VI.

Diagnosis and Treatment of Insomnia Comorbid with Obstructive Sleep Apnea.

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Lack, Leon; Sweetman, Alexander

2016-09-01

Insomnia is often comorbid with obstructive sleep apnea. It reduces positive airway pressure (PAP) therapy acceptance and adherence. Comorbid patients show greater daytime impairments and poorer health outcomes. The insomnia often goes undiagnosed, undertreated, or untreated. Pharmacotherapy is not recommended for long-term treatment. Although care should be taken administering behavioral therapies to patients with elevated sleepiness, cognitive behavior therapy for insomnia (CBTi) is an effective and durable nondrug therapy that reduces symptoms and may increase the effectiveness of PAP therapy. Sleep clinics should be alert to comorbid insomnia and provide adequate diagnostic tools and clinicians with CBTi expertise. Copyright © 2016 Elsevier Inc. All rights reserved.

Comorbidity of Migraine

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Shuu-Jiun Wang

2010-08-01

Full Text Available Migraine is a common neurological disorder and can cause severely disabling during attacks. The highest prevalence occurs between the ages of 25 and 55 years, potentially the most productive period of life. Migraine leads to a burden not only to the individual, but also to the family and society. Prior studies have found migraine occurs with some illness at a greater than coincidental rate than is seen in the general population. These occurrences are called “comorbidity”, which means that these disorders are interrelated with migraine. To delineate migraine comorbidity is important because it can help improve treatment strategies and understand the possible pathophysiology of migraine. The comorbid illnesses in patients with migraine include stroke, sub-clinical vascular brain lesions, coronary heart disease, hypertension, patent foramen ovale, psychiatric diseases (depression, anxiety, bipolar disorder, panic disorder, and suicide, restless legs syndrome, epilepsy, and asthma. In this paper, we review the existing epidemiological and hospital based studies and illustrate the connections between these illness and migraine.

Influence of culture on pain comorbidity in women with and without temporomandibular disorder-pain.

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Al-Harthy, M; Michelotti, A; List, T; Ohrbach, R

2017-06-01

Evidence on cultural differences in prevalence and impact of common chronic pain conditions, comparing individuals with temporomandibular disorders (TMD) versus individuals without TMD, is limited. The aim was to assess cross-cultural comorbid pain conditions in women with chronic TMD pain. Consecutive women patients (n = 122) with the index condition of chronic TMD pain diagnosed per the research diagnostic criteria for TMD and TMD-free controls (n = 121) matched for age were recruited in Saudi Arabia, Italy and Sweden. Self-report questionnaires assessed back, chest, stomach and head pain for prevalence, pain intensity and interference with daily activities. Logistic regression was used for binary variables, and ancova was used for parametric data analysis, adjusting for age and education. Back pain was the only comorbid condition with a different prevalence across cultures; Swedes reported a lower prevalence compared to Saudis (P 50% due to back pain compared to Italians or Swedes (P cultures. The total number of comorbid conditions did not differ cross-culturally but were reported more by TMD-pain cases than TMD-free controls (P Culture influences the associated comorbidity of common pain conditions. The cultural influence on pain expression is reflected in different patterns of physical representation. © 2017 John Wiley & Sons Ltd.

Psychoactive substance use and dependence among Spanish university students: prevalence, correlates, polyconsumption, and comorbidity with depression.

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Vázquez, Fernando L

2010-02-01

In this study, the prevalence of psychoactive substance use and dependence was estimated among students at a Spanish university, together with associated factors, polyconsumption, and comorbidity with depression, using a 554-member sample stratified by sex, degree year, and discipline. 86.5% had consumed some potentially addictive psychoactive substance in the past month, and 10.5% satisfied DSM-IV criteria for dependence on nicotine, alcohol, caffeine, or cannabis. Polyconsumers (90.4%) consumed an average 3.2 different substances. Current depression implied increased likelihood of having consumed tobacco or psychoactive pharmaceutical drugs in the past month, and DSM-IV symptoms of major depressive episode were shown by 8.6% of 58 substance-dependent participants, 8.7% of 540 past-month legal substance consumers, and 12.1% of 140 past-month illegal substance consumers.

Prevalence and associated factors of sarcopenia in elderly subjects with amnestic mild cognitive impairment or Alzheimer disease.

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Sugimoto, Taiki; Ono, Rei; Murata, Shunsuke; Saji, Naoki; Matsui, Yasumoto; Niida, Shumpei; Toba, Kenji; Sakurai, Takashi

2016-01-01

To date, very little is known about the nature of sarcopenia in subjects with cognitive impairment. The aims of this study were firstly to clarify the prevalence of sarcopenia at various stages of cognitive impairment, and secondly to examine factors related to sarcopenia in men and women with cognitive impairment. The subjects were 418 outpatients (normal cognition; NC: 35, amnestic mild cognitive impairment; aMCI: 40, Alzheimer disease; AD: 343) who attended the Memory Clinic at the National Center for Geriatrics and Gerontology of Japan during the period from October 2010 to July 2014. Cognitive status, vitality, depressive mood, body mass index, hand grip strength, timed up and go test, skeletal muscle mass and serum levels of 25-hydroxyvitamin D, albumin and creatinine were assessed. Sarcopenia was defined as the presence of both poor muscle function (low physical performance or low muscle strength) and low muscle mass. We performed the univariate and multivariate logistic regression analyses to explore factors associated with sarcopenia. The overall prevalence of sarcopenia was 21.1% (NC = 8.6%, aMCI = 12.5%, AD = 23.3%). In both sexes, factors associated with sarcopenia were age (P sarcopenia (P sarcopenia. Prevention of sarcopenia in patients with cognitive impairment should be approached from physical and psychologic points of view.

Comorbid Visual and Psychiatric Disabilities Among the Chinese Elderly: A National Population-Based Survey.

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Guo, Chao; Wang, Zhenjie; Li, Ning; Chen, Gong; Zheng, Xiaoying

2017-12-01

To estimate the prevalence of, and association between, co-morbid visual and psychiatric disabilities among elderly (>65 years-of-age) persons in China. Random representative samples were obtained using multistage, stratified, cluster sampling, with probabilities proportional to size. Standard weighting procedures were used to construct sample weights that reflected this multistage, stratified cluster sampling survey scheme. Logistic regression models were used to elucidate associations between visual and psychiatric disabilities. Among the Chinese elderly, >160,000 persons have co-morbid visual and psychiatric disabilities. The weighted prevalence among this cohort is 123.7 per 100,000 persons. A higher prevalence of co-morbid visual and psychiatric disabilities was found in the oldest-old (pvisual disability was significantly associated with a higher risk of having a psychiatric disability among persons aged ≥80 years-of-age [adjusted odds ratio, 1.24; 95% confidence interval (CI), 1.03-1.54]. A significant number of Chinese elderly persons were living with co-morbid visual and psychiatric disabilities. To address the challenge of these co-morbid disorders among Chinese elders, it is incumbent upon the government to implement additional and more comprehensive prevention and rehabilitation strategies for health-care systems, reinforce health promotion among the elderly, and improve accessibility to health-care services.

[Comorbidity of compulsive disorders in childhood and adolescence].

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Becker, K; Jennen-Steinmetz, Ch; Holtmann, M; el-Faddagh, M; Schmidt, M H

2003-08-01

The cross-sectional comorbidity of child and adolescent inpatients with obsessive-compulsive disorder (OCD) was assessed. The hospital records of all inpatients treated for OCD since 1976 (31 girls, 46 boys) were compared with data from a prospective epidemiological longitudinal study (90 girls, 84 boys) in two age cohorts ( or = 15 years) with regard to comorbid psychiatric diagnoses. Additionally, psychiatric Axis I diagnoses of patients with a supplementary diagnosis of compulsive symptoms (n = 45) were descriptively assessed in the client population. In the subgroup of OCD patients tic disorders. OCD girls > or = 15 years showed a tendency toward more frequent comorbid affective disorders and a significant result regarding concurrent eating disorders. Eighteen of 27 female patients with supplementary compulsive symptoms requiring clinical intervention had an Axis I diagnosis of eating disorder. Due to different criteria of classification, diverging definitions of comorbidity and different age cohorts and samples, studies on comorbidity in OCD patients are difficult to compare. The frequency of comorbid psychiatric disorders may be over-estimated if the general prevalence of psychiatric disorders in terms of gender and age is not taken into account.

Comorbidity of Auditory Processing, Language, and Reading Disorders

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Sharma, Mridula; Purdy, Suzanne C.; Kelly, Andrea S.

2009-01-01

Purpose: The authors assessed comorbidity of auditory processing disorder (APD), language impairment (LI), and reading disorder (RD) in school-age children. Method: Children (N = 68) with suspected APD and nonverbal IQ standard scores of 80 or more were assessed using auditory, language, reading, attention, and memory measures. Auditory processing…

Does comorbid anxiety counteract emotion recognition deficits in conduct disorder?

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Short, Roxanna M L; Sonuga-Barke, Edmund J S; Adams, Wendy J; Fairchild, Graeme

2016-08-01

Previous research has reported altered emotion recognition in both conduct disorder (CD) and anxiety disorders (ADs) - but these effects appear to be of different kinds. Adolescents with CD often show a generalised pattern of deficits, while those with ADs show hypersensitivity to specific negative emotions. Although these conditions often cooccur, little is known regarding emotion recognition performance in comorbid CD+ADs. Here, we test the hypothesis that in the comorbid case, anxiety-related emotion hypersensitivity counteracts the emotion recognition deficits typically observed in CD. We compared facial emotion recognition across four groups of adolescents aged 12-18 years: those with CD alone (n = 28), ADs alone (n = 23), cooccurring CD+ADs (n = 20) and typically developing controls (n = 28). The emotion recognition task we used systematically manipulated the emotional intensity of facial expressions as well as fixation location (eye, nose or mouth region). Conduct disorder was associated with a generalised impairment in emotion recognition; however, this may have been modulated by group differences in IQ. AD was associated with increased sensitivity to low-intensity happiness, disgust and sadness. In general, the comorbid CD+ADs group performed similarly to typically developing controls. Although CD alone was associated with emotion recognition impairments, ADs and comorbid CD+ADs were associated with normal or enhanced emotion recognition performance. The presence of comorbid ADs appeared to counteract the effects of CD, suggesting a potentially protective role, although future research should examine the contribution of IQ and gender to these effects. © 2016 Association for Child and Adolescent Mental Health.

Co-morbidities in severe asthma

DEFF Research Database (Denmark)

Porsbjerg, Celeste; Menzies-Gow, Andrew

2017-01-01

Patients with severe asthma represent a minority of the total asthma population, but carry a majority of the morbidity and healthcare costs. Achieving better asthma control in this group of patients is therefore of key importance. Systematic assessment of patients with possible severe asthma...... to identify treatment barriers and triggers of asthma symptoms, including co-morbidities, improves asthma control and reduces healthcare costs and is recommended by international guidelines on management of severe asthma. This review provides the clinician with an overview of the prevalence and clinical...... impact of the most common co-morbidities in severe asthma, including chronic rhinosinusitis, nasal polyposis, allergic rhinitis, dysfunctional breathing, vocal cord dysfunction, anxiety and depression, obesity, obstructive sleep apnoea syndrome (OSAS), gastroesophageal reflux disease (GERD...

The impact of comorbidity on mortality in multiple myeloma

DEFF Research Database (Denmark)

Gregersen, Henrik; Vangsted, Annette Juul; Abildgaard, Niels

2017-01-01

To describe the prevalence of comorbidity and its impact on survival in newly diagnosed multiple myeloma patients compared with population controls. Cases of newly diagnosed symptomatic multiple myeloma during the 2005-2012 period were identified in the Danish National Multiple Myeloma Registry....... For each myeloma patient, 10 members of the general population matched by age and sex were chosen from the national Civil Registration System. Data on comorbidity in the myeloma patients and the general population comparison cohort were collected by linkage to the Danish National Patient Registry (DNPR......). Cox proportional hazards regression models were used to evaluate the prognostic significance of comorbidity. The study included 2190 cases of multiple myeloma and 21,900 population controls. The comorbidity was increased in multiple myeloma patients compared with population controls, odds ratio (OR) 1...

The Early Diagnosis of Hypothyroidism as a Factor in the Progression of Osteoarthritis and Comorbid Processes, the Features of Phytocorrection

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L.O. Voloshynа

2016-10-01

Full Text Available Objective: to study the prevalence and forms of hypothyroidism in patients with osteoarthritis (OA and to investigate the effect of phytomedication zobofit on the functional and morphological status of the thyroid gland, the manifestations of comorbid diseases, oxidative status, fibrinolytic and proteolytic activity of the blood. Materials and methods. In 312 patients with OA, we have studied the manifestations of comorbid processes, and among them — hypothyroidism phenomena. We have used clinical, biochemical, radioimmunological, ultrasound methods. Results. All patients with OA after 50 years had the increasing number and severity of comorbid processes. Among them, 4.48 % of patients has symptomatic and 13.78 % — subclinical hypothyroidism. Symptoms of hypothyroidism were marked in people over 55, especially — over 60 years. Subclinical hypothyroidism slightly worsened clinical symptoms of OA and comorbid processes, but enhanced the effects of oxidative stress, reduction of fibrinolytic and increase of proteolytic activity of the blood, impaired glomerular filtration rate of the kidneys. The above is considered as non-specific pathophysiological basis for the progression of identified ailments. Three-month application of the herbal medication zobofit in most patients has normalized thyroid homeostasis, improved overall outcomes of the treatment for underlying and comorbid illnesses, reduced the severity of metabolic disorders. Conclusions. In OA patients aged over 50 years with a high level of comorbidity, it is necessary to carry out screening for hypothyroidism. If you noticed the signs of subclinical hypothyroidism in this population of patients, it is appropriate to use multicomponental phytomedications with diverse thyroid-stimulating action.

Comorbid psychiatric disorders in female adolescents with first-onset anorexia nervosa.

Science.gov (United States)

Bühren, K; Schwarte, R; Fluck, F; Timmesfeld, N; Krei, M; Egberts, K; Pfeiffer, E; Fleischhaker, C; Wewetzer, C; Herpertz-Dahlmann, B

2014-01-01

Patients with anorexia nervosa (AN) exhibit high rates of psychiatric comorbidity. To disentangle the effects of duration of illness on comorbid psychiatric symptoms, we investigated the rates of comorbid psychiatric disorders, suicidality and self-harm behaviour in adolescent patients with a first onset of AN. In adolescent females (n = 148) with a first onset of AN, body mass index, psychiatric comorbidity (according to DSM-IV), depressive symptoms, suicidality and self-injurious behaviour were assessed. Seventy patients (47.3%) met the criteria for at least one comorbid psychiatric disorder. The binge-purging subtype was associated with increased rates of psychiatric comorbidity, suicidality and self-injurious behaviour. The severity of eating disorder-specific psychopathology influenced current psychiatric comorbidity and suicidal ideation. Prevalence rates of comorbid psychiatric disorders and suicidal ideation are considerably lower among adolescents with AN compared with adults. An early and careful assessment, along with adequate treatment of the eating disorder, might prevent the development of severe psychiatric comorbidities. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.

Comorbidity between obsessive-compulsive disorder and body dysmorphic disorder: prevalence, explanatory theories, and clinical characterization

Science.gov (United States)

Frías, Álvaro; Palma, Carol; Farriols, Núria; González, Laura

2015-01-01

Background With the advent of the fifth edition of Diagnostic and Statistical Manual of Mental Disorders, body dysmorphic disorder (BDD) has been subsumed into the obsessive-compulsive disorders and related disorders (OCDRD) category. Objective We aimed to determine the empirical evidence regarding the potential relationship between BDD and obsessive-compulsive disorder (OCD) based on the prevalence data, etiopathogenic pathways, and clinical characterization of patients with both disorders. Method A comprehensive search of databases (PubMed and PsycINFO) was performed. Published manuscripts between 1985 and May 2015 were identified. Overall, 53 studies fulfilled inclusion criteria. Results Lifetime comorbidity rates of BDD–OCD are almost three times higher in samples with a primary diagnosis of BDD than those with primary OCD (27.5% vs 10.4%). However, other mental disorders, such as social phobia or major mood depression, are more likely among both types of psychiatric samples. Empirical evidence regarding the etiopathogenic pathways for BDD–OCD comorbidity is still inconclusive, whether concerning common shared features or one disorder as a risk factor for the other. Specifically, current findings concerning third variables show more divergences than similarities when comparing both disorders. Preliminary data on the clinical characterization of the patients with BDD and OCD indicate that the deleterious clinical impact of BDD in OCD patients is greater than vice versa. Conclusion Despite the recent inclusion of BDD within the OCDRD, data from comparative studies between BDD and OCD need further evidence for supporting this nosological approach. To better define this issue, comparative studies between BDD, OCD, and social phobia should be carried out. PMID:26345330

Prevalence of cognitive impairment in individuals aged over 65 in an urban area: DERIVA study

Directory of Open Access Journals (Sweden)

Rodríguez-Sánchez Emiliano

2011-11-01

Full Text Available Abstract Background Few data are available on the prevalence of cognitive impairment (CI in Spain, and the existing information shows important variations depending on the geographical setting and the methodology employed. The aim of this study was to determine the prevalence of CI in individuals aged over 65 in an urban area, and to analyze its associated risk factors. Methods Design: A descriptive, cross-sectional, home questionnaire-based study; Setting: Populational, urban setting. Participants: The reference population comprised over-65s living in the city of Salamanca (Spain in 2009. Randomized sampling stratified according to health district was carried out, and a total of 480 people were selected. In all, 327 patients were interviewed (68.10%, with a mean age of 76.35 years (SD: 7.33. Women accounted for 64.5% of the total. Measurements: A home health questionnaire was used to obtain the following data: age, sex, educational level, family structure, morbidity and functionality. All participants completed a neuropsychological test battery. The prevalence data were compared with those of the European population, with direct adjustment for age and sex. Diagnoses were divided into three general categories: normal cognitive function, cognitive impairment - no dementia (CIND, and dementia. Results The prevalence of CI among these over-65s was 19% (14.7% CIND and 4.3% dementia. The age-and sex-adjusted global prevalence of CI was 14.9%. CI increased with age (p Conclusions The observed raw prevalence of CI was 19% (14.9% after adjusting for age and sex. Older age and the presence of diabetes and anxiety-depression increased the risk of CI, while higher educational level reduced the risk.

Exploring the prevalence and variance of cognitive impairment, pain, neuropsychiatric symptoms and ADL dependency among persons living in nursing homes; a cross-sectional study.

Science.gov (United States)

Björk, Sabine; Juthberg, Christina; Lindkvist, Marie; Wimo, Anders; Sandman, Per-Olof; Winblad, Bengt; Edvardsson, David

2016-08-22

Earlier studies in nursing homes show a high prevalence of cognitive impairment, dependency in activities of daily living (ADL), pain, and neuropsychiatric symptoms among residents. The aim of this study was to explore the prevalence of the above among residents in a nationally representative sample of Swedish nursing homes, and to investigate whether pain and neuropsychiatric symptoms differ in relation to gender, cognitive function, ADL-capacity, type of nursing-home unit and length of stay. Cross-sectional data from 188 randomly selected nursing homes were collected. A total of 4831 residents were assessed for cognitive and ADL function, pain and neuropsychiatric symptoms. Data were analysed using descriptive statistics and the chi-square test. The results show the following: the prevalence of cognitive impairment was 67 %, 56 % of residents were ADL-dependent, 48 % exhibited pain and 92 % exhibited neuropsychiatric symptoms. The prevalence of pain did not differ significantly between male and female residents, but pain was more prevalent among cognitively impaired and ADL-dependent residents. Pain prevalence was not significantly different between residents in special care units for people with dementia (SCU) and general units, or between shorter-and longer-stay residents. Furthermore, the prevalence of neuropsychiatric symptoms did not differ significantly between male and female residents, between ADL capacities or in relation to length of stay. However, residents with cognitive impairment and residents in SCUs had a significantly higher prevalence of neuropsychiatric symptoms than residents without cognitive impairment and residents in general units. The prevalence rates ascertained in this study could contribute to a greater understanding of the needs of nursing-home residents, and may provide nursing home staff and managers with trustworthy assessment scales and benchmark values for further quality assessment purposes, clinical development work and

Prevalence, correlates, disability, and comorbidity of DSM-IV narcissistic personality disorder: results from the wave 2 national epidemiologic survey on alcohol and related conditions.

Science.gov (United States)

Stinson, Frederick S; Dawson, Deborah A; Goldstein, Risë B; Chou, S Patricia; Huang, Boji; Smith, Sharon M; Ruan, W June; Pulay, Attila J; Saha, Tulshi D; Pickering, Roger P; Grant, Bridget F

2008-07-01

To present nationally representative findings on prevalence, sociodemographic correlates, disability, and comorbidity of narcissistic personality disorder (NPD) among men and women. Face-to-face interviews with 34,653 adults participating in the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions conducted between 2004 and 2005 in the United States. Prevalence of lifetime NPD was 6.2%, with rates greater for men (7.7%) than for women (4.8%). NPD was significantly more prevalent among black men and women and Hispanic women, younger adults, and separated/divorced/widowed and never married adults. NPD was associated with mental disability among men but not women. High co-occurrence rates of substance use, mood, and anxiety disorders and other personality disorders were observed. With additional comorbidity controlled for, associations with bipolar I disorder, post-traumatic stress disorder, and schizotypal and borderline personality disorders remained significant, but weakened, among men and women. Similar associations were observed between NPD and specific phobia, generalized anxiety disorder, and bipolar II disorder among women and between NPD and alcohol abuse, alcohol dependence, drug dependence, and histrionic and obsessive-compulsive personality disorders among men. Dysthymic disorder was significantly and negatively associated with NPD. NPD is a prevalent personality disorder in the general U.S. population and is associated with considerable disability among men, whose rates exceed those of women. NPD may not be as stable as previously recognized or described in the DSM-IV. The results highlight the need for further research from numerous perspectives to identify the unique and common genetic and environmental factors underlying the disorder-specific associations with NPD observed in this study.

Refractory Hypertension: Determination of Prevalence, Risk Factors and Comorbidities in a Large, Population-Based Cohort

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Calhoun, David A.; Booth, John N.; Oparil, Suzanne; Irvin, Marguerite R.; Shimbo, Daichi; Lackland, Daniel T.; Howard, George; Safford, Monika M.; Muntner, Paul

2014-01-01

Refractory hypertension is an extreme phenotype of antihypertensive treatment failure. Participants in the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study, a large (n=30,239), population-based cohort were evaluated to determine the prevalence of refractory hypertension and associated cardiovascular risk factors and comorbidities. Refractory hypertension was defined as uncontrolled blood pressure (systolic/diastolic ≥ 140/90 mm Hg) on ≥ 5 antihypertensive drug classes. Participants with resistant hypertension (systolic/diastolic ≥140/90 mm Hg on ≥ 3 orhypertensive participants served as comparator groups. Of 14,809 REGARDS participants receiving antihypertensive treatment, 78 (0.5%) had refractory hypertension. The prevalence of refractory hypertension was 3.6% among participants with resistant hypertension(n=2,144) and 41.7% among participants on 5 or more antihypertensive drug classes. Among all hypertensive participants, African American race, male gender, living in the stroke belt or buckle, higher body mass index, lower heart rate, reduced estimated glomerular filtration rate, albuminuria, diabetes and history of stroke and coronary heart disease were associated with refractory hypertension. Compared to resistant hypertension, prevalence ratios for refractory hypertension were increased for African Americans (3.00, 95% CI 1.68 – 5.37) and those with albuminuria (2.22, 95% CI 1.40 – 3.52) and diabetes (2.09, 95% CI 1.32 – 3.31). The median 10-year Framingham risk for coronary heart disease and stroke was higher among participants with refractory hypertension compared to either comparator group. These data indicate that while resistant hypertension is relatively common among treated hypertensive patients, true antihypertensive treatment failure is rare. PMID:24324035

Online social networking addiction among college students in Singapore: Comorbidity with behavioral addiction and affective disorder.

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Tang, Catherine So-Kum; Koh, Yvaine Yee Woen

2017-02-01

This study aimed to determine the prevalence of addiction to social networking sites/platforms (SNS) and its comorbidity with other behavioral addiction and affective disorder among college students in Singapore. 1110 college students (age: M=21.46, SD=1.80) in Singapore completed measures assessing online social networking, unhealthy food intake and shopping addiction as well as depression, anxiety and mania. Descriptive analyses were conducted to investigate the prevalence and comorbidity of behavioral addiction and affective disorder. Chi-square tests were used to examine gender differences. The prevalence rates of SNS, food and shopping addiction were 29.5%, 4.7% and 9.3% respectively for the total sample. SNS addiction was found to co-occur with food addiction (3%), shopping addiction (5%), and both food and shopping addiction (1%). The comorbidity rates of SNS addiction and affective disorder were 21% for depression, 27.7% for anxiety, and 26.1% for mania. Compared with the total sample, students with SNS addiction reported higher comorbidity rates with other behavioral addiction and affective disorder. In general, females as compared to males reported higher comorbidity rates of SNS addiction and affective disorder. SNS addiction has a high prevalence rate among college students in Singapore. Students with SNS addiction were vulnerable to experience other behavior addiction as well as affective disorder, especially among females. Copyright © 2016. Published by Elsevier B.V.

Epidemiology, Comorbidity, and Behavioral Genetics of Antisocial Personality Disorder and Psychopathy.

Science.gov (United States)

Werner, Kimberly B; Few, Lauren R; Bucholz, Kathleen K

2015-04-01

Psychopathy is theorized as a disorder of personality and affective deficits while antisocial personality disorder (ASPD) diagnosis is primarily behaviorally based. While ASPD and psychopathy are similar and are highly comorbid with each other, they are not synonymous. ASPD has been well studied in community samples with estimates of its lifetime prevalence ranging from 1-4% of the general population. 4,5 In contrast, psychopathy is almost exclusively investigated within criminal populations so that its prevalence in the general population has been inferred by psychopathic traits rather than disorder (1%). Differences in etiology and comorbidity with each other and other psychiatric disorders of these two disorders are also evident. The current article will briefly review the epidemiology, etiology, and comorbidity of ASPD and psychopathy, focusing predominately on research completed in community and clinical populations. This paper aims to highlight ASPD and psychopathy as related, but distinct disorders.

Anxiety, depression and impaired health-related quality of life in patients with occupational hand eczema.

Science.gov (United States)

Boehm, Dana; Schmid-Ott, Gerhard; Finkeldey, Florence; John, Swen Malte; Dwinger, Christine; Werfel, Thomas; Diepgen, Thomas L; Breuer, Kristine

2012-10-01

Occupational hand eczema is one of the most frequent occupational diseases. Few data about the prevalence of mental comorbidities are available. Objectives. We aimed to investigate the prevalence of anxiety, depression symptoms, the impairment of health-related quality of life (HRQoL) and their correlates in patients with occupational hand eczema. A test battery consisting of the German versions of the Hospital Anxiety and Depression Scale, the Dermatology Life Quality Index (DLQI) as a specific instrument and the Short Form Health Survey-36 (SF-36) as a generic instrument for HRQoL was applied in 122 patients. The severity of hand eczema was assessed with the Osnabrueck Hand Eczema Severity Index (OHSI). Twenty per cent of patients had a positive anxiety score, and 14% had a positive depression score. Higher anxiety levels, a greater impairment in the SF-36 mental component summary score and a higher DLQI category score for symptoms and feelings was detected in females than in males. The OHSI correlated with the impairment in HRQoL, and an association of severe hand eczema with symptoms of anxiety and depression was found in males. We found a high prevalence of anxiety and depression in our study population of patients with occupational hand eczema. Preventive measures should consider the psychosocial implications of occupational hand eczema. © 2012 John Wiley & Sons A/S.

Psychiatric comorbidity and plasma levels of 2-acyl-glycerols in outpatient treatment alcohol users. Analysis of gender differences.

Science.gov (United States)

García Marchena, Nuria; Araos, Pedro; Pavón, Francisco Javier; Ponce, Guillermo; Pedraz, María; Serrano, Antonia; Arias, Francisco; Romero-Sanchiz, Pablo; Suárez, Juan; Pastor, Antoni; De la Torre, Rafael; Torrens, Marta; Rubio, Gabriel; Rodríguez de Fonseca, Fernando

2016-09-29

Alcohol addiction is associated with high psychiatric comorbidity. Objective stratification of patients is necessary to optimize care and improve prognosis. The present study is designed to gain insights into this challenge by addressing the following objectives: a) to estimate the prevalence of psychiatric comorbidities in a sample of outpatients seeking treatment for alcohol use disorder, b) to describe the existence of gender differences and c) to validate 2-acyl-glycerols as biomarkers of alcohol use disorder and/or psychiatric comorbidity. One hundred and sixty-two patients were recruited and evaluated with the semi-structured interview PRISM. The presence of psychopathology was associated with a greater number of criteria for alcohol abuse and dependence according to DSM-IV-TR. We found gender differences in psychiatric comorbidity, e.g., mood disorder, as well as in comorbid substance use disorders. The prevalence of lifetime psychiatric comorbidity was 68.5%, with mood disorders the most frequent (37%), followed by attention deficit disorder (24.7%) and anxiety disorders (17.9%). Substance-induced disorders were more frequent in mood and psychotic disorders, whereas the primary disorders were more prevalent in patients with comorbid anxiety disorders. We found that 2-acyl-glycerols were significantly decreased in comorbid anxiety disorders in alcohol dependent patients in the last year, which makes them a potential biomarker for this psychopathological condition.

Comorbidity amplifies the effects of post-9/11 posttraumatic stress disorder trajectories on health-related quality of life.

Science.gov (United States)

Li, Jiehui; Zweig, Kimberly Caramanica; Brackbill, Robert M; Farfel, Mark R; Cone, James E

2018-03-01

The present study aims to examine the impact of physical and mental health comorbidities on the association between post-9/11 posttraumatic stress disorder (PTSD) trajectories over 10 years and health-related quality of life (HRQOL) among 9/11-exposed persons. 30,002 responding adult World Trade Center Health Registry enrollees reporting no pre-9/11 PTSD were studied. PTSD trajectories (chronic, delayed, remitted, no PTSD) were defined based on a 17-item PTSD Checklist-Specific to 9/11 across three waves of survey data. Three indicators of poor HRQOL were defined based on CDC HRQOL-4 measures. We computed age-adjusted prevalence of physical and mental health comorbidity (depression/anxiety) by PTSD trajectory and used modified Poisson regression to assess the effect of PTSD trajectory on poor HRQOL prevalence, accounting for comorbidity. Age-adjusted prevalence of overall comorbid conditions was 95.8 and 61.4% among the chronic and no-PTSD groups, respectively. Associations between 9/11-related PTSD trajectories and poor HRQOL were significant and became greater when comorbidity was included. Adjusted prevalence ratios were elevated for fair/poor health status (APR 7.3, 95% CI 6.5, 8.2), ≥ 14 unhealthy days (4.7; 95% CI 4.4, 5.1), and ≥ 14 activity limitation days during the last 30 days (9.6; 95% CI 8.1, 11.4) in the chronic PTSD group with physical and mental health comorbidity compared to those without PTSD and comorbidity; similar associations were observed for delayed PTSD. Ten years post-9/11 physical and mental health comorbidities have a substantial impact on the PTSD trajectories and HRQOL association. The need for early identification and treatment of PTSD and comorbidity should be emphasized to potentially improve HRQOL.

Creating Inclusive School Environments: Recommendations for the Management of Neurobehavioural Comorbidities in Children with Epilepsy

Science.gov (United States)

MacKinnon, Cheryl; Roberts, Jillian; Wylie, Jaimie

2016-01-01

The neurobehavioural comorbidities associated with childhood epilepsy present significant physical challenges (i.e., excessive fatigue, memory impairment, headaches, visual impairments), emotional challenges (i.e., depression, anxiety), behavioural challenges (i.e., inattentiveness, distractibility, aggression), and social challenges (i.e., peer…

Burden and impact of congenital syndromes and comorbidities among adults with congenital heart disease.

Science.gov (United States)

Bracher, Isabelle; Padrutt, Maria; Bonassin, Francesca; Santos Lopes, Bruno; Gruner, Christiane; Stämpfli, Simon F; Oxenius, Angela; De Pasquale, Gabriella; Seeliger, Theresa; Lüscher, Thomas F; Attenhofer Jost, Christine; Greutmann, Matthias

2017-08-01

Our aim was to assess the overall burden of congenital syndromes and non-cardiac comorbidities among adults with congenital heart disease and to assess their impact on circumstances of living and outcomes. Within a cohort of 1725 adults with congenital heart defects (65% defects of moderate or great complexity) followed at a single tertiary care center, congenital syndromes and comorbidities were identified by chart review. Their association with arrhythmias, circumstances of living and survival was analyzed. Within the study cohort, 232 patients (13%) had a genetic syndrome, 51% at least one comorbidity and 23% ≥2 comorbidities. Most prevalent comorbidities were systemic arterial hypertension (11%), thyroid dysfunction (9%), psychiatric disorders (9%), neurologic disorders (7%), chronic lung disease (7%), and previous stroke (6%). In contrast to higher congenital heart defect complexity, the presence of comorbidities had no impact on living circumstances but patients with comorbidities were less likely to work full-time. Atrial arrhythmias were more common among patients with moderate/great disease complexity and those with comorbidities but were less common among patients with congenital syndromes (pCongenital syndromes and comorbidities are highly prevalent in adults with congenital heart disease followed at specialist centers and add to the overall complexity of care. The presence of these additional factors has an impact on living circumstances, is associated with arrhythmias and needs to be further explored as prognostic markers. Copyright © 2017 Elsevier B.V. All rights reserved.

Should excessive worry be required for a diagnosis of generalized anxiety disorder? Results from the US National Comorbidity Survey Replication.

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Ruscio, Ayelet Meron; Lane, Michael; Roy-Byrne, Peter; Stang, Paul E; Stein, Dan J; Wittchen, Hans-Ulrich; Kessler, Ronald C

2005-12-01

Excessive worry is required by DSM-IV, but not ICD-10, for a diagnosis of generalized anxiety disorder (GAD). No large-scale epidemiological study has ever examined the implications of this requirement for estimates of prevalence, severity, or correlates of GAD. Data were analyzed from the US National Comorbidity Survey Replication, a nationally representative, face-to-face survey of adults in the USA household population that was fielded in 2001-2003. DSM-IV GAD was assessed with Version 3.0 of the WHO Composite International Diagnostic Interview. Non-excessive worriers meeting all other DSM-IV criteria for GAD were compared with respondents who met full GAD criteria as well as with other survey respondents to consider the implications of removing the excessiveness requirement. The estimated lifetime prevalence of GAD increases by approximately 40% when the excessiveness requirement is removed. Excessive GAD begins earlier in life, has a more chronic course, and is associated with greater symptom severity and psychiatric co-morbidity than non-excessive GAD. However, non-excessive cases nonetheless evidence substantial persistence and impairment of GAD, high rates of treatment-seeking, and significantly elevated co-morbidity compared with respondents without GAD. Non-excessive cases also have sociodemographic characteristics and familial aggregation of GAD comparable to excessive cases. Individuals who meet all criteria for GAD other than excessiveness have a somewhat milder presentation than those with excessive worry, yet resemble excessive worriers in a number of important ways. These findings challenge the validity of the excessiveness requirement and highlight the need for further research into the optimal definition of GAD.

Co-morbid substance use behaviors among youth: any impact of school environment?

Science.gov (United States)

Costello, Mary Jean E; Leatherdale, Scott T; Ahmed, Rashid; Church, Dana L; Cunningham, John A

2012-03-01

Substance use is common among youth; however, our understanding of co-morbid tobacco, alcohol and marijuana use remains limited. The school-environment may play an important role in the likelihood a student engages in high risk substance use behaviors, including co-morbid use. This study aims to: (i) describe the prevalence of co-morbid substance use behaviors among youth; (ii) identify and compare the characteristics of youth who currently use a single substance, any two substances, and all three substances; (iii) examine if the likelihood of co-morbid use varies by school and; (iv) examine what factors are associated with co-morbid use. This study used nationally representative data collected from students in grades 9 to 12 (n = 41,886) as part of the 2006-2007 Canadian Youth Smoking Survey (YSS). Demographic and behavioral data were collected including, current cigarette, alcohol and marijuana use. Results. 6.5% (n = 107,000) reported current use of all three substances and 20.3% (n = 333,000) of any two substances. Multi-level analysis revealed significant between school variability in the odds a student used all three substances and any two substances; accounting for 16.9% and 13.5% of the variability, respectively. Co-morbid use was associated with sex, grade, amount of available spending money and perceived academic performance. Co-morbid substance use is high among youth; however, not all schools share the same prevalence. Knowing the school characteristics that place particular schools at risk for student substance use is important for tailoring drug and alcohol education programs. Interventions that target the prevention of co-morbid substance use are required.

Prevalence of medicinal drugs in suspected impaired drivers and a comparison with the use in the general Dutch population

NARCIS (Netherlands)

Bezemer, Karlijn D B; Smink, Beitske E; van Maanen, Rianne; Verschraagen, Miranda; de Gier, Johan J

The aim of this study was to investigate the prevalence of psychotropic medicines in drivers suspected of driving under the influence of medicinal and illicit drugs in The Netherlands and to compare the prevalence of selected impairing medicines with the use of these medicines in the general Dutch

An Investigation of Comorbid Psychological Disorders, Sleep Problems, Gastrointestinal Symptoms and Epilepsy in Children and Adolescents with Autism Spectrum Disorder

Science.gov (United States)

Mannion, Arlene; Leader, Geraldine; Healy, Olive

2013-01-01

The current study investigated comorbidity in eighty-nine children and adolescents with Autism Spectrum Disorder in Ireland. Comorbidity is the presence of one or more disorders in addition to a primary disorder. The prevalence of comorbid psychological disorders, behaviours associated with comorbid psychopathology, epilepsy, gastrointestinal…

The epidemiology of major depressive disorder and subthreshold depression in Izmir, Turkey: Prevalence, socioeconomic differences, impairment and help-seeking.

Science.gov (United States)

Topuzoğlu, Ahmet; Binbay, Tolga; Ulaş, Halis; Elbi, Hayriye; Tanık, Feride Aksu; Zağlı, Nesli; Alptekin, Köksal

2015-08-01

Subclinical and clinical depression is common, widely distributed in the general population, and usually associated with role impairment and help-seeking. Reliable information at the population level is needed to estimate the disease burden of depression and associated care needs in Turkey. The cross-sectional study aimed to assess the prevalence of subthreshold (SubD) and clinical major depressive disorder (MDD) in Izmir, Turkey. In the 5242 eligible households, a total of 4011 individuals were successfully interviewed, yielding a response rate of 76.5%. Prevalence estimates of MDD and SubD depression were formed by using the responses to the questions of the CIDI section E. Short Form 36 (SF-36) to assess health status and functional impairments in eight scaled scores during the last four weeks. All respondents were questioned about receiving 12-month treatment for any psychological complaints, the route of help-seeking, as well as prescribed medicines and any hospitalization. The one year prevalence estimate for CIDI/DSM IV MDD was 8.2% (95% CI, 7.4-9.1). Less educated, low income, uninsured, low SES, unemployed/disabled and housewives, slum area residents had higher one year MDD prevalence. Determined prevalence of help seeking from mental health services of SubD and MDD cases were 23.6%, 30.6% respectively. Only 24.8% of clinically depressive patients received minimally adequate treatment. Cross sectional design. Higher MDD prevalence correlates with younger ages, female gender, unemployment, less education, lower monthly income, lower SES and uninsurance. Help seeking from mental health services were low. There are treatment gap and impairment in depressive group. Copyright © 2015 Elsevier B.V. All rights reserved.

The MentDis_ICF65+ study protocol: prevalence, 1-year incidence and symptom severity of mental disorders in the elderly and their relationship to impairment, functioning (ICF) and service utilisation.

Science.gov (United States)

Andreas, Sylke; Härter, Martin; Volkert, Jana; Hausberg, Maria; Sehner, Susanne; Wegscheider, Karl; Rabung, Sven; Ausín, Berta; Canuto, Alessandra; Da Ronch, Chiara; Grassi, Luigi; Hershkovitz, Yael; Lelliott, Paul; Muñoz, Manuel; Quirk, Alan; Rotenstein, Ora; Santos-Olmo, Ana Belén; Shalev, Arieh; Siegert, Jens; Weber, Kerstin; Wittchen, Hans-Ulrich; Koch, Uwe; Schulz, Holger

2013-02-18

The EU currently lacks reliable data on the prevalence and incidence of mental disorders in older people. Despite the availability of several national and international epidemiological studies, the size and burden of mental disorders in the elderly remain unclear due to various reasons. Therefore, the aims of the MentDis_ICF65+ study are (1) to adapt existing assessment instruments, and (2) to collect data on the prevalence, the incidence, and the natural course and prognosis of mental disorders in the elderly. Using a cross-sectional and prospective longitudinal design, this multi-centre study from six European countries and associated states (Germany, Great Britain, Israel, Italy, Spain, and Switzerland) is based on age-stratified, random samples of elderly people living in the community. The study program consists of three phases: (1) a methodological phase devoted primarily to the adaptation of age- and gender-specific assessment tools for older people (e.g., the Composite International Diagnostic Interview, CIDI) as well as psychometric evaluations including translation, back translation; (2) a baseline community study in all participating countries to assess the lifetime, 12 month and 1 month prevalence and comorbidity of mental disorders, including prior course, quality of life, health care utilization and helpseeking, impairments and participation and, (3) a 12 month follow-up of all baseline participants to monitor course and outcome as well as examine predictors. The study is an essential step forward towards the further development and improvement of harmonised instruments for the assessment of mental disorders as well as the evaluation of activity impairment and participation in older adults. This study will also facilitate the comparison of cross-cultural results. These results will have bearing on mental health care in the EU and will offer a starting point for necessary structural changes to be initiated for mental health care policy at the level of

Functional impairment and hospital readmission in Medicare seniors.

Science.gov (United States)

Greysen, S Ryan; Stijacic Cenzer, Irena; Auerbach, Andrew D; Covinsky, Kenneth E

2015-04-01

Medicare currently penalizes hospitals for high readmission rates for seniors but does not account for common age-related syndromes, such as functional impairment. To assess the effects of functional impairment on Medicare hospital readmissions given the high prevalence of functional impairments in community-dwelling seniors. We created a nationally representative cohort of 7854 community-dwelling seniors in the Health and Retirement Study, with 22,289 Medicare hospitalizations from January 1, 2000, through December 31, 2010. Outcome was 30-day readmission assessed by Medicare claims. The main predictor was functional impairment determined from the Health and Retirement Study interview preceding hospitalization, stratified into the following 5 levels: no functional impairments, difficulty with 1 or more instrumental activities of daily living, difficulty with 1 or more activities of daily living (ADL), dependency (need for help) in 1 to 2 ADLs, and dependency in 3 or more ADLs. Adjustment variables included age, race/ethnicity, sex, annual income, net worth, comorbid conditions (Elixhauser score from Medicare claims), and prior admission. We performed multivariable logistic regression to adjust for clustering at the patient level to characterize the association of functional impairments and readmission. Patients had a mean (SD) age of 78.5 (7.7) years (range, 65-105 years); 58.4% were female, 84.9% were white, 89.6% reported 3 or more comorbidities, and 86.0% had 1 or more hospitalizations in the previous year. Overall, 48.3% had some level of functional impairment before admission, and 15.5% of hospitalizations were followed by readmission within 30 days. We found a progressive increase in the adjusted risk of readmission as the degree of functional impairment increased: 13.5% with no functional impairment, 14.3% with difficulty with 1 or more instrumental activities of daily living (odds ratio [OR], 1.06; 95% CI, 0.94-1.20), 14.4% with difficulty with 1 or more

Oral health knowledge, practice, oral hygiene status, and dental caries prevalence among visually impaired children in Bangalore

OpenAIRE

S T Prashanth; Sudhanshu Bhatnagar; Usha Mohan Das; H Gopu

2011-01-01

Introduction: Visually impaired children daily face challenges for bearing their everyday skills. Maintenance of proper oral hygiene is one among them. Aim: The aim of the study was to assess the oral health knowledge, practice, oral hygiene status, and dental caries prevalence among visually impaired children in Bangalore. Materials and Methods: A total of 85 children were asked verbally a questionnaire regarding the frequency of brushing, cleaning tools, use of dentifrice, knowledge about t...

Systemic Comorbidities of Dry Eye Syndrome: The Korean National Health and Nutrition Examination Survey V, 2010 to 2012.

Science.gov (United States)

Roh, Hyun Cheol; Lee, Jimmy K; Kim, Martha; Oh, Jong-Hyun; Chang, Min-Wook; Chuck, Roy S; Park, Choul Yong

2016-02-01

To identify systemic comorbidities in patients with dry eye syndrome in South Korea. From 2010 to 2012, 17,364 participants aged 20 or older were randomly included in the nationwide Korean National Health and Nutrition Examination Survey V. The prevalence of dry eye syndrome and demographics of these patients were investigated. We performed conditional logistic regression analyses based on age, sex, residential area, education level, occupation type, and household income level to obtain the odds ratio for each systemic comorbidity among subjects with and without dry eye syndrome. The prevalence of dry eye syndrome in this study was 10.4%. Age [adjusted odds ratio (AOR): 1.02], female gender (AOR: 3.01), and indoor occupation (AOR: 1.30) were associated with a higher prevalence of dry eye syndrome and found to be less prevalent in those residing in rural areas (AOR: 0.73) and with lower education levels (AOR: 0.66-0.99). With regard to systemic comorbidities, dyslipidemia (AOR: 1.63), degenerative arthritis (AOR: 1.56), rheumatoid arthritis (AOR: 1.44), thyroid disease (AOR: 1.79), and renal failure (AOR: 2.56) were associated with a significantly higher prevalence of dry eye syndrome. We found that patients with dry eye syndrome have a higher prevalence of several systemic comorbidities. A more comprehensive therapeutic approach considering the effect of systemic medication may be necessary in these patients.

Fibromyalgia syndrome: prevalence, pharmacological and non-pharmacological interventions in outpatient health care. An analysis of statutory health insurance data.

Science.gov (United States)

Sauer, Kristin; Kemper, Claudia; Glaeske, Gerd

2011-01-01

Fibromyalgia syndrome (FMS) is a chronic pain condition impacting on quality of life, causing physical and psychological impairment resulting in limited participation in professional and social life. The objective of this study was to assess the prevalence, recommended pharmacological and non-pharmacological interventions of FMS, patients' characteristics and to compare findings to current research. About 1.6 Mio patients of a German statutory health insurance company (GEK) in 2007 were analyzed for: (a) the prevalence of FMS (ICD-10: M79.7); (b) and comorbid depression (ICD-10: F32/33); (c) the recommended pharmacological and non-pharmacological intervention rates; (d) and characteristics of patients associated with being prescribed recommended interventions. The (a) standardized prevalence of FMS in 2007 was 0.05% in men and 0.4% in women. (b) 51.9% of the patients with prevalent FMS had a comorbid depression in 2007 (88.2% female). (c) 66% of FMS patients received the recommended pharmacological treatment, 59% physical therapy, 6.1% cognitive-behavioural therapy and 3.4% a combination of these (multi-component therapy, MCT). (d) One year increase in age was associated with a 3% decrease in the predicted odds of receiving MCT (95%, CI 0.95-0.99). The current data indicate an FMS-prevalence that differs from epidemiological surveys and screenings, probably due to methodological differences. Especially females with comorbid depression are affected. The likelihood of receiving MCT is not associated with gender, but with younger age. Yet, the findings seem to indicate insufficient and inadequate treatment, but FMS warrants more research. Copyright © 2010 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

[Cross sectional study of comorbidities and concomitant medications in a cohort of human immunodeficiency virus-infected patients].

Science.gov (United States)

García Gonzalo, Maria Asunción; Santamaría Mas, María Isabel; Pascual Tomé, Lidia; Ibarguren Pinilla, Maialen; Rodríguez-Arrondo, Francisco

2017-05-01

To assess the prevalence of comorbidities, concomitant therapies and adverse effects associated with the medication in a cohort of patients with HIV infection. Multicentre cross-sectional study. Infectious Diseases or Internal Medicine outpatient Clinics of 3 hospitals in the Basque Country. During a 3 month period, patients with the following inclusion criteria were randomly selected: HIV infection, age>18years, antiretroviral treatment (ART) for at least 6months, and no changes in ART in the previous 4weeks. A total of 224 patients (of the 225 expected) were included. Data were collected using a form, and include, epidemiological and anthropometric data, data related to HIV infection, comorbidities, current therapies, and adverse effects. Of the 224 patients, 95.5% had at least one comorbidity, the most common being HCV infection (51.3%), dyslipidaemia (37.9%), diabetes mellitus or impaired fasting glucose (21.9%), and hypertension (21.9%). A total of 155 patients (69.2%) were taking concomitant medication: anxiolytics (21.4%), antihypertensives (19.6%), proton pump inhibitors (17.9%), statins (17%), and antidepressants (16.5%). Adverse effects (AE) were observed in 62.9% of subjects, the most common being, changes in body fat distribution (32.6%) and gastrointestinal (24.1%). Patients with HIV infection are getting older, with more comorbidities, with very frequent use of concomitant treatments, and high number of adverse effects. This requires a multidisciplinary approach and a coordinated effort within the Primary Care setting. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Transdiagnostic Treatment of Bipolar Disorder and Comorbid Anxiety with the Unified Protocol: A Clinical Replication Series

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Ellard, Kristen K.; Deckersbach, Thilo; Sylvia, Louisa G.; Nierenberg, Andrew A.; Barlow, David H.

2012-01-01

Bipolar disorder (BD) is a chronic, debilitating disorder with recurrent manic and depressive episodes. More than 75% of bipolar patients have a current or lifetime diagnosis of a comorbid anxiety disorder. Comorbid anxiety in BD is associated with greater illness severity, greater functional impairment, and poorer illness-related outcomes.…

Lifetime prevalence, age of risk, and genetic relationships of comorbid psychiatric disorders in Tourette syndrome

NARCIS (Netherlands)

Hirschtritt, M.E.; Lee, P.C.; Pauls, D.L.; Dion, Y.; Grados, M.A.; Illmann, C.; King, R.A.; Sandor, P.; McMahon, W.M.; Lyon, G.J.; Cath, D.C.; Kurlan, R.; Robertson, M.M.; Osiecki, L.; Scharf, J.M.; Mathews, C.A.; Posthuma, D.; Singer, H.S.; Yu, D.; Cox, N.J.; Freimer, N.B.; Budman, C.L.; Chouinard, S.; Rouleau, G.; Barr, C.L.

2015-01-01

Importance: Tourette syndrome (TS) is characterized by high rates of psychiatric comorbidity; however, fewstudies have fully characterized these comorbidities. Furthermore, most studies have included relatively fewparticipants (< 200), and none has examined the ages of highest risk for each

Epidemiology and clinical impact of major comorbidities in patients with COPD

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Smith MC

2014-08-01

Full Text Available Miranda Caroline Smith,1 Jeremy P Wrobel2 1Respiratory Medicine, Royal Perth Hospital, Perth, WA, Australia; 2Advanced Lung Disease Unit, Royal Perth Hospital, Perth, WA, Australia Abstract: Comorbidities are frequent in chronic obstructive pulmonary disease (COPD and significantly impact on patients' quality of life, exacerbation frequency, and survival. There is increasing evidence that certain diseases occur in greater frequency amongst patients with COPD than in the general population, and that these comorbidities significantly impact on patient outcomes. Although the mechanisms are yet to be defined, many comorbidities likely result from the chronic inflammatory state that is present in COPD. Common problems in the clinical management of COPD include recognizing new comorbidities, determining the impact of comorbidities on patient symptoms, the concurrent treatment of COPD and comorbidities, and accurate prognostication. The majority of comorbidities in COPD should be treated according to usual practice, and specific COPD management is infrequently altered by the presence of comorbidities. Unfortunately, comorbidities are often under-recognized and under-treated. This review focuses on the epidemiology of ten major comorbidities in patients with COPD. Further, we emphasize the clinical impact upon prognosis and management considerations. This review will highlight the importance of comorbidity identification and management in the practice of caring for patients with COPD. Keywords: cardiovascular disease, prevalence, mortality, chronic bronchitis, emphysema

Psoriasis Uncovered – Comorbid Conditions with Special Reference to Metabolic Syndrome

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Belliappa Pemmanda Raju

2014-01-01

Full Text Available Introduction: Psoriasis is a chronic immune-inflammatory-mediated disease affecting approximately 1-3% of the population worldwide. All around the world, there is growing evidence of the association between psoriasis and comorbidities, especially metabolic syndrome which increases the risk of cardiovascular disease. Co-morbidities are likely linked to underlying chronic inflammatory nature of psoriasis. Aim: The objectives of our study were to determine the prevalence of diabetes, lipid abnormalities, and cardiovascular risk factors in patients with plaque psoriasis, and also to investigate metabolic syndrome associated with plaque psoriasis. Material and Methods: One hundred and twenty patients with psoriasis vulgaris diagnosed clinically and histopathologically were recruited. A detailed history and examination was recorded for all study subjects, including the age and gender of the patients, extent of psoriasis, duration, and age at onset. Metabolic syndrome was diagnosed in the presence of three or more criteria of abdominal obesity, blood pressure >130/85 mmHg, fasting blood glucose ≥100 mg/dl, hypertriglyceridemia >150 mg/dl, and low HDL cholesterol (<40 mg/dl for males, <50mg/dl for females. Results: Prevalence of various comorbidities was: central obesity (58.3%, hypertension (46.79%, dyslipidaemia (43.3%, diabetes mellitus (26.7%, metabolic syndrome (25%, ischaemic heart disease (5% and stroke (2.4%. Prevalence of metabolic syndrome was more in patients who had longer mean disease duration of psoriasis. Conclusions: The perception of psoriasis being merely ‘skin deep’ has to change among clinicians. Active screening for these cardiovascular comorbidities in all psoriasis patients is highly recommended..

Prevalence of depression in individuals with impaired glucose metabolism or undiagnosed diabetes

DEFF Research Database (Denmark)

Nouwen, Arie; Nefs, Giesje; Caramlau, Isabela

2011-01-01

diagnosed type 2 diabetes (PDD) has not been the subject of a systematic review/meta-analysis. This study examined the prevalence of depression in IGM and UDD subjects relative to each other and to NGM and PDD subjects by reviewing the literature and conducting a meta-analysis of studies on this topic......OBJECTIVE: Meta-analyses have shown that the risk for depression is elevated in type 2 diabetes. Whether this risk in individuals with impaired glucose metabolism (IGM) or undiagnosed diabetes (UDD) is elevated relative to normal glucose metabolism (NGM) or decreased relative to previously....... RESEARCH DESIGN AND METHODS: EMBASE and MEDLINE databases were searched for articles published up to May 2010. All studies that compared the prevalence of depression in subjects with IGM and UDD were included. Odds ratios (ORs) were calculated using fixed and random-effects models. RESULTS: The meta-analysis...

Comparative Prevalence of Eating Disorders in Obsessive-Compulsive Disorder and Other Anxiety Disorders

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Himanshu Tyagi

2015-01-01

Full Text Available Objective. The purpose of this study was to compare the prevalence of comorbid eating disorders in Obsessive-Compulsive Disorder (OCD and other common anxiety disorders. Method. 179 patients from the same geographical area with a diagnosis of OCD or an anxiety disorder were divided into two groups based on their primary diagnosis. The prevalence of a comorbid eating disorder was calculated in both groups. Results. There was no statistically significant difference in the prevalence of comorbid eating disorders between the OCD and other anxiety disorders group. Conclusions. These results suggest that the prevalence of comorbid eating disorders does not differ in anxiety disorders when compared with OCD. However, in both groups, it remains statistically higher than that of the general population.

Lifetime Prevalence, Age of Risk, and Genetic Relationships of Comorbid Psychiatric Disorders in Tourette Syndrome

NARCIS (Netherlands)

Hirschtritt, Matthew E; Lee, Paul C; Pauls, David L; Dion, Yves; Grados, Marco A; Illmann, Cornelia; King, Robert A; Sandor, Paul; McMahon, William M; Lyon, Gholson J; Cath, Danielle C; Kurlan, Roger; Robertson, Mary M; Osiecki, Lisa; Scharf, Jeremiah M; Mathews, Carol A

IMPORTANCE: Tourette syndrome (TS) is characterized by high rates of psychiatric comorbidity; however, few studies have fully characterized these comorbidities. Furthermore, most studies have included relatively few participants (<200), and none has examined the ages of highest risk for each

Bipolar disorder comorbidity in patients with a primary diagnosis of OCD.

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Saraf, Gayatri; Paul, Imon; Viswanath, Biju; Narayanaswamy, Janardhanan C; Math, Suresh Bada; Reddy, Y C Janardhan

2017-03-01

Bipolar disorder (BD) is considered to be a common comorbid condition in subjects with obsessive-compulsive disorder (OCD), but there is limited literature on the prevalence of BD and its clinical correlates in those with a primary diagnosis of OCD. We studied the prevalence of BD in a sample of consecutively registered outpatients attending a specialty OCD clinic in India over a period of 13 months. One hundred and seventy-one patients with a primary diagnosis of OCD were assessed systematically using structured and semi-structured instruments. The prevalence of lifetime BD in OCD was 4%. The OCD + BD group had an episodic course of OCD and higher rate of lifetime suicide attempts. BD may not be as highly prevalent in OCD as reported in literature. Those with OCD seem to have only a marginally higher risk for developing BD than the general population. A diagnosis of BD seems to have a pathoplastic effect on the course of OCD. Patients with OCD-BD comorbidity have to be specifically assessed for suicide risk.

Hearing and Cognitive Impairment and the Role of the International Classification of Functioning, Disability and Health as a Rehabilitation Framework

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Lind, Christopher; Meyer, Carly; Young, Jessica

2016-01-01

The International Classification of Functioning, Disability and Health (ICF) has been applied widely in the literature to describe and differentiate the broad implications of hearing impairment (HI) and cognitive impairment (CI) on communication. As CI and HI are largely age-related conditions, the likelihood of comorbidity of these conditions is high. In the context of an aging population, the prevalence of comorbidity is likely to rise, yet much of the clinical assessment and intervention in HI and CI occur separately. The benefit of addressing the dual impact of these conditions is of increasing clinical importance for all clinicians working with older adults and for audiologists and speech pathologists in particular. In this article, the ICF model will be applied to explore the everyday implications of HI and CI. Furthermore, the clinical implications of the ICF model are explored with particular respect to communication assessment and intervention options. The potential benefit of combining activity- and participation-focused interventions currently offered for HI and CI independently is examined. PMID:27489399

Prevalence and risk factors for visual impairment in preschool children the sydney paediatric eye disease study.

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Pai, Amy Shih-I; Wang, Jie Jin; Samarawickrama, Chameen; Burlutsky, George; Rose, Kathryn A; Varma, Rohit; Wong, Tien Yin; Mitchell, Paul

2011-08-01

To assess the prevalence and associations of visual impairment (VI) in preschool children. Cross-sectional, population-based study. A total of 2461 children (73.8% participation rate), aged 6 to 72 months, were examined in the Sydney Paediatric Eye Disease Study during 2007-2009; of whom 1188, aged 30 to 72 months, with complete visual acuity (VA) data in both eyes, were included in this report. Measurement of VA was attempted on all children using the Electronic Visual Acuity (EVA) system or a logarithm of the minimum angle of resolution (logMAR) chart. Visual impairment was defined as presenting VA children aged ≥48 months and Visual impairment prevalence and its associations with child demographic factors and birth parameters. Visual impairment was found in 6.4% of the worse eye and 2.7% of the better eye in our sample. Refractive errors (69.7%) and amblyopia (26.3%) were the principal causes of VI in the worse eye. Astigmatism (51.3%) and hyperopia (28.9%) were the main refractive errors causing VI. In regression analysis controlling for other factors, VI was independently associated with low birthweight of 0.05). Visual impairment in at least 1 eye was found in 6.4% of Australian preschool children, with bilateral VI found in 2.7%. Uncorrected refractive errors and amblyopia were the principal ocular conditions associated with VI. Low birthweight was a significant risk factor independent of age, gender, and ethnicity. The author(s) have no proprietary or commercial interest in any materials discussed in this article. Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Approaches to ascertaining comorbidity information: validation of routine hospital episode data with clinician-based case note review.

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Soo, Martin; Robertson, Lynn M; Ali, Tariq; Clark, Laura E; Fluck, Nicholas; Johnston, Marjorie; Marks, Angharad; Prescott, Gordon J; Smith, William Cairns S; Black, Corri

2014-04-21

In clinical practice, research, and increasingly health surveillance, planning and costing, there is a need for high quality information to determine comorbidity information about patients. Electronic, routinely collected healthcare data is capturing increasing amounts of clinical information as part of routine care. The aim of this study was to assess the validity of routine hospital administrative data to determine comorbidity, as compared with clinician-based case note review, in a large cohort of patients with chronic kidney disease. A validation study using record linkage. Routine hospital administrative data were compared with clinician-based case note review comorbidity data in a cohort of 3219 patients with chronic kidney disease. To assess agreement, we calculated prevalence, kappa statistic, sensitivity, specificity, positive predictive value and negative predictive value. Subgroup analyses were also performed. Median age at index date was 76.3 years, 44% were male, 67% had stage 3 chronic kidney disease and 31% had at least three comorbidities. For most comorbidities, we found a higher prevalence recorded from case notes compared with administrative data. The best agreement was found for cerebrovascular disease (κ = 0.80) ischaemic heart disease (κ = 0.63) and diabetes (κ = 0.65). Hypertension, peripheral vascular disease and dementia showed only fair agreement (κ = 0.28, 0.39, 0.38 respectively) and smoking status was found to be poorly recorded in administrative data. The patterns of prevalence across subgroups were as expected and for most comorbidities, agreement between case note and administrative data was similar. Agreement was less, however, in older ages and for those with three or more comorbidities for some conditions. This study demonstrates that hospital administrative comorbidity data compared moderately well with case note review data for cerebrovascular disease, ischaemic heart disease and diabetes, however there was

Social anxiety disorder and alcohol use disorder co-morbidity in the National Epidemiologic Survey on Alcohol and Related Conditions.

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Schneier, F R; Foose, T E; Hasin, D S; Heimberg, R G; Liu, S-M; Grant, B F; Blanco, C

2010-06-01

To assess the prevalence and clinical impact of co-morbid social anxiety disorder (SAD) and alcohol use disorders (AUD, i.e. alcohol abuse and alcohol dependence) in a nationally representative sample of adults in the United States. Data came from a large representative sample of the US population. Face-to-face interviews of 43093 adults residing in households were conducted during 2001-2002. Diagnoses of mood, anxiety, alcohol and drug use disorders and personality disorders were based on the Alcohol Use Disorder and Associated Disabilities Interview Schedule - DSM-IV version. Lifetime prevalence of co-morbid AUD and SAD in the general population was 2.4%. SAD was associated with significantly increased rates of alcohol dependence [odds ratio (OR) 2.8] and alcohol abuse (OR 1.2). Among respondents with alcohol dependence, SAD was associated with significantly more mood, anxiety, psychotic and personality disorders. Among respondents with SAD, alcohol dependence and abuse were most strongly associated with more substance use disorders, pathological gambling and antisocial personality disorders. SAD occurred before alcohol dependence in 79.7% of co-morbid cases, but co-morbidity status did not influence age of onset for either disorder. Co-morbid SAD was associated with increased severity of alcohol dependence and abuse. Respondents with co-morbid SAD and alcohol dependence or abuse reported low rates of treatment-seeking. Co-morbid lifetime AUD and SAD is a prevalent dual diagnosis, associated with substantial rates of additional co-morbidity, but remaining largely untreated. Future research should clarify the etiology of this co-morbid presentation to better identify effective means of intervention.

Prevalence and determinants of visual impairment in Canada: cross-sectional data from the Canadian Longitudinal Study on Aging.

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Aljied, Rumaisa; Aubin, Marie-Josée; Buhrmann, Ralf; Sabeti, Saama; Freeman, Ellen E

2018-06-01

To determine the prevalence and determinants of visual impairment in Canada. Cross-sectional population-based study. 30,097 people in the Comprehensive Cohort of the Canadian Longitudinal Study on Aging METHODS: Inclusion criteria included being between the ages of 45 and 85 years old, community-dwelling, and living near one of the 11 data collection sites across 7 Canadian provinces. People were excluded if they were in an institution, living on a First Nations reserve, were a full-time member of the Canadian Armed Forces, did not speak French or English, or had cognitive impairment. Visual acuity was measured using the Early Treatment Diabetic Retinopathy Study (ETDRS) chart while participants wore their usual prescription for distance, if any. Visual impairment was defined as presenting binocular acuity worse than 20/40. Of Canadian adults, 5.7% (95% CI 5.4-6.0) had visual impairment. A wide variation in the provincial prevalence of visual impairment was observed ranging from a low of 2.4% (95% CI 2.0-3.0) in Manitoba to a high of 10.9% (95% CI 9.6-12.2) in Newfoundland and Labrador. Factors associated with a higher odds of visual impairment included older age (odds ratio [OR] = 1.07, 95% CI 1.06-1.08), lower income (OR = 2.07 for those earning less than $20 000 per year, 95% CI 1.65-2.59), current smoking (OR = 1.52, 95% CI 1.25-1.85), type 2 diabetes (OR = 1.20, 95% CI 1.03-1.41), and memory problems (OR = 1.44, 95% CI 1.04-2.01). Refractive error was the leading cause of visual impairment. Older age, lower income, province, smoking, diabetes, and memory problems were associated with visual impairment. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Axis-I comorbidity in female patients with dissociative identity disorder and dissociative identity disorder not otherwise specified.

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Rodewald, Frauke; Wilhelm-Göling, Claudia; Emrich, Hinderk M; Reddemann, Luise; Gast, Ursula

2011-02-01

The aim of this study was to investigate axis-I comorbidity in patients with dissociative identity disorder (DID) and dissociative disorder not otherwise specified (DDNOS). Using the Diagnostic Interview for Psychiatric Disorders, results from patients with DID (n = 44) and DDNOS (n = 22) were compared with those of patients with posttraumatic stress disorder (PTSD) (n = 13), other anxiety disorders (n = 14), depression (n = 17), and nonclinical controls (n = 30). No comorbid disorders were found in nonclinical controls. The average number of comorbid disorders in patients with depression or anxiety was 0 to 2. Patients with dissociative disorders averagely suffered from 5 comorbid disorders. The most prevalent comorbidity in DDNOS and DID was PTSD. Comorbidity profiles of patients with DID and DDNOS were very similar to those in PTSD (high prevalence of anxiety, somatoform disorders, and depression), but differed significantly from those of patients with depression and anxiety disorders. These findings confirm the hypothesis that PTSD, DID, and DDNOS are phenomenologically related syndromes that should be summarized within a new diagnostic category.

A personal 35 year perspective on Gilles de la Tourette syndrome: prevalence, phenomenology, comorbidities, and coexistent psychopathologies.

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Robertson, Mary M

2015-01-01

This Series is a personal narrative of my experience with patients with Gilles de la Tourette syndrome and covers its definition and history since the first description in 1825. Controversy entered the prevalence debate early. Although originally considered very rare, in the 1980s, Tourette's syndrome was reported to be common. However, Tourette's syndrome has been shown to occur at a prevalence of about 0·85% to 1%. Tourette's syndrome is more common in the male population, more prominent during childhood, and usually improves, but does not disappear with age. Tourette's syndrome is considered less common in people of sub-Saharan black African, African-American, and American Hispanic ethnic origin. The phenomenology is similar worldwide, indicating a biological basis. The hallmark characteristics are multiple motor and one or more vocal/phonic tics. Other associated features include premonitory urges, a waxing and waning course, and to a much lesser degree, coprolalia. Comorbid disorders are common and are suggested to include obsessive-compulsive disorder and behaviours, attention deficit hyperactivity disorder, and autistic spectrum disorder. Coexistent psychopathologies are suggested to include depression and conduct and personality disorders. Importantly, I argue that Tourette's syndrome is not a unitary condition. Finally, I offer suggestions for future research. Copyright © 2015 Elsevier Ltd. All rights reserved.

Prevalence and causes of visual impairment according to World Health Organization and United States criteria in an aged, urban Scandinavian population

DEFF Research Database (Denmark)

Buch, Helena; Vinding, T; Nielsen, N V

2001-01-01

PURPOSE: To evaluate the prevalence and causes of visual impairment in an epidemiologic study of aged, urban individuals in Denmark. DESIGN: Cross-sectional study. PARTICIPANTS: The study population consisted of 1000 randomly selected residents aged 60 to 80 years in Copenhagen, Denmark. Of 976...... eligible persons, 946 (96.9%) could be examined. Information about best-corrected visual acuity (VA) was obtained from 944 cooperative persons (96.7%). METHODS: Data from the Copenhagen City Eye Study were used to assess the cause-specific prevalence of visual impairment as defined by the World Health...

Comorbidity and metabolic syndrome in patients with multiple sclerosis from Asturias and Catalonia, Spain.

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Sicras-Mainar, Antoni; Ruíz-Beato, Elena; Navarro-Artieda, Ruth; Maurino, Jorge

2017-07-17

The impact of comorbidity on multiple sclerosis (MS) is a new area of interest. Limited data on the risk factors of metabolic syndrome (MetS) is currently available. The aim of this study was to estimate the presence of comorbid conditions and MetS in a sample of adult patients with MS. A retrospective, cohort study was conducted using electronic medical records from 19 primary care centres in Catalonia and Asturias, Spain. The number of chronic diseases (diagnoses), the Charlson Comorbidity Index and the individual Case-mix Index were used to assess general comorbidity variables. MetS was defined using the National Cholesterol Education Program Adult Treatment Panel III. Patients were distributed into two groups according to the Expanded Disability Status Scale (EDSS) score: 0-3.5 and 4-10. A total of 222 patients were studied (mean age = 45.5 (SD 12.5) years, 64.4% were female and 62.2% presented a diagnosis of relapsing-remitting MS). Mean EDSS score was 3.2 (SD 2.0). Depression (32.4%), dyslipidaemia (31.1%), hypertension (23.0%) and obesity (22.5%) were the most common comorbidities. Overall MetS prevalence was 31.1% (95% CI: 25.0-37.2%). Patients with an EDSS ≥ 4.0 showed a significantly higher number of comorbidities (OR=2.2; 95% CI: 1.7-3.0; p<0.001). MS patients had a high prevalence of MetS. Screening for comorbidity should be part of standard MS care. Further studies are necessary to confirm this association and the underlying mechanisms of MS and its comorbidities.

Prevalence and causes of severe visual impairment and blindness among children in the lorestan province of iran, using the key informant method.

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Razavi, Hessom; Kuper, Hannah; Rezvan, Farhad; Amelie, Khatere; Mahboobi-Pur, Hassan; Oladi, Mohammad Reza; Muhit, Mohammad; Hashemi, Hassan

2010-03-01

To estimate the prevalence and causes of severe visual impairment and blindness among children in Lorestan province of Iran, and to assess the feasibility of the Key Informant Method in this setting. Potential cases were identified using the Key Informant Method, in 3 counties of Lorestan province during June through August 2008, and referred for examination. Causes of severe visual impairment/blindness were determined and categorized using standard World Health Organization methods. Of 123 children referred for examination, 27 children were confirmed to have severe visual impairment/blindness or blindness. The median age was11 years (interquartile range 6-13), and 59% were girls. After adjusting for non-attenders, the estimated prevalence of severe visual impairment/blindness was 0.04% (0.03-0.05). The main site of abnormality was retina (44%), followed by disorders of the whole eye (33%). The majority of causes had a hereditary etiology (70%), which was associated with a family history of blindness (P = 0.002). Potentially avoidable causes of severe visual impairment/blindness were found in 14 children (52%). Almost all children with severe visual impairment/blindness had a history of parental consanguinity (93%). Our findings suggest a moderate prevalence of childhood blindness in the Lorestan province of Iran, a high proportion of which may be avoidable, given improved access to ophthalmic and genetic counselling services in rural areas. The Key Informant Method is feasible in Iran; future research is discussed.

The Risk Factors of the Alcohol Use Disorders—Through Review of Its Comorbidities

Directory of Open Access Journals (Sweden)

Ping Yang

2018-05-01

Full Text Available Alcohol use disorders (AUDs represent a severe, world-wide problem, and are usually comorbid with psychiatric disorders, comorbidity increases the risks associated with AUDs, and results in more serious consequences for patients. However, currently the underlying mechanisms of comorbid psychiatric disorders in AUDs are not clear. Studies investigating comorbidity could help us understand the neural mechanisms of AUDs. In this review, we explore three comorbidities in AUDs, including schizophrenia, major depressive disorder (MDD, and personality disorders (PDs. They are all co-morbidities of AUDs with rate of 33.7, 28, and 50–70%, respectively. The rate is significantly higher than other diseases. Therefore we review and analyze relevant literature to explore whether these three diseases are the risk factors of AUDs, focusing on studies assessing cognitive function and those using neural imaging. We found that memory deficits, impairment of cognitive control, negative emotion, and impulsivity may increase an individual's vulnerability to AUDs. This comorbidity may indicate the neural basis of AUDs and reveal characteristics associated with different types of comorbidity, leading to further development of new treatment approaches for AUDs.

Prevalence and causes of visual impairment and rate of wearing spectacles in schools for children of migrant workers in Shanghai, China.

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He, Jiangnan; Lu, Lina; Zou, Haidong; He, Xiangui; Li, Qiangqiang; Wang, Weijie; Zhu, Jianfeng

2014-12-22

To assess the prevalence of visual impairment and rate of wearing spectacles in schools for children of migrant workers in Shanghai, China. Children from grade 1 to 5 in schools for children of migrant workers were randomly chosen for ocular examinations. All children were screened for uncorrected visual acuity and presenting visual acuity. After screening, the children whose uncorrected visual acuity was 20/40 or less received ocular motility evaluation, cycloplegic refraction/non-cycloplegic refraction, and external eye, anterior segment, media, and fundus examinations. A total of 9673 children were enumerated and 9512 (98.34%) participated in this study. The prevalence of uncorrected, presenting, and best-corrected visual acuity of 20/40 or worse in the better eye were 13.33%, 11.26%, and 0.63%, respectively. The rate of wearing spectacles of the children with visual impairment in one or both eyes was 15.50%. Of these, 26.05% were wearing spectacles with inaccurate prescriptions. Refractive error was a major cause of visual impairment, accounting for 89.48% of all the visual impairment causes. Other causes of visual impairment included amblyopia accounting for 10.12%; congenital cataract, 0.1%; congenital nystagmus, 0.1%; ocular prosthesis, 0.1%; macular degeneration, 0.05%; and opaque cornea, 0.05%. This is the first study of the prevalence and causes of visual impairment in schools for children of migrant workers in Shanghai, China. The visual impairment rate in schools for children of migrant workers in suburbs of Shanghai in the best eye before vision correction was lower than those of urban children in mainstream schools in Guangzhou in 2012, and higher than students in rural of Beijing in 1998 and in suburb of Chongqing in 2007. The refractive error was the principal cause of the visual impairment of the children of migrant workers. The rate of wearing spectacles was low and the percentage of inaccurate prescriptions, among those who wore spectacles, was

Effects of Comorbid ADHD with Learning Disabilities on Anxiety, Depression, and Aggression in Adults

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McGillivray, J. A.; Baker, K. L.

2009-01-01

Objective: ADHD and learning disabilities (LD) frequently coexist and there are indications that comorbidity may increase the risk of psychopathology. Method: The current study examined the gender distribution and frequency of comorbidity and its impact on the prevalence of symptoms of anxiety, depression, and aggression in a clinic sample of 80…

Prevalence of asthma among the adult general population of five Middle Eastern countries: results of the SNAPSHOT program.

Science.gov (United States)

Tarraf, Hesham; Aydin, Omur; Mungan, Dilsad; Albader, Mohammad; Mahboub, Bassam; Doble, Adam; Lahlou, Aaicha; Tariq, Luqman; Aziz, Fayaz; El Hasnaoui, Abdelkader

2018-05-11

Asthma is a common chronic respiratory disease leading to morbidity, mortality and impaired quality of life worldwide. Information on asthma prevalence in the Middle East is fragmented and relatively out-dated. The SNAPSHOT program was conducted to obtain updated information. SNAPSHOT is a cross-sectional epidemiological program carried out in five Middle Eastern countries (Egypt, Turkey, Kuwait, Saudi Arabia, and the United Arab Emirates, the latter three grouped into a Gulf cluster) to collect data on asthma, allergic rhinitis, benign prostatic hyperplasia and bipolar disorder. The survey was carried out by telephone in a random sample of the adult general population with quotas defined according to country demographics. The analysis presented in this paper focuses on asthma. Subjects were screened for asthma based on criteria from the global Asthma Insights and Reality studies. Current prevalence (last 12 months) was estimated. Multivariate logistic regression analyses were used to investigate risk factors related to asthma and the association with allergic rhinitis and other co-morbidities. Quality of life was assessed using the three-level EQ-5D questionnaire. 2124 out of the 33,486 subjects enrolled in the SNAPSHOT program fulfilled the criteria for asthma. The adjusted prevalence of asthma ranged from 4.4% [95% CI: 4.0-4.8%] in Turkey, to 6.7% [95% CI: 6.2-7.2%] in Egypt and 7.6% [95% CI: 7.1-8.0%] in the Gulf cluster. Prevalence was higher (p Middle East ranges from 4.4% to 7.6%, which is comparatively lower than the reported prevalence in Europe and North America. Asthma has a negative impact on quality of life, and is associated with high levels of co-morbid diseases, indicating a need for physicians to check for co-morbidities and ensure they are managed correctly in all asthma patients.

Prevalence and patterns of cognitive impairment in adult hemodialysis patients: the COGNITIVE-HD study.

Science.gov (United States)

van Zwieten, Anita; Wong, Germaine; Ruospo, Marinella; Palmer, Suetonia C; Barulli, Maria Rosaria; Iurillo, Annalisa; Saglimbene, Valeria; Natale, Patrizia; Gargano, Letizia; Murgo, Marco; Loy, Clement T; Tortelli, Rosanna; Craig, Jonathan C; Johnson, David W; Tonelli, Marcello; Hegbrant, Jörgen; Wollheim, Charlotta; Logroscino, Giancarlo; Strippoli, Giovanni F M

2017-11-22

Mounting evidence indicates an increased risk of cognitive impairment in adults with end-stage kidney disease on dialysis, but the extent and pattern of deficits across the spectrum of cognitive domains are uncertain. We conducted a cross-sectional study of 676 adult hemodialysis patients from 20 centers in Italy, aiming to evaluate the prevalence and patterns of cognitive impairment across five domains of learning and memory, complex attention, executive function, language and perceptual-motor function. We assessed cognitive function using a neuropsychological battery of 10 tests and calculated test and domain z-scores using population norms (age or age/education). We defined cognitive impairment as a z-score  ≤ -1.5. Participants' median age was 70.9 years (range 21.6-94.1) and 262 (38.8%) were women. Proportions of impairment on each domain were as follows: perceptual-motor function 31.5% (150/476), language 41.2% (273/662), executive function 41.7% (281/674), learning and memory 42.2% (269/638), complex attention 48.8% (329/674). Among 474 participants with data for all domains, only 28.9% (n  =  137) were not impaired on any domain, with 25.9% impaired on a single domain (n  =  123), 17.3% on two (n  =  82), 13.9% on three (n  =  66), 9.1% on four (n  =  43) and 4.9% (n  =  23) on all five. Across patients, patterns of impairment combinations were diverse. In conclusion, cognitive impairment is extremely common in hemodialysis patients, across numerous domains, and patients often experience multiple deficits simultaneously. Clinical care should be tailored to meet the needs of patients with different types of cognitive impairment and future research should focus on identifying risk factors for cognitive decline. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Noncardiac Comorbidities in Heart Failure With Reduced Versus Preserved Ejection Fraction

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Mentz, Robert J.; Kelly, Jacob P.; von Lueder, Thomas G.; Voors, Adriaan A.; Lam, Carolyn S. P.; Cowie, Martin R.; Kjeldsen, Keld; Jankowska, Ewa A.; Atar, Dan; Butler, Javed; Fiuzat, Mona; Zannad, Faiez; Pitt, Bertram; O’Connor, Christopher M.

2014-01-01

Heart failure patients are classified by ejection fraction (EF) into distinct groups: heart failure with preserved EF (HFpEF) or heart failure with reduced EF (HFrEF). Although patients with heart failure commonly have multiple comorbidities that complicate management and may adversely affect outcomes, their role in the HFpEF and HFrEF groups is not well-characterized. This review summarizes the role of noncardiac comorbidities in patients with HFpEF versus HFrEF, emphasizing prevalence, underlying pathophysiologic mechanisms, and outcomes. Pulmonary disease, diabetes mellitus, anemia, and obesity tend to be more prevalent in HFpEF patients, but renal disease and sleep-disordered breathing burdens are similar. These comorbidities similarly increase morbidity and mortality risk in HFpEF and HFrEF patients. Common pathophysiologic mechanisms include systemic and endomyocardial inflammation with fibrosis. We also discuss implications for clinical care and future HF clinical trial design. The basis for this review was discussions between scientists, clinical trialists, and regulatory representatives at the 10th Global CardioVascular Clinical Trialists Forum. PMID:25456761

Prevalence of Dental Caries, Oral Hygiene Knowledge, Status, and Practices among Visually Impaired Individuals in Chennai, Tamil Nadu.

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John, James Rufus; Daniel, Breena; Paneerselvam, Dakshaini; Rajendran, Ganesh

2017-01-01

Aim . To assess the prevalence of dental caries, oral hygiene knowledge, status, and practices among visually impaired individuals in Chennai, Tamil Nadu. Materials and Methods . A cross-sectional study was conducted among 404 visually impaired individuals in Chennai city, Tamil Nadu. Four schools were randomly selected for conducting the study. The oral hygiene status, prevalence of caries, and knowledge and attitude towards oral care among visually impaired individuals were collected and analysed. Results . In the present study, whilst 42% of individuals had fair oral hygiene status, 33% had good hygiene followed by 25% having poor oral hygiene. The overall mean number of DMFT was estimated to be 4.5 ± 2.7. The mean number of decayed teeth was 3.1 ± 2.2, mean number of missing teeth was 0.8 ± 1.4, and mean number of filled teeth was 0.5 ± 1.3. Conclusion . Whilst oral hygiene status was found to be relatively fair, there was a high rate of dental caries among the sample population. This shows that there is lack of knowledge regarding oral health maintenance. Therefore, early identification of caries coupled with effective oral health promotion programs providing practical knowledge to visually impaired students would prove beneficial.

Prevalence of Dental Caries, Oral Hygiene Knowledge, Status, and Practices among Visually Impaired Individuals in Chennai, Tamil Nadu

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James Rufus John

2017-01-01

Full Text Available Aim. To assess the prevalence of dental caries, oral hygiene knowledge, status, and practices among visually impaired individuals in Chennai, Tamil Nadu. Materials and Methods. A cross-sectional study was conducted among 404 visually impaired individuals in Chennai city, Tamil Nadu. Four schools were randomly selected for conducting the study. The oral hygiene status, prevalence of caries, and knowledge and attitude towards oral care among visually impaired individuals were collected and analysed. Results. In the present study, whilst 42% of individuals had fair oral hygiene status, 33% had good hygiene followed by 25% having poor oral hygiene. The overall mean number of DMFT was estimated to be 4.5±2.7. The mean number of decayed teeth was 3.1±2.2, mean number of missing teeth was 0.8±1.4, and mean number of filled teeth was 0.5±1.3. Conclusion. Whilst oral hygiene status was found to be relatively fair, there was a high rate of dental caries among the sample population. This shows that there is lack of knowledge regarding oral health maintenance. Therefore, early identification of caries coupled with effective oral health promotion programs providing practical knowledge to visually impaired students would prove beneficial.

Psychiatric comorbidity and additional abuse of drugs in maintenance treatment with L- and D,L-methadone.

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Wedekind, Dirk; Jacobs, Stefan; Karg, Iris; Luedecke, Christel; Schneider, Udo; Cimander, Konrad; Baumann, Pierre; Ruether, Eckart; Poser, Wolfgang; Havemann-Reinecke, Ursula

2010-03-01

Sixty D,L- or L-methadone treated patients in maintenance therapy were interviewed for additional drug abuse and psychiatric comorbidity; 51.7% of the entire population had a comorbid Axis-I disorder, with a higher prevalence in females (P=0.05). Comorbid patients tended to have higher abuse of benzodiazepines, alcohol, cannabis, and cocaine, but not of heroin. They had received a significantly lower D,L- (Pabuse.

How prevalent and morbid are subthreshold manifestations of major depression in adolescents? A literature review.

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Carrellas, Nicholas W; Biederman, Joseph; Uchida, Mai

2017-03-01

Major Depressive Disorder (MDD) among youth is a public health concern. Our aim was to examine the current body of knowledge to better characterize the prevalence and morbidity associated with subthreshold forms of MDD among youth. Given that MDD tends to develop gradually over time, we hypothesized a high prevalence and considerable impairment associated with youth suffering from depressive symptoms that fall short of full, syndromic status. A literature search was conducted using PubMed exclusively to identify studies assessing the prevalence and clinical characteristics of subthreshold MDD in adolescents. Six scientific papers that met our priori inclusion and exclusion criteria were identified. All papers sampled adolescents. The prevalence of subthreshold MDD ranged from 5% over the past year, to 29% over the two weeks prior to screening. These papers reported clinically significant morbidity associated with subthreshold MDD among adolescents, with evidence for elevated rates of psychiatric comorbidities, impaired functioning in social and familial domains, increased suicidality, and frequent mental health service utilization. Though we examined a sizeable and diverse sample, we only identified six cross-sectional informative studies for this review. Variability of subthreshold MDD and major outcome definitions across studies, likely limits the specificity of findings. Subthreshold MDD is prevalent among youth, and is associated with emotional and social impairments that reach the level of obtaining clinical care. These findings could lead to early intervention efforts aimed at mitigating the adverse outcomes associated with subthreshold MDD as well as the progression to full syndrome MDD. Our review documents that regardless of whether progression to full diagnostic status occurs, this condition is morbid. Copyright © 2016 Elsevier B.V. All rights reserved.

Current Guidelines Have Limited Applicability to Patients with Comorbid Conditions: A Systematic Analysis of Evidence-Based Guidelines

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Lugtenberg, Marjolein; Burgers, Jako S.; Clancy, Carolyn; Westert, Gert P.; Schneider, Eric C.

2011-01-01

Background Guidelines traditionally focus on the diagnosis and treatment of single diseases. As almost half of the patients with a chronic disease have more than one disease, the applicability of guidelines may be limited. The aim of this study was to assess the extent that guidelines address comorbidity and to assess the supporting evidence of recommendations related to comorbidity. Methodology/Principal Findings We conducted a systematic analysis of evidence-based guidelines focusing on four highly prevalent chronic conditions with a high impact on quality of life: chronic obstructive pulmonary disease, depressive disorder, diabetes mellitus type 2, and osteoarthritis. Data were abstracted from each guideline on the extent that comorbidity was addressed (general comments, specific recommendations), the type of comorbidity discussed (concordant, discordant), and the supporting evidence of the comorbidity-related recommendations (level of evidence, translation of evidence). Of the 20 guidelines, 17 (85%) addressed the issue of comorbidity and 14 (70%) provided specific recommendations on comorbidity. In general, the guidelines included few recommendations on patients with comorbidity (mean 3 recommendations per guideline, range 0 to 26). Of the 59 comorbidity-related recommendations provided, 46 (78%) addressed concordant comorbidities, 8 (14%) discordant comorbidities, and for 5 (8%) the type of comorbidity was not specified. The strength of the supporting evidence was moderate for 25% (15/59) and low for 37% (22/59) of the recommendations. In addition, for 73% (43/59) of the recommendations the evidence was not adequately translated into the guidelines. Conclusions/Significance Our study showed that the applicability of current evidence-based guidelines to patients with comorbid conditions is limited. Most guidelines do not provide explicit guidance on treatment of patients with comorbidity, particularly for discordant combinations. Guidelines should be more

Correlates of comorbid anxiety and externalizing disorders in childhood obsessive compulsive disorder.

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Langley, Audra K; Lewin, Adam B; Bergman, R Lindsey; Lee, Joyce C; Piacentini, John

2010-08-01

The present study examines the influence of diagnostic comorbidity on the demographic, psychiatric, and functional status of youth with a primary diagnosis of obsessive compulsive disorder (OCD). Two hundred and fifteen children (ages 5-17) referred to a university-based OCD specialty clinic were compared based on DSM-IV diagnostic profile: OCD without comorbid anxiety or externalizing disorder, OCD plus anxiety disorder, and OCD plus externalizing disorder. No age or gender differences were found across groups. Higher OCD severity was found for the OCD + ANX group, while the OCD + EXT group reported greater functional impairment than the other two groups. Lower family cohesion was reported by the OCD + EXT group compared to the OCD group and the OCD + ANX group reported higher family conflict compared to the OCD + EXT group. The OCD + ANX group had significantly lower rates of tic disorders while rates of depressive disorders did not differ among the three groups. The presence of comorbid anxiety and externalizing psychopathology are associated with greater symptom severity and functional and family impairment and underscores the importance of a better understanding of the relationship of OCD characteristics and associated disorders. Results and clinical implications are further discussed.

Association of Cognitive Impairment in Patients on 3-Hydroxy-3-Methyl-Glutaryl-CoA Reductase Inhibitors.

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Roy, Satyajeet; Weinstock, Joshua Louis; Ishino, Allyse Sachiko; Benites, Jefferson Felix; Pop, Samantha Rachel; Perez, Christopher David; Gumbs, Edvard Adrian; Rosenbaum, Jennifer Ann; Roccato, Mary Kate; Shah, Hely; Contino, Gabriela; Hunter, Krystal

2017-07-01

Atherosclerotic cardiovascular diseases are the leading cause of death in the United States. A reduction in cholesterol with 3-hydroxy-3-methyl-glutaryl-CoA reductase inhibitors (statin) significantly reduces mortality and morbidity. Statins may be associated with cognitive impairment or dementia. Our aim was to study the association of cognitive impairment or dementia in patients who were on a statin. Electronic medical records of 3,500 adult patients in our suburban internal medicine office were reviewed. There were 720 (20.6%) patients in the statin treatment group. Dementia or cognitive impairment was an associated comorbid condition in 7.9% patients in the statin treatment group compared to 3.1% patients in the non-statin group (P impairment or dementia showed that among the age ranges of 51 years through 100 years, the patients in the statin treatment group had a higher prevalence of cognitive impairment or dementia compared to the non-statin group. In the statin treatment group, we found significantly higher prevalence of hyperlipidemia (86.3%), hypertension (69.6%), diabetes mellitus (36.0%), osteoarthritis (31.5%), coronary artery disease (26.1%), hypothyroidism (21.5%) and depression (19.3%) compared to the non-statin group (P impairment were on statin therapy compared to 18.9% patients who had no dementia or cognitive impairment and were on statin therapy (P impairment with each year increase in age (1.3 times), in women (2.2 times), African American race (2.7 times), non-consumption of moderate amount of alcohol (two times), diabetes mellitus (1.6 times), hypothyroidism (1.7 times), cerebrovascular accident (3.2 times), and other rheumatological diseases (1.8 times). The association of dementia or cognitive impairment was significantly higher in the patients who were on statin therapy compared to the patients who were not on a statin.

The fragile X syndrome-autism comorbidity: what do we really know?

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Leonard eAbbeduto

2014-10-01

Full Text Available Autism spectrum disorder (ASD is a common comorbid condition in people with fragile X syndrome (FXS. It has been assumed that ASD symptoms reflect the same underlying psychological and neurobiological impairments in both FXS and nonsyndromic ASD, which has led to the claim that targeted pharmaceutical treatments that are efficacious for core symptoms of FXS are likely to be beneficial for nonsyndromic ASD as well. In contrast, we present evidence from a variety of sources suggesting that there are important differences in ASD symptoms, behavioral and psychiatric correlates, and developmental trajectories between individuals with comorbid FXS and ASD and those with nonsyndromic ASD. We also present evidence suggesting that social impairments may not distinguish individuals with FXS with and without ASD. Finally, we present data that demonstrate that the neurobiological substrates of the behavioral impairments, including those reflecting core ASD symptoms, are different in FXS and nonsyndromic ASD. Together, these data suggest that there are clinically important differences between FXS and nonsyndromic ASD that are masked by reliance on the categorical diagnosis of ASD. We argue for use of a symptom-based approach in future research, including studies designed to evaluate treatment efficacy.

High probability of comorbidities in bronchial asthma in Germany.

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Heck, S; Al-Shobash, S; Rapp, D; Le, D D; Omlor, A; Bekhit, A; Flaig, M; Al-Kadah, B; Herian, W; Bals, R; Wagenpfeil, S; Dinh, Q T

2017-04-21

Clinical experience has shown that allergic and non-allergic respiratory, metabolic, mental, and cardiovascular disorders sometimes coexist with bronchial asthma. However, no study has been carried out that calculates the chance of manifestation of these disorders with bronchial asthma in Saarland and Rhineland-Palatinate, Germany. Using ICD10 diagnoses from health care institutions, the present study systematically analyzed the co-prevalence and odds ratios of comorbidities in the asthma population in Germany. The odds ratios were adjusted for age and sex for all comorbidities for patients with asthma vs. without asthma. Bronchial asthma was strongly associated with allergic and with a lesser extent to non-allergic comorbidities: OR 7.02 (95%CI:6.83-7.22) for allergic rhinitis; OR 4.98 (95%CI:4.67-5.32) allergic conjunctivitis; OR 2.41 (95%CI:2.33-2.52) atopic dermatitis; OR 2.47 (95%CI:2.16-2.82) food allergy, and OR 1.69 (95%CI:1.61-1.78) drug allergy. Interestingly, increased ORs were found for respiratory diseases: 2.06 (95%CI:1.64-2.58) vocal dysfunction; 1.83 (95%CI:1.74-1.92) pneumonia; 1.78 (95%CI:1.73-1.84) sinusitis; 1.71 (95%CI:1.65-1.78) rhinopharyngitis; 2.55 (95%CI:2.03-3.19) obstructive sleep apnea; 1.42 (95%CI:1.25-1.61) pulmonary embolism, and 3.75 (95%CI:1.64-8.53) bronchopulmonary aspergillosis. Asthmatics also suffer from psychiatric, metabolic, cardiac or other comorbidities. Myocardial infarction (OR 0.86, 95%CI:0.79-0.94) did not coexist with asthma. Based on the calculated chances of manifestation for these comorbidities, especially allergic and respiratory, to a lesser extent also metabolic, cardiovascular, and mental disorders should be taken into consideration in the diagnostic and treatment strategy of bronchial asthma. PREVALENCE OF CO-EXISTING DISEASES IN GERMANY: Patients in Germany with bronchial asthma are highly likely to suffer from co-existing diseases and their treatments should reflect this. Quoc Thai Dinh at Saarland

Self-Reported Food Hypersensitivity: Prevalence, Characteristics, and Comorbidities in the Norwegian Women and Cancer Study.

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Monika Dybdahl Jakobsen

Full Text Available This study aims to investigate the prevalence of self-reported food hypersensitivity, (SFH, the characteristics of women with SFH, and whether SFH is associated with multiple health complaints among the participants of the Norwegian Women and Cancer study (NOWAC.We conducted a cross-sectional study among 64,316 women aged 41-76 years. The women were randomly selected from the Norwegian Central Person Register. Information on SFH and all covariates except age and place of residence was collected by questionnaires in 2002-2005.The prevalence of SFH in our study sample was 6.8% (95% confidence interval: 6.7-7.0. Logistic regression analysis showed a negative association between SFH and age (odds ratio [OR] 0.97. The odds of SFH increased among women living in or near urban centers, women with more than 9 years of education, women who did not have full-time work, women who had experienced poor economic conditions in childhood, those living without a partner, and those who did not consume alcohol or smoke (OR varied from 1.10 to 1.70. Women with a low body mass index had higher odds of SFH (OR 1.37 than those with a moderate body mass index. SFH was positively associated with poor self-perceived health (OR 2.56. The odds of SFH increased with the number of concurrent health complaints, with an OR for 5-6 comorbidities of 4.93.We found an association between SFH, poor health, and different socio demographic and lifestyle characteristics. Women with SFH had increased odds of reporting multiple health complaints.

Self-Reported Food Hypersensitivity: Prevalence, Characteristics, and Comorbidities in the Norwegian Women and Cancer Study.

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Jakobsen, Monika Dybdahl; Braaten, Tonje; Obstfelder, Aud; Abelsen, Birgit

2016-01-01

This study aims to investigate the prevalence of self-reported food hypersensitivity, (SFH), the characteristics of women with SFH, and whether SFH is associated with multiple health complaints among the participants of the Norwegian Women and Cancer study (NOWAC). We conducted a cross-sectional study among 64,316 women aged 41-76 years. The women were randomly selected from the Norwegian Central Person Register. Information on SFH and all covariates except age and place of residence was collected by questionnaires in 2002-2005. The prevalence of SFH in our study sample was 6.8% (95% confidence interval: 6.7-7.0). Logistic regression analysis showed a negative association between SFH and age (odds ratio [OR] 0.97). The odds of SFH increased among women living in or near urban centers, women with more than 9 years of education, women who did not have full-time work, women who had experienced poor economic conditions in childhood, those living without a partner, and those who did not consume alcohol or smoke (OR varied from 1.10 to 1.70). Women with a low body mass index had higher odds of SFH (OR 1.37) than those with a moderate body mass index. SFH was positively associated with poor self-perceived health (OR 2.56). The odds of SFH increased with the number of concurrent health complaints, with an OR for 5-6 comorbidities of 4.93. We found an association between SFH, poor health, and different socio demographic and lifestyle characteristics. Women with SFH had increased odds of reporting multiple health complaints.

Prevalence and correlates of bipolar disorders in patients with eating disorders.

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Tseng, Mei-Chih Meg; Chang, Chin-Hao; Chen, Kuan-Yu; Liao, Shih-Cheng; Chen, Hsi-Chung

2016-01-15

To investigate the prevalence and correlates of bipolar disorders in patients with eating disorders (EDs), and to examine differences in effects between major depressive disorder and bipolar disorder on these patients. Sequential attendees were invited to participate in a two-phase survey for EDs at the general psychiatric outpatient clinics. Patients diagnosed with EDs (n=288) and controls of comparable age, sex, and educational level (n=81) were invited to receive structured interviews for psychiatric co-morbidities, suicide risks, and functional level. All participants also completed several self-administered questionnaires assessing general and eating-related pathology and impulsivity. Characteristics were compared between the control, ED-only, ED with major depressive disorder, and ED with bipolar disorder groups. Patients with all ED subtypes had significantly higher rates of major depressive disorder (range, 41.3-66.7%) and bipolar disorder (range, 16.7-49.3%) than controls did. Compared to patients with only EDs, patients with comorbid bipolar disorder and those with comorbid major depressive disorder had significantly increased suicidality and functional impairments. Moreover, the group with comorbid bipolar disorder had increased risks of weight dysregulation, more impulsive behaviors, and higher rates of psychiatric comorbidities. Participants were selected in a tertiary center of a non-Western country and the sample size of individuals with bipolar disorder in some ED subtypes was small. Bipolar disorders were common in patients with EDs. Careful differentiation between bipolar disorder and major depressive disorder in patients with EDs may help predict associated psychopathology and provide accurate treatment. Copyright © 2015 Elsevier B.V. All rights reserved.

Prevalence and risk factors of diabetes and impaired fasting glucose in Nauru

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Dan Li

2011-09-01

Full Text Available Abstract Background No comprehensive assessment of diabetes prevalence in Nauru has been conducted since an extreme prevalence was documented more than two decades ago. This study aims to determine the prevalence and risk factors of diabetes and impaired fasting glucose. Methods A nationwide survey in 2004 of people aged 15- 64 years (n = 1592. Fasting plasma glucose levels were used to defined diabetes (≥7.0 mmol/l or 126 mg/dl and prediabetes (6.1-6.9 mmol/l or 110-125 mg/dl. Results The sex-standardized prevalence of diabetes was 13.0% (95% CI: 10.6, 15.4 in men, 14.4% (11.9, 16.9 in women, and 13.7% (12.0, 15.4 combined. The sex-standardized prevalence of prediabetes was 6.4% (4.6, 8.2 for men, 5.5% (3.9, 7.2 for women, and 6.0% (4.8, 7.3 combined. The prevalence of diabetes for individuals 15-24, 25-34, 35-44, 45-54 and 55-64 years was 4.5%, 7.6%, 24.1%, 32.9%, and 42.7%, respectively. The prevalence of prediabetes for the same age categories was 4.2%, 8.8%, 5.9%, 6.6%, 7.1%, respectively. Multivariable, multinomial logit modeling found risk factors for prediabetes were high cholesterol levels (OR: 2.02, 95% CI: 1.66, 2.47 and elevated waist circumference (OR: 1.04, 95% CI: 1.00, 1.08, and for diabetes were age in years (OR: 1.06; 95% CI: 1.04, 1.07, cholesterol levels (OR: 1.84, 95% CI: 1.58, 2.14 and waist circumference (OR: 1.04, 95% CI: 1.02, 1.07. Conclusions Diabetes remains a major public health problem in Nauru, affecting one out of every ten people. While the prevalence of diabetes has declined, its burden has persisted among the old but also extended towards the younger age groups.

Relationships of neuroticism and extraversion with axis I and II comorbidity among patients with DSM-IV major depressive disorder.

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Jylhä, Pekka; Melartin, Tarja; Isometsä, Erkki

2009-04-01

High comorbidity with axis I and II disorders among major depressive disorder (MDD) patients may in part be due to the predisposing personality dimensions of neuroticism and extraversion. However, a comprehensive view of this relationship is lacking. MDD patients (n=193) in the Vantaa Depression Study were interviewed at baseline and at 6 and 18 months with the SCAN and SCID-II, and a general population comparison group (n=388) surveyed by mail. Neuroticism and extraversion were measured with the Eysenck Personality Inventory. A dose-exposure relationship between standardized levels of neuroticism and extraversion and type and number of comorbid axis I and II disorders among patients with MDD was hypothesized. Prevalence and number of comorbid axis I and II disorders increased significantly with increasing level of neuroticism. In contrast, as the level of extraversion increased, the prevalences of social phobia and cluster C personality disorders decreased. Patients with pure MDD or with any comorbid axis I or II disorder had z-scores of neuroticism of +0.46, +0.90 and +1.30 and of extraversion of -0.34, -0.47 and -0.84, respectively. Patients' personality scores were not pre-morbid. Among MDD patients, a positive dose-exposure relationship appears to exist between neuroticism and prevalence and number of comorbid axis I and II disorders. A negative relationship exists between level of extraversion and prevalence of social phobia and cluster C personality disorders. These findings are consistent with the hypothesis that high neuroticism and low extraversion predispose to comorbid axis I and II disorders among patients with MDD.

Severe MUPS in a sick-listed population : a cross-sectional study on prevalence, recognition, psychiatric co-morbidity and impairment

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Hoedeman, R.; Krol, B.; Blankenstein, N.; Koopmans, P.C.; Groothoff, J.W.

2009-01-01

Background: Medically unexplained physical symptoms (MUPS) have a high prevalence in the general population and are associated with psychiatric morbidity. There are indications that MUPS are an important determinant of frequent and long-term disability. The primary objective was to assess the

Persistent visual impairment in multiple sclerosis: prevalence, mechanisms and resulting disability.

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Jasse, Laurence; Vukusic, Sandra; Durand-Dubief, Françoise; Vartin, Cristina; Piras, Carolina; Bernard, Martine; Pélisson, Denis; Confavreux, Christian; Vighetto, Alain; Tilikete, Caroline

2013-10-01

The objective of this article is to evaluate in multiple sclerosis (MS) patients the prevalence of persistent complaints of visual disturbances and the mechanisms and resulting functional disability of persistent visual complaints (PVCs). Firstly, the prevalence of PVCs was calculated in 303 MS patients. MS-related data of patients with or without PVCs were compared. Secondly, 70 patients with PVCs performed an extensive neuro-ophthalmologic assessment and a vision-related quality of life questionnaire, the National Eye Institute Visual Functionary Questionnaire (NEI-VFQ-25). PVCs were reported in 105 MS patients (34.6%). Patients with PVCs had more frequently primary progressive MS (30.5% vs 13.6%) and more neuro-ophthalmologic relapses (1.97 vs 1.36) than patients without PVCs. In the mechanisms/disability study, an afferent visual and an ocular-motor pathways dysfunction were respectively diagnosed in 41 and 59 patients, mostly related to bilateral optic neuropathy and bilateral internuclear ophthalmoplegia. The NEI-VFQ 25 score was poor and significantly correlated with the number of impaired neuro-ophthalmologic tests. Our study emphasizes the high prevalence of PVC in MS patients. Regarding the nature of neuro-ophthalmologic deficit, our results suggest that persistent optic neuropathy, as part of the progressive evolution of the disease, is not rare. We also demonstrate that isolated ocular motor dysfunctions induce visual disability in daily life.

Autoimmune, atopic, and mental health comorbid conditions associated with alopecia areata in the United States.

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Huang, Kathie P; Mullangi, Samyukta; Guo, Ye; Qureshi, Abrar A

2013-07-01

To evaluate the prevalence of comorbid conditions among patients with alopecia areata (AA) seen at tertiary care hospitals in Boston, Massachusetts, during an 11-year period. Retrospective cross-sectional study. Tertiary care hospitals in Boston, including Brigham and Women's Hospital and Massachusetts General Hospital. We identified 3568 individuals with AA seen in the Partners health care system in Boston between January 1, 2000, and January 1, 2011. We performed comprehensive searches of the Research Patient Data Repository using International Classification of Diseases, Ninth Revision code 704.01. We randomly selected 350 patients and manually reviewed their medical records to train and validate a novel artificial intelligence program. This program then used natural language processing to review free-text medical records and confirm a diagnosis of AA. To confirm the algorithm, we manually reviewed a subset of records and found 93.9% validity. The prevalence of comorbid conditions was assessed. Common comorbid conditions included autoimmune diagnoses (thyroid disease in 14.6%, diabetes mellitus in 11.1%, inflammatory bowel disease in (2.0%) [corrected], systemic lupus erythematosus in 4.3%, rheumatoid arthritis in 3.9%, and psoriasis and psoriatic arthritis in (6.3%) [corrected], atopy (allergic rhinitis, asthma, and/or eczema in 38.2% and contact dermatitis and other eczema in 35.9%), and mental health problems (depression or anxiety in 25.5%). We also found high prevalences of hyperlipidemia (24.5%), hypertension (21.9%), and gastroesophageal reflux disease (17.3%). This profile was different from that seen in a comparison psoriasis and psoriatic arthritis group. We found a high prevalence of comorbid conditions among individuals with AA presenting to academic medical centers in Boston. Physicians caring for patients with AA should consider screening for comorbid conditions.

Psychiatric Comorbidity in Depressed HIV-infected Individuals: Common and Clinically Consequential

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Gaynes, Bradley N.; O'Donnell, Julie; Nelson, Elise; Heine, Amy; Zinski, Anne; Edwards, Malaika; McGuinness, Teena; Riddhi, Modi A.; Montgomery, Charita; Pence, Brian W

2015-01-01

Objective To report on the prevalence of psychiatric comorbidity and its association with illness severity in depressed HIV patients. Methods As part of a multi-site randomized controlled trial of depression treatment for HIV patients, 304 participants meeting criteria for current Major Depressive Disorder (MDD) were assessed for other mood, anxiety and substance use disorders with the Mini-International Neuropsychiatric Interview, a structured psychiatric diagnostic interview. We also assessed baseline adherence, risk, and health measures. Results Complicated depressive illness was common. Only 18% of participants experienced MDD with no comorbid psychiatric diagnoses; 49% had comorbid dysthymia, 62% had ≥1 comorbid anxiety disorder, and 28% had a comorbid substance use disorder. Self-reported antiretroviral adherence did not differ by the presence of psychiatric comorbidity. However, psychiatric comorbidity was associated with worse physical health and functioning: compared to those with MDD alone, individuals with ≥1 comorbidity reported more HIV symptoms (5.1 vs. 4.1, p-value=0.01), and worse mental health-related quality of life on the SF-12 (29 vs. 35, p<0.01). Conclusion For HIV patients with MDD, chronic depression and psychiatric comorbidity are strikingly common, and this complexity is associated with greater HIV disease severity and worse quality of life. Appreciating this comorbidity can help clinicians better target those at risk of harder-to-treat HIV disease, and underscores the challenge of treating depression in this population. PMID:25892152

[Prevalence of blindness and moderate and severe visual impairment among adults aged 50 years or above in Yangxi County of Guangdong Province: the China Nine-Province Survey].

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Ge, Jian; He, Mingguang; Zhao, Jialiang; Fang, Min; Ellwein, Leon B; He, Ning; Yang, Mei; Wang, Yu; Gao, Xuecheng

2014-03-01

To investigate the prevalence of blindness and moderate and severe visual impairment among adults aged 50 years or above in Yangxi County of Guangdong Province, China. It was a population-based cross-section study.Geographically defined cluster sampling was used in randomly selecting 5 531 individuals aged 50 years or above in Yangxi County from September 2006 to January 2007. The survey was preceded by a pilot study where operational methods were refined and quality assurance evaluation was carried out. All participants were enumerated using village registers followed by door-to-door visits.Eligible individuals were invited to receive visual acuity measurement and eye examination.Statistical analyses were performed using Stata/SE Statistical Software, release 9.0. Chi-square test was used to investigate the association of age, gender and education with presenting and best corrected visual acuity. Five thousands five hundreds and thirty-one individuals were enumerated and 4 589 persons were examined, the response rate was 82.97%. Based on the criteria of World Health Organization visual impairment classification in 1973, the prevalence of blindness and moderate and severe visual impairment defined as best corrected visual acuity was 2.38% (109/4 589) and 9.44% (433/4 589) respectively. The prevalence of blindness and moderate and severe visual impairment defined as presenting visual acuity was 2.68% (123/4 589) and 18.15% (833/4 589) respectively. The prevalence of blindness and moderate and severe visual impairment was higher in aged (trend χ(2) = 1 239.34, P blindness and visual impairment. The prevalence of blindness and moderate and severe visual impairment is higher among older adults aged 50 years or above in Yangxi County. Cataract remains as the first leading cause of blindness and visual impairment.

[The occupational risk of hearing impairment associated with cardiovascular pathologies in the subjects engaged in 'noisy' industries].

Science.gov (United States)

Pankova, V B; Preobrazhenskaya, E A; Fedina, I N

The objective of the present study was to analyze the structure of concomitant somatic pathology in the subjects experiencing the occupational hearing problems. The study demonstrated the increase in the frequency of concomitant chronic diseases and the prevalence of polynosological conditions with the increasing severity of hearing impairment. It was shown that cardiovascular pathologies tend to enhance the risk of hearing loss in the employees engaged in «noisy» occupations. The cause-and-effect relationships were elucidated as the contribution of the "vascular" factor to the formation of occupational pathology of the organs of hearing. The clinical audilogical features of co-morbid occupational hearing impairment associated with vascular pathology were characterized by the accelerated development and progression of the hearing disorders with the gradual disappearance of the audiological signs characteristic of noise-induced lesions.

Learning disabilities among extremely preterm children without neurosensory impairment: Comorbidity, neuropsychological profiles and scholastic outcomes.

Science.gov (United States)

Johnson, Samantha; Strauss, Victoria; Gilmore, Camilla; Jaekel, Julia; Marlow, Neil; Wolke, Dieter

2016-12-01

Children born extremely preterm are at high risk for intellectual disability, learning disabilities, executive dysfunction and special educational needs, but little is understood about the comorbidity of intellectual and learning disabilities in this population. This study explored comorbidity in intellectual disability (ID) and learning disabilities (LD) in children born extremely preterm (EP; disabilities. LD were associated with a 3 times increased risk for SEN. However, EP children with ID alone had poorer neuropsychological abilities and curriculum-based attainment than children with no disabilities, yet there was no increase in SEN provision among this group. EP children are at high risk for comorbid intellectual and learning disabilities. Education professionals should be aware of the complex nature of EP children's difficulties and the need for multi-domain assessments to guide intervention. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Comorbidity profile of poliomyelitis survivors in a Chinese population: a population-based study.

Science.gov (United States)

Kang, Jiunn-Horng; Lin, Herng-Ching

2011-06-01

Previous reports of comorbid conditions in poliomyelitis survivors mainly focused on some disease categories, such as respiratory diseases, gastrointestinal diseases, psychiatric diseases, neurological diseases and cancer. Data regarding a wide spectrum of medical comorbidities in patients with poliomyelitis is still sparse. This study aimed to investigate and profile the wide range of comorbidities among the survivors of paralytic poliomyelitis in a Chinese population. In total, 2,032 paralytic poliomyelitis patients were selected as the study group and the comparison group consisted of 10,160 randomly selected enrollees. The comorbidities for analysis were based on a modified version of the Elixhauser Comorbidity Index. Conditional logistic regression analyses were computed to investigate the risk of comorbidities for these two groups. As compared to controls, patients with paralytic poliomyelitis had significantly higher prevalence of hypertension, ischemic heart disease, hyperlipidemia, congestive heart failure, cardiac arrhythmias, peripheral vascular disorder, stroke, paralysis, migraines, Parkinson's disease, rheumatoid arthritis, ankylosing spondylitis, pulmonary circulation disorders, chronic pulmonary disease, liver disease, peptic ulcers, hepatitis B or C, deficiency anemias, depression, and lymphoma. Most of the differences are of clinical interest, ORs often being between 2 and 3. No significant difference between poliomyelitis patients and controls was observed in the prevalence of SLE, tuberculosis, alcohol abuse and drug abuse. Our findings demonstrate that survivors of paralytic poliomyelitis in Taiwan are at higher risk of having multiple medical comorbidities although some potential confounding factors including educational level, marital status, obesity and physical activity are not available in our database. The pattern is generally consistent with previous observations from Western populations. Nevertheless, we found several novel associations

Prevalence of suicide risk and comorbidities in postpartum women in Pelotas Prevalência do risco de suicídio e de comorbidades em mulheres pós-parto em Pelotas

Directory of Open Access Journals (Sweden)

Daniele Tavares

2012-10-01

Full Text Available OBJECTIVES: To evaluate the prevalence of suicide risk and comorbidities in postpartum women. METHODS: This is a cross-sectional study of postpartum women. The sample comprised mothers who have received prenatal care from the Brazilian National System of Public Heath in the city of Pelotas. Suicide risk and other mental disorders were evaluated using the Mini International Neuropsychiatric Interview (MINI. A yes answer on one of the six interview questions was considered a sign of suicide risk. RESULTS: The sample consisted of 919 postpartum women. The 11.5% suicide prevalence was 4.62 (CI 2.45, 8.73 times higher in women with low educational levels. Women with comorbid depression or an anxiety disorder showed a 17.04 (CI 2.27; 19.96 times greater risk of suicide than those who did not suffer from any mood disorder. CONCLUSION: Lower education levels and psychiatric disorders are associated with suicide risk. Bipolar disorder is the psychiatric disorder with the highest impact on suicide risk.OBJETIVOS: Avaliar a prevalência do risco de suicídio e de comorbidades em mulheres pós-parto. MÉTODOS: Este foi um estudo em corte transversal com mulheres pós-parto. A amostra foi constituída de mães que receberam cuidados pré-natais prestados pelo Sistema Nacional de Saúde Pública do Brasil na cidade de Pelotas. O risco de suicídio e outros transtornos mentais foram avaliados pela Mini International Neuropsychiatric Interview (MINI. Uma resposta afirmativa a qualquer das seis perguntas é considerada um risco de suicídio. RESULTADOS: A amostra consistiu de 919 mulheres pós-parto. A prevalência do risco de suicídio foi de 11,5%. Ela foi 4,62 vezes mais alta (IC de 95% 2,45; 8,73 em mulheres de baixo nível educacional. Mulheres apresentando qualquer comorbidade para depressão e transtornos ansiosos tiveram uma chance 17,04 vezes maior (IC 95% 2,27; 19,96 àquelas que não apresentaram nenhum transtorno afetivo. CONCLUSÃO: Um n

Prevalence and associated behavioral symptoms of depression in mild cognitive impairment and dementia due to Alzheimer's disease

NARCIS (Netherlands)

Van der Mussele, Stefan; Bekelaar, Kim; Le Bastard, Nathalie; Vermeiren, Yannick; Saerens, Jos; Somers, Nore; Marien, Peter; Goeman, Johan; De Deyn, Peter P.; Engelborghs, Sebastiaan

Background: Mild cognitive impairment (MCI) is a clinical concept that categorizes subjects who are in an intermediate cognitive state between normal aging and dementia. The aims of this study are to determine the prevalence of significant depressive symptoms in MCI and Alzheimer's disease (AD)

Prevalence of Diabetes Mellitus and Impaired Fasting Blood Glucose in Patients with Lichen Planus

Directory of Open Access Journals (Sweden)

Shadi Peyghambari

2012-02-01

Full Text Available Background: The relationship between Lichen Planus (LP and diabetes was studied previously, but the re-sults were in conflict. The aim of this study was to find the prevalence of diabetes mellitus (DM in patients with LP among Iranian patients. Methods: In this study, 80 patients with LP were enrolled. They referred to dermatology clinic of our hospital during one year. A self-designed checklist for the study included duration of the disease, the pattern of the dis-tribution of lichenoid lesions and fasting blood sugar (FBS. Results: From 80 patients with LP, 16 (20% had diabetes. Also, 14 patients (17.5% had impaired fasting glucose. The mean age of diabetic patients was significantly higher than non-diabetic group (p=0.039. In addi-tion, the duration of LP in patients with DM was significantly higher than non-diabetic patients (p=0.024. Conclusion: In our study, we saw a high prevalence of DM among patients with LP. Comparing our findings with the overall prevalence of DM in Iran, there was a significant difference between the prevalence of DM among patients with LP and the overall prevalence (p=0.001. Regarding our findings screening for FBS in pa-tients with LP is required in Iran.

Psychiatric comorbidity reduces quality of life in chronic methadone maintained patients

NARCIS (Netherlands)

Carpentier, Pieter J; Krabbe, Paul F M; van Gogh, Mijke T; Knapen, Lieke J M; Buitelaar, Jan K; de Jong, Cor A J

2009-01-01

Despite the efficacy of methadone maintenance treatment (MMT), opioid dependence still involves severe impairment of functioning and low quality of life. This study examines the influence of the psychiatric comorbidity of MMT patients on their quality of life. A total of 193 middle-aged patients in

Preoperative Comorbidity Correlates Inversely with Survival after Intestinal and Multivisceral Transplantation in Adults

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Rajesh Sivaprakasam

2013-01-01

Full Text Available We investigated the relationship between preoperative comorbidity and postoperative survival after intestinal transplantation. Each patient received a score for preoperative comorbidity. Each comorbidity was given a score based on the degree it impaired function (score range 0–3. A total score was derived from the summation of individual comorbidity scores. Patients (72 adults (M : F, 33 : 39 received an isolated intestinal graft (27 or a cluster graft (45. Mean (standard deviation survival was 1501 (1444 days. The Kaplan-Meier analysis revealed a significant inverse association between survival and comorbidity score (logrank test for trend, . Patients grouped into comorbidity scores of 0 and 1, 2 and 3, 4 and 5, 6, and above had hazard ratios (95% confidence intervals for death (compared to group 0 + 1, which increased with comorbidity scores: 1.945 (0.7622–5.816, 5.075 (3.314–36.17, and 13.77 (463.3–120100, respectively, (. Receiver-operator curves at 1, 3, 5, and 10 years postoperative had “C” statistics of 0.88, 0.85, 0.88, and 0.92, respectively. When evaluating patients for transplantation, the degree of comorbidity should be considered as a major factor influencing postoperative survival.

Comorbidity of Depression and Anxiety: Association with Poor Quality of Life in Type 1 and 2 Diabetic Patients

Science.gov (United States)

de Ornelas Maia, Ana Claudia C.; Braga, Arthur de Azevedo; Paes, Flávia; Machado, Sergio; Carta, Mauro Giovanni; Nardi, Antonio Egidio; Silva, Adriana Cardoso

2013-01-01

Background: Diabetes is associates with depression and impairment in Quality of Life (QoL). Objective: The objective is to define the frequencies of depressive and anxiety symptoms in a sample of patients diagnosed with type 1 and 2 diabetes, the amount of impairment of QoL and the weight of depression and anxiety in determining the QoL in such of patients. Methods: A total of 210 patients were divided into two groups (type 1 and type 2). Patients completed the HADS and WHOQoL-bref. Results: Groups showed a high prevalence of anxiety (type 1 = 60%, type 2 = 43.8%) and depression (type 1 = 52.4%, type 2 = 38.1%), both measures were significantly higher (p < 0.05) in diabetes type 1 patients. Type 1 patients also showed a QoL in the overall assessment and the physical, psychological and social relations domains. In both Type 1 and 2 diabetes poor QoL was found associated by anxiety and depression comorbidity. Conclusion: In overall diabetes patients depression and anxiety seems to be a determinant of poor QoL. PMID:23935696

Parent Report of Community Psychiatric Comorbid Diagnoses in Autism Spectrum Disorders

OpenAIRE

Rosenberg, Rebecca E.; Kaufmann, Walter E.; Law, J. Kiely; Law, Paul A.

2011-01-01

We used a national online registry to examine variation in cumulative prevalence of community diagnosis of psychiatric comorbidity in 4343 children with autism spectrum disorders (ASD). Adjusted multivariate logistic regression models compared influence of individual, family, and geographic factors on cumulative prevalence of parent-reported anxiety disorder, depression, bipolar disorder, and attention deficit/hyperactivity disorder or attention deficit disorder. Adjusted odds of community-as...

Comorbidities in adults with asthma: Population-based cross-sectional analysis of 1.4 million adults in Scotland.

Science.gov (United States)

Weatherburn, C J; Guthrie, B; Mercer, S W; Morales, D R

2017-10-01

Comorbidity in people with asthma can significantly increase asthma morbidity and lower adherence to asthma guidelines. The objective of this study was to comprehensively measure the prevalence of physical and mental health comorbidities in adults with asthma using a large nationally representative population. Cross-sectional analysis of routine primary care electronic medical records for 1 424 378 adults in the UK, examining the prevalence of 39 comorbidities in people with and without asthma, before and after adjustment for age, sex, social deprivation and smoking status using logistic regression. Of 39 comorbidities measured, 36 (92%) were significantly more common in adults with asthma; 62.6% of adults with asthma had ≥1 comorbidity vs 46.2% of those without, and 16.3% had ≥4 comorbidities vs 8.7% of those without. Comorbidities with the largest absolute increase in prevalence in adults with asthma were as follows: chronic obstructive pulmonary disease (COPD) (13.4% vs 3.1%), depression (17.3% vs 9.1%), painful conditions (15.4% vs 8.4%) and dyspepsia (10.9% vs 5.2%). Comorbidities with the largest relative difference in adults with asthma compared to those without were as follows: COPD (adjusted odds ratio [aOR] 5.65, 95% CI 5.52-5.79), bronchiectasis (aOR 4.65, 95% CI 4.26-5.08), eczema/psoriasis (aOR 3.30, 95% CI 3.14-3.48), dyspepsia (aOR 2.20, 95% CI 2.15-2.25) and chronic sinusitis (aOR 2.12, 95% CI 1.99-2.26). Depression and anxiety were more common in adults with asthma (aOR 1.60, 95% CI 1.57-1.63, and aOR 1.53, 95% CI 1.48-1.57, respectively). Physical and mental health comorbidities are the norm in adults with asthma. Appropriate recognition and management should form part of routine asthma care. © 2017 John Wiley & Sons Ltd.

Associations between vascular co-morbidities and depression in insulin-naive diabetes patients

DEFF Research Database (Denmark)

Koopmans, B; Pouwer, F; de Bie, Rob A

2009-01-01

AIMS/HYPOTHESIS: The aim of the study was to determine the prevalence of depression in insulin-naive diabetes patients and to investigate the associations between different forms of vascular co-morbidity and depression. METHODS: Cross-sectional data were used from a primary-care sample of 1......,269 insulin-naive (i.e. not using insulin therapy) diabetes patients participating in the DIAZOB Primary Care Diabetes study. Demographics, vascular co-morbidities, clinical and lifestyle characteristics, and psychosocial factors were assessed. Depression symptoms were measured with the Edinburgh Depression.......2% vs 10.0%). Single vascular co-morbidities were not associated with increased rates of depression. The final model predicting depression included: having multiple vascular co-morbidities compared with none; having less social support; having experienced a recent stressful life event; female sex...

Course of Tourette Syndrome and Comorbidities in a Large Prospective Clinical Study

DEFF Research Database (Denmark)

Groth, Camilla; Mol Debes, Nanette; Rask, Charlotte Ulrikka

2017-01-01

Objective: Tourette syndrome (TS) is a childhood-onset neurodevelopmental disorder characterized by tics and frequent comorbidities. Although tics often improve during adolescence, recent studies suggest that comorbid obsessive-compulsive disorder (OCD) and attention-deficit/hyperactivity disorder...... (ADHD) tend to persist. This large prospective follow-up study describes the clinical course of tics and comorbidities during adolescence and the prevalence of coexisting psychopathologies. Method: The clinical cohort was recruited at the Danish National Tourette Clinic, and data were collected...... at baseline (n = 314, age range 5–19 years) and at follow-up 6 years later (n = 227) to establish the persistence and severity of tics and comorbidities. During follow-up, the Development and Well-Being Assessment (DAWBA) was used to diagnose coexisting psychopathologies. Repeated measures of severity scores...

Symptomatological and cognitive correlates of vascular comorbidity in older-elderly (at least 75 years old) men with major depressive disorder.

Science.gov (United States)

Wang, Yu-Yuan; Chang, Yun-Hsuan; Lee, Sheng-Yu; Huang, Chih-Chun; Lee, I-Hui; Yeh, Tzung-Lieh; Yang, Yen-Kuang; Ku, Yan-Chiou; Lu, Ru-Band

2012-11-01

Depression is a common geriatric psychiatric disorder increasing with age among elderly people (≥ 75 years old), especially those with medical comorbidities. They have higher suicide rates than younger men, but these are paid less attention. Elderly men (n=141) who were newly admitted residents of the Veterans' Home in Tainan, Taiwan from 2004 to 2006 were recruited and screened for major depression. Specialist physicians obtained past histories of medical illnesses through chart reviews, interview, and health examinations. Fifty-nine of the 141 elderly people had major depression and participated in this study. Thirty-nine men in the group with vascular comorbidities (VC), and 20 in the group without (NVC) vascular comorbidities were compared. The VC group had more time-orientation impairment, greater psychomotor retardation, and diminished concentration/decision-making than did the NVC group. Psychomotor retardation and other cognitive function impairments (e.g., concentration and decision-making) are characteristic manifestations among patients with major depression and vascular comorbidity compared with those without vascular comorbidity. Copyright © 2012. Published by Elsevier B.V.

Persistence of addictive disorders in a first-offender driving while impaired population.

Science.gov (United States)

Lapham, Sandra C; Stout, Robert; Laxton, Georgia; Skipper, Betty J

2011-11-01

We compared the prevalence of alcohol use and other psychiatric disorders in offenders 15 years after a first conviction for driving while impaired with a general population sample. To determine whether high rates of addictive and other psychiatric disorders previously demonstrated in this sample remain disproportionately higher compared with a matched general population sample. Point-in-time cohort study. Pacific Institute for Research and Evaluation, Albuquerque, New Mexico. We interviewed convicted first offenders using the Composite International Diagnostic Interview 15 years after referral to a screening program in Bernalillo County, New Mexico. We calculated rates of diagnoses for non-Hispanic white and Hispanic women (n = 362) and men (n = 220) adjusting for missing data using multiple imputation and compared psychiatric diagnoses with findings from the National Comorbidity Survey Replication by sex and Hispanic ethnicity. Eleven percent of non-Hispanic white women and 12.8% of Hispanic women in the driving while impaired sample reported 12-month alcohol abuse or dependence, compared with 1.0% and 1.8%, respectively, in the National Comorbidity Survey Replication (comparison) sample. Almost 12% of non-Hispanic white men and 17.5% of Hispanic men in the driving while impaired sample reported 12-month alcohol abuse or dependence, compared with to 2.0% and 1.8%, respectively, in the comparison sample. These differences were statistically significant. Rates of drug use disorders and nicotine dependence were also elevated compared with the general population sample, while rates of major depressive disorder and posttraumatic stress disorder were similar. In this sample, high rates of addictive disorders persisted over 10 years among first offenders and greatly exceeded those found in a general population sample.

Pilot study of comprehensive geriatric assessment (CGA) in allogeneic transplant: CGA captures a high prevalence of vulnerabilities in older transplant recipients.

Science.gov (United States)

Muffly, Lori S; Boulukos, Melissa; Swanson, Kate; Kocherginsky, Masha; Cerro, Paula Del; Schroeder, Linda; Pape, Lisa; Extermann, Martine; Van Besien, Koen; Artz, Andrew S

2013-03-01

Comprehensive geriatric assessment (CGA) is frequently used in oncology to measure the health status of older adults with cancer, but it has not been studied in allogeneic hematopoietic cell transplantation (HCT). We conducted a prospective pilot study of CGA in allogeneic HCT recipients aged ≥50 years to examine the prevalence of vulnerabilities in this population. Patients aged ≥50 years eligible for HCT were enrolled. CGA consisted mainly of self-reported, performance-based, and chart-extracted measures evaluating domains of comorbidity, physical and mental function, frailty, disability, and nutrition. Of 238 eligible patients, 166 completed CGA and underwent HCT. Only 1% had a Zubrod Performance Status score >1; 44% had high comorbidity defined by the Hematopoietic Cell Transplantation Comorbidity Index, and 66% had high comorbidity defined by the Cumulative Illness Rating Scale-Geriatrics. The presence of additional vulnerability was frequent. Disability was present in 40% by Instrumental Activities of Daily Living. Self-reported physical and mental function were significantly lower than population age group norms, 58% were pre-frail, and 25% were frail. Among those with Zubrod Performance Status score of 0, 28% demonstrated disability, 58% were pre-frail, 15% were frail, 35% reported low physical function, and 55% reported low mental function. CGA uncovers a substantial prevalence of undocumented impairments in functional status, frailty, disability, and mental health in older allogeneic HCT recipients. Copyright © 2013 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

Impaired-driving prevalence among US high school students: associations with substance use and risky driving behaviors.

Science.gov (United States)

Li, Kaigang; Simons-Morton, Bruce G; Hingson, Ralph

2013-11-01

We examined the prevalence of impaired driving among US high school students and associations with substance use and risky driving behavior. We assessed driving while alcohol or drug impaired (DWI) and riding with alcohol- or drug-impaired drivers (RWI) in a nationally representative sample of 11th-grade US high school students (n = 2431). We examined associations with drinking and binge drinking, illicit drug use, risky driving, and demographic factors using multivariate sequential logistic regression analysis. Thirteen percent of 11th-grade students reported DWI at least 1 of the past 30 days, and 24% reported RWI at least once in the past year. Risky driving was positively associated with DWI (odds ratio [OR] = 1.25; P phone calls (OR = 3.2) while driving. Our findings suggest the need for comprehensive approaches to the prevention of DWI, RWI, and other risky driving behavior.

[Prevalence and causes of blindness and moderate and severe visual impairment among adults aged 50 years or above in Longyao County of Hebei Province:the China Nine-Province survey].

Science.gov (United States)

Lü, Jian-hua; Zhao, Jia-liang; Ellwein, Leon B; Li, Shan-yu; Han, Dong; Yan, Zhong-yang; Zhang, Hong-bin; Yang, Mei; Wang, Yu; Gao, Xue-cheng

2013-09-01

To investigate the prevalence and causes of blindness and moderate and severe visual impairment among adults aged ≥ 50 years in Longyao County, Hebei Province, China. It was a population-based cross-section study.Geographically defined cluster sampling was used in randomly selecting 5527 individuals aged ≥ 50 years in Longyao County. The survey was preceded by a pilot study where operational methods were refined and quality assurance evaluation was carried out. All participants were enumerated through village registers followed door-to-door visits.Eligible individuals were invited to receive visual acuity measurement and eye examination. Prevalence of blindness and moderate and severe visual impairment was calculated according to different age, gender or education. And the reasons of blindness were analyzed.Statistical analyses were performed using Stata/SE Statistical Software, release 9.0. Chi-square test was used to investigate the association of age, gender and education with presenting and best corrected visual acuity. Five thousands five hundreds and twenty-seven individuals were enumerated and 5051 persons were examined, the response rate was 91.39%. Based on the criteria of World Health Organization visual impairment classification in 1973, the prevalence of blindness and moderate and severe visual impairment defined as best corrected visual acuity was 1.05% (53/5051) and 3.46% (175/5051) respectively. The prevalence of blindness and moderate and severe visual impairment defined as presenting visual acuity was 1.48% (75/5051) and 7.94% (401/5051) respectively. The prevalence of blindness and moderate and severe visual impairment was higher in aged (trend χ(2) = 897.27, P = 0.000) , female (χ(2) = 30.32, P = 0.000), illiterate (trend χ(2) = 83.20, P = 0.000) persons. Cataract was still the first leading cause of blindness. Un-corrected refractive error also was the main cause of visual impairment. The prevalence of blindness and moderate and severe

[Prevalence and causes of blindness and moderate and severe visual impairment among adults aged 50 years or above in Luxi County of Yunnan Province: the China Nine-Province survey].

Science.gov (United States)

Cai, Ning; Yuan, Yuan-sheng; Zhao, Jia-liang; Zhong, Hua; Ellwein, Leon B; Chen, Miao-miao; Dan, Ai-hua; Sun, Peng; Luo, Ting-hao; Wang, Yu; Gao, Xue-cheng

2013-09-01

To investigate the prevalence and causes of blindness and moderate and severe visual impairment among adults aged ≥ 50 years in Luxi County of Yunnan Province, China. It was a population-based cross-section study. Geographically defined cluster sampling was used in randomly selecting 5575 individuals aged ≥ 50 years in Luxi County. The survey was preceded by a pilot study where operational methods were refined and quality assurance evaluation was carried out. All participants were enumerated through village registers followed door-to-door visits.Eligible individuals were invited to receive visual acuity measurement and eye examination. Prevalence of blindness and moderate and severe visual impairment was calculated according to different age, gender or education. And the reasons of blindness were analyzed.Statistical analyses were performed using Stata/SE Statistical Software, release 9.0. Chi-square test was used to investigate the association of age, gender and education with presenting and best corrected visual acuity. Five thousands five hundreds and seventy-five individuals were enumerated and 5151 persons were examined, the response rate was 92.39%. Based on the criteria of World Health Organization visual impairment classification in 1973, the prevalence of blindness and moderate and severe visual impairment defined as best corrected visual acuity was 4.95% (255/5151) and 9.51% (490/5151) , respectively. The prevalence of blindness and moderate and severe visual impairment defined as presenting visual acuity was 5.40% (278/5151) and 15.84% (816/5151) , respectively. The prevalence of blindness and moderate and severe visual impairment was higher in aged (χ(2) = 1349.21, P = 0.000) , illiterate (χ(2) = 203.55, P = 0.000) persons. Cataract was still the first leading cause of blindness and visual impairment. The prevalence of blindness and moderate and severe visual impairment is highest in China Nine-Province Survey among older adults aged ≥ 50 years

Prevalence of cognitive impairment in individuals aged over 65 in an urban area: DERIVA study.

Science.gov (United States)

Rodríguez-Sánchez, Emiliano; Mora-Simón, Sara; Patino-Alonso, María C; García-García, Ricardo; Escribano-Hernández, Alfonso; García-Ortiz, Luis; Perea-Bartolomé, Ma Victoria; Gómez-Marcos, Manuel A

2011-11-17

Few data are available on the prevalence of cognitive impairment (CI) in Spain, and the existing information shows important variations depending on the geographical setting and the methodology employed. The aim of this study was to determine the prevalence of CI in individuals aged over 65 in an urban area, and to analyze its associated risk factors. A descriptive, cross-sectional, home questionnaire-based study; Populational, urban setting. The reference population comprised over-65s living in the city of Salamanca (Spain) in 2009. Randomized sampling stratified according to health district was carried out, and a total of 480 people were selected. In all, 327 patients were interviewed (68.10%), with a mean age of 76.35 years (SD: 7.33). Women accounted for 64.5% of the total. A home health questionnaire was used to obtain the following data: age, sex, educational level, family structure, morbidity and functionality. All participants completed a neuropsychological test battery. The prevalence data were compared with those of the European population, with direct adjustment for age and sex. Diagnoses were divided into three general categories: normal cognitive function, cognitive impairment - no dementia (CIND), and dementia. The prevalence of CI among these over-65s was 19% (14.7% CIND and 4.3% dementia). The age-and sex-adjusted global prevalence of CI was 14.9%. CI increased with age (p < 0.001) and decreased with increasing educational level (p < 0.001). Significant risk factors were found with the multivariate analyses: age (OR = 1.08, 95%CI: 1.03-1.12), anxiety-depression (OR = 3.47, 95%CI: 1.61-7.51) and diabetes (OR = 2.07, 95%CI: 1.02-4.18). In turn, years of education was found to be a protective factor (OR = 0.79, 95%CI: 0.70-0.90). Although CI was more frequent among women and in people living without a partner, these characteristics were not significantly associated with CI risk. The observed raw prevalence of CI was 19% (14.9% after adjusting for age

Dermatological comorbidity in psoriasis: results from a large-scale cohort of employees.

Science.gov (United States)

Zander, N; Schäfer, I; Radtke, M; Jacobi, A; Heigel, H; Augustin, M

2017-07-01

The field of dermatological comorbidity in psoriasis is only passively explored with contradictory results. Objective of this study was to further investigate the complex field of psoriasis and associated skin diseases by identifying skin comorbidity patterns in an extensive cohort of employees in Germany. Retrospective analysis of data deriving from occupational skin cancer screenings was conducted. From 2001 to 2014 German employees between 16 and 70 years from different branches underwent single whole-body screenings by trained dermatologists in their companies. All dermatological findings and need for treatment were documented. Point prevalence rates and their 95% confidence intervals were computed. Logistic regression analysis was performed to calculate odds ratios (OR) of single dermatological diseases to occur together with psoriasis controlled for age and sex. Data from 138,930 persons (56.5% male, mean age 43.2) were evaluated. Psoriasis point prevalence was 2.0%. Of those 20.6% had unmet treatment needs of their disease. Onychomycosis was the most frequent dermatological comorbidity with a prevalence of 7.8%. Regression analysis found rosacea (OR = 1.40, 95% CI 1.13-1.72) and telangiectasia (OR = 1.25, 95% CI 1.10-1.41) to be significantly associated with psoriasis. 17.2% of psoriasis patients had at least one further finding requiring treatment. The highest treatment needs were found for onychomycosis (3.4%), tinea pedis (3.1%), and verruca plantaris (1.0%). It can be concluded that persons with psoriasis are at increased risk to suffer from comorbid skin diseases, which should be considered in treatment regimens. Particular attention should be paid to fungal diseases of the feet.

Comorbidity in "DSM" Childhood Mental Disorders: A Functional Perspective

Science.gov (United States)

Cipani, Ennio

2014-01-01

In this article, I address the issue of comorbidity and its prevalence in the prior "Diagnostic and Statistical Manual of Mental Disorders" ("DSM") classification systems. The focus on the topography or form of presenting problems as the venue for determining mental disorders is scrutinized as the possible cause. Addressing the…

Epidemiology of comorbidities in early rheumatoid arthritis: with emphasis on cardiovascular disease

OpenAIRE

Kerola, Anne

2015-01-01

Rheumatoid arthritis (RA) is associated with a substantially increased risk for cardiovascular (CV) morbidity and mortality. Along with their CV burden, RA patients are at increased risk for other comorbidities such as hypothyroidism and depressive symptoms. The aim of this work was to evaluate the prevalence of CV comorbidities and hypothyroidism among RA patients in comparison to those of the general population at the time of RA diagnosis. We also aimed to determine, among patients wit...

Tinnitus and the prevalence of co-morbid psychological stress ...

African Journals Online (AJOL)

Three (3.2) patients had both depression and anxiety. Eighty three (90.2%) patients were in the active and productive age group with 13 patients (prevalence of 14.1%) having depression and 20 patients (prevalence of 21.7%) with anxiety. Conclusion: We recommend the screening or assessment for psychological distress ...

[Prevalence of blindness and moderate and severe visual impairment among adults aged 50 years or above in Shuangcheng City of Heilongjiang Province: the China Nine-Province Survey].

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Zhang, Liqiong; Cui, Hao; Zhao, Jialiang; Ellwein, Leon B; Li, Zhijian; Li, Mingsheng; Yu, Nannan; Wang, Yu; Gao, Xuecheng

2014-03-01

To investigate the prevalence of blindness and moderate and severe visual impairment among adults aged 50 years or above in Shuangcheng City of Heilongjiang Province, China. It was a population-based cross-section study. Geographically defined cluster sampling was used in randomly selecting 5 841 individuals aged 50 years or above in 28 basic sample units in Shuangcheng City from September to December 2006. The survey was preceded by a pilot study where operational methods were refined and quality assurance evaluation was carried out. All participants were enumerated through village registers followed door-to-door visits.Eligible individuals were invited to receive visual acuity measurement and eye examination. Statistical analyses were performed using Stata/SE Statistical Software, release 9.0. Chi-square test was used to investigate the association of age, gender and education with presenting and best corrected visual acuity. Five thousands four hundreds and eighty-one individuals were enumerated and 5 047 persons were examined, the response rate was 92.08%. Based on the criteria of World Health Organization visual impairment classification in 1973, the prevalence of blindness and moderate and severe visual impairment defined as best corrected visual acuity was 1.72% (87/5 047) and 4.69% (237/5 047) respectively. The prevalence of blindness and moderate and severe visual impairment defined as presenting visual acuity was 1.90% (96/5 047) and 7.23% (365/5 047) respectively. The prevalence of blindness and moderate and severe visual impairment was higher in aged (trend χ(2)=674.44, P blindness and visual impairment. The percentage of the retinal diseases, including age-related macular degeneration, high myopic retinopathy and diabetic retinopathy was 11.31% among the eyes with blindness and moderate and severe visual impairment. Un-corrected refractive error(13.38%) also was the main cause of visual impairment. The prevalence of blindness and moderate and severe

Prevalence, structure and correlates of anxiety-depression in boys with an autism spectrum disorder.

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Bitsika, Vicki; Sharpley, Christopher F; Andronicos, Nicholas M; Agnew, Linda L

2016-01-01

Comorbidity of anxiety and depression predicts impaired treatment outcomes, poor quality of life and increased suicide risk. No study has reported on a combined measure of anxiety-depression in boys with an Autism Spectrum Disorder. To explore the prevalence, underlying factor structure and relationships between anxiety-depression, physiological stress and symptoms of Autism Spectrum Disorder (ASD). 150 boys (aged 6-18 years; IQ M=94.9, range=73-132) with an ASD plus their parents (135 mothers, 15 fathers) completed scales about the boys' anxiety and depression, and the boys provided samples of their saliva in the morning and afternoon. Parents also completed the ASD Behaviour Checklist about the boys' ASD symptoms. The two sources of ratings were not significantly different for prevalence of anxiety-depression but the factor structures varied between the parents' and boys' responses, with a four-factor solution for the boys' ratings and a three-factor solution for the parents' ratings. There were also differences in the correlations between cortisol and anxiety-depression and between ASD symptoms and anxiety depression across the boys' and parents' data. Assessment of anxiety and depression comorbidity from parents and from children with an ASD themselves could provide a valuable adjunct datum when diagnosing ASD. Copyright © 2015 Elsevier Ltd. All rights reserved.

Social communication impairments: pragmatics.

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Russell, Robert L

2007-06-01

Social communication or pragmatic impairments are characterized and illustrated as involving inappropriate or ineffective use of language and gesture in social contexts. Three clinical vignettes illustrate different pragmatic impairments and the wealth of diagnostic information that can be garnered from observation of a child's social communication behavior. Definitions of, and developmental milestones in, domains of pragmatic competence are provided. Several screening instruments are suggested for use in assessing pragmatic competence within the time-frame of a pediatric examination. Frequent comorbid psychiatric conditions are described and a sample of current neurobiologic research is briefly summarized.

Meta-analysis of the comorbidity rate of allergic rhinitis and asthma in Chinese children.

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Kou, Wei; Li, Xuelei; Yao, Hongbing; Wei, Ping

2018-04-01

Allergic rhinitis (AR) and asthma often occur concomitantly and are the two most common inflammatory conditions of the airways in children. Large-scale studies investigating the comorbidity of asthma and AR in children are rare. So, we performed a meta-analysis to describe the comorbidity rate of asthma and AR in Chinese children. We retrieved related studies from Pubmed, Science, Springer, Elsevier, Embase, BMJ, and four Chinese biomedical databases, including Wanfang Data, VIP, CBM, and CNKI. From these individual studies, the comorbidity rate of asthma and AR in Chinese children was extracted and pooled to generate summary effect estimates in R version 3.2.3. The meta-analysis included 25 cross-sectional studies. The results indicated that in China, the incidence of asthma in children with AR is 35.01% (95% CI: 32.32%-37.70%) and the incidence of AR in children with asthma is 54.93% (95% CI: 53.05%-56.80%). The comorbidity of AR and asthma is high in Chinese children. Statistically, the prevalence of AR was higher in children with asthma, as opposed to the prevalence of asthma in children with AR. The comorbidity rate of AR and asthma signifies the importance of improving the recognition and treatment under both conditions by respiratory physicians and otolaryngologists. Copyright © 2018. Published by Elsevier B.V.

The Prevalence of Binge Eating Disorder and Its Relationship to Work and Classroom Productivity and Activity Impairment

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Filipova, Anna A.; Stoffel, Cheri L.

2016-01-01

Objective: The study aimed to determine the prevalence of binge eating disorder on university campus, its associations with health risk factors, and its associations with work and classroom productivity and activity impairment, adjusted for health risk factors. Participants: The study was conducted at a public midwestern university in the United…

Comorbidity in heart failure. Results of the Spanish RICA Registry.

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Ruiz-Laiglesia, F-J; Sánchez-Marteles, M; Pérez-Calvo, J-I; Formiga, F; Bartolomé-Satué, J A; Armengou-Arxé, A; López-Quirós, R; Pérez-Silvestre, J; Serrado-Iglesias, A; Montero-Pérez-Barquero, M

2014-12-01

We sought to identify the comorbidities associated with heart failure (HF) in a non-selected cohort of patients, and its influence on mortality and rehospitalization. Data were obtained from the 'Registro de Insuficiencia Cardiaca' (RICA) of the Spanish Society of Internal Medicine. The registry includes patients prospectively admitted in Internal Medicine units for acute HF. Variables included in Charlson Index (ChI) were collected and analysed according to age, gender, left ventricular ejection fraction (LVEF) and Barthel Index. The primary end point of study was the likelihood of rehospitalization and death for any cause during the year after discharge. We included 2051 patients, mean age 78 and 53% females. LVEF was ⩾ 50% in 59.1% of the cohort. There was a high degree of dependency as measured by Barthel Index (14.8 % had an index ≤ 60). Mean ChI was 2.91 (SD ± 2.4). The most frequent comorbidities included in ChI were diabetes mellitus (44.3%), chronic renal impairment (30.8%) and chronic obstructive pulmonary disease (COPD) (27.4%). Age, myocardial infarction, peripheral artery disease, dementia, COPD, chronic renal impairment and diabetes with target-organ damage were all identified as independent prognostic factors for the combined end point of rehospitalization and death at 1 year. However, if multivariate analysis was done including ChI, only this remained as an independent prognostic factor for the combined end point (P < 0.001). HF is a comorbid condition. ChI is a simple and feasible tool for estimating the burden of comorbidities in such population. We believe that a holistic approach to HF would improve prognosis and the relief the pressure exerted on public health services. © The Author 2014. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

[Prevalence and causes of blindness and moderate and severe visual impairment among adults aged 50 years or above in Yongchuan District of Chongqing City: the China Nine-Province survey].

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Yin, Zheng-qin; Zhao, Jia-liang; Li, Ping-hua; Ellwein, Leon b; Song, Sheng-fang; Li, Fu-liang; Wang, Ting-gang; Ren, Yi-ming; Yang, Mei; Wang, Yu; Gao, Xue-cheng

2013-09-01

To investigate the prevalence and causes of blindness and moderate and severe visual impairment among adults aged 50 years or above in Yongchuan of Chongqing City, China. It was a population-based cross-section study.Geographically defined cluster sampling was used in randomly selecting 5663 individuals aged ≥ 50 years in Yongchuan District. The survey was preceded by a pilot study where operational methods were refined and quality assurance evaluation was carried out. All participants were enumerated through village registers followed door-to-door visits.Eligible individuals were invited to receive visual acuity measurement and eye examination. Prevalence of blindness and moderate and severe visual impairment was calculated according to different age, gender or education. And the reasons of blindness were analyzed.Statistical analyses were performed using Stata/SE Statistical Software, release 9.0. Chi-square test was used to investigate the association of age, gender and education with presenting and best corrected visual acuity. Five thousands six hundreds and sixty-three individuals were enumerated and 5390 persons were examined, the response rate was 95.18%. Based on the criteria of World Health Organization visual impairment classification in 1973, the prevalence of blindness and moderate and severe visual impairment defined as best corrected visual acuity was 2.12% (114/5390) and 5.40% (291/5390) respectively. The prevalence of blindness and moderate and severe visual impairment defined as presenting visual acuity was 2.49% (134/5390) and 10.71% (577/5390) respectively. The prevalence of blindness and moderate and severe visual impairment was higher in aged (trend χ(2) = 951.32, P = 0.000) , female (χ(2) = 33.35, P = 0.000) and illiterate (trend χ(2) equals; 141.32, P = 0.000) persons. Cataract was still the first leading cause of blindness and visual impairment.Un-corrected refractive error also was the main cause of visual impairment. The prevalence

Psychiatric comorbidities in patients with major depressive disorder

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Thaipisuttikul P

2014-11-01

Full Text Available Papan Thaipisuttikul, Pichai Ittasakul, Punjaporn Waleeprakhon, Pattarabhorn Wisajun, Sudawan Jullagate Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand Background: Psychiatric comorbidities are common in major depressive disorder (MDD. They may worsen outcome and cause economic burden. The primary objective was to examine the prevalence of psychiatric comorbidities in MDD. The secondary objectives were to compare the presence of comorbidities between currently active and past MDD, and between patients with and without suicidal risk.Methods: This was a cross-sectional study. A total of 250 patients with lifetime MDD and age ≥18 years were enrolled. The Mini International Neuropsychiatric Interview (MINI, Thai version, was used to confirm MDD diagnosis and classify comorbidities. MDD diagnosis was confirmed in 190, and 60 patients were excluded due to diagnosis of bipolar disorder.Results: Of the 190 MDD patients, 25.8% had current MDD and 74.2% had past MDD. Eighty percent were women. The mean age at enrollment was 50 years, and at MDD onset was 41 years. Most patients were married (53.2%, employed (54.8%, and had ≥12 years of education (66.9%. There were 67 patients (35.3% with one or more psychiatric comorbidities. Comorbidities included dysthymia (19.5%, any anxiety disorders (21.1% (panic disorder [6.8%], agoraphobia [5.8%], social phobia [3.7%], obsessive–compulsive disorder [OCD] [4.7%], generalized anxiety disorder [5.3%], and post-traumatic stress disorder [4.2%], alcohol dependence (0.5%, psychotic disorder (1.6%, antisocial personality (1.1%, and eating disorders (0%. Compared with past MDD, the current MDD group had significantly higher OCD (P<0.001, psychotic disorder (P=0.048, past panic disorder (P=0.017, and suicidal risk (P<0.001. Suicidal risk was found in 32.1% of patients. Patients with suicidal risk had more comorbid anxiety disorder of any type (P=0.019 and

Mental disorders in primary care: prevalence and co-morbidity among disorders. results from the functional illness in primary care (FIP) study.

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Toft, Tomas; Fink, Per; Oernboel, Eva; Christensen, Kaj; Frostholm, Lisbeth; Olesen, Frede

2005-08-01

Prevalence and co-occurrence of mental disorders is high among patients consulting their family general practitioner (GP) for a new health problem, but data on diagnostics and socio-demographics are sketchy. A cross-sectional two-phase epidemiological study. A total of 1785 consecutive patients with new complaints, aged 18-65 years, consulting 28 family practices during March-April 2000 in Aarhus County, Denmark were screened, in the waiting room, for mental and somatic symptoms with SCL-8 and SCL-Somatization questionnaires, for illness worry with Whitely-7 and for alcohol dependency with CAGE. In a stratified random sample of 701 patients, physician interviewers established ICD-10 diagnoses using the SCAN interview. Prevalence was calculated using weighted logistic regression, thus correcting for sample skewness. Half of the patients fulfilled criteria for an ICD-10 mental disorders and a third of these for more than one group of disorders. Women had higher prevalence of somatization disorder and overall mental disorders than men. Men had higher prevalence of alcohol abuse and hypochondriasis than women. Psychiatric morbidity tended to increase with age. Prevalence of somatoform disorders was 35.9% (95% CI 30.4-41.9), anxiety disorders 164% (95% CI 12.7-20.9), mood disorders 13.5% (95% CI 11.1-16.3), organic mental disorders 3.1% (95% CI 1.6-5.7) and alcohol abuse 2.2% (95% CI 1.5-3.1). Co-morbidities between these groups were highest for anxiety disorders, where 89% also had another mental diagnosis, and lowest for somatoform disorders with 39%. ICD-10 mental disorders are very prevalent in primary care and there is a high co-occurrence between most disorders. Somatoform disorders, however, more often than not exist without other mental disorders.

Nursing Diagnosis Risk for falls: prevalence and clinical profile of hospitalized patients.

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Luzia, Melissa de Freitas; Victor, Marco Antonio de Goes; Lucena, Amália de Fátima

2014-01-01

to identify the prevalence of the Nursing Diagnosis (ND) Risk for falls in the hospitalizations of adult patients in clinical and surgical units, to characterize the clinical profile and to identify the risk factors of the patients with this ND. a cross-sectional study with 174 patients. The data was collected from the computerized nursing care prescriptions system and on-line hospital records, and analyzed statistically. the prevalence of the ND Risk for falls was 4%. The patients' profile indicated older adults, males (57%), those hospitalized in the clinical units (63.2%), with a median length of hospitalization of 20 (10-24) days, with neurological illnesses (26%), cardio-vascular illnesses (74.1%) and various co-morbidities (3±1.8). The prevalent risk factors were neurological alterations (43.1%), impaired mobility (35.6%) and extremes of age (10.3%). the findings contributed to evidencing the profile of the patients with a risk of falling hospitalized in clinical and surgical wards, which favors the planning of interventions for preventing this adverse event.

Cognitive therapy for depressed adults with comorbid social phobia.

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Smits, Jasper A J; Minhajuddin, Abu; Jarrett, Robin B

2009-04-01

Evidence suggests that comorbid depression influences the outcome of cognitive-behavioral treatment for patients presenting with social phobia. Little is known, however, about the influence of comorbid social phobia on the response to cognitive therapy (CT) for depression among adults presenting with recurrent major depressive disorder (MDD). These analyses seek to clarify this relationship. Patients (N=156) with recurrent DSM-IV MDD entered CT (20% also met DSM-IV criteria for social phobia). Every week during the course of CT, clinicians assessed depressive symptoms and patients completed self-report instruments measuring severity of depression and anxiety. At presentation, outpatients with comorbid social phobia reported greater levels of depressive symptoms and clinicians rated their impairment as more severe, compared to their counterparts without social phobia. Patients with or without comorbid social phobia did not differ significantly in (1) attrition rates; (2) response or sustained remission rates; (3) time to response or sustained remission; or (4) rate of improvement in symptoms of depression or anxiety. The lack of domain-specific measures limits inference with respect to the improvements in social anxiety that occur with CT of depression. These findings introduce the hypothesis that CT for depression may be flexible enough to treat the depressive symptoms of patients presenting with MDD who also suffer from social phobia.

Prevalence and causes of visual impairment in a Brazilian population: The Botucatu Eye Study

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Cordeiro Ricardo

2009-08-01

Full Text Available Abstract Background This paper reports population-based data on the prevalence and causes of visual impairment among children and adults in Botucatu, Brazil. Methods A population-based cross-sectional study was conducted involving a random start point and then systematic sampling of an urban Brazilian population in the city of Botucatu. There were approximately 3 300 individuals aged 1 to 91 years who were eligible to participate in the study. Of this sample, 2485 (75.3% underwent ophthalmic examination. The ophthalmic examination included uncorrected (presenting and best corrected distance visual acuity using standardized protocols. The primary cause of decreased visual acuity was identified for all patients with visual impairment. Results Presenting low vision and presenting blindness were found in 5.2% (95% CI: 4.3–6.1 and 2.2% (95% CI: 1.6–2.8 of the population, respectively. Unilateral presenting low vision and unilateral presenting blindness were found in 8.3% (95% CI: 7.2–9.5 and 3.7% (95% CI: 2.9–4.4 of the population respectively. Best corrected low vision was found in 1.3% of the population (95% CI: 0.9–1.7 and best corrected blindness was discovered in 0.4% of people (95% CI: 0.2–0.7. The main cause of presenting low vision was refractive error (72.3% and cataract was the most prevalent cause of blindness (50%. Conclusion The main causes of low vision and blindness in this Brazilian city were uncorrected refractive errors, cataract, and retinal diseases. Programs to further reduce the burden of visual impairment need to be targeted toward the correction of refractive error and surgery for cataracts.

ADHD and Comorbid Developmental Coordination Disorder: Implications and Recommendations for School Psychologists

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Lange, Stephen M.

2018-01-01

Developmental coordination disorder (DCD) is frequently comorbid with attention-deficit hyperactivity disorder (ADHD). DCD results in functional impairment in activities of daily living, and children's physical activities with peers. Children with DCD report fewer friendships, more bullying, and less confidence in their ability to participate in…

Prevalence of refractive error and visual impairment among rural school-age children of Goro District, Gurage Zone, Ethiopia.

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Kedir, Jafer; Girma, Abonesh

2014-10-01

Refractive error is one of the major causes of blindness and visual impairment in children; but community based studies are scarce especially in rural parts of Ethiopia. So, this study aims to assess the prevalence of refractive error and its magnitude as a cause of visual impairment among school-age children of rural community. This community-based cross-sectional descriptive study was conducted from March 1 to April 30, 2009 in rural villages of Goro district of Gurage Zone, found south west of Addis Ababa, the capital of Ethiopia. A multistage cluster sampling method was used with simple random selection of representative villages in the district. Chi-Square and t-tests were used in the data analysis. A total of 570 school-age children (age 7-15) were evaluated, 54% boys and 46% girls. The prevalence of refractive error was 3.5% (myopia 2.6% and hyperopia 0.9%). Refractive error was the major cause of visual impairment accounting for 54% of all causes in the study group. No child was found wearing corrective spectacles during the study period. Refractive error was the commonest cause of visual impairment in children of the district, but no measures were taken to reduce the burden in the community. So, large scale community level screening for refractive error should be conducted and integrated with regular school eye screening programs. Effective strategies need to be devised to provide low cost corrective spectacles in the rural community.

Prevalence of Drug-Induced Xerostomia in Older Adults with Cognitive Impairment or Dementia: An Observational Study.

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Gil-Montoya, José Antonio; Barrios, Rocío; Sánchez-Lara, Inés; Carnero-Pardo, Cristobal; Fornieles-Rubio, Francisco; Montes, Juan; Gonzalez-Moles, Miguel Angel; Bravo, Manuel

2016-08-01

Older adults, especially those with cognitive impairment or dementia, frequently consume drugs with potential xerostomic effects that impair their quality of life and oral health. The objective of this study was to determine the prevalence and analyze the possible pharmacological etiology of xerostomia in older people with or without cognitive impairment. Individuals with cognitive impairment were recruited from patients diagnosed using standardized criteria in two neurology departments in Southern Spain. A comparison group was recruited from healthcare centers in the same city after ruling out cognitive impairment. Data on oral health, xerostomia, and drug consumption were recorded in both groups. Dry mouth was evaluated using a 1-item questionnaire and recording clinical signs of oral dryness. All drugs consumed by the participants were recorded, including memantine, anticholinesterases, antipsychotics, antidepressants, and anxiolytics. The final sample comprised 200 individuals with mild cognitive impairment or dementia and 156 without. Xerostomia was present in 70.5 % of participants with cognitive impairment versus 36.5 % of those without, regardless of the drug consumed. Memantine consumption was the only variable significantly related to xerostomia in the multivariate model (OR 3.1; 95 % CI 1.1-8.7), and this relationship persisted after adjusting for possible confounders and forcing the inclusion of drugs with xerostomic potential. More than 70 % of participants diagnosed with cognitive impairment or dementia had xerostomia. Anticholinesterases and memantine were both associated with the presence of xerostomia. In the case of memantine, this association was independent of the consumption of the other drugs considered.

Multiplicity of comorbidities in patients with severe psoriasis

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N. V. Batkaeva

2018-01-01

Full Text Available Rationale: Severe treatment-resistant psoriasis and comorbidities are on the rise.Aim: To evaluate the prevalence of comorbidities in a  hospital-based cohort of patients with severe psoriases.Materials and methods: We performed a  retrospective analysis of medical files of 890  patients with moderate-to-severe plaque psoriasis (PASI > 10 treated in a  hospital from 2010 to 2015 (men, 516 [58%], women, 374 [42%]; mean age 51.9 ± 11.6 years; mean PASI, 44.3 ± 7.8  scores.Results: Comorbidities were found in 61% (543 / 890 of the patients with severe psoriasis, with cardiovascular disorders ranking first (59%, or 516 / 890 and gastrointestinal and hepatobiliary disorders ranking second (46,4%, or 413 / 890. Psoriatic arthritis was diagnosed in 34% (303 / 890 of the patients and other disorders of the musculoskeletal system unrelated to psoriasis in 19.8% (176 / 890. The proportion of diabetes was 15.4% (137 / 890.Conclusion: Psoriasis has a high rate of comorbidities, in particular of cardiovascular disorders. It significantly deteriorates the course of psoriasis and its response to therapy, and in some cases may reduce the possibility of adequate anti-psoriatic treatment due to contraindications.

The role of comorbid psychiatric conditions in health status in epilepsy.

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Zeber, John E; Copeland, Laurel A; Amuan, Megan; Cramer, Joyce A; Pugh, Mary Jo V

2007-06-01

Comorbid psychiatric conditions are highly prevalent in patients with epilepsy, yet the long-term implications across multiple mental health conditions are poorly understood. We examined the association between psychiatric diagnoses and self-reported health status in veterans with epilepsy. ANCOVA models were used to derive adjusted SF-36V scores for individuals with epilepsy alone (N=7379) or with additional psychiatric conditions (N=6320): depression, schizophrenia, bipolar disorder, anxiety disorder, substance abuse, and posttraumatic stress disorder (PTSD). Compared with patients with epilepsy alone, scores of veterans with comorbid psychiatric diagnoses averaged 21% lower across all domains. Role Limitation scales exhibited the greatest decrement across domains. A PTSD diagnosis consistently corresponded to lower scores, followed by depression. Schizophrenia contributed the least detriment to perceived health status. Comorbid psychiatric conditions impart significant emotional and physical burdens, requiring timely recognition and treatment of these disorders. Patients with epilepsy are uniquely at risk for high physical-psychiatric comorbidity profiles, with concomitant losses in perceived health status.