Psychiatry Journal The latest articles from Hindawi © 2017 , Hindawi Limited . All rights reserved. Dyslipidaemia and Medical Outcome (Health Related Quality of Life) in Patients with Schizophrenia Taking Antipsychotics in Enugu, Nigeria Mon, 20 Feb 2017 00:00:00 +0000 Aim. Determine association between use (and type) of antipsychotics and dyslipidaemia in newly diagnosed schizophrenia patients attending Federal Neuropsychiatric Hospital, Enugu. Methods. From sixty antipsychotic naive patients with schizophrenia and sixty first-degree relatives matched for gender and age, fasting blood lipid profiles were measured at baseline and after twelve weeks. Medical Outcome Study Short Form General Health Survey was administered to patients on both occasions. Fasting lipid profile changes of both groups were compared. Results. Mean endpoint of total cholesterol (TC), low density lipoprotein (LD), and triglycerides (TG) in mmol/l for cases was significantly higher than initial values (TC 4.5 versus 4.3, , ), (LDL 2.8 versus 2.6, , ), and (TG 1.3 versus 1.0, , ). Mean endpoint of high density lipoprotein (HDL) in mmol/l for cases was significantly lower than initial values (1.1 versus 1.2, , ). Prevalence of dyslipidaemia for cases was 13%. Mean endpoint of TC, LDL, TG, and HDL in mmol/l for controls was not significantly different from initial values (TC 4.30 versus 4.27, , ), (LDL 2.49 versus 2.46, , ), (TG 0.96 versus 0.94, , ), and (HDL 1.37 versus 1.38, , ). Subjects on atypical antipsychotics had higher risk for dyslipidaemia. Conclusion. Use of antipsychotics was significantly associated with dyslipidaemia. Emmanuel Omamurhomu Olose, John Edet, Monday Nwite Igwe, Donald Chidozie Chukwujekwu, Miriam Chinyere Aguocha, and Richard Uwakwe Copyright © 2017 Emmanuel Omamurhomu Olose et al. All rights reserved. High Magnitude of Social Anxiety Disorder in School Adolescents Thu, 16 Feb 2017 00:00:00 +0000 Introduction. Social phobia is the most prevalent and chronic type of anxiety disorder worldwide and it affects occupational, educational, and social affairs of the individual. Social phobia is also known for its association with depression and substance use disorder. Objective. The aim of this study was to assess the prevalence and associated factors of social phobia among high school students in Ethiopia. Methods. Cross-sectional study was conducted among 386 randomly selected students. Data were collected using pretested and self-administered questionnaire. Social phobia was assessed by using Social Phobia Inventory (SPIN). Logistic regression was used to analyze the data with 95% confidence interval and variables with value less than 0.05 were considered as statistically significant. Results. From 386 study participants, 106 (27.5%) of them were positive for social phobia. Being female (AOR = 3.1; 95% CI: 1.82–5.27), current alcohol drinking (AOR = 1.75; 95% CI: 1.03–2.98), poor social support (AOR = 2.40; 95% CI: 1.17–4.92), and living with single parent (AOR = 5.72; 95% CI: 2.98–10.99) were significantly associated with social phobia. Conclusion. The proportion of social phobia was higher compared to previous evidences. School-based youth-friendly mental health services might be helpful to tackle this problem. Kindie Mekuria, Haregwoin Mulat, Habtamu Derajew, Tesfa Mekonen, Wubalem Fekadu, Amsalu Belete, Solomon Yimer, Getasew Legas, Melak Menberu, Asmamaw Getnet, and Simegnew Kibret Copyright © 2017 Kindie Mekuria et al. All rights reserved. Patients’ Experience of Winter Depression and Light Room Treatment Wed, 15 Feb 2017 06:24:54 +0000 Background. There is a need for more knowledge on the effects of light room treatment in patients with seasonal affective disorder and to explore patients’ subjective experience of the disease and the treatment. Methods. This was a descriptive and explorative study applying qualitative content analysis. A purposeful sample of 18 psychiatric outpatients with a major depressive disorder with a seasonal pattern and a pretreatment score ≥12 on the 9-item Montgomery-Åsberg Depression self-rating scale was included (10 women and 8 men, aged 24–65 years). All patients had completed light room treatment (≥7/10 consecutive weekdays). Data was collected two weeks after treatment using a semistructured interview guide. Results. Patients described a clear seasonal pattern and a profound struggle to adapt to seasonal changes during the winter, including deterioration in sleep, daily rhythms, energy level, mood, activity, and cognitive functioning. Everyday life was affected with reduced work capacity, social withdrawal, and disturbed relations with family and friends. The light room treatment resulted in a radical and rapid improvement in all the major symptoms with only mild and transient side effects. Discussion. The results indicate that light room treatment is essential for some patients’ ability to cope with seasonal affective disorder. Cecilia Rastad, Lennart Wetterberg, and Cathrin Martin Copyright © 2017 Cecilia Rastad et al. All rights reserved. Exploring Complexity of Deliberate Self-Poisoning through Network Analysis Sun, 29 Jan 2017 00:00:00 +0000 The purpose of this research was to examine the complexity of circumstances that result in deliberate self-poisoning cases. For the purposes of this paper, the cases were patients that presented for care and were admitted to the specialty hospital in Northwest of Iran. The research examined the problems preceding deliberate self-poisoning and the interrelations among them by applying network analysis methods. The network was scored for degrees of centrality and betweenness centrality. Structural analysis of network also was conducted using block modelling. The results showed that family conflicts had the highest score for degree of centrality among women, while the highest score for degree of centrality among men belonged to those dealing with drug addiction. Analysis for degree of betweenness centrality revealed that drug addiction had the highest score among men, whereas the highest score for women on betweenness centrality was related to physical illness. Structural analysis of the network showed differences in role that various problems played in intentional self-poisoning. The findings from this research can be used by public health authorities to create prevention programs that address the problems leading to deliberate self-poisoning. Leila R. Kalankesh, Mostafa Farahbakhsh, Rebecca A. Fein, Nazila Moftian, and Zahra Nasiry Copyright © 2017 Leila R. Kalankesh et al. All rights reserved. Clinical Profile and Comorbidity of Obsessive-Compulsive Disorder among Children and Adolescents: A Cross-Sectional Observation in Bangladesh Wed, 14 Dec 2016 09:42:24 +0000 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. Md. Hafizur Rahman Chowdhury, Mohammad S. I. Mullick, and S. M. Yasir Arafat Copyright © 2016 Md. Hafizur Rahman Chowdhury et al. All rights reserved. Prevalence and Factors Associated with Undernutrition among Adults with Major Depressive Disorder in Northwest Ethiopia Mon, 21 Nov 2016 09:18:59 +0000 Background. Undernutrition and major depressive disorder are frequently co-occurring. Patients with impaired mental health are strongly vulnerable to the risks of having involuntary weight loss or deficiency of essential nutrients. However, there is no study which assesses undernutrition among major depressive patients in Ethiopia. Method. A total of 422 clients were included in the study. Structured questionnaires and anthropometric measurements were used for collecting the data. Bivariate and multivariate logistic regression model was fitted to identify factors associated with undernutrition. Odds ratio with 95% confidence interval was computed to determine the level of significance. Results. The prevalence of undernutrition was 31.4% [95% CI: 27.2–36.0]. Being in a rural residence [AOR = 1.84, 95% CI (1.18–2.85)], taking multiple medication [AOR = 1.77, 95% CI (1.03–3.05)], taking prescribed diet [AOR = 1.90, 95% CI (1.06–3.41)], and current use of alcohol [AOR = 2.96, 95% CI (1.34–6.55)] were factors significantly associated with undernutrition among depressive patients. Conclusion. The prevalence of undernutrition among adults with major depressive disorder was found to be higher than the general population. Appropriate nutritional education and nutritional assessment are recommended during the course of major depressive disorder. Edmialem Gezahegn, Melkie Edris, and Berihun Assefa Dachew Copyright © 2016 Edmialem Gezahegn et al. All rights reserved. Community Perception towards Mental Illness among Residents of Gimbi Town, Western Ethiopia Thu, 20 Oct 2016 12:06:11 +0000 Background. Despite the increased burden of mental health problem, little is known about knowledge and perception of the public towards mental health problems in Ethiopia. Methods. Community based cross-sectional study was conducted among selected 845 Gimbi town residents from May 28 to June 28, 2014. Results. Out of the total study participants, 304 (37.3%) were found to have poor perception (a score below mean five semantic differential scales for positive questions and above mean for negative questions) of mental illness. Being above 28 years of age (AOR = 0.48 CI (0.23, 0.78)), private workers (AOR = 0.41 CI (0.19, 0.87)), and lack of mental health information were found to be associated with poor perception of mental illness (AOR = 0.133 CI (0.09, 0.20)). Absence of family history of mental illness was also found to be associated with poor perception of mental illness (AOR = 0.37 CI (0.21, 0.66)). Conclusions. Significant proportions of the community in Gimbi town were found to have poor perception of mental illness. Poor perception is common among old aged, less educated, private workers, those unable to access mental health information, and those with no family history of mental illness. Mental health education on possible causes, treatment options, and possible outcome of treatment to the community is required. Misael Benti, Jemal Ebrahim, Tadesse Awoke, Zegeye Yohannis, and Asres Bedaso Copyright © 2016 Misael Benti et al. All rights reserved. Prevalence of Depression and Anxiety amongst Cancer Patients in a Hospital Setting: A Cross-Sectional Study Mon, 26 Sep 2016 07:13:57 +0000 Background. The biomedical care for cancer has not been complemented by psychosocial progressions in cancer care. Objectives. To find the prevalence of anxiety and depression amongst cancer patients in a hospital setting. Design and Setting. This cross-sectional study was conducted at the tertiary care hospitals Shifa International Hospital Islamabad and Nuclear Medicine, Oncology, and Radiotherapy Institute [NORI]. Patients and Methods. 300 patients were interviewed from both the outpatient and inpatient department using The Aga Khan University Anxiety and Depression Scale (AKUADS). Main Outcome Measures. Using a score of 20 and above on the AKUADS, 146 (48.7%) patients were suffering from anxiety and depression. Results. When cross tabulation was done between different factors and the cancer patients with anxiety and depression, the following factors were found out to be significant with associated value < 0.05: education of the patient, presence of cancer in the family, the severity of pain, and the patient’s awareness of his anxiety and depression. Out of 143 (47.7%) uneducated patients, 85 (59.4%) were depressed, hence making it the highest educational category suffering from depression and anxiety. Conclusion. The prevalence of anxiety and depression amongst cancer patients was high showing that importance should be given to screening and counseling cancer patients for anxiety and depression, to help them cope with cancer as a disease and its impact on their mental wellbeing. Limitations. The frequency of female patients in our research was higher than those of male patients. Anish Khalil, Muhammad Faheem, Ammad Fahim, Haran Innocent, Zainab Mansoor, Shehrbano Rizvi, and Hizra Farrukh Copyright © 2016 Anish Khalil et al. All rights reserved. The Brief Symptom Inventory and the Outcome Questionnaire-45 in the Assessment of the Outcome Quality of Mental Health Interventions Thu, 08 Sep 2016 09:17:13 +0000 Self-report questionnaires are economical instruments for routine outcome assessment. In this study, the performance of the German version of the Outcome Questionnaire-45 (OQ-45) and the Brief Symptom Inventory (BSI) was evaluated when applied in analysis of the outcome quality of psychiatric and psychotherapeutic interventions. Pre-post data from two inpatient samples () and one outpatient sample () were analyzed. Critical differences (reliable change index) and cut-off points between functional and dysfunctional populations were calculated using the Jacobson and Truax method of calculating clinical significance. Overall, the results indicated that the BSI was more accurate than the OQ-45 in correctly classifying patients as clinical subjects. Nonetheless, even with the BSI, about 25% of inpatients with schizophrenia attained a score at admission below the clinical cut-off. Both questionnaires exhibited the highest sensitivity to psychopathology with patients with personality disorders. When considering the differences in the prescores, both questionnaires showed the same sensitivity to change. The advantage of using these self-report measures is observed primarily in assessing outpatient psychotherapy outcome. In an inpatient setting two main problems—namely, the low response rate and the scarce sensitivity to psychopathology with severely ill patients—limit the usability of self-report questionnaires. Aureliano Crameri, Christopher Schuetz, Andreas Andreae, Margit Koemeda, Peter Schulthess, Volker Tschuschke, and Agnes von Wyl Copyright © 2016 Aureliano Crameri et al. All rights reserved. Common Mental Disorders among Occupational Groups: Contributions of the Latent Class Model Wed, 17 Aug 2016 06:49:59 +0000 Background. The Self-Reporting Questionnaire (SRQ-20) is widely used for evaluating common mental disorders. However, few studies have evaluated the SRQ-20 measurements performance in occupational groups. This study aimed to describe manifestation patterns of common mental disorders symptoms among workers populations, by using latent class analysis. Methods. Data derived from 9,959 Brazilian workers, obtained from four cross-sectional studies that used similar methodology, among groups of informal workers, teachers, healthcare workers, and urban workers. Common mental disorders were measured by using SRQ-20. Latent class analysis was performed on each database separately. Results. Three classes of symptoms were confirmed in the occupational categories investigated. In all studies, class I met better criteria for suspicion of common mental disorders. Class II discriminated workers with intermediate probability of answers to the items belonging to anxiety, sadness, and energy decrease that configure common mental disorders. Class III was composed of subgroups of workers with low probability to respond positively to questions for screening common mental disorders. Conclusions. Three patterns of symptoms of common mental disorders were identified in the occupational groups investigated, ranging from distinctive features to low probabilities of occurrence. The SRQ-20 measurements showed stability in capturing nonpsychotic symptoms. Kionna Oliveira Bernardes Santos, Fernando Martins Carvalho, and Tânia Maria de Araújo Copyright © 2016 Kionna Oliveira Bernardes Santos et al. All rights reserved. Cognitive Function before and during Treatment with Selective Serotonin Reuptake Inhibitors in Patients with Depression or Obsessive-Compulsive Disorder Mon, 15 Aug 2016 09:28:57 +0000 Objectives. Identification of adverse effects of selective serotonin reuptake inhibitors (SSRIs) is of great importance due to their extensive use in medicine. Some studies have reported the effects of SSRIs on cognitive functions, but the results are conflicting. This study was designed to assess the effect of these drugs on cognition of patients with depression or obsessive-compulsive disorder (OCD). Methods. Patients with depression or OCD, naïve to therapy, and candidates of receiving one drug from SSRI class, voluntarily, entered this study. Mini-Mental State Examination (MMSE) test was the tool to assess their cognitive functions. MMSE scores of each patient were recorded prior to taking SSRIs and at weeks 3, 5, and 8 of drug therapy. Results. 50 patients met our inclusion criteria, with a baseline mean MMSE score of 23.94. At 3, 5, and 8 weeks of treatment, the mean scores were 22.1, 21.4, and 20.66, respectively. With a value of <0.0001, the gradual decline was statistically significant. Conclusion. The MMSE scores of our patients showed a gradual decline over the consecutive weeks after taking SSRI drugs. It seems that the use of SSRIs in patients with depression or OCD, can cause cognitive dysfunction in the acute phase of treatment. Mehdi Sayyah, Kaveh Eslami, Shabnam AlaiShehni, and Leila Kouti Copyright © 2016 Mehdi Sayyah et al. All rights reserved. Forethought in Youth with Attention Deficit/Hyperactivity Disorder: An fMRI Study of Sex-Specific Differences Wed, 27 Jul 2016 12:46:52 +0000 Objective. The majority of studies investigating neurocognitive processing in attention deficit/hyperactivity disorder (ADHD) have been conducted on male participants. Few studies evaluated females or examined sex differences. Among various cognitive anomalies in ADHD, deficit in forethought seems particularly important as children with ADHD often fail to adequately use previous information in order to prepare for responses. The main goal of this study was to assess sex-specific differences in behavioral and neural correlates of forethought in youth with ADHD. Methods. 21 typically developing (TD) youth and 23 youth with ADHD were asked to judge whether two pictures told a congruent or incongruent story. Reaction time, performance accuracy, and cerebral activations were recorded during functional magnetic resonance imaging (fMRI). Results. Significant sex-specific differences in cerebral activations appeared, despite equivalent performance. Relative to the boys TD participants, boys with ADHD had extensive bilateral frontal and parietal hypoactivations, while girls with ADHD demonstrated more scattered hypoactivations in the right cerebral regions. Conclusion. Present results revealed that youth with ADHD exhibit reduced cerebral activations during forethought. Nevertheless, the pattern of deficits differed between boys and girls, suggesting the use of a different neurocognitive strategy. This emphasizes the importance of including both genders in the investigations of ADHD. H. Poissant, L. Rapin, S. Chenail, and A. Mendrek Copyright © 2016 H. Poissant et al. All rights reserved. Enhanced Early Neuronal Processing of Food Pictures in Anorexia Nervosa: A Magnetoencephalography Study Mon, 25 Jul 2016 16:03:04 +0000 Neuroimaging studies in Anorexia Nervosa (AN) have shown increased activation in reward and cognitive control regions in response to food, and a behavioral attentional bias (AB) towards food stimuli is reported. This study aimed to further investigate the neural processing of food using magnetoencephalography (MEG). Participants were 13 females with restricting-type AN, 14 females recovered from restricting-type AN, and 15 female healthy controls. MEG data was acquired whilst participants viewed high- and low-calorie food pictures. Attention was assessed with a reaction time task and eye tracking. Time-series analysis suggested increased neural activity in response to both calorie conditions in the AN groups, consistent with an early AB. Increased activity was observed at 150 ms in the current AN group. Neuronal activity at this latency was at normal level in the recovered group; however, this group exhibited enhanced activity at 320 ms after stimulus. Consistent with previous studies, analysis in source space and behavioral data suggested enhanced attention and cognitive control processes in response to food stimuli in AN. This may enable avoidance of salient food stimuli and maintenance of dietary restraint in AN. A later latency of increased activity in the recovered group may reflect a reversal of this avoidance, with source space and behavioral data indicating increased visual and cognitive processing of food stimuli. Lauren R. Godier, Jessica C. Scaife, Sven Braeutigam, and Rebecca J. Park Copyright © 2016 Lauren R. Godier et al. All rights reserved. Towards a Standard Psychometric Diagnostic Interview for Subjects at Ultra High Risk of Psychosis: CAARMS versus SIPS Mon, 30 May 2016 10:26:32 +0000 Background. Several psychometric instruments are available for the diagnostic interview of subjects at ultra high risk (UHR) of psychosis. Their diagnostic comparability is unknown. Methods. All referrals to the OASIS (London) or CAMEO (Cambridgeshire) UHR services from May 13 to Dec 14 were interviewed for a UHR state using both the CAARMS 12/2006 and the SIPS 5.0. Percent overall agreement, kappa, the McNemar-Bowker test, equipercentile methods, and residual analyses were used to investigate diagnostic outcomes and symptoms severity or frequency. A conversion algorithm (CONVERT) was validated in an independent UHR sample from the Seoul Youth Clinic (Seoul). Results. There was overall substantial CAARMS-versus-SIPS agreement in the identification of UHR subjects (, percent overall agreement = 86%; kappa = 0.781, 95% CI from 0.684 to 0.878; McNemar-Bowker test = 0.069), with the exception of the brief limited intermittent psychotic symptoms (BLIPS) subgroup. Equipercentile-linking table linked symptoms severity and frequency across the CAARMS and SIPS. The conversion algorithm was validated in 93 UHR subjects, showing excellent diagnostic accuracy (CAARMS to SIPS: ROC area 0.929; SIPS to CAARMS: ROC area 0.903). Conclusions. This study provides initial comparability data between CAARMS and SIPS and will inform ongoing multicentre studies and clinical guidelines for the UHR psychometric diagnostic interview. P. Fusar-Poli, M. Cappucciati, G. Rutigliano, T. Y. Lee, Q. Beverly, I. Bonoldi, J. Lelli, S. J. Kaar, E. Gago, M. Rocchetti, R. Patel, V. Bhavsar, S. Tognin, S. Badger, M. Calem, K. Lim, J. S. Kwon, J. Perez, and P. McGuire Copyright © 2016 P. Fusar-Poli et al. All rights reserved. Mass Psychogenic Illness: Demography and Symptom Profile of an Episode Mon, 16 May 2016 07:18:35 +0000 Background. Mass psychogenic illness has been a recurrent phenomenon in Bangladesh over recent times. Objectives. This study was aimed at investigating the demographic characteristics and symptom profile of an outbreak of mass psychogenic illness occurring in a girls’ high school. Methods and Materials. In 14 April 2013, a total of 93 students of a girls’ high school suddenly developed various symptoms following intake of tiffin cake which resulted in panic and hospital admission. A descriptive, cross-sectional observational survey was done to define various characteristics of the outbreak. Results. No organic explanation for the reported illnesses was found. 93 female students were included who were hospitalized during the incident. Trigger factor was found in 98% of students. Most of the students were 13 years old. Average interval between exposure to the trigger and onset of symptoms was 151.5 minutes. Commonest symptoms were abdominal pain (83%), headache (73%), chest pain (69%), body ache (63%), nausea (69%), and generalized weakness and fatigue (61%). Hospital stay following the incident was about 12 hours on average. Conclusion. To avoid unnecessary panic in the community a prompt, coordinated response is important in resolving widespread community anxiety surrounding these episodes. Binoy Krishna Tarafder, Mohammad Ashik Imran Khan, Md. Tanvir Islam, Sheikh Abdullah Al Mahmud, Md. Humayun Kabir Sarker, Imtiaz Faruq, Md. Titu Miah, and S. M. Yasir Arafat Copyright © 2016 Binoy Krishna Tarafder et al. All rights reserved. Arabic Translation and Psychometric Evaluation of the Depression Literacy Questionnaire among Adolescents Sun, 15 May 2016 08:44:02 +0000 Background. Depression is a serious mental health disease. Globally, it is estimated that almost 350 million people suffer from depression. It is important to assess depression literacy including knowledge and beliefs about mental disorders among adolescents. Objective. This study was conducted to validate the Arabic version of the Depression Literacy Questionnaire (D-Lit) among adolescents. Methods. A cross-sectional study was conducted among a sample size of 120 adolescents. Statistical analysis included face validation, confirmatory factor analysis, and reliability testing. A test-retest was carried out within a two-week interval. Results. The mean score for depression literacy among participants was 8.6 (SD = 4.48), the median was 8, and the interquartile range was 7. Preliminary construct validation analysis confirmed that factor analysis was appropriate for the Arabic version of D-Lit. The total internal consistency was measured by Cronbach’s alpha coefficient and split-half test and the results were 0.78 and 0.71, respectively. The test-retest reliability measured by Pearson’s correlation was 0.92 and spearman rho was equal to 0.91. Conclusions. Face validity, construct validity, and reliability analysis were found satisfactory for the Arabic version of D-Lit. The Arabic D-Lit was found valid and reliable to be used in the future studies. Hussain Ahmed Darraj, Mohamed Salih Mahfouz, Rashad Mohamed Al Sanosi, Mohammed Badedi, Abdullah Sabai, Abdulrahman AL Refaei, and Hussain Mutawm Copyright © 2016 Hussain Ahmed Darraj et al. All rights reserved. Depression among Ethiopian Adults: Cross-Sectional Study Mon, 09 May 2016 16:31:59 +0000 Background. Depression is one of the most common mental disorders worldwide and is the second leading cause of disability and major contributor to suicide. Methods. Community based cross-sectional study was conducted among 779 adults residing in Northwest Ethiopia. Multistage cluster sampling technique was used to select study participants. Depression was measured by Patient Health Questionnaire (PHQ-9). Bivariate as well as multivariate logistic regressions were used to identify associated factors. value of < 0.05 was considered statistically significant. Result. The prevalence of depression was 17.5%, where 10.7% of patients were with mild depression, 4.2% were with moderate depression, 1.9% were with moderately severe depression, and 0.6% had severe depression. Being female, age of 55 years and above, poor social support, having a comorbidity medical illness, current tobacco smoking, and living alone were significantly associated with depression. Conclusion and Recommendation. The prevalence of depression in Ethiopia is as common as the other lower and middle income countries. Female gender, being currently not married, poor social support, low wealth index, tobacco smoking, older age, having comorbid illness, and living alone were significantly associated with depression. So, depression is a significant public health problem that requires a great emphasis and some factors like smoking habit are modifiable. Getasew Legas Molla, Haregwoin Mulat Sebhat, Zebiba Nasir Hussen, Amsalu Belete Mekonen, Wubalem Fekadu Mersha, and Tesfa Mekonen Yimer Copyright © 2016 Getasew Legas Molla et al. All rights reserved. Comparison of Sexual Experience and Behavior between Bipolar Outpatients and Outpatients without Mood Disorders Sun, 17 Apr 2016 12:21:31 +0000 Sexual behavior over the past year of 32 outpatients with Bipolar disorder is compared to that of 44 Comparison patients that had never had an episode of affective illness. Subjects were outpatients treated with drugs and psychotherapy in routine office practice. Differences in sexual behavior between the two groups as a whole were minimal, but meaningful differences emerged when subgroups were compared. Compared to control men, Bipolar men had had more partners in the last year and were more likely to have had sex without condoms. Compared to Bipolar females, Bipolar males had more sex partners, had more sex with strangers, and were more likely to have engaged in homosexual behavior. Even so, some patients in the Comparison group also had engaged in risky sexual behavior. They had failed to use condoms and had had sex with strangers and prostitutes during the previous year. Jennifer Downey, Richard C. Friedman, Elizabeth Haase, David Goldenberg, Robinette Bell, and Sidney Edsall Copyright © 2016 Jennifer Downey et al. All rights reserved. Canadian Physicians’ Attitudes towards Accessing Mental Health Resources Sun, 10 Apr 2016 13:24:44 +0000 Despite their rigorous training, studies have shown that physicians experience higher rates of mental illness, substance abuse, and suicide compared to the general population. An online questionnaire was sent to a random sample of physicians across Canada to assess physicians’ knowledge of the incidence of mental illness among physicians and their attitudes towards disclosure and treatment in a hypothetical situation where one developed a mental illness. We received 139 responses reflecting mostly primary care physicians and nonsurgical specialists. The majority of respondents underestimated the incidence of mental illness in physicians. The most important factors influencing respondent’s will to disclose their illness included career implications, professional integrity, and social stigma. Preference for selecting mental health treatment services, as either outpatients or inpatients, was mostly influenced by quality of care and confidentiality, with lower importance of convenience and social stigma. Results from this study suggest that the attitudes of physicians towards becoming mentally ill are complex and may be affected by the individual’s previous diagnosis of mental illness and the presence of a family member with a history of mental illness. Other factors include the individual’s medical specialty and level of experience. As mental illness is common among physicians, one must be conscious of these when offering treatment options. Tariq M. Hassan, M. Selim Asmer, Nadeem Mazhar, Tariq Munshi, Tanya Tran, and Dianne L. Groll Copyright © 2016 Tariq M. Hassan et al. All rights reserved. The Relation between Psychiatric Diagnoses and Constipation in Hospitalized Patients: A Cross-Sectional Study Thu, 10 Mar 2016 12:14:38 +0000 Objective. Constipation is a prevalent problem in patients with psychiatric disorders; it reduces quality of life and may lead to severe complications. The prevalence distribution of constipation across all psychiatric diagnoses in patients with severe mental illness (SMI) has hardly been studied. The aim of this study is to estimate the association between psychiatric disorders and constipation in SMI inpatients. Methods. The strength of the association between constipation (based on use of laxatives) and DSM-IV psychiatric diagnosis was studied in a cross-sectional study with “adjustment disorders” as the reference group. The association was analyzed using logistic regression. Results. Of the 4728 patients, 20.3% had constipation. In the stratum of patients older than 60 years, all psychiatric categories except for substance related disorders were significantly associated with a higher prevalence of constipation (odds ratios ranging from 3.38 to 6.52), whereas no significant associations were found in the stratum of patients between 18 and 60 years (odds ratios ranging from 1.00 to 2.03). Conclusion. In the elderly, all measured psychiatric diagnoses are strongly associated with an increased prevalence of constipation. Physicians should be extra alert for constipation in SMI patients, independent of specific psychiatric diagnoses. Janique G. Jessurun, Peter N. van Harten, Toine C. G. Egberts, Ysbrand J. Pijl, Ingeborg Wilting, and Diederik E. Tenback Copyright © 2016 Janique G. Jessurun et al. All rights reserved. Prevalence of Antipsychotic Polypharmacy and Associated Factors among Outpatients with Schizophrenia Attending Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia Sun, 24 Jan 2016 08:55:23 +0000 Background. Despite recommendations by guidelines to avoid combinations of antipsychotics unless after multiple trials of antipsychotic monotherapy, it is quite a common practice to use combinations. This practice leads to unnecessary expenses and exposes the patient to severe drug adverse effects. Methods. An institution based cross-sectional study was conducted from April to May 2014. Systematic random sampling technique was used to select 423 study subjects. Logistic regression analysis was conducted to identify associated factors of antipsychotic polypharmacy among schizophrenia outpatients. Result. The overall prevalence of antipsychotic polypharmacy was found to be 28.2%. Extra pyramidal side effects (AOR = 2.80; 95% CI: 1.38, 5.71), repeated psychiatric hospitalization (AOR = 2.83; 95% CI: 1.45, 5.50), history of substance use (AOR = 2.82; 95% CI: 1.36, 5.88), longer duration of treatment (AOR = 2.10; 95% CI: 1.14, 3.87), and drug nonadherence (AOR = 1.84; 95% CI: 1.14, 2.98) were found to be significantly associated with antipsychotic polypharmacy. Conclusion. Prevalence of antipsychotic polypharmacy was found to be high among the current study participants. Individuals who had extra pyramidal side effects, admission, substance use, duration of treatment, and drug nonadherence were associated with antipsychotic polypharmacy. Siranesh Tesfaye, Nigussie Debencho, Teresa Kisi, and Minale Tareke Copyright © 2016 Siranesh Tesfaye et al. All rights reserved. Psychometric Validation of the Bangla Version of the Patient-Doctor Relationship Questionnaire Thu, 21 Jan 2016 13:36:33 +0000 Background. The patient-doctor relationship is an important issue in health care as it is linked to patient satisfaction, treatment adherence, and treatment outcome. The PDRQ-9 is brief instrument which has an excellent overall internal consistency to measure it. Objective. It was aimed at developing a culturally adapted and validated Bangla version of Patient-Doctor Relationship Questionnaire (PDRQ-9). Method. Data were collected during the period of May 2015 to July 2015 from 50 patients by interviewing with the final Bangla version of PDRQ-9 obtained by ideal translation-back translation procedure with nonprobability purposive consecutive sampling and analyzed by Statistical Package of Social Science (SPSS) 16.0 and Microsoft Excel 2007 version software. Result. The internal consistency of Bangla PDRQ-9 was measured by Cronbach’s α which was 0.97. Only one factor was extracted from varimax rotation factor analysis with high commonalities between the items. Conclusion. Bangla version of PDRQ-9 is valid, accepted, and widely applicable in clinical practice, research, public health, and primary health care in Bangladesh. S. M. Yasir Arafat Copyright © 2016 S. M. Yasir Arafat. All rights reserved. Pattern of Presentation and Utilization of Services for Mental and Neurological Disorders in Northeastern Nigeria: A Ten-Year Study Tue, 24 Nov 2015 08:09:05 +0000 Mental and neurological disorders are common in the primary health care settings. The organization of mental health services focuses on a vertical approach. The northeast as other low income regions has weak mental health services with potentially huge mental health burden. The manner of presentations and utilization of these services by the population may assist in determining treatment gap. We investigated the pattern and geographical distribution of presentations with mental disorders and explored the linkages with primary care in northeastern Nigeria over the last decade. A retrospective review of hospital-based records of all the available mental health service units in the region was conducted over a decade spanning between January 2001 and December 2011. A total of 47, 664 patients attended available mental health facilities within the past decade in the northeast. Overwhelming majority (83%, ) attended the region’s tertiary mental health facility. A substantial proportion (30%, ) had primary physical illness, while 18%, , had primary neurologic disorders. The commonest physical comorbidity was hypertension (4%) and diabetes (2%). A significant proportion of the populace with mental disorders appeared not to be accessing mental health care services, even when it is available. Meaningful efforts to improve access to mental health services in the northeast region of Nigeria will require successful integration of mental health into primary and general medical services. Jidda Mohammed Said, Abdulmalik Jibril, Rabbebe Isah, and Omeiza Beida Copyright © 2015 Jidda Mohammed Said et al. All rights reserved. The Use of Physical Restraint in Norwegian Adult Psychiatric Hospitals Mon, 23 Nov 2015 12:32:38 +0000 Background. The use of coercion within the psychiatric services is problematic and raises a range of ethical, legal, and clinical questions. “Physical restraint” is an emergency procedure used in psychiatric hospitals to control patients that pose an imminent physical danger. We wished to review the literature published in scientific peer-reviewed journals describing studies on the use of physical restraint in Norway, in order to identify the current state of knowledge and directions for future research. Design. The databases PubMed, PsycINFO, CINAHL, Web of Science, and Embase were searched for studies relating to physical restraint (including holding) in Norwegian psychiatric hospitals, supplemented with hand searches. Results. 28 studies were included. Most of the studies were on rates of restraint, but there were also some studies on perceptions of patients and staff, case studies, and ethnographic studies. There was only one intervention study. There are differences in use between wards and institutions, which in part may be explained by differences in patient populations. Staff appear to be less negative to the use of restraint than patients. Conclusions. The studies that were identified were primarily concerned with rates of use and with patients’ and staff’s perspectives. More interventional studies are needed to move the field forward. Rolf Wynn Copyright © 2015 Rolf Wynn. All rights reserved. Acceptance and Avoidance Processes at Different Levels of Psychological Recovery from Enduring Mental Illness Tue, 20 Oct 2015 11:27:36 +0000 Objective. This study examined the use of psychological acceptance and experiential avoidance, two key concepts of Acceptance and Commitment Therapy (ACT), in the psychological recovery process of people with enduring mental illness. Method. Sixty-seven participants were recruited from the metropolitan, regional, and rural areas of New South Wales, Australia. They all presented some form of chronic mental illness (at least 12 months) as reflected in DSM-IV Axis I diagnostic criteria. The Acceptance and Action Questionnaire (AAQ-19) was used to measure the presence of psychological acceptance and experiential avoidance; the Recovery Assessment Scale (RAS) was used to examine the levels of psychological recovery; and the Scales of Psychological Well-Being was used to observe if there are benefits in utilizing psychological acceptance and experiential avoidance in the recovery process. Results. An analysis of objectively quantifiable measures found no clear correlation between the use of psychological acceptance and recovery in mental illness as measured by the RAS. The data, however, showed a relationship between psychological acceptance and some components of recovery, thereby demonstrating its possible value in the recovery process. Conclusion. The major contribution of this research was the emerging correlation that was observed between psychological acceptance and positive levels of psychological well-being among individuals with mental illness. Vinicius R. Siqueira and Lindsay G. Oades Copyright © 2015 Vinicius R. Siqueira and Lindsay G. Oades. All rights reserved. The Contribution of Alexithymia to Obsessive-Compulsive Disorder Symptoms Dimensions: An Investigation in a Large Community Sample in Italy Sun, 06 Sep 2015 12:17:44 +0000 Poor attention has been dedicated to the relation between Alexithymia and specific OCD symptoms dimensions. Knowledge about which Alexithymia domains are the most affected ones in OCD dimensions could inform clinical practice, suggesting the need for the introduction of psychotherapeutic interventions targeting Alexithymia deficits. The current study aimed to investigate which OCD symptom dimension correlated with Alexithymia domains. A total of 425 community individuals (mean age = 27.80, SD = 9.89, 60% women) completed measures of Alexithymia, OCD symptoms dimensions, anxiety, and depression. Moderate correlations emerged between Difficulty Identifying Feelings and Hoarding and Checking symptoms and between Difficulty Describing Feelings and Pure Obsessing . Difficulty Identifying Feelings uniquely predicted OCD symptoms , after controlling for anxiety and depression. A main effect emerged of Alexithymia on Ordering and Pure Obsessing symptoms . Psychotherapeutic interventions specifically targeting Alexithymia should be integrated in the treatment of Ordering and Pure Obsessing symptoms. Difficulty Identifying Feelings and Difficulty Describing Feelings should be addressed in the psychotherapeutic treatment of Hoarding, Checking, and Pure Obsessing, respectively. Andrea Pozza, Nicoletta Giaquinta, and Davide Dèttore Copyright © 2015 Andrea Pozza et al. All rights reserved. Prevalence and Factors Associated with Perceived Stigma among Patients with Epilepsy in Ethiopia Sun, 06 Sep 2015 12:16:34 +0000 Background. Epilepsy stigma is considered to be one of the most important factors that have a negative influence on people with epilepsy. Among all types of stigma perceived stigma further exerts stress and restricts normal participation in society. Methods. Hospital based cross-sectional study was conducted from May 1, 2013, to May 30, 2013. All patients with epilepsy in Ethiopia were source population. The sample size was determined using single population proportion formula and 347 subjects were selected by using systematic random sampling method. Data was analyzed by using SPSS version 20. Results. A total of 346 participants with mean age of 29.3 ± 8.5 SD participated with a response rate of 99.7%. The prevalence of perceived stigma was 31.2%. Age range between 18 and 24 [AOR = 2.84, 95%CI: 1.02, 7.92], difficulty to attend follow-up because of stigma [AOR = 3.15, 95%CI: 1.19, 8.34], seizure related injury [AOR = 1.88, 95%CI: 1.12, 3.15], and contagion belief [AOR = 1.88, 95%CI: 1.10, 5.08] were significantly associated with perceived stigma. Conclusions. Perceived stigma was found to be a common problem among patients suffering from epilepsy. The results reinforce the need for creating awareness among patients with epilepsy and addressing misconceptions attached to epilepsy. Tolesa Fanta, Telake Azale, Dawit Assefa, and Mekbit Getachew Copyright © 2015 Tolesa Fanta et al. All rights reserved. Do Panic Symptoms Affect the Quality of Life and Add to the Disability in Patients with Bronchial Asthma? Thu, 03 Sep 2015 14:20:47 +0000 Background. Anxiety and panic are known to be associated with bronchial asthma with variety of impact on clinical presentation, treatment outcome, comorbidities, quality of life, and functional disability in patients with asthma. This study aims to explore the pattern of panic symptoms, prevalence and severity of panic disorder (PD), quality of life, and disability in them. Methods. Sixty consecutive patients of bronchial asthma were interviewed using semistructured proforma, Panic and Agoraphobia scale, WHO Quality of life (QOL) BREF scale, and WHO disability schedule II (WHODAS II). Results. Though 60% of the participants had panic symptoms, only 46.7% had diagnosable panic attacks according to DSM IV TR diagnostic criteria and 33.3% had PD. Most common symptoms were “sensations of shortness of breath or smothering,” “feeling of choking,” and “fear of dying” found in 83.3% of the participants. 73.3% of the participants had poor quality of life which was most impaired in physical and environmental domains. 55% of the participants had disability score more than a mean (18.1). Conclusion. One-third of the participants had panic disorder with significant effect on physical and environmental domains of quality of life. Patients with more severe PD and bronchial asthma had more disability. A. D. Faye, S. Gawande, R. Tadke, V. C. Kirpekar, S. H. Bhave, A. P. Pakhare, and B. Tayade Copyright © 2015 A. D. Faye et al. All rights reserved. Comparative Prevalence of Eating Disorders in Obsessive-Compulsive Disorder and Other Anxiety Disorders Sun, 23 Aug 2015 11:41:11 +0000 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. Himanshu Tyagi, Rupal Patel, Fabienne Rughooputh, Hannah Abrahams, Andrew J. Watson, and Lynne Drummond Copyright © 2015 Himanshu Tyagi et al. All rights reserved. Near-Infrared Transcranial Radiation for Major Depressive Disorder: Proof of Concept Study Wed, 19 Aug 2015 11:58:57 +0000 Transcranial near-infrared radiation (NIR) is an innovative treatment for major depressive disorder (MDD), but clinical evidence for its efficacy is limited. Our objective was to investigate the tolerability and efficacy of NIR in patients with MDD. We conducted a proof of concept, prospective, double-blind, randomized study of 6 sessions of NIR versus sham treatment for patients with MDD, using a crossover design. Four patients with MDD with mean age 47 ± 14 (SD) years (1 woman and 3 men) were exposed to irradiance of 700 mW/cm2 and a fluence of 84 J/cm2 for a total NIR energy of 2.40 kJ delivered per session for 6 sessions. Baseline mean HAM-D17 scores decreased from 19.8 ± 4.4 (SD) to 13 ± 5.35 (SD) after treatment (; ; ). Patients tolerated the treatment well without any serious adverse events. These findings confirm and extend the preliminary data on NIR as a novel intervention for patients with MDD, but further clinical trials are needed to better understand the efficacy of this new treatment. This trial is registered with NCT01538199. Paolo Cassano, Cristina Cusin, David Mischoulon, Michael R. Hamblin, Luis De Taboada, Angela Pisoni, Trina Chang, Albert Yeung, Dawn F. Ionescu, Samuel R. Petrie, Andrew A. Nierenberg, Maurizio Fava, and Dan V. Iosifescu Copyright © 2015 Paolo Cassano et al. All rights reserved.