1
|
Basu S, Maheshwari V, Sodhi B, Mannan P, Kukreti P. The prevalence of depression, determinants, and linkage with functional disability amongst postmenopausal women in India: Evidence from the Longitudinal Ageing Study in India. Asian J Psychiatr 2024; 96:104030. [PMID: 38598934 DOI: 10.1016/j.ajp.2024.104030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND The study objective was estimating the prevalence and determinants of depression amongst postmenopausal women in India. Additionally, we used panel mediation analysis to model the extent to which multimorbidity was associated with depression after adjusting for the effects of functional disability in the participants. METHODS Data from 28,160 women aged 50 and above from the Longitudinal Aging Study in India (LASI) Wave 1 were analyzed. Depression was assessed using the Composite International Diagnostic Interview-Short Form (CIDI-SF), with multimorbidity and functional disability (ADL and IADL) considered as key predictor variables. Logistic regression and Karlson-Holm-Breen (KHB) mediation analysis were employed. RESULTS The weighted prevalence of depression among women aged ≥ 50 years was 21.76% (95% CI: 20.81, 22.73), significantly higher women aged < 50 years (17.60%, 95% CI: 16.33, 18.94). Factors independently associated with increased odds of depression included being unmarried, rural residence, and multimorbidity, while higher educational status was associated with lower odds of depression. The relationship between multimorbidity and depression was partially mediated by ADL and IADL disabilities. Notable regional (state) variations in the magnitude of depression were observed. CONCLUSIONS Nearly one in five postmenopausal women in India aged 50 years and older have clinical depression. Community screening for reaching the unreached with primary care mental health strengthening need enhanced policy focus.
Collapse
Affiliation(s)
- Saurav Basu
- Indian Institute of Public Health - Delhi, Public Health Foundation of India (PHFI), India
| | - Vansh Maheshwari
- Indian Institute of Public Health - Delhi, Public Health Foundation of India (PHFI), India
| | - Baani Sodhi
- Indian Institute of Public Health - Delhi, Public Health Foundation of India (PHFI), India
| | - Pallak Mannan
- Indian Institute of Public Health - Delhi, Public Health Foundation of India (PHFI), India
| | | |
Collapse
|
2
|
Chen HH, Wu PY, Lin CH, Wu CL, Chao WC. Factors associated with mental illness in patients with rheumatoid arthritis initiating b/ts DMARDs: A population-based study. Int J Rheum Dis 2024; 27:e14992. [PMID: 38061767 DOI: 10.1111/1756-185x.14992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/09/2023] [Accepted: 11/23/2023] [Indexed: 01/31/2024]
Abstract
AIM Mental health is an essential issue in patients with rheumatoid arthritis (RA) but remains unclear among those receiving biological and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs). We aim to assess the incidence and factors associated with mental illness among patients with RA who underwent b/tsDMARD therapy. METHOD We used Taiwan's National Health Insurance Research Database for the period 2001-2020 to identify patients with RA receiving b/tsDMARDs. The primary outcome was newly developed mental illness, including anxiety and mood disorders. We performed a Cox regression analysis to determine factors associated with mental illness and presented as hazard ratios (HR) with 95% confidence interval (CI). RESULTS We enrolled 10 852 patients, with 7854 patients receiving tumor necrosis factors inhibitors (TNFi), 1693 patients receiving non-TNFi bDMARDs, and 1305 patients treated with tsDMARD. We found that 13.62% of enrolled patients developed mental illness, with an incidence rate of 4054 per 100 000 person-year. Those receiving tocilizumab (aHR 0.64, 95% CI: 0.51-0.82), abatacept (aHR 0.69, 95% CI: 0.55-0.86), or tsDMARDs (aHR 0.58, 95% CI: 0.47-0.73) had a lower risk of mental illness compared with those receiving TNFi. We also found that old age, low income, diabetes mellitus, use of cyclosporine, and use of steroids were associated with incident mental illness. CONCLUSION This population-based study investigated the incidence and factors associated with mental illness among patients with RA receiving b/tsDMARDs. Our findings highlight the need for vigilance with respect to the possibility of mental illness in patients with RA.
Collapse
Affiliation(s)
- Hsin-Hua Chen
- Division of General Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Institute of Biomedical Science and Rong Hsing Research Centre for Translational Medicine, Chung Hsing University, Taichung, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Big Data Center, Chung Hsing University, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung, Taiwan
| | - Peng-Yen Wu
- Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ching-Heng Lin
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung, Taiwan
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Healthcare Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
- Department of Public Health, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Chieh-Liang Wu
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung, Taiwan
- Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Wen-Cheng Chao
- Big Data Center, Chung Hsing University, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| |
Collapse
|
3
|
Haghparast Z, Riazi H, Shams J, Montazeri A. Couple Burnout and Partner's Substance-Dependency: Is there any Association? Health Serv Res Manag Epidemiol 2023; 10:23333928221144445. [PMID: 36760678 PMCID: PMC9905033 DOI: 10.1177/23333928221144445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
Objectives Substance-dependency is a significant health problem that might affect couples' relationships and lead to several complications such as burnout. This study aimed to assess and compare couple burnout in women with and without substance-dependent partners. Methods In this cross-sectional study samples of women with and without substance-dependent partners were studied. Couple burnout was assessed using the Couple Burnout Measure (CBM). The data then were compared between the study groups by performing descriptive statistics, independent t-test, and chi-square. Logistic regression analysis was carried out to examine the association between couple burnout and independent variables. Results In all 264 women with (n = 121) and without (n = 143) substance-dependent partners were studied. Couple burnout was assessed using the Couple Burnout Measure (CBM). There were significant differences between both groups in most characteristics. The mean score of couple burnout in women with and without substance-dependent partners were 3.8 ± 1.2 and 2.6 ± 0.85 respectively (p < 0.001). In logistic regression analysis, the probability of couple burnout in women with substance-dependent partners was 4.5 times more than those without substance-dependent partners (OR = 4.50, CI = 2.48-8.17, p < 0.001). Conclusion The findings showed that women with substance-dependent partners might suffer from higher couple burnout. Indeed, implementing appropriate interventions such as educational and counseling programs in health centers and substance abuse treatment centers is recommended. In fact, the current study highlights the extra burden that women with substance-dependent partners experience.
Collapse
Affiliation(s)
- Zeinab Haghparast
- Department of Midwifery and Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hedyeh Riazi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Hedyeh Riazi, Department of Midwifery and Reproductive Health, Shahid Beheshti University of Medical Sciences, ValiAsr Ave., Cross of Niayesh Highway and ValiAsr, Tehran, Iran.
| | - Jamal Shams
- Behavioral Science Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Montazeri
- Population Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran,Faculty of Humanity Sciences, University of Sciences and Culture, Tehran, Iran
| |
Collapse
|
4
|
Real-World Evidence for the Association between Heat-Related Illness and the Risk of Psychiatric Disorders in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138087. [PMID: 35805746 PMCID: PMC9265553 DOI: 10.3390/ijerph19138087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/27/2022] [Accepted: 06/30/2022] [Indexed: 01/15/2023]
Abstract
This study aimed to investigate the association between the heat-related illness (HRI) and the risk of developing psychiatric disorders. From 2000 to 2015, there were 3126 patients with newly diagnosed HRI selected from the National Health Insurance Research Database, along with 31,260 controls matched for gender and age. Fine and Gray’s analysis was used to compare the risk of psychiatric disorders during the 16 years of follow-up. Among the subjects, 523 of the HRI patients and 3619 of the control group (1774.18 vs. 1193.78 per 100,000 person-years) developed psychiatric disorders. Compared with non-HRI patients, the HRI ones had a 3.849-fold risk of being attacked by psychiatric disorders (95% CI: 3.632−4.369, p < 0.001) after adjusting for potential confounders. The sensitivity analysis revealed that the relationship between the HRI and the listed psychiatric disorders was determined by the exclusion of the first-year psychiatric events after the HRI. In spite of deleting the psychiatric diagnoses of the first five years, the HRI was still correlated with the development of psychiatric disorders with the exception of schizophreniform disorders, posttraumatic stress disorders, and acute stress disorder. Therefore, our findings concluded that the HRI could be a potential influence on the increased hazard of psychiatric disorders.
Collapse
|
5
|
Chao PC, Chien WC, Chung CH, Huang CK, Li HM, Tzeng NS. Association Between Antibiotic Treatment of Leptospirosis Infections and Reduced Risk of Dementia: A Nationwide, Cohort Study in Taiwan. Front Aging Neurosci 2022; 14:771486. [PMID: 35401144 PMCID: PMC8985874 DOI: 10.3389/fnagi.2022.771486] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 02/14/2022] [Indexed: 01/01/2023] Open
Abstract
Background To explore the association between leptospirosis, the risk of dementia, and the potential protective role of antibiotic treatment. Methods We conducted a retrospective cohort nationwide, population-based study, from Taiwan’s National Health Insurance Research Database (NHIRD). We enrolled 1,428 subjects aged 50 years or above, in the index year of 2000, which included those retrieved from the NHIRD record. Dementia diagnosis and incidence over 16 years follow-up was retrieved from the NHIRD records. The Fine and Gray survival analysis was used to determine the risk of dementia, and the results were presented as a sub-distribution hazard ratio (SHR) with a 95% confidence interval. Results In the study period, 43 of the 357 leptospirosis patients developed dementia, as compared to 103 of the control group (930.90 vs. 732.49 per 105 person-years). By the Fine and Gray survival analysis, the leptospirosis was associated with the risk of dementia, and the adjusted SHR was 1.357 (95% confidence interval [CI]: 1.213–1.519, P < 0.001), across 16-year of the follow-up period. To exclude the protopathic bias, the sensitivity analysis was conducted. This analysis revealed that the leptospirosis was associated with the increased risk of dementia, even after excluding the dementia diagnosis within the first year (adjusted SHR = 1.246, 95%CI: 1.114–1.395, P < 0.001) or within the first 5 years (adjusted SHR = 1.079, 95%CI: 1.023–1.152, P = 0.028), antibiotic treatment for leptospirosis was associated with the reduced risk of dementia (P = 0.001). Conclusion Leptospirosis was associated with an increased risk for dementia, and antibiotic treatment was associated with a reduced risk. Further research will be necessary to explore the underlying mechanisms of this association.
Collapse
Affiliation(s)
- Pei-Chun Chao
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
| | - Chih-Kang Huang
- Department of Emergency Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Hao-Ming Li
- Department of General Surgery, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
- *Correspondence: Nian-Sheng Tzeng,
| |
Collapse
|
6
|
Afshari R, Kaveh MH, Lankarani KB, Doolub D, Jaafari N, Ostovarfar J. Empowering teachers to screen, guide, and refer schoolchildren with behavioral and mental health problems. A pilot study to promote mental health in Iran. Front Psychiatry 2022; 13:894483. [PMID: 35990076 PMCID: PMC9385954 DOI: 10.3389/fpsyt.2022.894483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/04/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Schools are ideal for promoting the mental health of school-age children, but the teachers' current knowledge is insufficient to play an influential role in mental health services at schools. Fortunately, however, teachers have a high sense of responsibility, interest, and talent to receive knowledge and the ability to participate in this field. This study aimed to examine whether a protocol focused on the role of teachers could identify, guide, and care for school-age children with behavioral and mental health problems. METHOD The current research was a "before and after" pilot quasi-experimental study conducted in three elementary, secondary, and high schools. The main intervention consisted of a 5-h workshop based on a ready-to-use booklet for teachers conducted separately in each school. A total of 58 teachers and 872 school-age children were included using a judgmental sampling technique. RESULTS The pre-and post-workshop mean scores of teachers' knowledge about common mental disorders in school-age children were 6.21 ± 4.58 and 12.50 ± 7.27, respectively. According to the Strengths and Difficulties Questionnaire (SDQ), the teachers made 127 referrals, of whom 102 school-age children had problems. Consultants diagnosed 114 school children who reflected 90% of all teachers' recommendations needing psychological care and counseling. Finally, only 50 diagnosed school-age children were followed up and attended therapy sessions at counseling centers. The sensitivity and specificity of this brief intervention in detecting school-age children with psychological problems were respectively 80.3 and 98.0%. CONCLUSIONS This study's results support teacher empowerment training's effectiveness in identifying and guiding school-age children needing mental health care. Psychological counseling programs in schools in various quantitative and qualitative dimensions, including responding to school-age children's needs and psychological problems, should be adequately evaluated, and appropriate measures should be taken to promote mental health services. Collaboration between health systems and the education department will increase the effectiveness of mental health programs' promotion and drug abuse prevention. These pilot data lead the way to designing scientifically sound follow-up studies that will concretely ascertain the benefit of this program.
Collapse
Affiliation(s)
- Ramin Afshari
- Research Center of Social Harms and Substance abuse, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hossein Kaveh
- Research Center for Health Sciences, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran Bagheri Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Damien Doolub
- Research Center on Cognition and Learning, CeRCA, CNRS UMR, University of Poitiers, University of Tours, Poitiers, France.,Pierre Deniker Clinical Research Unit, Henri Laborit Hospital Centre, Poitiers, France
| | - Nematollah Jaafari
- Pierre Deniker Clinical Research Unit, Henri Laborit Hospital Centre, Poitiers, France.,Faculty of Medicine and Pharmacy, University of Poitiers, Poitiers, France
| | - Jeyran Ostovarfar
- Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
7
|
Spencer LP, Addison M, Alderson H, McGovern W, McGovern R, Kaner E, O'Donnell A. 'The Drugs Did For Me What I Couldn't Do For Myself': A Qualitative Exploration of the Relationship Between Mental Health and Amphetamine-Type Stimulant (ATS) Use. Subst Abuse 2021; 15:11782218211060852. [PMID: 34898985 PMCID: PMC8655440 DOI: 10.1177/11782218211060852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 10/27/2021] [Indexed: 12/11/2022]
Abstract
Substance use and mental ill health constitute a major public health burden, and a key global policy priority is to reduce illicit and other harmful substance use. Amphetamine-type stimulants (ATS) are the second most used class of illicit drugs and a range of mental health issues have been documented amongst users. This paper explores the relationship between mental health and ATS use, through a thematic analysis of qualitative interviews with n = 18 current and former ATS users in England. The findings are presented by trajectory point of; (1) Initiation of ATS use; (2) continued and increased ATS use and (3) decreased and remitted ATS use. This work helps to develop understanding around the complex and bi-directional relationship between ATS use and mental health. Many ATS users lead chaotic lives and engage in multiple risk behaviours, however there is a need to better understand and conceptualise the dynamic interaction between different individual, social, environment and cultural factors that determine individuals’ mental health and substance use. There is no ‘one size fits all’ approach to prevention and treatment, and these findings highlight the need for more joined-up, tailored and holistic approaches to intervention development.
Collapse
Affiliation(s)
- Liam Patrick Spencer
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | | | - Hayley Alderson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - William McGovern
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK
| | - Ruth McGovern
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Eileen Kaner
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Amy O'Donnell
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| |
Collapse
|
8
|
Ramsewak S, Putteeraj M, Somanah J. Exploring substance use disorders and relapse in Mauritian male addicts. Heliyon 2020; 6:e04731. [PMID: 32904255 PMCID: PMC7452487 DOI: 10.1016/j.heliyon.2020.e04731] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 07/03/2020] [Accepted: 08/12/2020] [Indexed: 11/23/2022] Open
Abstract
Background Substance Use Disorder (SUD) places a heavy burden on societal and health systems given its association with high mortality and morbidity rates worldwide, including Mauritius. Illicit substances act as a positive reinforcement and stimulate addiction through its pleasure-seeking attributes. Aim This study focused on identifying the risk factors leading to SUD among Mauritian male addicts as well as examining the potency of those factors in SUD development. The study also aimed at determining the prevalence of relapse and its causation. Research setting A cross-sectional study was conducted over a period of six months using a sample of 180 male addicts registered in a public hospital. A questionnaire investigating dimensions such as risk factors, self-esteem and peer pressure was administered. Findings A high percentage of relapse was noted amongst users within the first year of abstinence. Majority of respondents originated from nuclear or single parents’ family and were deprived of adequate social supports given their marital status. 57.5% of participants had a positive family history of SUD. Cannabis was the most commonly abused substance and 76.2% of the addicts were introduced to drugs through curiosity. Transposing the results against the Gateway Drug Theory showed a constant progression from soft to hard drugs for male addicts, a trend which was consistent with literature. Lastly, a theoretical model was developed based on the strong statistical association found between impulsivity and reduced thought processes prior to relapse; data revealing increased impulsivity which is a common trait in antisocial personality disorder and borderline personality disorder as being largely responsible for relapse. Conclusion The study was successful in bringing out the most common risk factors of SUDs which are linked to low socioeconomic status. The inability of addicts to progress with their rehabilitation given the alarming 92% of relapse was related to social pressure as prime deterrent to successful remission. Programmes involving relapse prevention must implemented in the first year of abstinence to facilitate rehabilitation.
Collapse
Affiliation(s)
- Shalina Ramsewak
- Psychiatry Department, Dr A.G. Jeetoo Hospital, Port-Louis, Mauritius
| | - Manish Putteeraj
- School of Health Sciences, La Tour Koeing, Point aux Sables, 11108, University of Technology, Mauritius
- Corresponding author.
| | - Jhoti Somanah
- School of Health Sciences, La Tour Koeing, Point aux Sables, 11108, University of Technology, Mauritius
| |
Collapse
|
9
|
Wan FJ, Chien WC, Chung CH, Yang YJ, Tzeng NS. Association between traumatic spinal cord injury and affective and other psychiatric disorders-A nationwide cohort study and effects of rehabilitation therapies. J Affect Disord 2020; 265:381-388. [PMID: 32090763 DOI: 10.1016/j.jad.2020.01.063] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 01/06/2020] [Accepted: 01/14/2020] [Indexed: 02/09/2023]
Abstract
BACKGROUND This study aimed to investigate the association between traumatic spinal cord injury (TSCI) and the risk of affective and other psychiatric disorders, and the role of the rehabilitation therapies. METHODS In this population-based, retrospective cohort study, we used Taiwan's National Health Insurance Research Database to analyze the patients who were newly diagnosed with TSCI between 2000 and 2015 were included, with a 1:3 ratio by age, sex, and index year matched in the non-TSCI comparison group, for the risk of affective and other psychiatric disorders. RESULTS In total, 5375 out of 16,151 patients with TSCI developed psychiatric disorders, and 1467 out of 48,543 patients in the non-TSCI group developed psychiatric disorders (2930.88 vs 2823.29 per 100,000 persons/year). The Kaplan-Meier analysis showed that the TSCI cohort had a significantly higher risk of psychiatric disorders (log-rank, p < 0.001). Fine and Gray's survival analysis revealed that the adjusted hazard ratio was 1.977 (95% CI: 1.914-2.042, p < 0.001). Rehabilitation therapies, including physical and occupational therapies, within 90 days after the injury, was associated with a lowered risk of psychiatric disorders, including anxiety, depression, and bipolar disorder, in the TSCI cohort (adjusted HR = 0.702 [95% CI: 0.661-0.746, p < 0.001]). In the subgroups with low, medium, and high intensity, rehabilitation therapies were associated with a lowered risk of psychiatric disorders. CONCLUSIONS TSCI was associated with the risk of affective and other psychiatric disorders, and rehabilitation therapies were associated with a lowered risk of these in the TSCI cohort.
Collapse
Affiliation(s)
- Fang-Jung Wan
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC; School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC; Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC; School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC; Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan, ROC
| | - Yun-Ju Yang
- Department of Neurological Surgery, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC; Student Counseling Center, National Defense Medical Center, Taipei, Taiwan, ROC.
| |
Collapse
|
10
|
Abstract
Mothers have used opioids for thousands of years but neonatal abstinence syndrome (NAS) or rather, survivors of NAS, is a modern phenomenon. Unrecognized and/or untreated opioid withdrawal was almost always fatal but with greater awareness and standardization of treatment, NAS is now an uncommon direct cause of infant death. However, opioids are now increasingly accessible and potent and the outcomes of children after the neonatal period are of great concern, especially when coupled with multiple other social and health risks. Complex individual, environmental and genetic factors need to be considered when assessing outcomes or future research for babies with NAS. Any intervention or research efforts must address these multifactorial complexities. This review will discuss pertinent post neonatal outcomes, including mortality, physical and mental health and social functioning of children with a history of NAS.
Collapse
Affiliation(s)
- Ju Lee Oei
- Department of Newborn Care, The Royal Hospital for Women, Barker Street, Randwick, NSW, 2031, Australia; School of Women's and Children's Health, University of New South Wales, High Street, Randwick, NSW, 2031, Australia; Drug and Alcohol Services, Murrumbidgee Local Health District, Wagga Wagga, NSW, 2650, Australia.
| |
Collapse
|