BMC Psychiatry最新文献

Background: Hazardous alcohol use frequently occurs among individuals with psychiatric disorders and may complicate clinical outcomes. However, there is limited evidence on its prevalence and associated factors in Sub-Saharan African psychiatric outpatient settings. This study aimed to estimate the prevalence of hazardous alcohol use and identify associated sociodemographic and clinical factors among patients receiving psychiatric care in Kinshasa, Democratic Republic of the Congo.

Methods: A cross-sectional analytical study was conducted at the Neuro-Psycho-Pathological Centre of Kinshasa over a period of 3 months (November 2023 to January 2024). Adults (≥ 18 years) with a documented psychiatric diagnosis attending outpatient follow-up were consecutively recruited. Data were collected via a structured questionnaire including the French version of the Alcohol Use Disorders Identification Test (AUDIT). Hazardous alcohol use was defined as an AUDIT score ≥ 10. Univariate logistic regression was used to screen variables; those with p-value < 0.20 entered a multivariate logistic regression model (forward stepwise). Multicollinearity was assessed (VIF < 2). Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) and p-values were reported.

Results: Of 204 participants, 190 (94.1%) reported regular alcohol consumption, and 121 (59.3%) met the threshold for hazardous alcohol use. In multivariate analysis, three variables were independently associated with hazardous alcohol use: increased alcohol consumption during the acute phase of psychiatric illness (aOR 5.21; 95% CI 2.40-11.34; p < 0.001), being in paid employment (aOR 2.28; 95% CI 1.01-5.14; p = 0.048), and having experienced a change or cessation of professional activity due to illness (aOR 2.15; 95% CI 1.02-4.52; p = 0.043).

Conclusions: More than half of psychiatric outpatients in Kinshasa exhibited hazardous alcohol use. Elevated consumption during symptomatic episodes, employment status, and occupational disruption were key correlates. These findings underscore the need for routine alcohol use screening and integrated psychosocial interventions in psychiatric services in low-resource settings.

Objectives: To examine the prevalence of comorbidities and the use of psychiatric comedication among individuals in medical treatment for attention deficit hyperactivity disorder (ADHD), in comparison to a matched control group from the general population.

Methods: This nationwide case-control study included 1,082,378 Danish individuals aged 7-64 of whom 98,398 had at least one prescription of ADHD medication during 2023. Data was collected over an observation period spanning from 2013 to 2023. Cases were matched to controls (1:10) from the general population on birth year and sex. Data were obtained and accessed through The Danish Health Data Authority. Associations were estimated using conditional logistic regression models.

Results: Somatic and particularly psychiatric comorbidities were more common among individuals in ADHD treatment across all age groups. Among those in ADHD treatment 46.7% had at least one comorbidity compared to 23.3% in the control group. The use of psychiatric comedications (besides ADHD medication) was likewise more common among individuals in ADHD treatment (32.7%) compared to the controls (7.2%). The association estimates from conditional logistic regression revealed a higher likelihood of somatic and psychiatric comorbidities among those in ADHD treatment in all age groups. Females in ADHD treatment had 4.48-4.50 times higher odds of comorbidities compared to females not in ADHD treatment (OR_{7 - 17 years} = 4.48, 95% CI: 4.27-4.70; OR_{18 - 29 years} = 4.50, 95% CI: 4.37-4.64). Similar patterns were observed for males but with slightly lower ORs (OR_{7 - 17 years} = 2.35, 95% CI: 2.27-2.44; OR_{18 - 29 years} = 3.38, 95% CI: 3.28-3.50).

Conclusion: This study reveals that both prevalence of somatic and psychiatric comorbidities and the use of psychiatric comedication are significantly higher among individuals in ADHD treatment. The highest occurrence is seemingly among females aged 7-17 year and 18-29 years. The coexistence of ADHD with other somatic and psychiatric conditions can constitute a more complex disease burden, necessitating enhanced disease management strategies to reduce complications and enhance quality of life. Longitudinal studies are needed to confirm the temporal association of these results.

Background: Relatives' expressed emotions (EE) and caregiving appraisals are associated with the prognosis of individuals with psychotic disorders as well as relatives' own well-being. The main aim of the present study was to examine whether sociodemographic factors, patients' clinical characteristics, relatives' health and quality of life (QoL), and relatives' perceived support explained a significant amount of the variance in expressed emotion (EE) and caregiving appraisals among relatives of patients with psychotic disorders.

Methods: Baseline data from The Implementation of guidelines on Family Involvement for persons with Psychotic disorders (IFIP) trial were compiled from 231 patient-relative pairs across 15 Community Mental Health Centres (CMHC). Relatives completed assessments on EE; emotional overinvolvement (EOI) and critical comments (CC) (Family Questionnaire), negative and positive caregiving appraisals (Experience of Caregiving Inventory), health and QoL (Care Related Quality of Life), healthcare professional support (Caregiver Well-being and Support) and sociodemographic factors. Patients reported on their own difficulties with mental health and functioning (Behavior and Symptom Identification scale) while clinicians assessed patients' functioning (Global Assessment of Functioning) and sociodemographic factors. Pearson and Spearman correlations and hierarchical multiple linear regressions were used for statistical analyses.

Results: Duration since first psychosis diagnosis, patients' mental health and functioning, and relatives' health problems explained a substantial proportion of variance in relatives' EOI and negative caregiving appraisals. Together with household income level, duration since first psychosis diagnosis explained a significant amount of the variance in positive caregiving appraisals. Relatives' perceived support from healthcare professionals explained a significant amount of the variance in CC and negative caregiving appraisals, even after adjusting for contextual variables.

Conclusion: Psychotic disorders entail significant burdens and shape the family climate for both patients and their relatives. Negative caregiving appraisals and EOI may reflect normal reactions to the responsibilities and challenges relatives face. EOI and CC, however, may be associated with distinct factors, necessitating tailored psychoeducational and support interventions. The findings suggest that relatives' perceived support from healthcare professionals could have a substantial positive impact on CC and negative caregiving appraisals, which is important for clinicians to recognise and address.