Termination of Pregnancy and Psychiatric Morbidity

1995 ◽  
Vol 167 (2) ◽  
pp. 243-248 ◽  
Author(s):  
Anne C. Gilchrist ◽  
Philip C. Hannaford ◽  
Peter Frank ◽  
Clifford R. Kay
Keyword(s):  
Social Factors ◽  
Psychiatric Illness ◽  
Unplanned Pregnancy ◽  
Psychiatric Morbidity ◽  
Previous History ◽  
Termination Of Pregnancy ◽  
Factors Associated ◽  
Confounding Variables ◽  
History Of ◽  
Self Harm

BackgroundWe investigated whether reported psychiatric morbidity was increased after termination of pregnancy compared with other outcomes of an unplanned pregnancy.MethodThis was a prospective cohort study of 13 261 women with an unplanned pregnancy. Psychiatric morbidity reported by GPs after the conclusion of the pregnancy was compared in four groups: women who had a termination of pregnancy (6410), women who did not request a termination (6151), women who were refused a termination (379), and women who changed their minds before the termination was performed (321).ResultsRates of total reported psychiatric disorder were no higher after termination of pregnancy than after childbirth. Women with a previous history of psychiatric illness were most at risk of disorder after the end of their pregnancy, whatever its outcome. Women without a previous history of psychosis had an apparently lower risk of psychosis after termination than postpartum (relative risk RR = 0.4, 95% confidence interval CI = 0.3–0.7), but rates of psychosis leading to hospital admission were similar. In women with no previous history of psychiatric illness, deliberate self-harm (DSH) was more common in those who had a termination (RR 1.7, 95%CI 1.1–2.6), or who were refused a termination (RR 2.9, 95%CI 1.3–6.3).ConclusionsThe findings on DSH are probably explicable by confounding variables, such as adverse social factors, associated both with the request for termination and with subsequent self-harm. No overall increase in reported psychiatric morbidity was found.

scholarly journals Factors of psychiatric morbidity during perinatal period

2018 ◽  
Vol 29 (2) ◽  
pp. 53-58
Author(s):  
Shahana Parveen ◽  
Mohammad Akteruzzaman ◽  
Mohammad Muntasir Maruf ◽  
Sumiya Akhter ◽  
Sadya Tarannum
Keyword(s):  
Psychiatric Disorders ◽  
Family Environment ◽  
Psychiatric Illness ◽  
Psychiatric Morbidity ◽  
Positive Family History ◽  
Previous History ◽  
Perinatal Period ◽  
Psychiatric Evaluation ◽  
History Of ◽  
Axis I

The presence of psychiatric disorders during perinatal period imposes negative and long-term effect on maternal health and child development as well as normal family environment. The purpose of our study was to investigate the socio-demographic factors associated with psychiatric morbidity during perinatal period. It was a descriptive cross-sectional study conducted among purposively selected 197 perinatal women attending the Obstetrics & Gynaecology Outpatient Department (OPD) of Bangabandhu Sheikh Mujib Medical University and Dhaka Medical College Hospital, Dhaka from August 2012 to July 2013. Data were collected through face-to-face interview by administering a semistructured questionnaire, containing socio-demographic and other variables and translated Bangla version of Structured Clinical Interview for DSM-IV Axis-I Disorders – Clinician Version (SCID-CV). Majority (79.7%) of the women were included in the age group of 20-34 years. The mean (±SD) age of the respondents were calculated as 24.60 (±4.88) years. Rural habitat was predominant (53.6%). A good number (5.1%) of respondents with psychiatric disorders had positive family history of psychiatric illness which was found statistically significant. Majority (7.6%) of the respondents with psychiatric disorders had previous history of psychiatric illness. Women in perinatal period with the risk factors for developing psychiatric disorders need proper psychiatric evaluation to prevent and treat perinatal mental illness.Bang J Psychiatry December 2015; 29(2): 53-58

Which Neurotic Patients Do Psychiatrists Treat?

1988 ◽  
Vol 152 (2) ◽  
pp. 222-228 ◽  
Author(s):  
John M. Eagles ◽  
David A. Alexander
Keyword(s):  
Alcohol Abuse ◽  
Short Duration ◽  
Psychiatric Treatment ◽  
Deliberate Self Harm ◽  
Factors Associated ◽  
Main Hospital ◽  
Duration Of Illness ◽  
History Of ◽  
Self Harm

Of 336 newly referred neurotic patients, 80 were not offered continuing psychiatric treatment. The factors associated with patients' not being offered continuing treatment were: short duration of illness; history of alcohol abuse and/or deliberate self-harm; age over 50 years; being widowed; and living more than 20 miles from the main hospital complex. The implications of these findings are discussed.

The Expression of Schizophrenia, Affective Disorder and Vulnerability to Tardive Dyskinesia in an Extensive Pedigree

1988 ◽  
Vol 153 (3) ◽  
pp. 376-381 ◽  
Author(s):  
John L. Waddington ◽  
Hanafy A. Youssef
Keyword(s):  
Family History ◽  
Tardive Dyskinesia ◽  
Movement Disorder ◽  
Affective Disorder ◽  
Psychiatric Illness ◽  
Late Onset ◽  
Psychiatric Morbidity ◽  
Neuroleptic Treatment ◽  
History Of

The demography, psychiatric morbidity, and motor consequences of long-term neuroleptic treatment in the 14 children born to a father with a family history of chronic psychiatric illness and a mother with a late-onset affective disorder resulting in suicide are documented. Twelve siblings lived to adulthood, nine of whom were admitted to a psychiatric hospital in their second or third decade, and required continuous in-patient care; five remaining in hospital, with long-term exposure to neuroleptics, had chroniC., deteriorating, schizophrenic illness and emergence of movement disorder. Two siblings showed no evidence of psychosis but developed a late-onset affective disorder. The implications for the issues of homotypia, vulnerability to involuntary movements, and interaction with affective disorder are discussed.

Attempted suicide in west London, II. Inter-group comparisons

1999 ◽  
Vol 29 (5) ◽  
pp. 1131-1139 ◽  
Author(s):  
D. BHUGRA ◽  
D. S. BALDWIN ◽  
M. DESAI ◽  
K. S. JACOB
Keyword(s):  
Social Factors ◽  
Social Stress ◽  
Attempted Suicide ◽  
Asian Women ◽  
Culture Conflict ◽  
Deliberate Self Harm ◽  
The United Kingdom ◽  
History Of ◽  
Self Harm ◽  
Group Comparisons

Background. Previous studies of attempted suicide have suggested that cultural and social factors play a significant role in the causation of deliberate self-harm.Method. In order to measure elements of culture conflict two inter-group comparisons were undertaken. In the first, 27 Asian women who had presented to hospital services following attempted suicide (Asian group) were matched with a group of similar age Asian women attending GP surgeries for other reasons (Asian GP attenders group). The second comparison was between the Asian and 46 White attempters.Results. On comparing Asian attempters with Asian GP attenders group the former were more likely to have a history of previous suicidal behaviour, to have a psychiatric diagnosis, and be unemployed. Their parents were more likely to have arrived in the United Kingdom at an older age. In addition, those who attempted suicide were more likely to have been in an inter-racial relationship and to have changed religions. In the second inter-group comparison, the characteristics of Asian and White suicide attempt patients were examined. White attempters were more likely to have mental illness, and were more likely to use alcohol as part of the method of attempted suicide. By contrast, Asian attempters had experienced life events pertaining to relationships, took fewer tablets and yet expressed greater regret at not succeeding in the attempt.Conclusions. Although numbers are small, social stress and other cultural factors play an important role in the act of deliberate self-harm.

scholarly journals Characteristics of Individuals with Self-Harm: A Retrospective Descriptive Study from Karachi, Pakistan

2021 ◽  
Author(s):  
Ambreen Tharani ◽  
Salima Farooq ◽  
Maryam Ali ◽  
Uroosa Talib ◽  
Murad Moosa Khan
Keyword(s):  
Psychiatric Illness ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Descriptive Study ◽  
Global Public Health ◽  
Over The Counter ◽  
Prevention Programmes ◽  
History Of ◽  
Self Harm ◽  
Global Public Health Problem

Abstract Background: Self-Harm (SH) is a major global public health problem which is under-researched in Pakistan. A prior act of self-harm is one of the strongest predictors of future suicide.Method: This retrospective descriptive study describes the characteristics of SH cases (n=350) that presented to a tertiary care teaching hospital in Karachi, Pakistan, from January 2013 to December 2017. Details related to demography, history, associated factors, access to methods used, and intent to die were collected on a structured proforma and analysed using STATA version 14. Results: It was found that self-harm acts were twice as more common in females than in males. More than half of the reported cases were in the age group 20-39 years. Drug overdose and use of insecticides were the two most common methods used in both genders. Depression was identified in nearly half of the reported SH cases. Intention to die was found to be 3 times greater among patients with psychiatric illness as compared to those with no history of psychiatric illness. Conclusion: This study suggests that limiting access to lethal means, regulating over-the-counter sale of medications, and safe storage of pesticides can possibly serve as effective measures to minimize self-harm incidences. Moreover, integration of suicide assessment and prevention programmes for the general population is also suggested.

scholarly journals Problem-Based Review: Paracetamol Overdose

2011 ◽  
Vol 10 (4) ◽  
pp. 212-215
Author(s):  
Tom Heaps ◽  
Keyword(s):  
Emergency Department ◽  
Glasgow Coma Scale ◽  
Past History ◽  
Previous History ◽  
Past Medical History ◽  
Minute Period ◽  
Normal Diameter ◽  
History Of ◽  
Self Harm ◽  
History Of Depression

A 29-year old male presents to the emergency department 1h after an overdose of cocodamol. He admits to taking approximately 60 x 8/500mg tablets, with alcohol, over a 20 minute period. He has a past history of depression, treated by his GP with citalopram 20mg OD. He has no previous history of deliberate self-harm. His past medical history is otherwise unremarkable and he is not on any additional medications. He drinks approximately 40 units of alcohol per week. Physical examination is unremarkable, his pupils are normal diameter and his Glasgow Coma Scale is 15. He weighs 82kg.

scholarly journals The long-term impact of vaginal surgical mesh devices in UK primary care: a cohort study in the CPRD

2021 ◽  
Author(s):  
Emily McFadden ◽  
Sarah Lay-Flurrie ◽  
Constantinos Koshiaris ◽  
Georgia C Richards ◽  
Carl Heneghan
Keyword(s):  
Cohort Study ◽  
Sexual Dysfunction ◽  
Surgical Mesh ◽  
Previous History ◽  
Antibiotic Use ◽  
Opioid Use ◽  
Mesh Surgery ◽  
History Of ◽  
Self Harm

Objective: Stress urinary incontinence (SUI) and pelvic organ prolapse (POP) are treated with surgical mesh devices; evidence of their long-term complications is lacking. To examine long-term complications in women with SUI and/or POP, with and without surgical mesh implants. Design: Longitudinal open cohort study from April 01 2006 to November 30 2018 Setting: The Clinical Practice Research Datalink (CPRD) Gold database, linked to Hospital Episodes Statistics (HES) inpatient data, Office for National Statistics mortality data, and Index of Multiple Deprivation socioeconomic status data. Participants: Women aged ≥18 years with a diagnostic SUI/POP code. Exposure: Mesh surgery coded in HES or CPRD data, compared to no mesh surgery. Main Outcomes measures: Rates of diagnoses of depression, anxiety or self-harm (composite measure) and sexual dysfunction, using Cox proportional hazards regression, and rates of prescriptions for antibiotics and opioids, using negative binomial regression. Results: There were 220,544 women eligible for inclusion; 74% (n=162,687) had SUI, 37% (n=82,123) had POP and 11% (n=24,266) had both. Women undergoing mesh surgery for SUI or POP had higher rates of antibiotic use (SUI: IRR 1.15 (95% CI 1.13 to 1.18; p<0.001); POP: IRR 1.09 (95% CI 1.04 to 1.14; p<0.001)). Women with no previous history of the outcome, who underwent mesh surgery for SUI or POP, had higher rates of depression, anxiety, or self-harm (SUI: HR 2.43 (95% CI 2.19 to 2.70; p<0.001; POP: HR 1.47 (95% CI 1.19 to 1.81; p<0.001)), sexual dysfunction (SUI: HR 1.88 (1.50 to 2.36; p<0.001); POP: HR 1.64 (95% CI 1.02 to 2.63; p=0.04)) and opioid use (SUI: IRR 1.40 (95% CI 1.26 to 1.56, p<0.001); POP: IRR 1.23 (95% CI 1.01 to 1.49; p=0.04)). Women with a history of depression, anxiety and self-harm had lower rates of these outcomes with SUI or POP mesh surgery (SUI: HR 0.70 (95% CI 0.67 to 0.73; p<0.001), POP: HR 0.72 (95% CI 0.65 to 0.79; p<0.001). Women with a history of opioid use who had POP mesh surgery had lower rates of prescriptions (IRR 0.91 95% CI (0.86 to 0.96); p=0.001). Conclusions: Mesh surgery was associated with poor mental and sexual health outcomes, alongside increased opioid and antibiotic use, in women with no history of these outcomes and improved mental health, and lower opioid use, in women with a previous history of these outcomes. Careful consideration of the benefits and risk of mesh surgery for women with SUI or POP on an individual basis is required.

scholarly journals 541. Factors Associated with the Persistence of Colonization by Multidrug-Resistant Organisms in Cali, Colombia

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S258-S258
Author(s):  
Juan Diego Velez ◽  
Marly Orrego ◽  
Sofia Montes ◽  
Eric Tafur ◽  
Claudia M Parra ◽  
...  
Keyword(s):  
Previous History ◽  
Rapid Test ◽  
Multidrug Resistant ◽  
Anatomical Site ◽  
Factors Associated ◽  
Contact Precautions ◽  
Carbapenem Resistant ◽  
Significant Difference ◽  
Multidrug Resistant Organisms ◽  
History Of

Abstract Background Colonized patients represent a reservoir for transmission to other non-colonized patients for health institutions, so surveillance measures and contact precautions have been taken in the worldwide to mitigate transmission. However, despite the different interventions implemented, factors associated with persistence have not been evaluated in our context. This study aimed to describe the persistence of colonization in patients with multidrug-resistant organisms (MDROs) re-admitted to a health institution. Methods A retrospective observational study was conducted. Patients re-admitted with a previous positive rapid test for MDROs, who had received chlorhexidine bathing and contact precautions during hospitalization were included. Samples were obtained from two rectal and one nasal swap. Colonization was defined as MDRO detection in at least one anatomical site, in the absence of symptoms or signs of infection. Persistence was defined as two positive screening for the same MDRO. Laboratory tests were chromID®, CHROMID® CARBA and MacConkey agar. VITEK MS® MALDI-TOF conducted MDROs genus identification, and carbapenem-resistant was evaluated through Sensi-Disc™. Logistic regression was performed to examine any association between persistence and clinical data. Results A total of 4,362 screening for MDROs was analyzed form July 2015 to December 2016, and 142 patients were included in the study; the median age was 39 years (IQR=12–62) and 56% were male. The most frequent MDRO was carbapenem-resistant Enterobacteriaceae. There was a statistically significant difference in length of hospitalization (P = 0.003) and ICU (P = 0.035) between non-colonized and persistence of colonization. Factor associated with persistence of colonization included liver disease [OR=3.1; 95% CI: 1.068–9.019; P = 0.037], history of infection in the last year [OR=3.78; 95% CI: 1.036–13.839; P = 0.044], use of permanent urinary catheter [OR=6.48; 95% CI: 1.314–31.975; P = 0.022], history of gastrostomy before hospitalization [OR=5.37; 95% CI: 1.547–18.638; P = 0.008], and use of nasogastric tube [OR=5.14; 95% CI: 1.108–23.861; P = 0.036]. Conclusion It is necessary to consider the previous history of infection in the last year, and other patient’s comorbidities and conditions as risk factors of persistence to colonization by MDROs. Disclosures All authors: No reported disclosures.

scholarly journals Depression, Anxiety and Stress among Obese Patients with Chronic Illnesses: Prevalence and Associated Factors in North East Malaysia

2019 ◽  
Vol 18 (2) ◽  
pp. 252-259
Author(s):  
Raihan Hassan ◽  
Maryam Mohd Zulkifli ◽  
Imran Ahmad ◽  
Siti Suhaila MohdYusoff
Keyword(s):  
Family History ◽  
Outpatient Clinic ◽  
Psychiatric Illness ◽  
Medical Science ◽  
High Body Mass Index ◽  
Medical Illness ◽  
Obese Patients ◽  
Factors Associated ◽  
Younger Age ◽  
History Of

Introduction: Concomitant obesity and chronic medical illness is a significant health problem in Malaysia and worldwide. The comorbid psychological impact in obese patients is associated with a social stigma and low self-esteem. The aim of this study was to determine the prevalence and the factors associated with depression, anxiety and stress in obese patients with chronic medical illnesses attending an outpatient clinic. Methods: This was a cross-sectional study among obese patients with chronic medical illnesses presenting at the Universiti Sains Malaysia Hospital outpatient clinic. A total of 274 patients were involved. The 21-item Depression, Anxiety and Stress Scale questionnaire was used, and the results were evaluated using single and multiple logistic regression analyses. Results: The prevalences of depression, anxiety and stress among the obese patients with chronic medical illnesses were 13.9%, 23.4% and 10.9%, respectively. Younger age [p=0.003, adjusted odds ratio (AOR),1.0; 95%confidence interval (CI),0.91–0.98], unemployed employment(p=0.013, AOR,3.7;95% CI,1.32–10.09) and smoking (p=0.022, AOR,3.2; 95% CI,1.18–8.55) were associated with depression. No formal education (p=0.011, AOR,5.7; 95%CI,1.49–21.89), high body mass index (p=0.029, AOR,1.1;95% CI,1.01–1.13) and family history of psychiatric illness (p=0.018, AOR,5.1; 95% CI,1.33–19.56) were associated with anxiety. Stress was strongly associated with females (p=0.004, AOR,5.0; 95% CI,1.70–15.13) and smoking(p=0.002, AOR,6.5; 95% CI,2.03–20.7). Conclusion: Interestingly, younger age group was associated with depression. Current smokers, no education, family history of psychiatric illness and female sex were significantly associated with anxiety and stress. This notifies new emerging knowledge on factors associated with obese patients that would empower the development of effective preventive strategies for it. Bangladesh Journal of Medical Science Vol.18(2) 2019 p.252-259

scholarly journals Prevalence and factors associated with multidrug-resistant tuberculosis in South India

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Smita S. Shivekar ◽  
Venkatesh Kaliaperumal ◽  
Usharani Brammacharry ◽  
Anbazhagi Sakkaravarthy ◽  
C. K. Vidya Raj ◽  
...  
Keyword(s):  
Treatment Failure ◽  
South India ◽  
Previous History ◽  
Treatment Compliance ◽  
Positive Association ◽  
Rifampicin Resistance ◽  
Factors Associated ◽  
Tb Treatment ◽  
Mdr Tb ◽  
History Of

Abstract India accounts for about one-fourth of the global burden of MDR-TB. This study aims to assess  the prevalence and factors associated with tuberculosis drug resistance among patients from South India. MTBDRplus assay and MGIT liquid culture performed on 20,245 sputum specimens obtained from presumptive MDR-TB cases during a six-year period from 2013 to 2018 were analyzed retrospectively. Univariate and multivariate logistic regression analysis was carried out to evaluate factors associated with MDR, Rifampicin mono-resistance, and Isoniazid mono-resistance. MDR, Rifampicin mono- resistant and Isoniazid mono-resistant TB were  found in 5.4%, 2.5%, and 11.4% cases of presumptive MDR-TB, respectively. Based on the rpoB gene, true resistance, hetero-resistance, and inferred resistance to Rifampicin was found in 38%, 29.3%, and 32.7% of the 1582 MDR cases, respectively. S450L (MUT3) was the most common rpoB mutation present in 59.4% of the Rifampicin resistant cases. Of the 3390 Isoniazid resistant cases, 72.5% had mutations in the katG gene, and 27.5% had mutations in the inhA gene. True resistance, heteroresistance, and inferred resistance accounted for 42.9%, 22.2%, and 17.3% of the 2459 katG resistant cases, respectively. True resistance, heteroresistance, and inferred resistance for the inhA gene were found in 54.5%, 40.7%, and 4.7% cases, respectively. MDR-contact (AOR 3.171 95% CI: 1.747–5.754, p-0.000) treatment failure (AOR 2.17595% CI: 1.703–2.777, p-0.000) and female gender (AOR 1.315 95% CI: 1.117–1.548, p-0.001), were positively associated with MDR-TB. Previous TB treatment did not show a significant positive association with MDR (AOR 1.113 95% CI: 0.801–1.546, p-0.523). Old age (AOR 0.994 95% CI: 0.990–0.999, p-0.023) and HIV seropositivity (AOR 0.580 95% CI: 0.369–0.911, p-0.018) were negatively associated with MDR-TB. Although Rifampicin mono-resistance had a positive association with treatment failure (AOR 2.509 95% CI: 1.804–3.490, p < .001), it did not show any association with previous TB treatment (AOR 1.286 95% CI: 0.765–2.164, p-0.342) or with history of contact with MDR-TB (AOR 1.813 95% CI: 0.591–5.560, p-0.298). However, INH mono-resistance showed a small positive association with the previous history of treatment for TB (AOR 1.303 95% CI: 1.021–1.662, p-0.033). It was also positively associated (AOR 2.094 95% CI: 1.236–3.548, p-0.006) with MDR-TB contacts. Thus INH resistance may develop during treatment if compliance has not adhered too and may be easily passed on to the contacts while Rifampicin resistance is probably due to factors other than treatment compliance. MDR-TB, i.e. resistance to both Rifampicin and Isoniazid, is strongly correlated with treatment failure, spread through contact, and not to treatment compliance. The temporal trend in this region shows a decrease in MDR prevalence from 8.4% in 2015 to 1.3% in 2018. A similar trend is observed for Rifampicin mono-resistance and Isoniazid mono-resistance, pointing to the effectiveness of the TB control program. The higher proportion of inferred resistance observed for Rifampicin compared with INH may indicate a surfeit of mechanisms that enable rifampicin resistance. Association of MDR-TB with age, gender, and HIV status suggest the role of the immune system in the emergence of the MDR phenotype.

Sign in / Sign up

Export Citation Format

Share Document