Psychiatric symptoms and quality of life in systemic sclerosis. Mura G, Bhat KM, Pisano A, et al. Clin Pract Epidemiol Ment Health. 2012;8:30-35.
The aim of Mura and colleagues was to define the amount of impairment of quality of life (QoL) in patients with systemic sclerosis (SSc) and how much of this is due to depressive or other psychiatric symptoms. Psychiatric symptoms are frequent in patients with SSc, but pain, fatigue, disability, and body changes do not appear to explain the high prevalence of psychiatric comorbidity in SSc. The high rate of depression seems to strictly correlate with poor QoL, and this finding needs more research to establish the cause of such a correlation.
Prevalence of psychiatric disorders in patients with diabetes types 1 and 2. de Ornelas Maia AC, Braga Ade A, Brouwers A, et al. Compr Psychiatry. 2012;53:1169-1173.
The Mini International Neuropsychiatric Interview was used to identify psychiatric disorders in 100 patients with type 1 diabetes mellitus and 100 patients with type 2 diabetes mellitus. Eighty-five patients (42.5%) were found to have at least 1 psychiatric disorder: generalized anxiety disorder (21%), dysthymia (15%), social phobia (7%), current depression (5.5%), lifelong depression (3.5%), panic disorder (2.5%), and risk of suicide (2%). Dysthymia, current depression, and panic disorder were more prevalent in patients with type 1 diabetes mellitus. The high prevalence of psychiatric disorders in diabetic patients indicates the need to consider mental issues when performing a diagnostic evaluation of patients.
Psychiatric and neuropsychological manifestations of systemic lupus erythematosus. Fietta P, Fietta P, Delsante G. Acta Biomed. 2011;82:97-114.
Psychiatric/neuropsychological syndromes are frequent and challenging manifestations of systemic lupus erythematosus (SLE) in both adults and children. Ischemia (due to disease-related vascular injury or cerebral vasospasm) and inflammatory/immunopathological mechanisms appear to be the main pathogenic factors. There are no standardized treatment guidelines; however, therapeutic recommendations have been proposed. Because of the high prevalence of psychiatric syndromes and significant risk of suicide in patients with SLE, systematic assessment to provide prompt diagnosis and adequate care should be a critical part of the evaluation protocol.
Pretransplant psychiatric and substance use comorbidity inpatients with cholangiocarcinoma who received a liver transplant. Schneekloth TD, Jowsey SG, Biernacka JM, et al. Psychosomatics. 2012;53:116-122.
Pretransplant psychopathology and substance use disorders in liver transplant recipients were assessed to better characterize patients with cholangiocarcinoma. The records of 143 liver transplant recipients (26 of whom had cholangiocarcinoma) who completed pretransplant psychological screening between 2000 and 2004 were retrospectively reviewed. The results showed that 35% had a pretransplant psychiatric diagnosis, 35% had a substance use disorder, and 43% were current or former smokers. The two groups did not differ significantly in the likelihood of having a psychiatric disorder or smoking history; however, the cholangiocarcinoma group was less likely to have an alcohol(Drug information on alcohol) use disorder or any substance use disorder.
The Canadian Network for Mood and Anxiety Treatments (CANMAT) task force recommendations for the management of patients with mood disorders and select comorbid medical conditions.Ramasubbu R, Taylor VH, Samaan Z, et al. Ann Clin Psychiatry. 2012;24:91-109.
To help understand the bidirectional relationship and to provide an evidence-based framework to guide the treatment of mood disorders that are comorbid with medical illness, the authors looked at the links between mood disorders and several common medical conditions and evaluated the efficacy and safety of pharmacological and psychosocial treatments. They focused on cardiovascular disease, cerebrovascular disease, cancer, HIV infection, hepatitis C, migraine, multiple sclerosis, epilepsy, and osteoporosis. Their findings suggest that depression is often comorbid with medical disorders, and it is treatable. Failure to treat depression in medically ill patients may have a negative effect on medical outcomes.
The CANMAT task force recommendations for the management of patients with mood disorders and comorbid medical conditions: diagnostic, assessment, and treatment principles. Ramasubbu R, Beaulieu S, Taylor VH, et al. Ann Clin Psychiatry. 2012;24:82-90.
The authors describe the complex interactions between medical illness and mood disorders and provide an approach for clinical diagnosis and management of the comorbidities. Evidence from epidemiological, clinical, and biological studies suggests that the relationship between medical illness and mood disorders is bidirectional. Furthermore, evidence shows that there are shared and specific etiological factors that link these conditions.