Context:Aging of population is currently a global phenomenon. At least one in 5 people over the age of 65 years will suffer from a mental disorder by 2030. Study of psychiatric morbidities in this age group is essential to prepare for upcoming challenges.Aims:To find out the prevalence of different psychiatric morbidities in elderly population and to find out if there are any age and gender specific differences.Settings and Design:Retrospective review; Psychiatric outpatient department of Manipal Teaching Hospital, Pokhara, Nepal.Materials and Methods:Data for patients ≥ 65 years of age attending the psychiatric outpatient department of Manipal Teaching Hospital, Pokhara, Nepal, from 1st January 2012 to 15th January 2013 were collected retrospectively in a predesigned proforma.Statistical Analysis Used:Risk of having different psychiatric disorders was estimated using odds ratio.Results:The mean age of 120 patients included in this study was 69.67 (SD = 5.94) years. Depressive disorder (26.7%) was the most common diagnosis. There was no statistically significant difference in psychiatric disorders in >75 years compared with ≤75 years except for dementia [odd ratio (OR) (≤75 years/>75 years)=0.055, 95% confidence interval (CI)=0.016; 0.194]. Alcohol dependence syndrome [OR (male/female)=7.826, 95% CI = 1.699;36.705] and dementia [OR (male/female)=3.394, 95% CI = 1.015;11.350] was more common in males.Conclusions:Depressive disorder was the most common psychiatric morbidity among the elderly patients. The odds suffering from dementia increased with increasing age. The odds of having alcohol related problems and dementia were more in males compared with females.
Introduction: The co-occurence of substance abuse and mental illness is well known. Alcoholics are reported to be three times more likely to suffer from another psychiatric disorder. This study aims to observe the prevalence of psychiatric comorbidity in alcohol dependent patients in our setup. Methods: This was a hospital based cross-sectional observational study conducted over a period of three months. Consecutive patients presenting to the out-patient section of Psychiatric department who met the DSM-IV-TR criteria for alcohol dependence were included in the study. They were interviewed using Structured Clinical Interview for DSM-IV-TR (SCID I&II) to assess for comorbidity. Data was analyzed using Statistical Package for Social Sciences (SPSS TM) software. Mann Whitney U test and Chi square or Fisher's Exact tests were used for statistical analysis. Results: Out of 31 patients enrolled, 14 (45.16%) had psychiatric comorbid conditions all of which were Axis I disorders. Anxiety disorder (35.71%) was the most frequent associated disorder followed by depressive disorder (28.57%). The alcohol dependent patients with comorbidity was significantly younger (mean age=35.71±13.60 years) in comparison to those without comorbidity (mean age=42.59±11.15 years). Other socio-demographic parameters were comparable between the two groups. Patients with history of past psychiatric illness and medication were less likely to have comorbidity, which was statistically significant. Conclusion: Psychiatric comorbidity is common in alcohol dependent people. Anxiety disorder and depression were more prevalent entities. Those with past illness and medications were less likely to have comorbidities.
Introduction: Insomnia is a common problem among old age population. Almost half of all old age adults report difficulty in initiating and maintaining sleep. The objective of this study was to assess the prevalence of insomnia, its associated factors and effects in old age adults. Methods: This was an observational analytical study where adults above 60 years of age from a ward of a village development committee were included. Data were collected for a period of four months. Insomnia was measured by Athens Insomnia Scale and structured questionnaires were used to assess the effects of insomnia. Descriptive statistics were presented as frequency and percentages. Association between variables was assessed with Chi-square test or Fisher's Exact test as appropriate. Results: There were a total of 55 participants in the study. Insomnia was prevalent in 56.4% (n=31) of the study population. Among the studied socio-demographic variables, presence of medical illness was significantly associated with insomnia. Insomnia was significantly associated with morning headache, irritability, unhappiness, fatigue, lack of concentration, day time sleepiness, avoiding interaction with people, and need of sedative for sleep. Conclusion: Majority of the old age adults suffer from insomnia with night awakenings as the most common symptom. Insomnia significantly affects various aspects of life at an old age.
Introduction: A variety of psychiatric manifestations can be seen in children and adolescents below the age of 19 years. This study aims to examine the socio-demographic, morbidity profiles, and clinical correlates of child and adolescent patients attending the psychiatry out-patient clinic of Lumbini Medical College and Teaching Hospital (LMCTH). Methods: It was an observational, cross-section study involving case record analysis of all children and adolescent patients attending the psychiatry out-patient clinic between December 1, 2018 to November 30, 2019 in LMCTH, Nepal. Socio-demographic and clinical data were entered into computer software and analysed. Results: One hundred and forty cases fulfilling inclusion criteria were included in the study. There were 96 (68.6%) females and 44 (31.4%) males. Majority of the patients were from 16-19 years age-group. Cases from urban areas predominated the picture. Most common psychiatric diagnosis was conversion disorder (29, 20.7%) followed by depressive disorder (25 or 17.9%) and anxiety disorder (14, 10%). Majority of females had conversion disorder (25 or 26%) followed by seizure disorder (23, 24%) and depressive disorder (15, 15.6%) whereas majority of males had equal count of depressive disorder and seizure disorder (10, 22.7%) followed by anxiety disorder (7, 15.9%). Conclusions: Psychiatric illness was most common in children and adolescents in the age group 16-19 years, followed by 11-15 years age-group. They were more common in female sex, and slightly higher in those from urban background. Common psychiatric diagnoses were conversion disorder followed by depressive disorder and anxiety disorder.
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