We conducted a cross-sectional study to understand the differences in demographics and psychiatric comorbidities in adolescents with major depressive disorder (MDD) and assess the risk of suicidality due to comorbid attention-deficit/hyperactivity disorder (ADHD). Methods We included 141,530 adolescents (age, 12 to 18 years) with a primary diagnosis of MDD from the nationwide inpatient sample (NIS, 2012-2014), and grouped by a comorbid diagnosis of ADHD (N = 22,665, 16%). Logistic regression analysis was used to measure the demographic predictors for ADHD in adolescents with MDD, and to measure the suicidal risk in ADHD versus non-ADHD. Results Comorbid ADHD was prevalent in whites (71.9%), and males had two times higher odds (95% CI 2.25-2.41) compared to females. The most prevalent comorbidities seen in ADHD-cohort were anxiety disorders (46.3%) and substance abuse (20.1%) with 1.3 times higher odds of substance abuse (95% CI 1.41-1.65) compared to non-ADHD. Suicidal behaviors were seen in a higher proportion of the ADHD cohort compared to the non-ADHD cohort (54.3% vs. 52.7%). ADHD and suicidal behaviors relationship was statistically significant but had a very small positive association (OR 1.04, 95% CI 1.01-1.08) after controlling for demographic confounders and comorbidities. There was a significant increase in the number of MDD hospitalization with ADHD for suicidal behaviors from 51.1% (N = 3,360) in 2012 to 58.2% (N = 5,115) in 2014. Conclusion There exists a significant but small positive association between suicidal behaviors and comorbid ADHD in MDD adolescents. The suicide rate has increased by 52.2% during the study period in depressed adolescents with ADHD. This calls for early diagnosis and management of ADHD and early-onset depression in adolescents to prevent suicide risk.
Objective To investigate the association between opioid drug use and cardiometabolic risk factors in an adult sample data acquired from the National Health and Nutrition Examination Survey (NHANES). Methods A retrospective cross-sectional analysis was performed using the data from the NHANES for the period 2009-2018 provided by the Centers for Disease Control and Prevention (CDC), amounting to a total of N = 10,032 eligible participants. The data were analyzed to study the relationship between opioid drug use (dividing into four dichotomy groups: drug use (DU) group, illicit drug use (IDU) group, repeated drug use (RDU) group, and current drug use (CDU) group) and cardiometabolic disease risk factors (CDRF) (i.e., hypertension, abnormal triglyceride levels, low-level of high-density lipoproteins (HDLs), high waist circumference, insulin resistance, serum cotinine levels, higher C-reactive protein, hypercholesterolemia, and increased BMI). The statistical correlation was evaluated using the chi-square analysis, and a p-value of less than 0.05 was considered statistically significant. Alcohol use, age, race, ethnicity, education level, and poverty to income ratio (PIR) were analyzed as covariates. Results Overall, our analysis found that males were more likely than females (p ≤ 0.001) to have ever reported using drugs at least once in their lifetime. In fact, males were more likely than females to report ever using cocaine (p = 0.01), heroin (p = 0.01), and marijuana (p = 0.01). Additionally, males were significantly more likely than females to disclose the current use of illicit drugs (p = 0.002), and also tend to have consumed more with at least 12 alcoholic beverages per year (p < 0.001). Overall, we found no association between substance use and having a cluster of three or more CDRF variables for both males and females. Conclusion Study results highlight the prevalence of gender differences in DU and its reporting. With the rising popularity of illicit drugs, clinicians must be aware of its association with CDRF.
Depression is one of the highest prevalent mental illnesses and is one of the common illnesses that can have its onset during childhood or adolescence. It is estimated that up to 20% of children experience mental illness worldwide. Preventing the onset of depression in children and adolescents should be a vital public health goal that will improve public health and decrease health care costs. We reviewed literature that described school-based interventions to prevent the onset of depression, reduce the severity of depressive symptoms, and enhance global functioning in adolescents. Our research also provides strategies for school-based intervention programs that are mainly categorized into three main subtypes. We also discussed each subtype and its advantages and limitations. The goal is to bring the readers an understanding of the importance of preventing depression on a community level, beginning at schools.
Adult-onset Still's disease (AOSD) is a rare multisystemic autoinflammatory disease with symptoms, including spiking fever, evanescent rash, arthralgia or arthritis, sore throat, lymphadenopathy, hepatosplenomegaly, and myalgia. The prevalence of anxiety and depressive symptoms in rheumatological diseases is quite high, which impacts social as well as occupational functioning. Depression and anxiety are known to be the most common psychiatric comorbidities in patients with arthritis and other rheumatological disorders. Here, we report the case of an adult white female with AOSD who showed improvement in symptoms of AOSD with monoclonal antibodies and steroids; however, significant worsening of pain along with depression & anxiety were noted. With the use of antidepressant serotonin-norepinephrine reuptake inhibitor (SNRI), specifically duloxetine, our patient was able to experience improvement in depression, anxiety, and pain.
We aim to discern the demographic predictors that may extend the hospitalization length of stay (LOS) for patients with bipolar disorder (BD), manic episodes managed with electroconvulsive therapy (ECT), and to study the impact of insurance and hospital characteristics on LOS. Methods We used the Nationwide Inpatient Sample (NIS, 2012-2014) from the United States hospitals and included 2,785 adult inpatients (mean age 51.3 ± 16.2 years) with a primary diagnosis of BD, manic episode, and managed with ECT. The median LOS of the sample population is 16 days, and the study inpatients were divided into subgroups: ≤16 days versus >16 days. The logistic regression model was used to find the odds ratio (OR) for the associations of demographic and hospital variables with inpatient stay >16 days versus ≤16 days. Results BD inpatients managed with ECT during their hospitalization had a mean LOS of 21.6 ± 22.1 days. About 48.65% (N = 1355) had LOS >16 days. Older adults (age >50 years) have 2.4 times higher odds (95% CI 2.06-2.87) for hospital LOS >16 days compared to younger adults. Although a higher proportion of females received ECT (71.8%), males had two times higher odds (95% CI 1.59-2.27) for hospital LOS >16 days. BD inpatients covered by private insurance/self-pay were at 1.5 times higher odds (95% CI 1.27-1.77) for hospital LOS >16 days. In terms of hospital setting, ownership type and teaching status are significant predictors with inpatients managed in public and teaching hospitals at higher odds for LOS >16 days. Conclusions Older men and inpatients covered by private insurance/self-pay have a higher likelihood of extended hospitalization stay during ECT management of BD, manic episodes. The LOS is also influenced by hospital setting with patients managed in public teaching hospitals at higher odds of longer LOS compared to their counterparts.
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