Psychiatric Morbidity and Referral on Two General Medical Wards

Maguire, G. P.; Julier, David; Hawton, Keith; Bancroft, John

doi:10.1136/bmj.1.5902.268

Cited by 244 publications

(81 citation statements)

References 17 publications

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“…In community study, psychiatric morbidity had their peak occurrence between 25-44 years old in diabetic patients. 13 It was found that anxiety was closely related to depression in diabetic and one study showed that prevalence of anxiety and depression were common in diabetic patients. 14 In our study, MDD was more in comparing that of GAD in diabetic patients.…”

Section: Resultsmentioning

confidence: 99%

Major depressive disorder and generalized anxiety disorder among the patients with diabetes mellitus

et al. 2017

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IntroductionDiabetes mellitus is a chronic disorder characterized by impaired metabolism of glucose and other energy-yielding fuels as well as by the late development of vascular and neurological complication. 1 DM may present with characteristic or classical symptoms such as polydipsia, polyuria, polyphagia, loss of weight, fatigue, blurring of vision etc. Diabetic subjects are at an increased risk of atherosclerotic changes affecting the vessels leading to cardiovascular, cerebrovascular and peripheral vascular diseases. Several pathogenetic processes are involved in the development of diabetes. The autoimmune destruction of the beta cells of the islets of Langerhans of the pancreas results in insulin deficiency. DM is a major global public health problem which is increasing dramatically in developing countries. 2 The prevalence of DM worldwide is estimated to be around 200 million people, more than 5% of the adult population globally. 3 Several factors contribute in type 2 DM pathogenesis, including environmental and lifestyle factors. 4,5 In modern life suffering from diabetes mellitus has become an integral part for many. Not only the genetic inheritance but also the environmental factors and lifestyle we lead in this era also can cause diabetes in people. Among the many additional complications which coincide with DM, depression, anxiety, tension and stress are most commonly under-detected. 6 This is that a growing body of literature has reported that patients with diabetes are almost twice as suffer from anxiety and depression as the general population. 7,8 To our knowledge, insufficient studies had conducted regarding psychiatric morbidities among diabetic patients in our country and no study had conducted in North zone of Bangladesh. So the objective of the study was to evaluate the proportion of MDD and GAD among the patients suffering from Diabetes mellitus as well as to identify the socio-demographic characteristics of patients in this area. This study will give baseline information about psychiatric co-morbidity among the diabetic patients. Among them 18 (22.5%) were suffering from MDD and 11 (13.7%) were suffering from GAD. It was shown that both MDD and GAD were higher among female patients. So physicians should pay attention to rule out psychiatric disorders in patients with DM.

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Section: Resultsmentioning

confidence: 99%

Major depressive disorder and generalized anxiety disorder among the patients with diabetes mellitus

et al. 2017

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“…Maguire et al [16] reported a 23% rate in a study of patients on general medical wards. However, Bridges and Goldberg [17] reported a 39% rate in patients with neurological disorders and Surridge et al [5] reported varying figures (e.g., 60%) for patients who complained of fatigability and energy loss.…”

Section: Discussionmentioning

confidence: 99%

Psychiatric Aspects of Diabetes Mellitus

et al. 1990

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We studied the psychiatric morbidity in 47 insulin-dependent diabetic patients who attended the Diabetic Clinic at King Fahd Hospital of the University, Al-Khobar, in eastern Saudi Arabia. Clinical psychiatric assessment and the Hospital Anxiety and Depression Scale (HAD Scale) were used in assessing the patients. The physiological characteristics of the patients were studied by physicians running the Diabetic Clinic. The prevalence of psychiatric illness was high (44.7%). The most common diagnoses were anxiety and depression. In addition, fatigability and loss of energy (40%), irritability (47%), sexual dysfunction (36%), and cognitive deficit (15%) were noticed. Psychiatric morbidity does not appear to be related to the duration of the illness or age at diagnosis.HBA Hafeiz, G Al-Ghassab, H Al-Freihi, F Al-Muhanna, Psychiatric Aspects of Diabetes Mellitus. 1990; 10(6): 629-632 In the past, diabetes mellitus (DM) was considered a psychosomatic illness caused by emotional stress [1,2]. In the "diabetic personality" [2], anxiety, depression, sexual dysfunction, and cognitive deficits are among the most common psychiatric aspects [3][4][5][6][7]. Disturbed family background has also been associated with DM; high anxiety levels in the mothers of diabetic children [8], overprotectiveness, rigidity, and family discord [9,10] have also been reported. The psychiatric changes reported are thought to be related to factors such as the stressful way of life of diabetics [3] or its effect on the central nervous system [11]. Family dynamics and the treatment problems of diabetes are also involved.The aim of this study was to investigate the prevalence and describe the nature of psychiatric morbidity in DM. MethodsThe study included all consecutive insulin-dependent diabetic patients who attended the Diabetic Clinic at King Fahd Hospital of the University. The patients were first examined, investigated, and assessed by the physicians (coauthors) and the relevant diabetic data recorded. A psychiatric interview consisting of a history and standard mental state examination was conducted in each subject by the psychiatrist. Assessment of cognitive function included orientation, concentration, memory, and intelligence, the last judged by general information and school and work records. The patients were rated as negative, doubtful, and positive cases. The psychiatric diagnoses were based on the criteria for anxiety neurosis and depression of the International Classification of Diseases of the World Health Organization [12]. In addition, the patients were rated blindly on the Hospital Anxiety and Depression Scale (HAD). This is a self-assessment scale that is claimed to be reliable in detecting states of anxiety and depression [13]. An Arabic version, which had been validated in Saudi patients, was used [14].Educational level was computed on the basis of one point for each level (0-5). Actual body weights were compared with ideal weights calculated from heights, and only deviations of more than 10% from the ideal were considere...

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“…In contrast, general liaison services tend to be reactive rather than proactive. Feldman (1987) has suggested that less than 1% of patients are referred to psychiatrists, even when psychological problems are recognised, and that the most common reasons for referral are disturbed behaviour and non-compliance (Maguire et al, 1974 1997). Our findings that such funding arrangements remain the exception rather than the rule reflect the inevitable difficulties that liaison psychiatry has in competing for funding with other priorities in secondary care.…”

Section: Discussionmentioning

confidence: 99%

Liaison psychiatry continues to expand: developing services in the British Isles

Swift¹,

Guthrie

2003

Psychiatr. bull.

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Aims and Method A postal survey of consultants in liaison psychiatry was carried out in the spring of 2002 to document the current state of liaison psychiatry in the UK and the Republic of Ireland. Information was collected on post specifications, clinical organisation and plans for further local development. Results Ninety-three liaison consultants were identified. Seventy-seven posts were full-time or half-time, compared with 43 such posts in 1996. During the same time period, specialist registrar training posts have doubled from 30 to 61. A third of respondents anticipated further consultant posts in their region. Clinical Implications Despite the increase in the number of liaison consultants since 1996, the numbers still fall below that recommended by the Royal College of Psychiatrists. Liaison consultants need to improve links with primary care and continue to develop specialised services to demonstrate the qualitative and financial benefits that liaison psychiatry has to offer to a wide range of patients.

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Psychiatric Morbidity and Referral on Two General Medical Wards

Cited by 244 publications

References 17 publications

Major depressive disorder and generalized anxiety disorder among the patients with diabetes mellitus

Major depressive disorder and generalized anxiety disorder among the patients with diabetes mellitus

Psychiatric Aspects of Diabetes Mellitus

Liaison psychiatry continues to expand: developing services in the British Isles

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