exudates and Adjustment-Disorders

Distress and psychiatric morbidity in cancer patients are associated with poorer outcomes including mortality. In this study, we examined the prevalence of psychiatric morbidity and its association with cancer survival over time.. Participants were 467 consecutive adult cancer patients attending oncology follow-ups at a single academic medical centre. Assessment consisted of the Hospital Anxiety and Depression Scale and Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision. Comparison between co-morbid psychiatric cases and non-cases was made in follow-ups of up to 24 months.. Of the 467 patients, 217 of 220 patients with elevated total Hospital Anxiety and Depression Scale scores (≥16) met the criteria for an Axis I disorder at 6 months follow-up, with 102 of the follow-up sample having a persistent diagnosable psychiatric disorder after 1 year. The most frequent initial diagnoses were minor depression (17.6%), major depressive disorder (15.8%) and adjustment disorder (15.8%). Cancer patients without psychiatric morbidity had a survival benefit of 2.24 months or 67 days. Mean survival at 24 months was 20.87 months (95% CI 20.06-21.69) for cancer patients with psychiatric morbidity versus 23.11 months (95% CI 22.78-23.43) for those without (p < 0.001 for log rank). After adjusting for demographics and cancer stage on a Cox proportional hazards model, psychiatric morbidity remained associated with worse survival (hazard ratio 4.13, 95% CI 1.32-12.92, p = 0.015).. This study contributes to the growing body of evidence linking psychiatric morbidity to cancer mortality. Treating underlying psychiatric conditions in cancer may therefore improve not just quality of life but also survival.

Topics: Adjustment Disorders; Adolescent; Adult; Aged; Anxiety; Anxiety Disorders; Depression; Depressive Disorder; Depressive Disorder, Major; Female; Humans; Interview, Psychological; Longitudinal Studies; Malaysia; Male; Middle Aged; Neoplasms; Prevalence; Proportional Hazards Models; Young Adult

Hypokalemia is not an isolated disease but an associated finding in a number of different diseases. It is also a commonly neglected condition among patients with acute acetaminophen overdose.. This study intended to determine the prevalence of hypokalemia and its clinical correlates in acute psychiatric illness among hypokalemic and normokalemic patients after acetaminophen overdose.. This is a retrospective cohort study of hospital admissions for acute acetaminophen overdose conducted over a period of 5 years from 1 January 2004 to 31 December 2008. Demographic data and different types of psychiatric illness were compared between hypokalemic and normokalemic patients. Hypokalemia was predefined by a serum concentration <3.5 mmol/L. Statistical Package for Social Sciences (SPSS) 15 was used for data analysis.. Two hundred and eighty patients out of 305 admissions were studied. Hypokalemia was found in 63.6% of patients with a higher prevalence in the presence of psychiatric illness (67.7%). Hypokalemic patients were significantly associated with the presence of major depression (p = .04), adjustment disorder (p < .001), anxiety (p = .01), and suicidal attempts (p = .04).. Hypokalemia was common among patients with psychiatric illness and acute acetaminophen overdose.

Topics: Acetaminophen; Adjustment Disorders; Adolescent; Adult; Anxiety Disorders; Cohort Studies; Depressive Disorder, Major; Drug Overdose; Female; Humans; Hypokalemia; Malaysia; Male; Mental Disorders; Potassium; Prevalence; Retrospective Studies; Severity of Illness Index; Suicide, Attempted; Young Adult

Topics: Adjustment Disorders; Adult; Attitude to Death; Humans; Malaysia; Male; Stress Disorders, Post-Traumatic; Superstitions