• psychiatry close

The objective of the study was to explore the relationship between birthplace and the treated prevalence of mental disorder in Australia. Treated prevalence rates were derived from two surveys. These were the 1989-1990 National Health Survey, carried out by the Australian Bureau of Statistics, and the general practice component of a one-day mental health census carried out in the state of Victoria by the authors in 1993. Differences due to the age and sex composition of birthplace groups were controlled statistically. Treated rates of mental disorder, and the use of psychotropic medication, were consistently high amongst those born in Greece, and low amongst those born in the U.K./Ireland or in South East Asia, compared to the Australian-born. Country of birth has a significant effect on the treated prevalence of mental disorder, as reported by patients or their doctor. Further research is needed to reveal the underlying causes of these differences.

Abstract Objectives The objectives of this study were to describe the longitudinal trends of pharmacological treatment initiation and persistence in adult patients with attention-deficit/hyperactivity disorder (ADHD) and to explore how patients' sociodemographic and clinical characteristics affect these patterns. Methods A retrospective cohort of 23,747 adult patients with new ADHD episodes was assembled using Medicaid extract files of 29 US states from 1999 and 2010. Sociodemographic and clinical characteristics of treatment initiators and noninitiators, and treatment persistent and nonpersistent patients were compared using multivariable logistic regression. Results The overall treatment initiation and 1-year persistence rate was 22.5% and 34.2%, respectively. After adjustment, the propensity of initiating pharmacotherapy and being persistent tripled (2010 vs 2000; odds ratio, 3.25; 95% confidence interval, 2.61–4.04) and almost doubled (2009 vs 2000; odds ratio, 1.86; 95% confidence interval, 1.20–2.90) over the study period. Male, racial and ethnic minorities, and younger age groups had a decreased propensity for treatment initiation and persistence. The likelihood of initiating treatment was similar for rural and urban residents but varied among different US states. Severe mental comorbidities and, concordantly, use of antipsychotics or mood stabilizers reduced the propensity of treatment initiation but had little effect on persistence. Patients filling sustained release stimulants were most likely to be persistent. Finally, preexisting cardiovascular conditions reduced the likelihood of receiving treatment but were not associated with persistence. Conclusions The propensity to initiate and persist on pharmacological treatment in adults with ADHD has increased in the last decade but remains low. Treatment patterns were closely related to several sociodemographic and clinical determinants. Our findings provide valuable information to ensure appropriate treatment choices for these patients.

The hypothesis of vestibuloocular or cerebellooccular motor dysfunction as a possible cause of the field-dependent behavior of alcoholics on the Rod-and-Frame Test could not be verified.

To identify the specific features of cognitive functioning in patients with youth chronic endogenous depressions (YCED).Fifty-one male patients with YCED (duration 36.5±12.5 month) and 18 patients with youth depression without chronic course as a comparison group were examined. A neuropsychological battery of the following techniques was used to assess cognitive functioning: the Rey - Osterrieth complex figure test, the Design Fluency Test, the Verbal Fluency Test, the 20-question Test, the Color-Word Interference Test, arithmetic problem solving, compilation of stories based on Bidstrup's cartoons, SDMT, the Digit span.Based on the heterogeneity of psychopathological features of YCED, two types were identified: unitary depressions (type 1) and supplementary depressions (type 2). Among type 2 depressions, two subtypes were distinguished: with neurosis-like disorders (subtype 2.1) and with psychopathic-like disorders (subtype 2.2). The following significant differences between different types of YHED and comparison groups were revealed: on the scale «Copying», «Simultaneity « and points when reproducing the Rey-Osterritz figure (Patients with YCED show signs of neurocognitive dysfunction. The patients of supplementary and unitary types of YCED demonstrate the differences in the neurocognitive profile. The revealed peculiarities show the perspective of YCED research and typification of chronic depression in adolescence due to the differences in the neurocognitive profile.Выявление особенностей когнитивного функционирования больных с юношескими хроническими эндогенными депрессиями (ЮХЭД).В исследовании приняли участие 51 пациент мужского пола с ЮХЭД (средняя длительность 36,5±12,5 мес) и 18 больных с юношеской депрессией без хронического течения (группа сравнения). Для оценки когнитивного функционирования использовалась нейропсихологическая батарея, состоящая из следующих методик: Сложная фигура Рея—Остеррица, тест «Визуальная беглость», тест «Вербальная беглость», тест «20 вопросов», Словесно-цветовой интерференционный тест, Решение арифметических задач, Составление рассказов по карикатурам Бидструпа, Шифрование, Прямые и обратные ряды.В связи с гетерогенностью психопатологических особенностей ЮХЭД выделено два типа: унитарные (1-й тип) и саплементарные (2-й тип) депрессии. Среди депрессий 2-го типа было выделено два подтипа: с неврозоподобными (2.1 подтип) и психопатоподобными (2.2 подтип) расстройствами. Выявлены следующие значимые различия между ЮХЭД различных типов и группы сравнения: по шкалам «Копирование», «Целостность» и баллам при воспроизведении фигуры Рея—Остеррица (У пациентов с ЮХЭД выявлены признаки нейрокогнитивной дисфункции. Пациенты с депрессией саплементарного и унитарного типов ЮХЭД демонстрируют различия нейрокогнитивного профиля. Выявленные особенности показывают перспективность исследований ЮХЭД и типизации хронических депрессий в юношеском возрасте в связи с различиями в нейрокогнитивном профиле.