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1
Grant, Donald C., and Edwin Harari. "Diagnosis and Serious Mental Illness." Australian & New Zealand Journal of Psychiatry 30, no. 4 (August 1996): 445–49. http://dx.doi.org/10.3109/00048679609065015.
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We examine some limitations of the psychiatric diagnosis, particularly in the assessment of the seriousness of a patient';;s mental illness. The bureaucratic or technocratic use of the concept ‘serious mental illness’ is contrasted with the perspective of the clinician who provides ongoing patient care. A decline in the clinical skills of psychiatrists is likely if proposed mental health reforms regulate psychiatric practice according to bureaucratic and technocratic definitions of serious mental illness rather than the realities of the clinical encounter between patient and doctor.
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Anderson, Bernard, and Richard Khoo. "Mental illness: diagnosis or value judgment?" British Journal of Nursing 3, no. 18 (October 13, 1994): 957–59. http://dx.doi.org/10.12968/bjon.1994.3.18.957.
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Stone, Louise, Elizabeth Waldron, and Heather Nowak. "Making a good mental health diagnosis: Science, art and ethics." Australian Journal of General Practice 49, no. 12 (December 1, 2020): 797–802. http://dx.doi.org/10.31128/ajgp-08-20-5606.
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Background There are limitations to psychiatric classification, which affects the utility of diagnosis in general practice. Objective The aim of this article is to explore the principles of science, art and ethics to create clinically useful psychiatric diagnoses in general practice. Discussion Psychiatric classification systems provide useful constructs for clinical practice and research. Evidence-based treatments are based on the classification of mental illnesses. However, while classification is necessary, it is not sufficient to provide a full understanding of ‘what is going on’. A good psychiatric diagnosis will also include a formulation, which provides an understanding of the psychosocial factors that provide a context for illness. Experiences such as trauma and marginalisation will change the illness experience but also provide other forms of evidence that shape therapy. Diagnoses also carry ethical implications, including stigma and changes in self‑concept. The science, art and ethics of diagnosis need to be integrated to provide a complete assessment.
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Bai, Yuxin. "Deep Learning-based Pre-diagnosis and Analysis of Psychological Disorders." International Journal of Education and Humanities 6, no. 3 (January 11, 2023): 126–30. http://dx.doi.org/10.54097/ijeh.v6i3.4763.
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At present, due to the lack of sufficient treatment institutions as well as professional psychotherapists, numerous patients with mental illnesses do not receive help from professional psychiatrists, thus worsening their conditions. In order to determine the condition of mental illness patients at an early stage, this paper applies natural language processing technology to the psychological field and proposes a text-based and deep learning model for mental illness recognition. The BERT (Bidirectional Encoder Representations from Transformers) pre-trained language model is used to complete the sentence-level feature vector representation of mental health text data, and the obtained feature vectors are subsequently targeted and input to a classifier for classification, which can effectively identify depression, anxiety, post-traumatic stress, and unmet mental illness multiple classifications, breaking the previous common depression identification, improving from the original simple depression dichotomous classification to a mental illness multiple classification task, and focusing on a few focal points, which not only saves human and material resources, but also can achieve twice the result with half the effort. Finally, the algorithm is validated using mental health text dataset, and the experimental results show that the lowest F1 value of the trained model on the test set is 0.77, which can achieve fast screening of text content with the tendency of mental illness, reduce the expert labeling workload, improve the labeling efficiency, and provide a new idea for the recognition of mental illness.
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Haag, Amanda Leigh. "Biomarkers trump behavior in mental illness diagnosis." Nature Medicine 13, no. 1 (December 28, 2006): 3. http://dx.doi.org/10.1038/nm0107-3.
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Cannington, Victoria. "Mental Illness and the Body, Beyond Diagnosis." Issues in Mental Health Nursing 29, no. 1 (January 2008): 95–96. http://dx.doi.org/10.1080/01612840701749134.
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Edwards, Megan. "Mental Illness and the Body: Beyond Diagnosis." Journal of Advanced Nursing 60, no. 1 (October 2007): 111. http://dx.doi.org/10.1111/j.1365-2648.2007.04414.x.
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Bhattacharya, Manami, Helen Parsons, Anne Hudson Blaes, Kathleen Call, and Donna McAlpine. "Pre-existing mental illness and guideline-concordant treatment for breast cancers among older women." Journal of Clinical Oncology 40, no. 28_suppl (October 1, 2022): 138. http://dx.doi.org/10.1200/jco.2022.40.28_suppl.138.
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138 Background: Guideline-concordant care (GCC) of breast cancer greatly improves survival. Women with mental illness experience worse survival after breast cancer; in this study, we examined whether women with mental illnesses pre-existing their breast cancer diagnosis receive GCC for breast cancer as often as women without. Methods: We used Surveillance and Epidemiology and End Results (SEER) cancer registry and Medicare claims (SEER-Medicare) to select cases of women (67+ years old) with Stage I-III breast cancers (n = 89,172). Mental illness was measured through diagnostic codes within 2 years before cancer diagnosis and categorized as serious mental illness (SMI: schizophrenia, bipolar disorder, depression with psychosis, and other psychotic disorders); depression or anxiety; or other mental illnesses. To determine receipt of GCC we used the National Comprehensive Cancer Network’s (NCCN) treatment guidelines, commonly referenced by oncologists as best practices. Outcomes included 1. surgery and radiation completion for all cancers (complete/incomplete treatment/no surgery); 2. surgery, radiation completion, and chemotherapy initiation (complete/incomplete/no surgery) for triple negative and HER2+ breast cancers; and 3. radiation completion after mastectomy for Stage III cancers with lymph involvement. We used generalized ordinal logistic regression to compare outcomes with mental illness categories, controlling for demographic, cancer-related, and clinical factors. Results: We found that 28.8% of women in this study had at least one diagnosis of a mental illness in the two years prior to their breast cancer diagnosis and 1.7% had SMI. Women with SMI are more likely to not receive surgery than women without (OR = 1.24, CI = 1.02-1.60). Women with mental illnesses have a higher risk of not completing radiation after breast conserving surgery (SMI: OR = 1.24, CI = 1.01-1.30, Depression and anxiety: OR = 1.11, CI = 1.06-1.16, other mental illnesses: OR = 1.09 CI = 1.01-1.16). Women with SMI and triple negative or HER2+ cancers are more likely to not complete all treatment (OR = 1.65, CI = 1.22-2.24). Conclusions: Women with mental illnesses may be at higher risk for incomplete treatment or lack of treatment initiation, especially for multi-part treatment, such as completion of radiation and initiation of chemotherapy, which may contribute to worse survival outcomes. Breast cancer and mental illness are both common illnesses among older women in the United States. Health systems should consider strategies for improving GCC among women with mental illness and breast cancer.
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Coelho, Richard J., and Jodi L. Saunders. "Diagnostic Implications of Dual Diagnosis: Mental Retardation and Mental Illness." Journal of Applied Rehabilitation Counseling 27, no. 4 (December 1, 1996): 19–24. http://dx.doi.org/10.1891/0047-2220.27.4.19.
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Individuals with mental retardation are at a greater than average risk of developing psychiatric disorders. Many of these individuals are being seen by rehabilitation counselors through various community settings. The accurate diagnosis of psychopathology within this at-risk population helps the rehabilitation counselor to develop and implement appropriate service delivery. Thus, the diagnostic process is a critical aspect of the counseling process. This article examines diagnostic issues and challenges for determining psychopathology in individuals with mental retardation. Aspects of mental retardation that influence the diagnostic process, assessment measures, the importance of the clinical interview, and implications for rehabilitation counselors who are working with this population are also addressed.
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Allen, John R., Caroline P. Hoch, Daniel J. Scott, and Christopher E. Gross. "Is There a Psychiatric Diagnosis in Chronic Ankle Instability Patients?" Foot & Ankle Orthopaedics 7, no. 4 (October 2022): 2473011421S0055. http://dx.doi.org/10.1177/2473011421s00553.
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Category: Ankle; Other Introduction/Purpose: Ankle instability is an extremely common clinical entity. Chronic ankle instability (CAI) can develop in some patients, leading to continued pain and dysfunction. However, there is very limited data to date on what impact common psychiatric pathology may have on patients' experience with CAI. This study aimed to investigate the association between psychiatric diagnosis and CAI, and whether having a diagnosed psychiatric illness impacts the outcome of CAI. We hypothesized that a concomitant diagnosis of psychiatric pathology with CAI would be significantly associated with lower postoperative patient- reported outcome measures (PROMs). Methods: A retrospective review was conducted of 276 patients (280 ankles) treated between 2005 and 2021 at an academic medical center by one of three fellowship-trained foot and ankle orthopaedic surgeons, of which 56 underwent surgery and 130 had a concomitant psychiatric diagnosis (i.e., anxiety=111, depression=105, post-traumatic stress disorder [PTSD]=19, obsessive- compulsive disorder [OCD]=6, bipolar disorder [BPD]=5). Data collected included demographics, conservative treatment history, and patient-reported outcome measures (PROMs), such as Visual Analogue Scale (VAS), Brief Resiliency Scale (BRS), 12-Item Short-Form Survey (SF-12), Somatic Symptom Scale (SSS-8), Pain Catastrophizing Scale (PCS), Pain Disability Index (PDI), Foot and Ankle Outcome Score (FAOS), and Foot and Ankle Ability Measure (FAAM). Results: Preoperatively, patients with these concomitant psychiatric diagnoses had worse preoperative PROMs. However, the overall cohort improved postoperatively across all PROMs. In particular, the FAOS Total score relatively increased by 35.28% (preop=57.29%, postop=77.50%, p=.011) and the FAAM Total by 49.86% (preop=45.87%, postop=68.74%, p=.027). Both improvements were significant. Of note, the relative change of pre- to postoperative FAOS and FAAM scores was greater among the mental illness group in all scores but FAOS Sports and Recreation. (Table 1) However, no postoperative PROM among the mental illness group, aside from the FAOS Symptoms and Stiffness score, was as high as the postoperative score of those without mental illness. Although patients with these psychiatric illnesses more often failed conservative measures and subsequently received surgical treatment, this was not significant. Conclusion: CAI patients with a concomitant psychiatric diagnosis improved more following surgery than those without mental illness, as measured by FAOS and FAAM scores. However, the mental illness group did not report postoperative FAOS and FAAM scores as high as those without mental illness. Furthermore, CAI patients with a concomitant mental illness more often failed conservative treatment and went on to receive surgery. Physicians should be aware of this information when counseling CAI patients with a concomitant mental illness.
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Lee, Tae Young, and Hang Joon Jo. "Differential diagnosis and comorbid physical illness of schizophrenia." Journal of the Korean Medical Association 64, no. 8 (August 10, 2021): 551–58. http://dx.doi.org/10.5124/jkma.2021.64.8.551.
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Background: Schizophrenia is a neurodevelopmental disorder that generally develops during adolescence or early adulthood. However, differentiating it from psychosis caused by a physical illness is difficult due to the phenotypebased diagnostic system. In this review, differential diagnosis of schizophrenia and the comorbid physical illnesses of patients with schizophrenia will be discussed.Current Concepts: Psychotic symptoms can be caused by various physical illnesses, and patients with schizophrenia have many physical comorbidities. Symptoms of psychosis can also be expressed by physical illness including brain tumors, encephalitis, temporal lobe epilepsy, autoimmune disease, and genetic disease. For the differential diagnosis of other physical illnesses that can cause psychosis, biological tests are essential. Depending on the cause, antipsychotics and treatment of physical diseases are required. In addition, patients with schizophrenia have many comorbid medical conditions such as obesity, diabetes, cardiovascular disease, but the diagnosis rate is low, and the mortality is higher than that of the general population due to untreated medical diseases.Discussion and Conclusion: The differential diagnoses of schizophrenia and physical illness causing psychosis are important. To decrease the high mortality of patients with schizophrenia, periodic physical condition examinations and mental status examinations should be conducted.
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Bril-Barniv, Shani, Galia S. Moran, Adi Naaman, David Roe, and Orit Karnieli-Miller. "A Qualitative Study Examining Experiences and Dilemmas in Concealment and Disclosure of People Living With Serious Mental Illness." Qualitative Health Research 27, no. 4 (October 24, 2016): 573–83. http://dx.doi.org/10.1177/1049732316673581.
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People with mental illnesses face the dilemma of whether to disclose or conceal their diagnosis, but this dilemma was scarcely researched. To gain in-depth understanding of this dilemma, we interviewed 29 individuals with mental illnesses: 16 with major depression/bipolar disorders and 13 with schizophrenia. Using a phenomenological design, we analyzed individuals’ experiences, decision-making processes, and views of gains and costs regarding concealment and disclosure of mental illness. We found that participants employed both positive and negative disclosure/concealment practices. Positive practices included enhancing personal recovery, community integration, and/or supporting others. Negative practices occurred in forced, uncontrolled situations. We also identified various influencing factors, including familial norms of sharing, accumulated experiences with disclosure, and ascribed meaning to diagnosis. Based on these findings, we deepen the understanding about decision-making processes and the consequences of disclosing or concealing mental illness. We discuss how these finding can help consumers explore potential benefits and disadvantages of mental illness disclosure/concealment occurrences.
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Mirabile, Charles S., and Martin H. Teicher. "Hand Preference and Diagnosis in Major Mental Illness." Perceptual and Motor Skills 95, no. 3 (December 2002): 875–76. http://dx.doi.org/10.2466/pms.2002.95.3.875.
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A sample of 1,671 patients in a long-term psychiatric inpatient hospital were polled for hand preference in writing. Nonright-handers ( n = 420) were more often diagnosed schizophrenic than Right-handers ( n 1,251), but the overall proportion of psychotic illness was the same in both handedness groups, suggesting the possibility that nonright-handedness may be associated with a change in the expression of psychotic illness so it is somewhat more likely to be manifest as thought disorder than mood disorder.
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Bongiorno, Frank P. "DUAL DIAGNOSIS-DEVELOPMENTAL DISABILITY COMPLICATED BY MENTAL ILLNESS." Southern Medical Journal 88 (October 1995): S58. http://dx.doi.org/10.1097/00007611-199510001-00116.
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Sayre, Joan. "The Patient’s Diagnosis: Explanatory Models of Mental Illness." Qualitative Health Research 10, no. 1 (January 2000): 71–83. http://dx.doi.org/10.1177/104973200129118255.
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Schmidt, Mathias, Saskia Wilhelmy, and Dominik Gross. "Retrospective diagnosis of mental illness: past and present." Lancet Psychiatry 7, no. 1 (January 2020): 14–16. http://dx.doi.org/10.1016/s2215-0366(19)30287-1.
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O'Connor, Cliodhna. "Public perspectives on AI diagnosis of mental illness." General Psychiatry 37, no. 3 (May 2024): e101370. http://dx.doi.org/10.1136/gpsych-2023-101370.
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Reid, Jeffrey. "Mental Illness as Irony: Hegel's Diagnosis of Novalis." Studia Hegeliana 10 (June 1, 2024): 7–21. http://dx.doi.org/10.24310/stheg.10.2024.17808.
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Hegel reads the poet Novalis as an expression of terminal irony, a pathological case of Gemüt, where the conscious mind is alienated from reality and turns its negativity inwards on the contents of its own natural soul. The condition of self-feeling, presented in Hegel’s “Anthropology”, is a self-consumption that manifests itself somatically in the physical disease (consumption) from which Novalis dies. The poet’s literary production represents a pathological fixation that impedes the dynamic organicity of Hegelian Science. As such, Novalis’s mental illness and death constitute an expression of romantic irony and an ongoing threat to Hegel’s philosophy.
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Riyahi, Azade, Hosseinali Abdolrazaghi, Nazanin Sarlak, Sepideh Faraji, and Zahra Nobakht. "Comparison of time-use patterns and self-efficacy in family caregivers of patients with chronic disease." International Journal of Therapy and Rehabilitation 27, no. 12 (December 2, 2020): 1–10. http://dx.doi.org/10.12968/ijtr.2018.0129.
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Background/Aims Caregivers perform an important role but caring affects other roles they perform, resulting in poor time management and reduced quality of life. This study aimed to compare the time-use patterns and self-efficacy of caregivers of two groups of patients with chronic disease: those with a diagnosis of mental illness and those without a diagnosis of mental illness. Methods Family caregivers of patients with a chronic disease who were aged between 20–60 years, resident in Arak, not taking care of another patient and literate were eligible to participate. The presence of mental illness was based on a psychiatrist's diagnosis at least 6 months before the study. The Mothers' Time Use Questionnaire, Sherer Self-efficacy Scale and a demographic questionnaire were used to capture data relating to time-use, self-efficacy and participant characteristics. Data were analysed using independent t-test and Mann–Whitney U test to identify and compare time-use patterns and self-efficacy. Results There were no significant between-group differences in demographics or mean time-use scores in six domains (rest/sleep, leisure, housework, work/occupation, social participation and satisfaction with time management). Self-care time-use scores (time, quality, importance and enjoyment) were significantly higher for caregivers of patients with chronic disease with a diagnosis of mental illness. Patient care time-use scores were significantly higher for caregivers of patients with chronic disease without a diagnosis of mental illness. Mean self-efficacy score was significantly higher in the group caring for patients with a diagnosis of psychiatric disease. Conclusions Chronic physical illnesses may result in greater dependence on caregivers than mental illness, increasing the amount of time spent on care and reducing caregiver self-efficacy.
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Raharisti, Nur Arifah, Vihi Atina, and Dwi Hartanti. "Penerapan Metode Dempster Shafer Pada Sistem Pakar Diagnosis Penyakit Kejiwaan." Infotek: Jurnal Informatika dan Teknologi 7, no. 2 (July 24, 2024): 467–77. http://dx.doi.org/10.29408/jit.v7i2.26123.
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Mental illness is a condition where the sufferer has problems related to mental, physical, developmental and social disorders which can hinder the life process in interacting with the environment or other people properly. Limited mental health service facilities and a lack of understanding about mental illness often cause sufferers to ignore their condition, which can worsen their illness. From this problem, so it is necessary to have an expert system that can diagnose mental illness. This research aims to produce the design and development of an expert system for diagnosing mental illness so that it is able to overcome existing limitations and reduce the level of risk of mental illness. The Dempster Shafer method is used to assess the level of confidence in decision making regarding a disease by paying attention to each selected symptom value. This research produces an expert system that includes 28 symptom data and 5 disease data providing output in the form of diagnosis results, symptoms, the highest percentage of a disease and appropriate advice. This system has been tested with 15 test data, with an accuracy success rate of 86.6%.
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Choo, Carol C., Peter K. H. Chew, and Roger C. Ho. "Controlling Noncommunicable Diseases in Transitional Economies: Mental Illness in Suicide Attempters in Singapore—An Exploratory Analysis." BioMed Research International 2019 (January 15, 2019): 1–8. http://dx.doi.org/10.1155/2019/4652846.
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Background. Mental illness is a pertinent risk factor related to suicide. However, research indicates there might be underdiagnosis of mental illness in Asian suicide attempters; this phenomenon is concerning. This study explored prediction of diagnosis of mental illness in suicide attempters in Singapore using available variables. Methods. Three years of medical records related to suicide attempters (N = 462) who were admitted to the emergency department of a large teaching hospital in Singapore were subjected to analysis. Of the sample, 25% were diagnosed with mental illness; 70.6% were females and 29.4% were males; 62.6% were Chinese, 15.4% Malays, and 16.0% Indians. Their age ranged from 12 to 86 (M = 29.37, SD = 12.89). All available variables were subjected to regression analyses. Findings. The full model was significant in predicting cases with and without diagnosis of mental illness and accurately classified 79% of suicide attempters with diagnosis of mental illness. Conclusions. The findings were discussed in regard to clinical implications in diagnosis and primary prevention.
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Weiss, Mary Jane. "Dual Diagnosis: Updated Information on Treating Mental Illness and Mental Retardation." Contemporary Psychology: A Journal of Reviews 40, no. 11 (November 1995): 1098–99. http://dx.doi.org/10.1037/004138.
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Singh, Nirbhay N., Aradhana Sood, Neil Sonenklar, and Cynthia R. Ellis. "Assessment and Diagnosis of Mental Illness in Persons with Mental Retardation." Behavior Modification 15, no. 3 (July 1991): 419–43. http://dx.doi.org/10.1177/01454455910153008.
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Archambault, Étienne, Simone N. Vigod, Hilary K. Brown, Hong Lu, Kinwah Fung, Michelle Shouldice, and Natasha Ruth Saunders. "Mental Illness Following Physical Assault Among Children." JAMA Network Open 6, no. 8 (August 16, 2023): e2329172. http://dx.doi.org/10.1001/jamanetworkopen.2023.29172.
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ImportancePhysical assault during childhood is common and can lead to lasting mental health problems. Yet, there are few studies on the patterns of mental illness (ie, timing of onset, type, and acuity) in survivors of physical assault.ObjectiveTo determine the risk of incident health record diagnoses of mental illness among children who experienced assault compared with children who did not.Design, Setting, and ParticipantsThis population-based matched cohort study used linked health administrative data sets in Ontario, Canada. Children aged 0 to 13 years who experienced an incident physical assault between 2006 and 2014 were age-matched (1:4) to children who had not experienced assault and followed up for a minimum of 5 years. Data were analyzed from January 2020 to March 2022.ExposurePhysical assault resulting in hospitalization or an emergency department (ED) visit between the ages of 0 and 13 years.Main Outcomes and MeasuresThe primary outcome was incident health record diagnosis of mental illness measured as any physician or hospital mental health care use or completed suicide. Secondary outcome measures included the acuity of incident mental illness and mental illness diagnostic category. Cox proportional hazards regression analysis generated hazard ratios (HR) for incident mental illness.ResultsA total of 21 948 children unexposed to assault and 5487 exposed to assault were included in the study with a mean (SD) age of 7.0 (4.6) years. There were more boys in the group that experienced assault (3006 individuals [54.8%]) compared with the group who did not (9909 individuals [45.1%]). Compared with children unexposed to assault, those exposed were more likely to be in the highest deprivation index quintile (standardized difference, 0.21) and live in rural areas (standardized difference, 0.48). Their mothers more often had active mental illness (standardized difference, 0.35). More than one-third of the exposed children had a health record diagnosis of mental illness (2219 children [38.6%]; incidence rate (IR), 53.3 per 1000 person-years) compared with 23.4% (5130 children; IR, 32.2 per 1000 person-years) of unexposed children, with an overall adjusted hazard ratio (aHR) of 1.96 (95% CI, 1.85-2.08). The greatest risk was observed in the first year following the assault (aHR, 3.08; 95% CI, 2.68-3.54). In both groups, nonpsychotic disorders were the most common type of mental illness. Initial mental illness diagnoses occurred in an acute care setting for 14.0% of exposed children (769 children) vs 2.8% of unexposed children (609 children).Conclusions and RelevanceIn this population-based matched cohort study, children who experienced assault had, on average, a 2 times higher risk of receiving a mental illness diagnosis and were more likely than children who had not experienced assault to present to acute care for mental illness. Early intervention to support mental health of assaulted children is warranted, particularly in the first year following assault.
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Kim, Ho Joon, Sam Yi Shin, and Seong Hoon Jeong. "Nature and Extent of Physical Comorbidities Among Korean Patients With Mental Illnesses: Pairwise and Network Analysis Based on Health Insurance Claims Data." Psychiatry Investigation 19, no. 6 (June 25, 2022): 488–99. http://dx.doi.org/10.30773/pi.2022.0068.
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Objective The nature of physical comorbidities in patients with mental illness may differ according to diagnosis and personal characteristics. We investigated this complexity by conventional logistic regression and network analysis.Methods A health insurance claims data in Korea was analyzed. For every combination of psychiatric and physical diagnoses, odds ratios were calculated adjusting age and sex. From the patient-diagnosis data, a network of diagnoses was constructed using Jaccard coefficient as the index of comorbidity.Results In 1,017,024 individuals, 77,447 (7.6%) were diagnosed with mental illnesses. The number of physical diagnoses among them was 11.2, which was 1.6 times higher than non-psychiatric groups. The most noticeable associations were 1) neurotic illnesses with gastrointestinal/ pain disorders and 2) dementia with fracture, Parkinson’s disease, and cerebrovascular accidents. Unexpectedly, the diagnosis of metabolic syndrome was only scarcely found in patients with severe mental illnesses (SMIs). However, implicit associations between metabolic syndrome and SMIs were suggested in comorbidity networks.Conclusion Physical comorbidities in patients with mental illnesses were more extensive than those with other disease categories. However, the result raised questions as to whether the medical resources were being diverted to less serious conditions than more urgent conditions in patients with SMIs.
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Bhui, Kamaldeep. "From the Editor's desk." British Journal of Psychiatry 207, no. 5 (November 2015): 467–68. http://dx.doi.org/10.1192/bjp.207.5.467.
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Is medical illness a myth?The National Institute of Health's (NIH's) emphasis on mental illness as a brain disorder has transformed psychiatric research and attitudes towards mental illness. Despite the departure of the Director of the National Institute of Mental Health, Thomas Insel, to join Google Life Sciences (http://www.nih.gov/about/director/09152015_statement_insel.htm), the move away from symptom-based diagnoses in favour of more neuroscientific rationales for diagnosis is necessary and likely to be sustained. The absence of demonstrable organic pathology in mental illnesses motivated the NIH programmes, yet essentially all behaviours and adaptations to context will have physiological correlates; Google and other software and technology companies may well offer better and more powerful methods for assessing pathophysiology and making diagnoses in the future. Such shifts in diagnostic practice require much disciplined research, and seem to not obviate the need for compassionate, caring and emotionally intelligent clinicians who are able to contain and negotiate meanings and experiences, and transform conversations and care packages to positive outcomes for patients.
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Rothenberg, Albert. "DIAGNOSIS OF OBSESSIVE-COMPULSIVE ILLNESS." Psychiatric Clinics of North America 21, no. 4 (December 1998): 791–801. http://dx.doi.org/10.1016/s0193-953x(05)70041-1.
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Mlambo, Kupukai. "Does mental health matter? Commentary on the provision of mental health services in Mozambique." International Psychiatry 9, no. 2 (May 2012): 36–38. http://dx.doi.org/10.1192/s1749367600003064.
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Despite attempts made in recent years to address the diagnosis and treatment of mental illness in Mozambique, service provision remains deficient. The present paper focuses on the attitudes to mental illness and its diagnosis and treatment in Mozambique. This paper is based on both a thorough literature search and on the results of qualitative interviews carried out with six individuals of Mozambican origin now living in the UK.
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Enticott, Joanne C., I.-Hao Cheng, Grant Russell, Josef Szwarc, George Braitberg, Anne Peek, and Graham Meadows. "Emergency department mental health presentations by people born in refugee source countries: an epidemiological logistic regression study in a Medicare Local region in Australia." Australian Journal of Primary Health 21, no. 3 (2015): 286. http://dx.doi.org/10.1071/py13153.
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This study investigated if people born in refugee source countries are disproportionately represented among those receiving a diagnosis of mental illness within emergency departments (EDs). The setting was the Cities of Greater Dandenong and Casey, the resettlement region for one-twelfth of Australia’s refugees. An epidemiological, secondary data analysis compared mental illness diagnoses received in EDs by refugee and non-refugee populations. Data was the Victorian Emergency Minimum Dataset in the 2008–09 financial year. Univariate and multivariate logistic regression created predictive models for mental illness using five variables: age, sex, refugee background, interpreter use and preferred language. Collinearity, model fit and model stability were examined. Multivariate analysis showed age and sex to be the only significant risk factors for mental illness diagnosis in EDs. ‘Refugee status’, ‘interpreter use’ and ‘preferred language’ were not associated with a mental health diagnosis following risk adjustment for the effects of age and sex. The disappearance of the univariate association after adjustment for age and sex is a salutary lesson for Medicare Locals and other health planners regarding the importance of adjusting analyses of health service data for demographic characteristics.
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Kovyazina, M., E. Rasskazova, N. Varako, and S. Palatov. "Personality, Psychopathological Symptoms and Illness Perception in Mental Disorders: Results from Russian MMPI-2 Validation Study." European Psychiatry 41, S1 (April 2017): S713—S714. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1277.
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IntroductionAccording to common-sense model illness representation regulates her coping both in somatic and mental illnesses.ObjectivesAs a personal reaction illness representation should partially depend not only on diagnosis and symptoms but also on personality. Aim is to identify direct and indirect effects of personality and psychopathological complaints in illness representation in mental disorders.MethodsEighty patients (20 males) from MMPI-2 validation sample (Butcher et al., 2001) filled revised version of Illness Perception Questionnaire and Symptom Checklist 90-R. Eleven patients met ICD-10 criteria for addictions, 28 – for mood disorders, 20 – for schizophrenia and schizotypal disorder, 21 – for acute stress reactions.ResultsAccording to moderation analysis, illness-related beliefs in mental disorders are relatively independent on clinical diagnosis and specific symptoms, but are associated with the overall level of psychopathological complaints. Regardless of the clinical group and complaints, depressive traits are associated with negative and emotional appraisal of illness. Social introversion and hypomanic activation serve as moderators of the relationship between complaints, illness duration and emotional representations.ConclusionsPersonality and overall level of psychopathological symptoms could be stronger predictor of illness-related beliefs than specific clinical factors in mental illness. Preliminary diagnostics of personality in mental illnesses could be used to reveal high-risk group for poor insight and non-compliance due to unrealistic beliefs. Research supported by the grant of President of the Russian Federation for the state support for young Russian scientists, project MK2193.2017.6.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Gaedtke, Andrew. "Diagnosis, Literature, and Legitimation." American Literary History 35, no. 3 (June 21, 2023): 1317–25. http://dx.doi.org/10.1093/alh/ajad147.
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Abstract This commentary responds to several patterns in the articles that constitute the special issue on “Diagnosing America” and underscores questions of legitimacy related to the history of psychiatric diagnoses. Clinical diagnosis often operates as a speech-act through which a patient’s distress is made recognizable and legitimated. However, diagnostic categories have long been plagued by questions of legitimacy from within and beyond the field of psychiatry. Despite attempts to resolve these controversies through successive editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM), concerns about the validity and reliability of diagnostic categories persist. The stakes of such questions are significant. Diagnostic categories may not only describe but can also shape historically shifting expressions of mental illness and their treatments. Many works of contemporary literature have engaged in these debates by foregrounding the social, political, and phenomenological dimensions of mental illness that have often been absent from diagnostic and therapeutic procedures. Such works prompt fundamental questions about how and why certain categories of mental illness come to be recognized as real. Discussions of the cultural and social dimensions of psychiatric diagnosis should include . . . questions of legitimacy—not of patients’ distress but of the nosological systems that purport to recognize forms of distress as real according to the historically prevailing ontology.
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Sloan, Graham. "Mental Illness and the Body - Beyond DiagnosisMental Illness and the Body - Beyond Diagnosis." Nursing Standard 21, no. 9 (November 8, 2006): 30. http://dx.doi.org/10.7748/ns2006.11.21.9.30.b542.
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Bråten, Ragnhild Haugli, Susanna Sten-Gahmberg, Christoffer Bugge, Ivar Sønbø Kristiansen, Erlend Strand Gardsjord, and Erik Magnus Sæther. "Økt bruk av psykiske diagnoser for unge." Tidsskrift for Norsk psykologforening 60, no. 4 (March 31, 2023): 208–15. http://dx.doi.org/10.52734/vhhp4493.
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Background/aim: Substance abuse and mental illness cause considerable health loss in Norway. Prescription and survey data indicate increased occurrence of such ailments among young people. The aim of this study was to explore the trend in the assignment of mental health diagnoses among primary care physicians and in specialist health care. Methods: We linked data from the national primary care register Norwegian Control and Payment of Health Reimbursements Database (KUHR) and the Norwegian Patient Registry for specialist care for the years 2008–2018 for individuals born between 1986 and 1997. For each episode of care, we received information on age, sex and registered diagnosis. We estimated proportions of the population that had been diagnosed with various mental illnesses for the age groups 15–21 and 22–28 in the birth cohorts 1993–1997 and 1986–1990. Results: In the cohort that turned 21 years of age in 2018, 30% of women and 23% of men had been diagnosed with a mental illness during the period 2012–2018. The proportions increased from 23% for women and 21% for men in the cohort that turned 21 years of age in 2014. A similar increase was observed among those aged 22–28. Anxiety and depression-related diagnoses accounted for the greatest increases in both age groups. Implications: We find increased assignment of mental health diagnoses for young people during the period 2008–2018. This increase may be caused by a higher occurrence of mental health problems and illnesses, expanded treatment provision, change of diagnostic criteria among clinicians and/or a lower threshold for seeking help. Keywords: mental health diagnoses, mental illness, mental disorders, young adults, youth
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Copeland, J. R. M., and M. E. Dewey. "Neuropsychological Diagnosis (GMS-HAS-AGECAT Package)." International Psychogeriatrics 3, S1 (March 1991): 43–49. http://dx.doi.org/10.1017/s1041610205001122.
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The limitations of establishing neuropsychological diagnosis through psychological testing and psychiatric examination by clinicians are discussed, along with the need to define cases of illness in a standardized way for research. The GMS-HAS-AGECAT package is a standardized assessment of mental state and historical information about onset of illness, from which data are used in a computer-assisted method to derive clinically based diagnoses of the principal types of dementia, depression and other mental illness. Recording is made of co-morbid states and levels of diagnostic confidence. Agreement between psychiatrists on AECAT diagnoses ranges from kappa values of 0.76 to 0.88, and validity has now been tested further by outcome studies. A short description is given of the Medical Research Council, EURODEM, World Health Organization and Pan American Health Organization studies now using this method.
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Jacob, KS. "Psychosocial adversity and mental illness: Differentiating distress, contextualizing diagnosis." Indian Journal of Psychiatry 55, no. 2 (2013): 106. http://dx.doi.org/10.4103/0019-5545.111444.
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Whalen, Ruth. "Ongoing caffeine anaphylaxis: a differential diagnosis for mental illness." Medical Veritas: The Journal of Medical Truth 1 (November 2004): 252–60. http://dx.doi.org/10.1588/medver.2004.01.00028.
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Rose, Diana, and Graham Thornicroft. "Service user perspectives on the impact of a mental illness diagnosis." Epidemiologia e Psichiatria Sociale 19, no. 2 (June 2010): 140–47. http://dx.doi.org/10.1017/s1121189x00000841.
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SummaryAim – to provide a conceptual and practical analysis of the impacts of mental health diagnoses on consumers and to consider how service users might contribute to the new psychiatric classifications currently being drawn up. Methods – A search was carried out revealing a very sparse literature on this topic. Consultations with service users were conducted and the views of experts sought. Results – Diagnosis is important as it marks the formal status of psychiatric patient being conferred. Consumers react differently, and often, negatively to this. Stigma can follow from a diagnosis. The process of giving a diagnosis can range from one of negotiation and taking the person's strengths into account to the blunt allocation of an unwanted label. Consumers can be reduced to their diagnosis so it becomes their whole personhood and this can have an effect on their sense of self. However, consumers are not passive victims and have their own strategies for dealing with these issues. Conclusion – Consumers can use these experiences to make contributions to the new diagnostic classification systems and to future research.
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Alvarez Montoya, A. M., C. Diago Labrador, and T. Ruano Hernandez. "Illness or simulation." European Psychiatry 33, S1 (March 2016): S387. http://dx.doi.org/10.1016/j.eurpsy.2016.01.1390.
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ObjectivesThe revision of the differential diagnosis of simulation cases versus real psychopathological cases. Analysis of a case of the Ganser syndrome by revising the diagnosis criterions and their historical characteristics.MethodWe analyze the case of a 38-year-old male who came to the community mental health team and reference hospital. Following symptoms were observed: involuntary movements of the upper extremities associated with delirium coinciding with the premature birth of a child. This refers also to a compatible episode of a dissociative fugue.ResultsTo establish the diagnosis, we differentiate against disorders such as Simulation, factitious disorders with psychological symptoms or Factitious Disorders with somatic symptoms (Münchhausen syndrome). In order to support our diagnosis, we base on the CIE-10 and the DSM-IVTR classification.ConclusionsWe don’t diagnose the clinical pictures in which we don’t think. The Syndrome of Ganser could be positioned between neurosis and psychosis and between illness and simulation. The recommended treatment includes hospitalization in order to insure the diagnosis. While some authors recommend neuroleptics and others - anxiolytics, the psychotherapy is obligatory. The goal is to help the patient restore function and adapt to his environment again.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Dinos, Sokratis, Scott Stevens, Marc Serfaty, Scott Weich, and Michael King. "Stigma: the feelings and experiences of 46 people with mental illness." British Journal of Psychiatry 184, no. 2 (February 2004): 176–81. http://dx.doi.org/10.1192/bjp.184.2.176.
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BackgroundStigma defines people in terms of some distinguishing characteristic and devalues them as a consequence.AimsTo describe the relationship of stigma with mental illness, psychiatric diagnosis, treatment and its consequences of stigma for the individual.MethodNarrative interviews were conducted by trained users of the local mental health services; 46 patients were recruited from community and day mental health services in North London.ResultsStigma was a pervasive concern to almost all participants. People with psychosis or drug dependence were most likely to report feelings and experiences of stigma and were most affected by them. Those with depression, anxiety and personality disorders were more affected by patronising attitudes and feelings of stigma even if they had not experienced any overt discrimination. However, experiences were not universally negative.ConclusionsStigma may influence how a psychiatric diagnosis is accepted, whether treatment will be adhered to and how people with mental illness function in the world. However, perceptions of mental illness and diagnoses can be helpful and non-stigmatising for some patients.
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Holzman, Lois, and Elisabeth Genn. "Diagnosis: A Thousand People Speak Out." Journal of Humanistic Psychology 59, no. 1 (August 2, 2018): 48–68. http://dx.doi.org/10.1177/0022167818791852.
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The public is rarely asked its opinions concerning mental health issues and, as revealed by a literature search, is almost never surveyed on this topic without the use of medicalized, diagnostic, forced choice illness language. This article reports on an ongoing community outreach project that gave people the opportunity to reflect on and share their thoughts about the medical-mental illness-diagnostic model and its impact on their lives. Two organizations with long-standing opposition to the individualized model of human development and the medicalized understanding of emotionality designed and conducted open-ended surveys on emotional distress and diagnosis online and at two New York City street fairs. Results from over 1,000 surveys indicate that mental illness diagnosis is viewed as a “necessary evil” at best, and an isolating and destructive practice at worst. The results strongly suggest that nonmental health professionals are important allies in the fight for alternatives to diagnosis.
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Thornicroft, Graham. "Stigma and discrimination limit access to mental health care." Epidemiologia e Psichiatria Sociale 17, no. 1 (March 2008): 14–19. http://dx.doi.org/10.1017/s1121189x00002621.
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AbstractThis editorial provides an overview of how far access to mental health care is limited by perceptions of stigma and anticipated discrimination. Globally over 70% of young people and adults with mental illness receive no treatment from healthcare staff. The rates of non-treatment are far higher in low income countries. Evidence from some descriptive studies and epidemiological surveys suggest that potent factors increasing the likelihood of treatment avoidance, or long delays before presenting for care include: (i) lack of knowledge about the features and treatability of mental illnesses; (ii) ignorance about how to access assessment and treatment; (iii) prejudice against people who have mental illness, and (iv) expectations of discrimination against people who have a diagnosis of mental illness. The associations between low rates of help seeking, and stigma and discrimination are as yet poorly understood and require more careful characterisation and analysis, providing the platform for more effective action to ensure that a greater proportion of people with mental illness are effectively treated in future.
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Snedkov, Evgeny V. "Does psychometry increase the quality of psychiatric diagnosis?" Neurology Bulletin LII, no. 3 (January 26, 2021): 15–20. http://dx.doi.org/10.17816/nb44806.
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Norm and illness, stages of illness, forms of illness differ from each other in qualitative, and not quantitative characteristics. Psychometric tools are unable to capture the gestalt of the clinical picture and determine the qualitative changes taking place in it. The article argues for the pseudoscientific basis and unreliability of quantitative measurements of intelligence, personality, statics and dynamics of mental illness.
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Crome, Ilana B., and Tracey Myton. "Pharmacotherapy in dual diagnosis." Advances in Psychiatric Treatment 10, no. 6 (November 2004): 413–24. http://dx.doi.org/10.1192/apt.10.6.413.
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The prevalence of coexisting substance misuse and psychiatric disorder (dual diagnosis, comorbidity) has increased over the past decade, and the indications are that it will continue to rise. There have simultaneously been unprecedented developments in the pharmacological treatment of alcohol, opiate and nicotine misuse. Here we evaluate the evidence on the use of some of these treatments in dual diagnosis (with psychotic, mood and anxiety disorders). The evidence base is limited by the exclusion of mental illness when pharmacological agents for substance misuse are evaluated and vice versa. We set the available information within the context of the psychosocial management of comorbid substance misuse and mental illness, and the framework for service delivery recommended by UK national policy.
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Gjere, Niki A. "Working With Serious Mental Illness." Clinical Nurse Specialist 21, no. 3 (May 2007): 172. http://dx.doi.org/10.1097/01.nur.0000270011.74587.72.
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Segal, Steven P., Leena Badran, and Lachlan Rimes. "Accessing acute medical care to protect health: the utility of community treatment orders." General Psychiatry 35, no. 6 (December 2022): e100858. http://dx.doi.org/10.1136/gpsych-2022-100858.
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BackgroundThe conclusion that people with severe mental illness require involuntary care to protect their health (including threats due to physical—non-psychiatric—illness) is challenged by findings indicating that they often lack access to general healthcare and the assertion that they would access such care voluntarily if available and effective. Victoria, Australia’s single-payer healthcare system provides accessible medical treatment; therefore, it is an excellent context in which to test these challenges.AimsThis study replicates a previous investigation in considering whether, in Australia’s easy-access single-payer healthcare system, patients placed on community treatment orders, specifically involuntary community treatment, are more likely to access acute medical care addressing potentially life-threatening physical illnesses than voluntary patients with and without severe mental illness.MethodsReplicating methods used in 2000–2010, for the years 2010–2017, this study compared the acute medical care access of three new cohorts: 7826 hospitalised patients with severe mental illness who received a post-hospitalisation, community treatment order; 13 896 patients with severe mental illness released from the hospital without a community treatment order and 12 101 outpatients who were never psychiatrically hospitalised (individuals with less morbidity risk who were not considered to have severe mental illness) during periods when they were under versus outside community mental health supervision. Logistic regression was used to determine the influence of community-based community mental health supervision and the type of community mental health supervision (community treatment order vs non-community treatment order) on the likelihood of receiving an initial diagnosis of a life-threatening physical illness requiring acute care.ResultsValidating their shared elevated morbidity risk, 43.7% and 46.7%, respectively, of each hospitalised cohort (community treatment order and non-community treatment order patients) accessed an initial acute-care diagnosis for a life-threatening condition vs 26.3% of outpatients. Outside community mental health supervision, the likelihood that a community treatment order patient would receive a diagnosis of physical illness was 36% lower than non-community treatment order patients—1.30 times that of outpatients. Under community mental health supervision, their likelihood was two times greater than that of non-community treatment order patients and 6.6 times that of outpatients. Each community treatment order episode was associated with a 14.6% increase in the likelihood of a community treatment order patient receiving a diagnosis. The results replicate those found in an independent 2000–2010 cohort comparison.ConclusionsCommunity mental health supervision, notably community treatment order supervision, in two independent investigations over two decades appeared to facilitate access to physical healthcare in acute care settings for patients with severe mental illness who were refusing treatment—a group that has been subject to excess morbidity and mortality.
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West, Joel. "The Joker on the Couch." International Journal of Semiotics and Visual Rhetoric 3, no. 1 (January 2019): 1–11. http://dx.doi.org/10.4018/ijsvr.2019010101.
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Do tests for various mental illnesses work? How reliable are they and how well do they capture what we call “mental illness?” Since the infamous comic book character, the Joker, has often been called a “psychopath,” and this psychopathy is, culturally, conflated with mental illness, how would a model of the Joker be diagnosed using the current standard tools for psychiatric diagnosis? The authors tested this model Joker against DSM-5, ICD-10 and the PCL-R. They then discussed the results of these tests and concluded that the Joker as captured in Alan Moore and Brian Bolland's The Killing Joke is a psychopath according to current medical and psychiatric models. They also discussed issues with the models of mental illness used by these tests.
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Jabbar, F., A. Doherty, R. Duffy, M. Aziz, P. Casey, J. Sheehan, T. Lynch, and B. D. Kelly. "The role of a neuropsychiatry clinic in a tertiary referral teaching hospital: a 2-year study." Irish Journal of Psychological Medicine 31, no. 4 (July 30, 2014): 271–73. http://dx.doi.org/10.1017/ipm.2014.38.
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ObjectivesMental disorder is common among individuals with neurological illness. We aimed to characterise the patient population referred for psychiatry assessment at a tertiary neurology service in terms of neurological and psychiatric diagnoses and interventions provided.MethodsWe studied all individuals referred for psychiatry assessment at a tertiary neurology service over a 2-year period (n= 82).ResultsThe most common neurological diagnoses among those referred were epilepsy (16%), Parkinson’s disease (15%) and multiple sclerosis (8%). The most common reasons for psychiatric assessment were low mood or anxiety (48%) and medically unexplained symptoms or apparent functional or psychogenic disease (21%). The most common diagnoses among those with mental disorder were mood disorders (62%), and neurotic, stress-related and somatoform disorders, including dissociative (conversion) disorders (28%). Psychiatric diagnosis was not related to gender, neurological diagnosis or psychiatric history.ConclusionIndividuals with neurological illness demonstrate significant symptoms of a range of mental disorders. There is a need for further research into the characteristics and distribution of mental disorder in individuals with neurological illness, and for the enhancement of integrated psychiatric and neurological services to address the comorbidities demonstrated in this population.
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Brown, Maria Teresa, and Douglas A. Wolf. "Estimating the Prevalence of Serious Mental Illness and Dementia Diagnoses Among Medicare Beneficiaries in the Health and Retirement Study." Research on Aging 40, no. 7 (August 31, 2017): 668–86. http://dx.doi.org/10.1177/0164027517728554.
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Objective: To estimate the prevalence of serious mental illness and dementia among Medicare beneficiaries in the Health and Retirement Study (HRS). Methods: This study utilizes HRS-linked Medicare claims data sets and inverse probability weighting to estimate overall and age-specific cumulative prevalence rates of dementia and serious mental illnesses among 18,740 Medicare beneficiaries. Two-way tabulations determine conditional probabilities of dementia diagnoses among beneficiaries diagnosed with specific mental illnesses, and binary logistic regressions determine conditional probabilities of dementia diagnoses among beneficiaries diagnosed with specific mental illnesses, controlling for covariates. Results: Weighted prevalence estimates for dementia, schizophrenia (SZP), bipolar disorder (BPD), and major depressive disorder (MDD) are similar to previous studies. Odds of dementia diagnosis are significantly greater for beneficiaries diagnosed with SZP, BPD, or MDD. Conclusions: Co-occurring mental disabilities require further investigation, as in the near future increasing numbers of mentally ill older adults will need appropriate and affordable community-based services and supports.
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Guðmundsson, Ólafur Ó., Guðmundur Hjaltalín, Haukur Eggertsson, and Þóra Jónsdóttir. "Diagnosis, rehabilitation and development of disability 2000-2019 in Iceland." Læknablaðið 107, no. 12 (December 4, 2021): 575–80. http://dx.doi.org/10.17992/lbl.2021.12.664.
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INTRODUCTION: The disability assessment standard based on medically recognized illnesses or disabilities was introduced in Iceland 1999. The aim of this study is to examine the development of Social Insurance Administration (Tryggingastofnun ríkisins, TR) rulings regarding rehabilitation and disability pensions over a twenty-year period, since its introduction. MATERIAL AND METHODS: All registered diagnoses in the medical certificates of TR due to the approved rehabilitation or disability pension were examined in the period 2000-2019. The gender distribution and age distribution of these applicants and the number development during the period are described. At the same time, costs as a percentage of government expenditure are examined. RESULTS: The number of younger rehabilitation pensioners has increased rapidly in recent years, at the same time as the relative increase in disability pensioners has slowed slightly. Mental and musculoskeletal disorders are by far the most common types of illness leading to disability. Mental illnesses differ in terms of age distribution and increase over time. The proportion of individuals aged 18-66 with a 75% disability assessment has increased by a third during the period, from about 6% to 8%. The gender distribution of disability pensioners remains similar, with women accounting for 62% in total. Women are much more likely to receive disability pension due to musculoskeletal disorders than men and men are somewhat more likely to suffer from mental illness. The relative development of central government expenditure on total payments to rehabilitation and pensioners continues to grow as a proportion of central government expenditure. CONCLUSION: The number of rehabilitation pensioners has increased significantly since 2018, at the same time as the number of disability pensioners has decreased and there are indications that rehabilitation results in a lower number of new disability pensioners. Mental and musculoskeletal disorders are by far the most common types of illness leading to disability. A slightly lower proportion of disabled people have psychiatric diagnosis as a first diagnosis in the period 2000-2019 compared to those with a valid disability assessment in 2005, but the proportion of musculoskeletal disorders is slightly higher. Nevertheless, mental illnesses differ in age distribution and increase over time.
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Avina, Robert M., Jim E. Banta, Ronald Mataya, Benjamin J. Becerra, and Monideepa B. Becerra. "Burden of Mental Illness among Primary HIV Discharges: A Retrospective Analysis of Inpatient Data." Healthcare 10, no. 5 (April 26, 2022): 804. http://dx.doi.org/10.3390/healthcare10050804.
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Background: Empirical evidence demonstrates the substantial burden of mental illness among people living with HIV and AIDS (PLWHA). Current literature also notes the co-morbidity of these two illnesses and its impact on quality of life and mortality. However, little evidence exists on patient outcomes, such as hospital length of stay or post-discharge status. Methods: A retrospective analysis of National Inpatient Sample data was conducted. The study population was defined as discharges having a primary diagnosis of HIV based on International Classification of Disease, 10th Revision, Clinical Modification (ICD-10-CM) codes in primary diagnosis field. Clinical Classification Software (CCS) codes are used to identify comorbid mental illness. Length of stay was defined as number of days between hospital admission and discharge. Disposition (or post-discharge status) was defined as routine versus not routine. Patient and hospital characteristics were used as control variables. All regression analyses were survey-weighted and adjusted for control variables. Results: The weighted population size (N) for this study was 26,055 (n = 5211). Among primary HIV discharges, presence of any mental illness as a secondary discharge was associated with 12% higher LOS, when compared to a lack of such comorbidity (incidence rate ratio [IRR] = 1.12, 95% confidence interval [CI] = 1.05, 1.22, p < 0.01). Likewise, among primary HIV discharges, those with mental illness had a 21% lower routine disposition, when compared to those without any mental illness (OR = 0.79, 95% CI = 0.68, 0.91, p < 0.001). Conclusion: Our results highlight the need for improved mental health screening and coordinated care to reduce the burden of mental illness among HIV discharges.