The recognition of psychiatric

morbidity on a medical oncology

ward
A Hardman 1, P Maguire, D Crowther
Affiliations expand

 PMID: 2724199

 DOI: 10.1016/0022-3999(89)90051-2

Abstract
The Generalised Health Questionnaire and Standardised Psychiatric Interview
were used to determine psychiatric morbidity among 126 patients consecutively
admitted to a medical oncology unit. Senior house officers and nurses also rated
anxiety and depression. 36 (29%) patients were psychiatrically ill and affective
disorders (29, 23%) predominated. Psychiatric morbidity was associated with
feeling moderately or severely physically ill, and previous psychiatric illness, but
not with awareness of having cancer or lack of a confiding tie. The General Health
Questionnaire identified 79% of affective disorders at the cost of a 34% false
positive rate. Doctors and nurses recognised only 49% of the depressed group;
more of those with morbid anxiety (79%) were identified but only because they
assumed most patients were anxious. Training in interviewing skills could
substantially improve the identification and referral rates of patients with
psychiatric morbidity.
 Psychiatric morbidity in Chinese
patients with chronic hepatitis B
infection in a local infectious
disease clinic
H Chan 1, C S Yu, S Y Li
Affiliations expand

 PMID: 23271585

Free article

Abstract
OBJECTIVE. To determine the prevalence of psychiatric morbidity, identify
correlates of psychiatric morbidities, and evaluate the effectiveness of the 12-item
General Health Questionnaire as a screening tool for psychiatric morbidity in
Chinese patients infected with chronic hepatitis B. METHODS. This cross-sectional
study was conducted in a local public specialist outpatient infectious disease clinic
from October 2008 to June 2009, in which a total of 160 patients were randomly
selected. Psychiatric diagnoses were established by using the Chinese-Bilingual
Structured Clinical Interview for the DSM-IV (Axis I Disorders). Scores for the
General Health Questionnaire were compared against the psychiatric diagnoses.
RESULTS. Among 149 patients, the respective point prevalence of overall
psychiatric disorders, depressive disorders, and anxiety disorders was 32%, 16%,
and 14%. A family history of psychiatric disorder and absence of knowledge of
mode of hepatitis B virus transmission were identified as being associated with
current psychiatric disorders, current depressive disorders, and current anxiety
disorders. Absence of a confidant was an independent factor for current
depressive disorders and use of herbal medicine in the previous month was an
independent factor for current anxiety disorders. CONCLUSIONS. Psychiatric
disorders are common in Chinese patients with chronic hepatitis B. Identifying
associated factors and using the General Health Questionnaire as a screening tool
are useful for identifying patients with psychiatric disorders in an infectious
disease clinic.
 PSYCHIATRIC MORBIDITY IN A
NIGERIAN NEUROLOGY CLINIC
P O Ajiboye, A Abiodun, M F Tunde-Ayinmode, E O Sanya, K W Wahab, O I N Buhari, K
A Ayanda, M K Jimba, T Agbabiaka

 PMID: 26845814

Abstract
Objective: The objective of the study was to determine the prevalence and
nature of psychiatric morbidity among patients attending a neurology outpatient
clinic.

Design: A two-stage screening procedure with General Health Questionnaire

(GHQ-12) and Schedules for Clinical Assessment in Neuropsychiatry (SCAN) was
used to assess psychological disorders over a one year period. Psychiatric
diagnosis was based on ICD-10 criteria.

Setting: University of Ilorin Teaching Hospital (UITH), Ilorin-Nigeria

Subjects: Two hundred and thirty-five (235) patients aged 18 years and above
attending the neurology outpatient clinic.

Results: Overall prevalence of psychiatric morbidity was 26.0% (61/235). The most

frequent diagnoses were depression (14.9%), generalised anxiety disorder (5.5%),
dementia (2.6%) and substance use disorder (1.3%). Significantly more patients
with stroke had psychiatric morbidity.

Conclusion: The study supports previous reports that psychiatric disorders are

quite common among patients with neurological disorders. Efforts should,
therefore, be directed at identifying and treating neurological patients with
psychiatric morbidity since this will ensure improved outcome. In this regard,
mental health professionals would need to provide liaison services for the
neurologists and train them in the use of simple screening instruments for
detecting associated psychiatric disorders with appropriate referral where
necessary.
 Psychiatric morbidity among
physically ill patients in a Ugandan
Regional Referral Hospital
Z G Rukundo 1, S Musisi, N Nakasujja
Affiliations expand

 PMID: 23658573

 PMCID: PMC3645103

 DOI: 10.4314/ahs.v13i1.13

Free PMC article

Abstract
Background: Mental illness is a global health burden that remains poorly
understood even by health care providers. It is important to get insight of the
prevalence, clinical features and management of psychiatric morbidity in general
practice in Uganda as it affects treatment outcome.

Objective: To determine the prevalence, types and associations of psychiatric

morbidity as seen among adult in-patients on medical and surgical wards of
Mbarara Regional Referral hospital as a prototype Ugandan regional referral
hospital.

Methods: This was a cross sectional descriptive study. Psychiatric diagnosis was

arrived at by administering the Mini International Neuropsychiatric Interview
(MINI) as the diagnostic instrument.

Results: Of the 258 participants in this study, 109 (42%) met criteria for at least
one DSM IV psychiatric diagnosis. Only 6% of all the psychiatrically diagnosed
patients were recognized by their treating doctors as having mental illness.

Conclusion: The psychiatric disorders on the general medical and surgical wards

are highly prevalent and not recognized by staff on these wards despite their
common occurrence. There is need for sensitisation of staff on recognition and
management of psychiatric disorders in physical illness.
 Psychiatric morbidity and referral
on two general medical wards
G P Maguire, D L Julier, K E Hawton, J H Bancroft

 PMID: 4818184

 PMCID: PMC1633152

 DOI: 10.1136/bmj.1.5902.268

Free PMC article

Abstract
Psychiatric morbidity among 230 medical inpatients was determined by a two-
stage screening procedure, using the General Health Questionnaire and
Standardized Psychiatric Interview. Of these patients, 23% were considered
psychiatrically ill, affective disorders being the commonest illnesses encountered;
and 27 (12%) were psychiatrically referred. While referral was related to severity of
psychiatric illness and previous psychiatric illness, the degree to which the
psychiatric illness obtruded or created problems in management appeared more
crucial in determining referral. In half of those with psychiatric illness the
problems did not appear to have been detected or dealt with. It is suggested that
medical clerking should routinely include questions about mood and
psychological responses to illness.
 The incidence of stoma related
morbidity - a systematic review of
randomised controlled trials
Tam Malik 1, M J Lee 1 2, A B Harikrishnan 2
Affiliations expand

 PMID: 30112948

 PMCID: PMC6214073

 DOI: 10.1308/rcsann.2018.0126

Free PMC article

Abstract
Introduction Several stoma related complications can occur following ileostomy
or colostomy formation. The reported incidence of these conditions varies widely
in the literature. A systematic review of randomised controlled trials reporting the
incidence of stoma related complications in adults was performed to provide the
most comprehensive summary of existing data. Methods PubMed,
CINAHL® (Cumulative Index to Nursing and Allied Health Literature) and the
Cochrane Library were searched for trials assessing the incidence of complications
in adults undergoing conventional stoma formation. Data were extracted by two
independent reviewers and entered into SPSS® for statistical analysis. The
Cochrane Collaboration tool for assessing risk of bias was used to critically
appraise each study. Cochran's Q statistic and the I2 statistic were used to
measure the level of heterogeneity between studies. Results Overall, 18 trials were
included, involving 1,009 patients. The incidence of stoma related complications
ranged from 2.9% to 81.1%. Peristomal skin complications and parastomal hernia
were the most common complications. End colostomy had the highest incidence
of morbidity, followed by loop colostomy and loop ileostomy. There were no
trials involving patients with end ileostomy. There was a high level of detection
bias and heterogeneity between studies. Conclusions This systematic review has
summarised the best available evidence concerning the incidence of stoma
related morbidity. The high level of heterogeneity between studies has limited the
accuracy with which the true incidence of each stoma related complication can be
 reported. Large, multicentre trials investigating homogenous participant
populations are therefore required.

Stigma and its influencing factors

among Chinese patients with stoma
Jing Min Yuan 1, Jun E Zhang 2, Mei Chun Zheng 3, Xiu Qing Bu 2
Affiliations expand

 PMID: 29508500

 DOI: 10.1002/pon.4695

Abstract
Background: Although stomas are necessary for disease treatment, they
unavoidably affect patients' lives from physical, psychological, social, spiritual, and
familial perspectives and contribute to feelings of embarrassment and shame.
This study explored the current status and factors influencing stigma among
Chinese patients with stoma.

Methods: A total of 209 patients with stoma at the stoma clinic of a tertiary
cancer centre in Guangzhou, China, were recruited and investigated by using the
Social Impact Scale, the Coping Self-Efficacy Scale, the State Self-Esteem Scale,
and a demographic questionnaire. Multivariate linear regression was used to
identify the factors influencing stigma.

Results: The mean Social Impact Scale score was 69.65 ± 13.18, which represents
a moderate effect; specifically, 44% of the patients experienced high levels of
stigma. Stoma patients with the following characteristics had high levels of
stigma: young, low coping self-efficacy, low stoma acceptance by one's spouse or
other family members, poor perceived body image, stool leakage, and no
experience of participating in activities with other stoma patients.

Conclusions: Medical staff members should pay more attention to stigma in

stoma patients. Coping self-efficacy, family members' acceptance of the stoma,
and participation in activities with other stoma patients are influencing factors
that protect these patients against stigma, whereas body image loss and stool
leakage place them at higher risk for stigma. Interventions aimed at improving
protective factors and decreasing risk factors should be considered to reduce the
level of stigma in patients with stoma.
 Body Image Perceptions of Persons
With a Stoma and Their Partners: A
Descriptive, Cross-sectional Study
Dilek Aktas 1, Zehra Gocman Baykara 2
Affiliations expand

 PMID: 25965090

Abstract
The body image perceptions of persons with a stoma and their partners are rarely
examined and have yet to be evaluated in a Turkish sample. Using convenience
sampling methods, a descriptive, cross-sectional study was conducted among
individuals receiving treatment at the authors' stomatherapy unit between March
1, 2012 and May 31, 2012 to assess the effect of the stoma on self-image and
partner perception. Eligible participants had to be >18 years of age, married, and
with an abdominal stoma (colostomy, urostomy, or ileostomy) for at least 2
months. Data were obtained through separate (patient or partner), face-to-face,
30-minute to 45-minute interviews using the appropriate questionnaire.
Questionnaire items assessed demographic variables and patient/partner feelings
toward the ostomate's body using the Body Cathexis Scale (BCS) and author-
developed questionnaires comprising statements eliciting individual responses
(agree, disagree, undecided) regarding their feelings toward the stoma. Data were
tabulated and analyzed using percentile distributions, and Mann Whitney U and
Kruskal Wallis H tests were performed (Bonferroni correction was applied). Sixty
(60) patients (25 women, 35 men, mean age 56.01 ± 10.1 years; 25 with an
ileostomy, 30 with a colostomy, 5 with an ileostomy) participated, along with their
60 heterosexual partners (mean age 54.56 ± 10.25 years) married a mean of 33.06
± 11.03 years. Mean patient BCS score was 133.15 ± 20.58 (range 40--low
perception--to 200--high perception). Mean BCS score of patients whose partner
helped in stoma care was significantly higher (136.04) than those whose partners
did not (120.27) (P = 0.033). Patients who consulted their partners' opinions on
stoma creation and participation in care had significantly higher BCS scores (P
<0.05), and BCS scores of patients whose partners thought the stoma had a
negative effect on their relationship were significantly lower (P = 0.040); patients'
perceptions toward their bodies were parallel to their partners'. Mean BCS score
of patients experiencing physical and psychosocial problems was significantly
lower than those of patients who did not experience such problems. The results
of this study show a number of factors, including involving patient partners
before surgery, affect body perception of persons following stoma surgery.
 Psychological Adaptation to
Alteration of Body Image among
Stoma Patients: A Descriptive Study
Umesh Jayarajah 1, Dharmabandhu Nandadeva Samarasekera 1
Affiliations expand

 PMID: 28250561

 PMCID: PMC5329994

 DOI: 10.4103/0253-7176.198944

Free PMC article

Abstract
Background: Creation of an ostomy leads to significant change in the body
image of the patient. However, adaptation to this alteration of body image is
necessary for rehabilitation following surgery. The objective of this study was to
identify the factors that influence adaptation to altered body image.

Materials and methods: An analytical cross-sectional study was conducted

among 41 ostomy patients who were treated at a single tertiary care unit. Body
image disturbance questionnaire (BIDQ) was used to assess the perception of
body image. Data were analyzed using independent samples t-test (unpaired),
Chi-square test, and Spearman's correlation.

Results: In our study, the mean BIDQ score was 2.22 (standard deviation ± 0.88).
The body image disturbance was significantly associated with younger age (P <
0.05). The prevalence of body image disturbance was significantly higher among
overweight patients (P < 0.05). Males had a higher BIDQ score than females.
Those who had temporary stoma had significantly higher BIDQ score (P < 0.05).
Those who felt depressed or had thoughts of self-harm soon after surgery had
significantly high body image disturbance score (P < 0.05). There was a significant
negative correlation with the perception of self-efficacy and body image
disturbance (P < 0.01). There was no significant association between body image
disturbance and the diagnosis, type of surgery, or time duration after surgery.
Conclusions: Poor adaptation to alteration of body image was associated with
younger age, overweight, and temporary stoma. Individuals at risk of poor
adaptation should be identified before surgery and counseled before surgery,
after surgery, and during follow-up visits.

Keywords: Body image; contributory factors; stoma.