Hurricane Michael and Adverse Social and Mental Health Risk Factors

OBJECTIVES

To assess changes in mental health and social risk factors in pregnant women in counties affected by Hurricane Michael (October 2018).

METHODS

Data from the Universal Perinatal Risk Screen (UPRS) and vital statistics for the state of Florida were obtained. Prenatal risk factors (unplanned pregnancy, mental health services, high stress, use of tobacco or alcohol, young children at home or with special needs, trouble paying bills) were compared in the year before and year after Hurricane Michael in affected counties (n = 18,887). Log-Poisson regression with robust variance was used for binary outcomes, adjusting for maternal age, race, BMI, and education.

RESULTS

A smaller proportion of pregnant women were screened in the months after the hurricane. No changes were seen in overall scores. The proportion referred was lower in the 1 month after Michael compared to that in 1 month before Michael (RR 0.78, 95% CI = 0.71, 0.86), but greater in the year after (RR = 1.07, 95% CI: 1.04, 1.10). Most individual risk factors on the screener did not change significantly, except having an illness that required ongoing medical care was less common in the short term (3 months after vs. 3 months before: aRR = 0.76, 95% CI: 0.66, 0.87), and more common in the longer term (1 year after vs. 1 year before, aRR = 1.09, 95% CI: 1.02, 1.18). Birth certificate data suggested smoking during pregnancy was higher among women who experienced Michael during their pregnancies (aRR = 1.15, 95% CI: 1.01, 1.32).

DISCUSSION

Perinatal screening and referral declined in the short-term aftermath of Hurricane Michael.

The Man Behind the Royal Massacre

Delusional disorder is a relatively uncommon psychiatric condition in which patients present with non-bizarre delusions, but with no accompanying prominent perceptual disturbances, thought disorder or significant and sustained mood symptoms. Apart from their delusions, people with delusional disorder may continue to socialize and function in a normal manner and their behavior does not generally seem odd or bizarre to others for many years of the onset of their symptoms. Because of this, they are brought to the clinician many years after the onset of their symptoms, only when their delusional behavior becomes overt. Thus, identifying and treating delusional disorders in time is a challenging task.

Monthly pattern of psychiatric morbidity and duration of stay among the patients admitted in Mental Hospital, a central level tertiary care hospital

Psychiatric morbidity is a major public health problem in the world across developed and developing countries. There is a paucity of Nepalese studies on psychiatric morbidity. All the patients who were admitted in mental hospital, Lagankhel from 17th July 2009 to 16th July 2010 were included in this study. Information on their Socio-demographic profiles and hospital diagnosis was extracted from their clinical notes. Eight hundred and fifty two patients were included in this study. Fifty eight percent were males. More than sixty percent of the patients were aged between 21 and 40 years. Sixty patients were married. In terms of ICD 10 diagnosis, the most common diagnoses were Schizophrenia in 427 (50.1%), mood disorders in 286 (33.5%) and substance use disorder in 80 (9.3%). In terms of length of stay, majority of them (56.4%) had stayed for 0-14 days. Thus, there is a need to increase the awareness in the general public regarding the impact of mental illness and the need for timely treatment.

Psychiatric morbidity among physically ill persons in eastern Nepal

This cross-sectional hospital-based study investigated the prevalence and pattern of psychiatric morbidity among 151 physically ill psychiatric-referred cases admitted various departments in BPKIHS. Consecutive referral cases were initially worked up by junior residents and diagnosis/differential diagnosis was made by consultant according to ICD-10 diagnostic guidelines. Of total 151; M: 77 (50.9%) and F: 74 (49.1); Majority 38 (25.1%) of subjects were young with age 15-24 yrs and 95 (62.9%) were from plains. About 21.8% referrals came from internal medicine followed by emergency department, 9 (5.9%). The highest number of cases 48 (31.7%) had neuropsychiatric illnesses and 17.0% had some medical complications resulted from suicide act. Among psychiatric co morbidity, dissociative/conversion disorders were the commonest 26 (17.2%) followed by alcohol use-related disorders 25 (16.5%) and depressive disorder 20 (13.2%). To conclude, the co-occurrence of medical and psychological/psychiatric conditions is common, which demands timely identification and early interventions in order to reduce morbidity and mortality.