Comorbidity of Mental Disorder in Patients with Chronic Disease: A Comparative Study of Heroin Dependence Patients and Diabetes Mellitus Patients
,
Abstract
Background: Chronic patients are at greater risk for a psychiatric problem than the normal population; yet, the increased rate of mental disorder among one chronic patient compared to another chronic patient is uncertain. We aimed to assess the rate of mental disorder among people with heroin dependence and diabetes mellitus in comparison with the healthy population.
Methods: This cross-sectional study was carried out in Kuala Lumpur, Malaysia in 2017-2020. The study consisted of 648 participants including heroin dependence patients, diabetes mellitus patients, and healthy population. The GHQ-28 and SCL-90-R scales were used to assess mental disorder among the study populations.
Results: The current study revealed the rate of mental disorder among heroin dependence patients, diabetes mellitus patients, and healthy population respectively at 52.1%, 49.5%, and 23.2% using SCL-90-R and GHQ-28. The rate of mental disorder in both heroin dependent (OR 95%= 3.59: 2.37-5.44) and diabetic groups (OR 95%=3.25: 2.14-4.92) were significantly more than the healthy population; however, the odds ratio of mental disorder was not significantly different between heroin dependent and diabetic groups. Furthermore, the results revealed an acceptable agreement between SCL-90-R and GHQ-28 to detect mental disorders (Kappa=0.60; P<0.001).
Conclusion: People with diabetes mellitus and heroin dependence have significantly poorer mental health than healthy people in Malaysia have. Furthermore, the equivalent rate of mental disorder among such patients suggests that heroin dependence patients are not more distressed than diabetes mellitus patients are. However, further comparative studies are needed to prove these findings.
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14. Naicker K, Johnson JA, Skogen JC, et al (2017). Type 2 Diabetes and Comorbid Symptoms of Depression and Anxiety: Longitudinal Associations With Mortality Risk. Diabetes Care, 40(3):352-358.
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16. Bergly TH, Nordfjærn T, Hagen R (2014). The dimensional structure of SCL-90-R in a sample of patients with substance use disorder. J Subst Use, 19(3):257-61.
17. Paap MC, Meijer RR, Van Bebber J, et al (2011). A study of the dimensionality and measurement precision of the SCL-90-R using item response theory. Int J Methods Psychiatr Res, 20(3):e39-55.
18. Noorbala AA, Bagheri Yazdi SA, Mohammad K (2009). The Validation of General Health Questionnaire-28 as a Psychiatric Screening Tool. HAKIM RESEARCH JOURNAL , 11(4):47-53.
19. Tomioka M, Shimura M, Hidaka M, et al (2008). The reliability and validity of a Japanese version of symptom checklist 90 revised. BioPsychoSocial Medicine, 2:19.
20. Wan Shahrazad WS, Roseliza Murni AR, Lukman ZM, et al (2011). Consistency and Validity of Psychopathological Measure among Drug Addicts in Developing Culture. Pertanika J Soc Sci & Hum, 19:99-107.
21. Vallejo MA, Jordan CM, Diaz MI, et al (2007). Psychological assessment via the internet: a reliability and validity study of online (vs paper-and-pencil) versions of the General Health Questionnaire-28 (GHQ-28) and the Symptoms Check-List-90-Revised (SCL-90-R). J Med Internet Res, 9(1):e2.
22. Zuraida NZ, Parameswaran R (2007). Prevalence of Depression among Patients with Headache in Kuala Lumpur, Malaysia. Malaysian Journal of Psychiatry, 16(2):59-64.
23. Derogatis, L. R. (1994). SCL-90-R : symptom checklist-90-R : administration, scoring & procedures manual. Minneapolis. Pearson.
24. Goldner E, Lusted A, Roerecke M, et al (2014). Prevalence of Axis-1 psychiatric (with focus on depression and anxiety) disorder and symptomatology among non-medical prescription opioid users in substance use treatment: Systematic review and meta-analyses. Adapt Behav, 39(3):520-31.
25. Baharudin A, Anuar L, Saini S, et al (2013). Psychiatric Comorbidity Among Community-based, Treatment Seeking Opioid Dependents in Klang Valley. Sains Malays, 42 (3):417-421.
26. Koirala NR, Dev SV, Ojha SP, et al (2011). Prevalence of anxiety symptoms among the clients maintained in methadone maintenance treatment programme at Tribhuvan University Teaching Hospital. Journal of Nobel Medical College, 1(1):15-19.
27. Batki SL, Canfield KM, Ploutz-Snyder R (2011). Psychiatric and substance use disorders among methadone maintenance patients with chronic hepatitis C infection: effects on eligibility for hepatitis C treatment. Am J Addict, 20(4):312-8.
28. Rezaei S, Taramian S, Kafie SM (2013). Psychopathological Dimensions in Substance Abusers with and without HIV/AIDS and Healthy Matched Group. Addict Health, 5(3):115-25.
29. Shantna K, Chaudhury S, Verma AN, et al(2009). Comorbid psychiatric disorders in substance dependence patients: A control study. Ind Psychiatry J, 18(2):84-87.
30. Tovilla-Zarate C, Juarez-Rojop I, Peralta Jimenez Y, et al (2012). Prevalence of anxiety and depression among outpatients with type 2 diabetes in the Mexican population. PLoS One, 7(5):e36887.
31. Bener A, Al-Hamaq AOAA, Dafeeah EE (2011). High Prevalence of Depression, Anxiety and Stress Symptoms Among Diabetes Mellitus Patients. The Open Psychiatry Journal, 5(9):5-12.
32. Maia AC, Braga Ade A, Brouwers A, et al (2012). Prevalence of psychiatric disorders in patients with diabetes types 1 and 2. Compr Psychiatry, 53(8):1169-73.
33. Ganasegeran K, Renganathan P, Manaf RA, et al (2014). Factors associated with anxiety and depression among type 2 diabetes outpatients in Malaysia: a descriptive cross-sectional single-centre study. BMJ Open, 4(4):e004794.
34. Sajjadi A, Bakhshani M, Baghban-Haghighi M, et al (2012). Prevalence of Psychiatric Disorders in Patients with Diabetes Type 2. Zahedan Journal of Research in Medical Sciences, 14(1):82-85.
35. Ardakani, Banaei Boroujeni, Dastjerdi (2013). Psychiatric Disorders Prevalence Comparison in Opiate-Dependent and Non-Opiate Dependent Individuals. J Addict Res Ther, S8:005.
36. Farrell M, Howes S, Bebbington P, et al (2001). Nicotine, alcohol and drug dependence and psychiatric comorbidity. Results of a national household survey. Br J Psychiatry, 179:432-7.
37. Callaly T TT, Munron L, Whelan G (2001). Prevalence of psychiatric disorder in a methadone maintenance population. Aust NZ J Psychiatry, 35(5):601–5.
38. Vojudi B, Otared N, Poursharifi H (2014). On the Comparison of Interpersonal Sensitivity and Assertiveness between DrugDependent and Normal People. Research on Addiction Quarterly Journal of Drug Abuse, 8(31):109-18.
39. Langås A-M, Malt UF, Opjordsmoen S (2011). Comorbid mental disorders in substance users from a single catchment area - a clinical study. BMC Psychiatry, 11:25.
40. Gragnoli C (2014). Hypothesis of the neuroendocrine cortisol pathway gene role in the comorbidity of depression, type 2 diabetes, and metabolic syndrome. Appl Clin Genet, 7:43-53.
41. Lin SH, Chen WT, Chen KC, et al (2013). Associations among hypothalamus-pituitary-adrenal axis function, novelty seeking, and retention in methadone maintenance therapy for heroin dependency. J Addict Med, 7(5):335-41.
42. Marin MF, Lord C, Andrews J, et al (2011). Chronic stress, cognitive functioning and mental health. Neurobiol Learn Mem, 96(4):583-95.
43. Niraula K, Kohrt BA, Flora MS,et al (2013). Prevalence of depression and associated risk factors among persons with type-2 diabetes mellitus without a prior psychiatric history: a cross-sectional study in clinical settings in urban Nepal. BMC Psychiatry, 13:309.
44. ZamZam R, Thambu M, Midin M, et al (2009). Psychiatric morbidity among adult patients in a semi-urban primary care setting in Malaysia. Int J Ment Health Syst, 3:13.
45. Vallejo MA, Mananes G, Isabel Comeche MA, et al (2008). Comparison between administration via Internet and paper-and-pencil administration of two clinical instruments: SCL-90-R and GHQ-28. J Behav ther Exp Psychiatry, 39(3):201-8.
2. Feingold D, Brill S, Goor-Aryeh I, et al (2018). The association between severity of depression and prescription opioid misuse among chronic pain patients with and without anxiety: A cross-sectional study. J Affect Disord, 235:293-302.
3. Cioca IE (2013). Type 2 diabetes – psychosomatic disease approachable through music therapy. Proc Rom Acad, 15(1):38–46.
4. Arenliu A, Kelmendi K, Haskuka M, et al (2014). Drug use and reported suicide ideation and attempt among Kosovar adolescents. J Subst Use, 19(5):358-63.
5. Kaur G, Tee GH, Ariaratnam S, et al (2013). Depression, anxiety and stress symptoms among diabetics in Malaysia: a cross sectional study in an urban primary care setting. BMC Fam Pract, 14:69.
6. Hutter N, Schnurr A, Baumeister H (2010). Healthcare costs in patients with diabetes mellitus and comorbid mental disorders--a systematic review. Diabetologia, 53(12):2470-9.
7. Rutte A, van Splunter MM, van der Heijden AA, et al (2015). Prevalence and Correlates of Sexual Dysfunction in Men and Women With Type 2 Diabetes. J Sex Marital Ther, 41(6):680-90.
8. Hackett RA, Steptoe A (2017). Type 2 diabetes mellitus and psychological stress — a modifiable risk factor. Nat Rev Endocrinol, 13(9):547-560.
9. Seghatoleslam T, West R, Agin K, et al (2013). Prevalence and Characterizations of Current Smoking Habit of Iranian Medical University Students: A Cross-Sectional Study in Mental Health. IMJ, 20(3):308-11.
10. Carta MG, Patten S, Nardi AE, et al (2017). Mental health and chronic diseases: a challenge to be faced from a new perspective. Int Rev Psychiatry, 29(5):373-376.
11. Daré LO, Bruand P-E, Gérard D, et al (2019). Co-morbidities of mental disorders and chronic physical diseases in developing and emerging countries: a meta-analysis. BMC Public Health, 19(1):304.
12. Li H, Ge S, Greene B, Dunbar-Jacob J (2019). Depression in the context of chronic diseases in the United States and China. Int J Nurs Sci, 6(1):117-122.
13. Fu T, Cao H, Yin R, Zhang L, et al (2018). Depression and anxiety correlate with disease-related characteristics and quality of life in Chinese patients with gout: a case-control study. Psychol Health Med, 23(4):400-410.
14. Naicker K, Johnson JA, Skogen JC, et al (2017). Type 2 Diabetes and Comorbid Symptoms of Depression and Anxiety: Longitudinal Associations With Mortality Risk. Diabetes Care, 40(3):352-358.
15. Emre N, Topal K, Edirne T, et al (2018). Factors affecting risk of anxiety and depression among diabetic and hypertensive patients who refer to family health centers. Int J Diabetes Dev C, 38(3):305-11.
16. Bergly TH, Nordfjærn T, Hagen R (2014). The dimensional structure of SCL-90-R in a sample of patients with substance use disorder. J Subst Use, 19(3):257-61.
17. Paap MC, Meijer RR, Van Bebber J, et al (2011). A study of the dimensionality and measurement precision of the SCL-90-R using item response theory. Int J Methods Psychiatr Res, 20(3):e39-55.
18. Noorbala AA, Bagheri Yazdi SA, Mohammad K (2009). The Validation of General Health Questionnaire-28 as a Psychiatric Screening Tool. HAKIM RESEARCH JOURNAL , 11(4):47-53.
19. Tomioka M, Shimura M, Hidaka M, et al (2008). The reliability and validity of a Japanese version of symptom checklist 90 revised. BioPsychoSocial Medicine, 2:19.
20. Wan Shahrazad WS, Roseliza Murni AR, Lukman ZM, et al (2011). Consistency and Validity of Psychopathological Measure among Drug Addicts in Developing Culture. Pertanika J Soc Sci & Hum, 19:99-107.
21. Vallejo MA, Jordan CM, Diaz MI, et al (2007). Psychological assessment via the internet: a reliability and validity study of online (vs paper-and-pencil) versions of the General Health Questionnaire-28 (GHQ-28) and the Symptoms Check-List-90-Revised (SCL-90-R). J Med Internet Res, 9(1):e2.
22. Zuraida NZ, Parameswaran R (2007). Prevalence of Depression among Patients with Headache in Kuala Lumpur, Malaysia. Malaysian Journal of Psychiatry, 16(2):59-64.
23. Derogatis, L. R. (1994). SCL-90-R : symptom checklist-90-R : administration, scoring & procedures manual. Minneapolis. Pearson.
24. Goldner E, Lusted A, Roerecke M, et al (2014). Prevalence of Axis-1 psychiatric (with focus on depression and anxiety) disorder and symptomatology among non-medical prescription opioid users in substance use treatment: Systematic review and meta-analyses. Adapt Behav, 39(3):520-31.
25. Baharudin A, Anuar L, Saini S, et al (2013). Psychiatric Comorbidity Among Community-based, Treatment Seeking Opioid Dependents in Klang Valley. Sains Malays, 42 (3):417-421.
26. Koirala NR, Dev SV, Ojha SP, et al (2011). Prevalence of anxiety symptoms among the clients maintained in methadone maintenance treatment programme at Tribhuvan University Teaching Hospital. Journal of Nobel Medical College, 1(1):15-19.
27. Batki SL, Canfield KM, Ploutz-Snyder R (2011). Psychiatric and substance use disorders among methadone maintenance patients with chronic hepatitis C infection: effects on eligibility for hepatitis C treatment. Am J Addict, 20(4):312-8.
28. Rezaei S, Taramian S, Kafie SM (2013). Psychopathological Dimensions in Substance Abusers with and without HIV/AIDS and Healthy Matched Group. Addict Health, 5(3):115-25.
29. Shantna K, Chaudhury S, Verma AN, et al(2009). Comorbid psychiatric disorders in substance dependence patients: A control study. Ind Psychiatry J, 18(2):84-87.
30. Tovilla-Zarate C, Juarez-Rojop I, Peralta Jimenez Y, et al (2012). Prevalence of anxiety and depression among outpatients with type 2 diabetes in the Mexican population. PLoS One, 7(5):e36887.
31. Bener A, Al-Hamaq AOAA, Dafeeah EE (2011). High Prevalence of Depression, Anxiety and Stress Symptoms Among Diabetes Mellitus Patients. The Open Psychiatry Journal, 5(9):5-12.
32. Maia AC, Braga Ade A, Brouwers A, et al (2012). Prevalence of psychiatric disorders in patients with diabetes types 1 and 2. Compr Psychiatry, 53(8):1169-73.
33. Ganasegeran K, Renganathan P, Manaf RA, et al (2014). Factors associated with anxiety and depression among type 2 diabetes outpatients in Malaysia: a descriptive cross-sectional single-centre study. BMJ Open, 4(4):e004794.
34. Sajjadi A, Bakhshani M, Baghban-Haghighi M, et al (2012). Prevalence of Psychiatric Disorders in Patients with Diabetes Type 2. Zahedan Journal of Research in Medical Sciences, 14(1):82-85.
35. Ardakani, Banaei Boroujeni, Dastjerdi (2013). Psychiatric Disorders Prevalence Comparison in Opiate-Dependent and Non-Opiate Dependent Individuals. J Addict Res Ther, S8:005.
36. Farrell M, Howes S, Bebbington P, et al (2001). Nicotine, alcohol and drug dependence and psychiatric comorbidity. Results of a national household survey. Br J Psychiatry, 179:432-7.
37. Callaly T TT, Munron L, Whelan G (2001). Prevalence of psychiatric disorder in a methadone maintenance population. Aust NZ J Psychiatry, 35(5):601–5.
38. Vojudi B, Otared N, Poursharifi H (2014). On the Comparison of Interpersonal Sensitivity and Assertiveness between DrugDependent and Normal People. Research on Addiction Quarterly Journal of Drug Abuse, 8(31):109-18.
39. Langås A-M, Malt UF, Opjordsmoen S (2011). Comorbid mental disorders in substance users from a single catchment area - a clinical study. BMC Psychiatry, 11:25.
40. Gragnoli C (2014). Hypothesis of the neuroendocrine cortisol pathway gene role in the comorbidity of depression, type 2 diabetes, and metabolic syndrome. Appl Clin Genet, 7:43-53.
41. Lin SH, Chen WT, Chen KC, et al (2013). Associations among hypothalamus-pituitary-adrenal axis function, novelty seeking, and retention in methadone maintenance therapy for heroin dependency. J Addict Med, 7(5):335-41.
42. Marin MF, Lord C, Andrews J, et al (2011). Chronic stress, cognitive functioning and mental health. Neurobiol Learn Mem, 96(4):583-95.
43. Niraula K, Kohrt BA, Flora MS,et al (2013). Prevalence of depression and associated risk factors among persons with type-2 diabetes mellitus without a prior psychiatric history: a cross-sectional study in clinical settings in urban Nepal. BMC Psychiatry, 13:309.
44. ZamZam R, Thambu M, Midin M, et al (2009). Psychiatric morbidity among adult patients in a semi-urban primary care setting in Malaysia. Int J Ment Health Syst, 3:13.
45. Vallejo MA, Mananes G, Isabel Comeche MA, et al (2008). Comparison between administration via Internet and paper-and-pencil administration of two clinical instruments: SCL-90-R and GHQ-28. J Behav ther Exp Psychiatry, 39(3):201-8.
| Files | ||
| Issue | Vol 51 No 1 (2022) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v51i1.8305 | |
| Keywords | ||
| Mental disorder Heroin dependence Diabetes Mellitus | ||
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How to Cite
1.
Seghatoleslam T, Ardakani A, Habil H, Rashid R. Comorbidity of Mental Disorder in Patients with Chronic Disease: A Comparative Study of Heroin Dependence Patients and Diabetes Mellitus Patients. Iran J Public Health. 2022;51(1):142-150.
