Studies indicate that sleep problems in children and adolescents are highly prevalent, with prevalence rates ranging from 25% to 40%. They are even more common in special populations, especially children with psychiatric issues. Furthermore, sleep issues are often persistent. Unfortunately, sleep disturbances often do not receive the attention that they deserve, especially since they are often highly amenable to intervention. Sleep problems, in general, range from those that are physiologically-based, such as obstructive sleep apnoea and restless legs syndrome, to those that are behaviorally-based. The behaviourally-based sleep disorders are reviewed, including a discussion of assessment, prevalence and treatment. Non-pharmacologic approaches are usually the preferred treatment and have received the most empirical support in paediatric populations. It is strongly recommended that all paediatric healthcare providers consider sleep issues in their comprehensive assessment of all children and adolescents, especially those with psychiatric issues, and provide preventive education as part of their usual standard of care.
Adolescent ; Arousal ; Behavior Therapy ; Child ; Comorbidity ; Humans ; Medical History Taking ; Mental Disorders ; epidemiology ; Sleep Disorders, Circadian Rhythm ; epidemiology ; Sleep Initiation and Maintenance Disorders ; epidemiology ; Sleep Wake Disorders ; diagnosis ; epidemiology ; physiopathology ; therapy

This study investigated the patterns of alcohol disorder comorbidity with other psychiatric disorders, using Korean nationwide epidemiological data. By two-stage cluster sampling, 5,176 adult household residents of Korea were interviewed using the Korean version of the Diagnostic Interview Schedule. Psychiatric disorders strongly associated with alcohol disorders were, other drug abuse or dependence, major depression, simple phobia, antisocial personality disorder, tobacco dependence, and pathological gambling. Male alcoholics had a tendency to begin with tobacco dependence, and some male pathological gamblers first had alcohol disorders. The presence of comorbid psychiatric disorders was associated with a more severe form and the later onset of alcohol disorders, and associated with help-seeking for alcohol abuse/dependence.
Adolescent ; Adult ; Age of Onset ; Aged ; Alcohol-Induced Disorders/*epidemiology/physiopathology/psychology ; Alcoholism/*epidemiology/physiopathology/psychology ; Cluster Analysis ; Comorbidity ; Female ; Humans ; Interviews as Topic ; Male ; Mental Disorders/*epidemiology/physiopathology ; Middle Aged ; Patient Acceptance of Health Care ; Time Factors

INTRODUCTIONElevated levels of psychopathology have been described in various groups of obese patients. This study aimed to describe the presence of depressive and binge eating symptoms in patients presented for clinical weight management at a general hospital in Singapore, as well as their health-related quality of life (HRQOL). Correlations between these symptoms and other demographic and clinical variables were also sought.

MATERIALS AND METHODSPatients presented at a clinical weight management programme were asked to complete the Beck Depression Inventory (BDI), Binge Eating Scale (BES) and the Short Form-36 (SF-36). Clinical and demographic data were also collected.

RESULTSOf the group, 17.1% reported moderate or severe binge eating symptoms and 9.7% reported moderate or severe depressive symptoms. HRQOL, mostly in physical health domains, was lower in this sample compared to local norms. Within the group, binge eating and depressive symptoms, but not increasing obesity, predicted poorer HRQOL.

CONCLUSIONSPsychological symptoms are significantly present in patients presented for clinical weight management and these contribute to poorer quality of life. Addressing these symptoms will improve the overall well-beings of these patients and the total benefits gained will exceed the benefits of weight loss per se.

Adult ; Aged ; Depression ; complications ; diagnosis ; epidemiology ; Feeding and Eating Disorders ; complications ; epidemiology ; Female ; Health Status Indicators ; Humans ; Male ; Mental Disorders ; epidemiology ; physiopathology ; Middle Aged ; Obesity ; complications ; ethnology ; psychology ; therapy ; Psychiatric Status Rating Scales ; Quality of Life ; psychology ; Singapore ; epidemiology ; Young Adult

INTRODUCTIONLittle is known about the sociodemographic and clinical profile of older adults with intellectual disabilities (ID) in Singapore. We studied the sociodemographic and clinical profile of older adults with ID and investigated factors associated with caregiver availability and identity in this population.

MATERIALS AND METHODSThe study population involved all adults with ID aged ≥40 years receiving services from the Movement for the Intellectually Disabled of Singapore (MINDS), the largest such provider in Singapore. Information on sociodemographic and clinical profiles, functional status, and availability of caregivers were collected via interviewer-administered questionnaires from guardians of older adults with ID. Descriptive characteristics were computed and chi-square and logistic regression identifi ed predictors of caregiver availability and identity.

RESULTSParticipation was 95% (227/239). There were differences in client age, gender, and caregiver availability between recipients of residential and non-residential services (all P <0.05). Common comorbidities included hyperlipidaemia (17.6%), hypertension (15.9%), psychiatric diagnoses (16.3%) and epilepsy (10.6%). The majority were fully independent in basic activities of daily living, but only 21.1% were fully communicative. Only a small minority (9.4%) were exercising regularly. The majority (73.5%) of clients had a primary caregiver; almost equal proportions relied on either parents or siblings. Older client age was associated independently with the lack of a primary caregiver, independent of greater functional dependence and presence of medical comorbidities in the client.

CONCLUSIONOlder adults with ID have multiple medical, functional, and social issues. More can be done to support the care of this unique group of adults with special needs.

Activities of Daily Living ; Adult ; Age Factors ; Caregivers ; classification ; statistics & numerical data ; supply & distribution ; Chi-Square Distribution ; Comorbidity ; Demography ; Epilepsy ; epidemiology ; Female ; Humans ; Hyperlipidemias ; epidemiology ; Hypertension ; epidemiology ; Intellectual Disability ; epidemiology ; physiopathology ; psychology ; therapy ; Logistic Models ; Male ; Mental Disorders ; epidemiology ; Quality of Life ; Singapore ; epidemiology ; Social Support ; Socioeconomic Factors