Overlooked mental illnesses in patients with neurological disorders

BACKGROUND: Very often clinicians forget or overlook mental illnesses in patients diagnosed with some neurological disorders and hence the mental illness continues to remain under-recognized and also under treated. Psychiatric co morbidities are common to be present or develop over time in patients with neurological disorders as they have an increased risk for development of cognitive, behavioral, psychosocial disorders. AIM: To find out prevalence of psychiatric co morbidity in patients attending neurology opd. METHODOLOGY: Study was conducted in department of Neurology, IMS and SUM Hospital, Bhubaneswar during the first and follow up visit. Twenty five patients each of confirmed diagnosis of headache, stroke, epilepsy and musculoskeletal pain were enrolled in study after their written informed consent. Patients were put to screening using the GMHAT Questionnaire, responses were noted and provisional diagnosis was made. Patients were assessed for anxiety and depression using HAM-A and HAM-D scale respectively in the same sitting. RESULTS: The GMHAT questionnaire revealed that 68% with headache, 72% of musculoskeletal pain, 80% who had stroke and 56% with epilepsy had psychiatric comorbidity. HAM A scale showed that 20% with headache, 24% with musculoskeletal pain,12% who had stroke and 12% with epilepsy had anxiety as co morbidity. HAM D scale showed 40% who had stroke, 28% of headache, 20% with musculoskeletal pain and 28% with epilepsy had depression as co morbidity. CONCLUSION: Results revealed depression and anxiety as the most frequently encountered psychiatric co morbidity in the study patients.