WorldWideScience

Sample records for psychiatric diagnoses including

  1. Psychiatric diagnoses, trauma, and suicidiality

    Directory of Open Access Journals (Sweden)

    Elklit Ask

    2007-04-01

    Full Text Available Abstract Background This study aimed to examine the associations between psychiatric diagnoses, trauma and suicidiality in psychiatric patients at intake. Methods During two months, all consecutive patients (n = 139 in a psychiatric hospital in Western Norway were interviewed (response rate 72%. Results Ninety-one percent had been exposed to at least one trauma; 69 percent had been repeatedly exposed to trauma for longer periods of time. Only 7% acquired a PTSD diagnosis. The comorbidity of PTSD and other psychiatric diagnoses were 78%. A number of diagnoses were associated with specific traumas. Sixty-seven percent of the patients reported suicidal thoughts in the month prior to intake; thirty-one percent had attempted suicide in the preceding week. Suicidal ideation, self-harming behaviour, and suicide attempts were associated with specific traumas. Conclusion Traumatised patients appear to be under- or misdiagnosed which could have an impact on the efficiency of treatment.

  2. ASD, a Psychiatric Disorder, or Both? Psychiatric Diagnoses in Adolescents with High-Functioning ASD

    Science.gov (United States)

    Mazefsky, Carla A.; Oswald, Donald P.; Day, Taylor N.; Eack, Shaun M.; Minshew, Nancy J.; Lainhart, Janet E.

    2012-01-01

    Varied presentations of emotion dysregulation in autism complicate diagnostic decision making and may lead to inaccurate psychiatric diagnoses or delayed autism diagnosis for high-functioning children. This pilot study aimed to determine the concordance between prior psychiatric diagnoses and the results of an autism-specific psychiatric interview…

  3. Psychiatric diagnoses in 3275 suicides: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Turecki Gustavo

    2004-11-01

    Full Text Available Abstract Background It is well known that most suicide cases meet criteria for a psychiatric disorder. However, rates of specific disorders vary considerably between studies and little information is known about gender and geographic differences. This study provides overall rates of total and specific psychiatric disorders in suicide completers and presents evidence supporting gender and geographic differences in their relative proportion. Methods We carried out a review of studies in which psychological autopsy studies of suicide completers were performed. Studies were identified by means of MEDLINE database searches and by scanning the reference list of relevant publications. Twenty-three variables were defined, 16 of which evaluating psychiatric disorders. Mantel-Haenszel Weighted Odds Ratios were estimated for these 16 outcome variables. Results Twenty-seven studies comprising 3275 suicides were included, of which, 87.3% (SD 10.0% had been diagnosed with a mental disorder prior to their death. There were major gender differences. Diagnoses of substance-related problems (OR = 3.58; 95% CI: 2.78–4.61, personality disorders (OR = 2.01; 95% CI: 1.38–2.95 and childhood disorders (OR = 4.95; 95% CI: 2.69–9.31 were more common among male suicides, whereas affective disorders (OR = 0.66; 95% CI: 0.53–0.83, including depressive disorders (OR = 0.53; 95% CI: 0.42–0.68 were less common among males. Geographical differences are also likely to be present in the relative proportion of psychiatric diagnoses among suicides. Conclusions Although psychopathology clearly mediates suicide risk, gender and geographical differences seem to exist in the relative proportion of the specific psychiatric disorders found among suicide completers.

  4. TBI-ROC Part Nine: Diagnosing TBI and Psychiatric Disorders

    Science.gov (United States)

    Elias, Eileen; Weider, Katie; Mustafa, Ruman

    2011-01-01

    This article is the ninth of a multi-part series on traumatic brain injury (TBI). It focuses on the process of diagnosing TBI and psychiatric disorders. Diagnosing traumatic brain injury can be challenging. It can be difficult differentiating TBI and psychiatric symptoms, as both have similar symptoms (e.g., memory problems, emotional outbursts,…

  5. Life expectancies for individuals with psychiatric diagnoses.

    Science.gov (United States)

    Hannerz, H; Borgå, P; Borritz, M

    2001-09-01

    The aim of the study was to estimate life expectancies in different diagnostic groups for individuals treated as inpatients at Swedish psychiatric clinics. All individuals, older than 18 y and alive on the first of January 1983, who had been registered in the National Hospital Discharge Registry by a psychiatric clinic in 1978-82, were monitored for mortality during 1983 by using the National Cause of Death Registry. The study group consisted of 91 385 men and 77 217 women. The patients were divided into nine diagnostic groups according to the principal diagnosis registered at the latest discharge. Actuarial mathematics was used to construct life expectancy tables, which present the number of years expected to live, by gender and diagnostic group. Expectancies of life were significantly shortened for both genders and in all nine diagnostic groups (with one exception). Mental disorders in general are life shortening. This fact should be recognised in community health when setting health priorities. It should also be addressed in curricula as well as in treatment and preventive programmes.

  6. Comorbid Psychiatric Diagnoses in Preschoolers with Autism Spectrum Disorders

    Science.gov (United States)

    Hayashida, Kristen; Anderson, Bryan; Paparella, Tanya; Freeman, Stephanny F. N.; Forness, Steven R.

    2010-01-01

    Although comorbid or co-occurring psychiatric diagnoses such as attention deficit hyperactivity disorder, anxiety disorders, depression, and oppositional defiant or conduct disorders have been well studied in children or adolescents with autism spectrum disorders (ASDs), very little research is available on preschool samples. The current study…

  7. Psychiatric diagnoses are not mental processes: Wittgenstein on conceptual confusion.

    Science.gov (United States)

    Rosenman, Stephen; Nasti, Julian

    2012-11-01

    Empirical explanation and treatment repeatedly fail for psychiatric diagnoses. Diagnosis is mired in conceptual confusion that is illuminated by Ludwig Wittgenstein's later critique of philosophy (Philosophical Investigations). This paper examines conceptual confusions in the foundation of psychiatric diagnosis from some of Wittgenstein's important critical viewpoints. Diagnostic terms are words whose meanings are given by usages not definitions. Diagnoses, by Wittgenstein's analogy with 'games', have various and evolving usages that are connected by family relationships, and no essence or core phenomenon connects them. Their usages will change according to the demands and contexts in which they are employed. Diagnoses, like many psychological terms, such as 'reading' or 'understanding', are concepts that refer not to fixed behavioural or mental states but to complex apprehensions of the relationship of a variety of behavioural phenomena with the world. A diagnosis is a sort of concept that cannot be located in or explained by a mental process. A diagnosis is an exercise in language and its usage changes according to the context and the needs it addresses. Diagnoses have important uses but they are irreducibly heterogeneous and cannot be identified with or connected to particular mental processes or even with a unity of phenomena that can be addressed empirically. This makes understandable not only the repeated failure of empirical science to replicate or illuminate genetic, neurophysiologic, psychic or social processes underlying diagnoses but also the emptiness of a succession of explanatory theories and treatment effects that cannot be repeated or stubbornly regress to the mean. Attempts to fix the meanings of diagnoses to allow empirical explanation will and should fail as there is no foundation on which a fixed meaning can be built and it can only be done at the cost of the relevance and usefulness of diagnosis.

  8. Parental history of psychiatric diagnoses and unipolar depression: a Danish National Register-based cohort study.

    Science.gov (United States)

    Musliner, K L; Trabjerg, B B; Waltoft, B L; Laursen, T M; Mortensen, P B; Zandi, P P; Munk-Olsen, T

    2015-10-01

    Depression is known to run in families, but the effects of parental history of other psychiatric diagnoses on depression rates are less well studied. Few studies have examined the impact of parental psychopathology on depression rates in older age groups. We established a population-based cohort including all individuals born in Denmark after 1954 and alive on their 10th birthday (N = 29 76 264). Exposure variables were maternal and paternal history of schizophrenia, bipolar disorder, depression, anxiety or 'other' psychiatric diagnoses. Incidence rate ratios (IRRs) were estimated using Poisson regressions. Parental history of any psychiatric diagnosis increased incidence rates of outpatient (maternal: IRR 1.88, p history. IRRs for parental history of non-affective disorders remained relatively stable across age groups, while IRRs for parental affective disorders (unipolar or bipolar) decreased with age from 2.29-3.96 in the youngest age group to 1.53-1.90 in the oldest group. IRR estimates for all parental diagnoses were similar among individuals aged ⩾41 years (IRR range 1.51-1.90). Parental history of any psychiatric diagnosis is associated with increased incidence rates of unipolar depression. In younger age groups, parental history of affective diagnoses is more strongly associated with rates of unipolar depression than non-affective diagnoses; however, this distinction disappears after age 40, suggesting that parental psychopathology in general, rather than any one disorder, confers risk for depression in middle life.

  9. Psychiatric diagnoses and psychoactive medication use among nonsurgical critically ill patients receiving mechanical ventilation

    DEFF Research Database (Denmark)

    Wunsch, Hannah; Christiansen, Christian Fynbo; Johansen, Martin B

    2014-01-01

    IMPORTANCE: The relationship between critical illness and psychiatric illness is unclear. OBJECTIVE: To assess psychiatric diagnoses and medication prescriptions before and after critical illness. DESIGN, SETTING, AND PARTICIPANTS: Population-based cohort study in Denmark of critically ill patien...

  10. Psychiatric diagnoses in patients with burning mouth syndrome and atypical odontalgia referred from psychiatric to dental facilities

    Science.gov (United States)

    Takenoshita, Miho; Sato, Tomoko; Kato, Yuichi; Katagiri, Ayano; Yoshikawa, Tatsuya; Sato, Yusuke; Matsushima, Eisuke; Sasaki, Yoshiyuki; Toyofuku, Akira

    2010-01-01

    Background Burning mouth syndrome (BMS) and atypical odontalgia (AO) are two conditions involving chronic oral pain in the absence of any organic cause. Psychiatrically they can both be considered as “somatoform disorder”. From the dental point of view, however, the two disorders are quite distinct. BMS is a burning or stinging sensation in the mouth in association with a normal mucosa whereas AO is most frequently associated with a continuous pain in the teeth or in a tooth socket after extraction in the absence of any identifiable cause. Because of the absence of organic causes, BMS and AO are often regarded as psychogenic conditions, although the relationship between oral pain and psychologic factors is still unclear. Some studies have analyzed the psychiatric diagnoses of patients with chronic oral pain who have been referred from dental facilities to psychiatric facilities. No study to date has investigated patients referred from psychiatric facilities to dental facilities. Objective To analyze the psychiatric diagnoses of chronic oral pain patients, diagnosed with BMS and AO, and referred from psychiatric facilities to dental facilities. Study design Psychiatric diagnoses and disease conditions of BMS or AO were investigated in 162 patients by reviewing patients’ medical records and referral forms. Psychiatric diagnoses were categorized according to the International Statistical Classification of Disease and Related Health Problems, Tenth Revision. Results The proportion of F4 classification (neurotic, stress-related, and somatoform disorders) in AO patients was significantly higher than in BMS patients. BMS patients were more frequently given a F3 classification (mood/affective disorders). However, 50.8% of BMS patients and 33.3% of AO patients had no specific psychiatric diagnoses. Conclusion Although BMS and AO are both chronic pain disorders occurring in the absence of any organic cause, the psychiatric diagnoses of patients with BMS and AO differ

  11. "Is It Her Hormones?": Psychiatric Diagnoses and Polycystic Ovarian Syndrome.

    Science.gov (United States)

    Genovese, Ann; Smith, Teri; Kramer, Holly; Augustyn, Marilyn

    2016-01-01

    Beth, whom you have cared for in your primary care practice since she was born, is a 15-year-old adolescent girl with no prior psychiatric history who developed significant symptoms of clinical depression, associated with self-injurious behavior (cutting on wrists, arms, and thighs). She denied any known precipitant for her depression.She is a ninth grade honors student in the gifted program at a local high school and is described as a talented musician, playing multiple musical instruments as well as soccer and basketball. She has good family support, was sociable, and had several close friends. She denied any history of trauma and denied ever using recreational drugs or other mood-altering substances.At this visit, she reported feeling "sad and anxious." Family history was significant for maternal depression, which persisted through her teens and twenties. Her older sister had been diagnosed with Social Anxiety Disorder. Beth reported anhedonia, fatigue and irritable mood, lack of motivation, impaired concentration, and anxiety related to failing grades.You decide to begin medication because of the severity of her symptoms, and 1 week after starting fluoxetine 10 mg, she reportedly overdosed on an unknown quantity of acetaminophen. Within a few days of switching to escitalopram (due to persistent gastrointestinal complaints while taking fluoxetine), she developed homicidal ideation. She reported feeling grandiose, empowered, invincible, elated, and "crazy," although she never demonstrated or endorsed psychotic symptoms. She became fixated upon the idea that she could kill someone and "get away with it." At the time she tried to suffocate a peer with her hands, she was described as having "a glazed over look in her eyes." Moods were now described as alternating between depressed and elated, with mood shifts occurring every few days. These symptoms did not improve after the antidepressant medication was discontinued.Subsequently, patient was admitted for acute

  12. The Experience of Being Diagnosed with a Psychiatric Disorder ...

    African Journals Online (AJOL)

    denise

    psychiatric disorder who live outside rather than inside the psychiatric ..... behaviours, signs and symptoms (Frances & Egger,. 1999). .... and a student at university. He was ..... This experience of being misinterpreted, of being perceived as a ...

  13. Psychiatric Symptoms in Children Diagnosed with an Autism Spectrum Disorder: An Examination of Gender Differences

    Science.gov (United States)

    Worley, Julie A.; Matson, Johnny L.

    2011-01-01

    In addition to the triad of impairments experienced by children and adolescents diagnosed with Autism Spectrum Disorders (ASD), they often present with symptoms of psychiatric disorders. To date, very few studies have examined gender differences in regards to psychiatric symptoms in children and adolescents diagnosed with an ASD. Thus, the current…

  14. Pathological gambling: comorbid psychiatric diagnoses in patients and their families.

    Science.gov (United States)

    Dannon, Pinhas N; Lowengrub, Katherine; Aizer, Anat; Kotler, Moshe

    2006-01-01

    Pathological gambling is a highly prevalent and disabling impulse control disorder. Recent studies have consistently demonstrated that pathological gamblers respond well to treatment with selective serotonin reuptake inhibitors, mood stabilizers and opioid antagonists. These findings have supported the observation that pathological gambling is associated with anxiety and mood spectrum disorders as well as addictive disorders. Fifty-two male pathological gamblers and their first-degree relatives (n=93) completed a semi-structured DSM-IV-based diagnostic interview as well as a series of data collection instruments including the South Oaks Gambling Scale, the Hamilton Rating Scale for Depression, the Hamilton Rating Scale for Anxiety, the Yale-Brown Obsessive-Compulsive Scale, and the Young Mania Rating Scale. The study subjects and their first-degree relative were compared to demographically matched normal controls (n=96). We found higher prevalence of alcohol, substance abuse, problematic gambling, depression, and anxiety disorders in the pathological gamblers and their first-degree relatives than in the control group. In particular, the scores on the Hamilton Rating Scale for Depression, the Hamilton Rating Scale for Anxiety, and the Yale-Brown Obsessive-Compulsive Scale were higher in the study group than in the control group. Our finding of a high prevalence of psychiatric comorbidity in pathological gamblers and their families raises the question of the proper classification of pathological gambling in the DSM-IV. Furthermore, the pattern of psychiatric disorders seen in the first-degree relatives can lead to new insights about the etiopathology of pathological gambling.

  15. Psychiatric diagnoses in patients with burning mouth syndrome and atypical odontalgia referred from psychiatric to dental facilities

    Directory of Open Access Journals (Sweden)

    Miho Takenoshita

    2010-10-01

    Full Text Available Miho Takenoshita1, Tomoko Sato1, Yuichi Kato1, Ayano Katagiri1, Tatsuya Yoshikawa1, Yusuke Sato2, Eisuke Matsushima3, Yoshiyuki Sasaki4, Akira Toyofuku11Psychosomatic Dentistry, 2Complete Denture Prosthodontics, 3Liaison Psychiatry and Palliative Medicine, 4Center for Education and Research in Oral Health Care, Faculty of Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, JapanBackground: Burning mouth syndrome (BMS and atypical odontalgia (AO are two conditions involving chronic oral pain in the absence of any organic cause. Psychiatrically they can both be considered as “somatoform disorder”. From the dental point of view, however, the two disorders are quite distinct. BMS is a burning or stinging sensation in the mouth in association with a normal mucosa whereas AO is most frequently associated with a continuous pain in the teeth or in a tooth socket after extraction in the absence of any identifiable cause. Because of the absence of organic causes, BMS and AO are often regarded as psychogenic conditions, although the relationship between oral pain and psychologic factors is still unclear. Some studies have analyzed the psychiatric diagnoses of patients with chronic oral pain who have been referred from dental facilities to psychiatric facilities. No study to date has investigated patients referred from psychiatric facilities to dental facilities.Objective: To analyze the psychiatric diagnoses of chronic oral pain patients, diagnosed with BMS and AO, and referred from psychiatric facilities to dental facilities.Study design: Psychiatric diagnoses and disease conditions of BMS or AO were investigated in 162 patients by reviewing patients’ medical records and referral forms. Psychiatric diagnoses were categorized according to the International Statistical Classification of Disease and Related Health Problems, Tenth Revision.Results: The proportion of F4 classification (neurotic, stress

  16. Axis I psychiatric diagnoses in adolescents and young adults with 22q11 deletion syndrome

    Science.gov (United States)

    Ousley, O.Y.; Smearman, E.; Fernandez-Carriba, S.; Rockers, K.A.; Coleman, K.; Walker, E.F.; Cubells, J.F.

    2017-01-01

    Background 22q11.2 deletion syndrome (22q11DS) associates with schizophrenia spectrum disorders (SSDs), autism spectrum disorders (ASDs), and other psychiatric disorders, but co-occurrence of diagnoses are not well described. Methods We evaluated the co-occurrence of SSDs, ASDs and other axis I psychiatric diagnoses in 31 adolescents and adults with 22q11DS, assessing ASDs using either stringent Collaborative Program for Excellence in Autism (ASD-CPEA) criteria, or less stringent DSM-IV criteria alone (ASD-DSM-IV). Results Ten (32%) individuals met criteria for an SSD, five (16%) for ASD-CPEA, and five others (16%) for ASD-DSM-IV. Of those with ASD-CPEA, one (20%) met SSD criteria. Of those with ASD-DSM-IV, four (80%) met SSD criteria. Depressive disorders (8 individuals; 26%) and anxiety disorders (7; 23%) sometimes co-occurred with SSDs and ASDs. SSDs, ASDs, and anxiety occurred predominantly among males and depression predominantly among females. Conclusions Individuals with 22q11DS can manifest SSDs in the presence or absence of ASDs and other axis I diagnoses. The results suggest that standard clinical care should include childhood screening for ASDs, and later periodic screening for all axis I diagnoses. PMID:23916466

  17. Comorbid psychiatric diagnoses in kleptomania and pathological gambling: a preliminary comparison study.

    Science.gov (United States)

    Dannon, Pinhas N; Lowengrub, Katherine; Sasson, Marina; Shalgi, Bosmat; Tuson, Lali; Saphir, Yafa; Kotler, Moshe

    2004-08-01

    Kleptomania and pathological gambling (PG) are currently classified in the DSM IV as impulse control disorders. Impulse control disorders are characterized by an overwhelming temptation to perform an act that is harmful to the person or others. The patient usually feels a sense of tension before committing the act and then experiences pleasure or relief while in the process of performing the act. Kleptomania and PG are often associated with other comorbid psychiatric diagnoses. Forty-four pathological gamblers and 19 kleptomanics were included in this study. All enrolled patients underwent a complete diagnostic psychiatric evaluation and were examined for symptoms of depression and anxiety using the Hamilton depression rating scale and the Hamilton anxiety rating scale, respectively. In addition, the patients completed self-report questionnaires about their demographic status and addictive behavior. The comorbid lifetime diagnoses found at a high prevalence among our kleptomanic patients included 47% with affective disorders (9/19) and 37% with anxiety disorders (7/19). The comorbid lifetime diagnoses found at a high prevalence in our sample of pathological gamblers included 27% with affective disorders (12/44), 21% with alcohol abuse (9/44), and 7% with a history of substance abuse (3/44). A larger study is needed to confirm these preliminary results.

  18. Delusional infestation is typically comorbid with other psychiatric diagnoses: review of 54 patients receiving psychiatric evaluation at Mayo Clinic.

    Science.gov (United States)

    Hylwa, Sara A; Foster, Ashley A; Bury, Jessica E; Davis, Mark D P; Pittelkow, Mark R; Bostwick, J Michael

    2012-01-01

    Delusional infestation, which encompasses both delusions of parasitosis and delusions of infestation with inanimate objects (sometimes called Morgellons disease), has been said to represent a distinct and encapsulated delusion, that is, a stand-alone diagnosis. Anecdotally, we have observed that patients with delusional infestation often have one or more psychiatric comorbid conditions and that delusional infestation should not be regarded as a stand-alone diagnosis. The purpose of this study was to identify whether patients with delusional infestation have psychiatric comorbid conditions. We therefore identified patients who had been formally evaluated in the Department of Psychiatry during their visit to Mayo Clinic. We retrospectively searched for and reviewed the cases of all patients with delusional infestation seen from 2001 through 2007 at Mayo Clinic, Rochester, Minnesota, and who underwent psychiatric evaluation. The diagnoses resulting from psychiatric evaluation were analyzed. During the 7-year study period, 109 patients seen for delusional infestation at Mayo Clinic were referred to the Department of Psychiatry, 54 (50%) of whom actually followed through with psychiatric consultation. Of these 54 patients, 40 (74%) received additional active psychiatric diagnoses; 14 patients (26%) had delusional infestation alone. Abnormal personality traits were rarely documented. Most patients with delusional infestation have multiple coexisting or underlying psychiatric disorders. Therefore, evaluation by a psychiatrist, when possible, is advised for all patients with delusional infestation. Copyright © 2012 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  19. [Long-term analysis of disability pensions in survivors of the Holocaust: somatic and psychiatric diagnoses].

    Science.gov (United States)

    Biermann, T; Sperling, W; Müller, H; Schütz, P; Kornhuber, J; Reulbach, U

    2010-12-01

    Survivors of the Holocaust are known to suffer more often from mental as well as somatic consequential illness. The assessment of the degree of disability and invalidity due to the persecution complies with the interaction of directly Holocaust-related mental and somatic primary injuries as well as physical, psychical and psychosocial disadvantages and illnesses acquired later on. The presented descriptive as well as multivariate analyses included complete reports (expertise, medical records, physicians' assessments, witnessed hand-written notes of the patients) of 56 survivors of the Holocaust (36 women and 20 men). The disability pension reports of 56 Holocaust survivors (36 women and 20 men) were analysed referring to the diagnostic groups and socio-demographic aspects. In 92.3 % a psychiatric illness could be diagnosed within the first year after liberation. In a separate analysis of somatic diagnoses, gastrointestinal diseases were statistically significant more often in Holocaust survivors with a degree of disability of more than 30 % (chi-square χ (2) = 4.0; df = 1; p = 0.046). The question of an aggravation of psychiatrically relevant and persecution-associated symptomatology is mainly the objective of the expert opinion taking into account endogenous and exogenous factors such as so-called life events. Above all, newly acquired somatic diseases seem to be responsible for an aggravation of persecution-associated psychiatric symptoms, at least in the presented sample of Holocaust survivors. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Psychiatric disorders in individuals diagnosed with infantile autism as children: A case control study

    DEFF Research Database (Denmark)

    Mouridsen, S.E.; Rich, B.; Isager, T.

    2008-01-01

    The objective of this study was to compare the prevalence and types of psychiatric disorders in a clinical sample of 118 individuals diagnosed as children with infantile autism (IA) with psychiatric disorders in 336 matched controls from the general population using data from the nationwide Danish...

  1. Psychiatric Diagnoses in Individuals with Non-Syndromic Oral Clefts

    DEFF Research Database (Denmark)

    Pedersen, Dorthe Almind; Wehby, George L; Murray, Jeffrey C

    2016-01-01

    for 247,821 person-years, and 85,653 individuals without OC followed for 2,501,129 person-years. RESULTS: A total of 953 (11.1%) of the individuals with OC (9.6% for cleft lip (CL), 10.8% for cleft lip and palate (CLP) and 13.1% for cleft palate (CP)) and 8,117 (9.5%) in the comparison group had at least...... one psychiatric diagnosis. Cox proportional hazard regression model revealed that individuals with OC had significantly higher risk of a psychiatric diagnosis (hazard ratio (HR) = 1.19, 95% CI: 1.12-1.28). When examining cleft type, no difference was found for CL (HR = 1.03, 95% CI: 0.......90-1.17), but CLP was associated with a small increased risk (HR = 1.13, 95% CI: 1.01-1.26), whereas individuals with CP had the largest increased risk (HR = 1.45, 95% CI: 1.30-1.62). The largest differences were found in schizophrenia-like disorders, mental retardation and pervasive developmental disorders, but we...

  2. Correlates of Length of Stay and Boarding in Florida Emergency Departments for Patients With Psychiatric Diagnoses.

    Science.gov (United States)

    Smith, Joseph L; De Nadai, Alessandro S; Storch, Eric A; Langland-Orban, Barbara; Pracht, Etienne; Petrila, John

    2016-11-01

    Length of stay (LOS) and boarding in the emergency department (ED) for psychiatric patients have been the subject of concern, given the problems with crowding and excessive wait times in EDs. This investigation examined correlates of LOS and boarding in Florida EDs for patients presenting with psychiatric complaints from 2010 to 2013. Utilizing the Florida ED discharge database, the authors examined the association of LOS and boarding with hospital and encounter factors for adult patients presenting with a primary psychiatric diagnosis (N=597,541). The mean LOS was 7.77 hours. Anxiety disorders were the most frequent psychiatric complaint and were associated with the lowest mean LOS compared with other diagnoses (pboarding (a stay of more than six or more hours in the ED). Extended LOS was endemic for psychiatric patients in Florida EDs.

  3. Association Between Substance Use Diagnoses and Psychiatric Disorders in an Adolescent and Young Adult Clinic-Based Population.

    Science.gov (United States)

    Welsh, Justine Wittenauer; Knight, John R; Hou, Sherry Shu-Yeu; Malowney, Monica; Schram, Patricia; Sherritt, Lon; Boyd, J Wesley

    2017-06-01

    Adolescents with substance use disorders are more likely to have a current psychiatric disorder. However, when compared with the adult literature, there is relatively limited information regarding the specific co-occurrence of certain mental health diagnoses and substance use disorders in adolescents. The objectives of this study were to build on the previous literature regarding mental health diagnoses and different types of substance use disorders in adolescents, as well as explore the differences, if any, between groupings of mental health diagnosis and type of substance used. Data were extracted from the clinical records of 483 individuals aged 11-24 years referred for an evaluation at the Adolescent Substance Abuse Program at Boston Children's Hospital. According to DSM-IV-Text Revision criteria, individuals received diagnoses of substance abuse or dependence and any additional psychiatric disorders. Problematic use was included within the sample for greater power analysis. A multivariable logistic regression model estimated the association between psychiatric diagnosis and substance use while adjusting for covariates including age and gender. Multiple significant associations were found, including having any anxiety-related diagnosis and opioid use (odds ratio [OR] = 2.23, p < .001), generalized anxiety disorder and opioids (OR = 3.42, p = .008), cocaine and post-traumatic stress disorder (OR = 3.61, p = .01), and marijuana and externalizing behavior disorders (OR = 2.10, p = .024). Our study found multiple significant associations between specific substances and certain co-occurring psychiatric disorders. The use of office screening systems to efficiently identify these youths should be a part of routine medical and psychiatric care. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  4. The reliability of child psychiatric diagnosis. A comparison among Danish child psychiatrists of traditional diagnoses and a multiaxial diagnostic system

    DEFF Research Database (Denmark)

    Skovgaard, A M; Isager, T; Jørgensen, O S

    1988-01-01

    The study was conducted to compare an experimental multiaxial diagnostic system (MAS) with traditional multicategorical diagnoses in child psychiatric work. Sixteen written case histories were circulated to 21 child psychiatrists, who made diagnoses independently of one another, using two different...

  5. Gender differences in psychiatric diagnoses in older people with intellectual disability: a register study.

    Science.gov (United States)

    Axmon, Anna; Sandberg, Magnus; Ahlström, Gerd

    2017-05-22

    Gender differences regarding psychiatric ill-health are well known in the general population. However, not much research is done on people with intellectual disability, and especially not among older people with intellectual disability. People with intellectual disability aged 55+ years in 2012 in Sweden were identified through a register containing information on those receiving support and service for this type of disability. The cohort comprised 3609 women and 4327 men with mean age 65 and 64 years, respectively. Information on psychiatric diagnoses was collected from the National Patient Register for the period 2002-2012. Potential gender differences were evaluated both for diagnostic categories (e.g. affective disorders) and single diagnoses (e.g. depressive episodes). The most common diagnoses among women were in the diagnostic category affective disorders, and among men in psychotic disorders. The majority of both women (72%) and men (71%) had diagnoses in only one diagnostic category. Women were more likely than men to have at least one diagnosis of dementia (odds ratio 1.40, 95% confidence interval 1.06-1.83) or affective disorders (1.33, 1.21-1.58) during the study period. They were, however, less likely to have at least one diagnosis of alcohol/substance use related disorder (0.59, 0.43-0.80). No gender differences were found for diagnoses of psychotic (1.04, 0.86-1.27) or anxiety disorders (1.15, 0.94-1.40). Regarding single diagnoses, women were more likely than men to have had at least one diagnosis of unspecified nonorganic psychosis (1.75, 1.23-2.50), depressive episode (1.47, 1.19-1.82), recurrent depressive disorder (1.53, 1.06-2.22), other anxiety disorder (1.34, 1.06-1.69), or dementia in Alzheimer disease (2.50, 1.40-4.49), but less likely to be diagnosed with psychiatric and behavioral disorders due to use of alcohol (0.41, 0.27-0.61). As in the general population, there seem to be gender differences with respect to several types of

  6. A client-centred, occupation-based occupational therapy programme for adults with psychiatric diagnoses.

    Science.gov (United States)

    Schindler, Victoria P

    2010-09-01

    The purpose of this study was to assess the effectiveness of a client-centred, occupation-based occupational therapy programme for individuals with psychiatric diagnoses. The study took place in a college campus. A pre-test/post-test design was used. There were 38 participants which included college students and community members who desired to attend college, work and/or address life skill goals. The Canadian Occupational Performance Measure (COPM) was used as a pre- and post-test measure. Goals were based on problems identified in the COPM, reflected academic, vocational, life skill, and leisure goals, and were systematically addressed weekly through activities developed by the participant and a graduate occupational therapy student who acted as a mentor. The Participant Overall Satisfaction Scale was completed by each participant. A case study was used to describe the programme in more depth. The results support that the client-centred, occupation-based occupational therapy programme increased client scores on satisfaction and performance of occupational performance problems identified on the COPM. Further research is recommended to explore how client-centred occupational therapy programmes can be effective in improving academic, vocational and life skill goals. Copyright 2010 John Wiley & Sons, Ltd.

  7. Chance of psychiatric morbidity amongst recently diagnosed cancer outpatients attending a chemotherapy unit

    Directory of Open Access Journals (Sweden)

    A.C. Chaves

    2005-09-01

    Full Text Available The prevalent rate of psychiatry morbidity amongst patients with cancer reported in various studies ranges from 5 to 50%, a variation that can be attributed to differences in sample size, the disease itself and treatment factors. The objectives of the present study were to determine the frequency of psychiatric morbidity amongst recently diagnosed cancer outpatients and try to identify which factors might be related to further psychological distress. Two hundred and eleven (70.9% female patients and 87 (29.1% male patients from the chemotherapy unit of the Cancer Hospital A.C. Camargo (São Paulo completed a questionnaire that featured data on demographic, medical and treatment details. The Self Reporting Questionnaire (SRQ-20 was administered to the patients to determine their personal psychiatric morbidity. Seventy-two patients (25.8% scored > or = 8 in the SRQ-20, the cut-off point for a patient to be considered a psychiatric case. When the low and high scoring groups were compared no differences were detected regarding age, marital status, tumor site, sex, or previous treatment. Nonetheless, patients in the lowest social class and those who were bedridden less than 50% of the time had a significantly higher probability of being a psychiatric case. Regarding help-seeking behavior in situations in which they had doubts or were frightened, about 64% of the total sample did not seek any type of support and did not talk to anyone. This frequency of psychiatric morbidity agrees with data from the cancer literature. According to many investigators, the early detection of a comorbid psychiatric disorder is crucial to relieve a patient's suffering.

  8. Comorbid psychiatric diagnoses among individuals presenting to an addiction treatment program for alcohol dependence.

    LENUS (Irish Health Repository)

    Lyne, John Paul

    2011-01-01

    A retrospective patient record review was conducted to examine comorbid psychiatric diagnoses, and comorbid substance use, among 465 patients below 45 years of age, presenting to a national alcohol addiction treatment unit in Dublin, between 1995 and 2006. Rates were high for depressive disorder (25.3%) particularly among females (35.4%). Lifetime reported use of substances other than alcohol was 39.2%, and further analysis showed significantly higher rates of deliberate self-harm among this group. Lifetime reported use of ecstasy was also significantly associated with depression in this alcohol-dependent population using logistic regression analysis. Implications and limitations of the findings are discussed.

  9. Forty-Five-Year Mortality Rate as a Function of the Number and Type of Psychiatric Diagnoses Found in a Large Danish Birth Cohort

    DEFF Research Database (Denmark)

    Madarasz, Wendy; Manzardo, Ann; Mortensen, Erik Lykke

    2012-01-01

    Central Psychiatric Research Registry for 8109 birth cohort members aged 45 years. Lifetime psychiatric diagnoses (International Classification of Diseases, Revision 10, group F codes, Mental and Behavioural Disorders, and one Z code) for identified subjects were organized into 14 mutually exclusive......Objective: Psychiatric comorbidities are common among psychiatric patients and typically associated with poorer clinical prognoses. Subjects of a large Danish birth cohort were used to study the relation between mortality and co-occurring psychiatric diagnoses. Method: We searched the Danish...

  10. The cost-effectiveness of psychotherapy for the major psychiatric diagnoses.

    Science.gov (United States)

    Lazar, Susan G

    2014-09-01

    Psychotherapy is an effective and often highly cost-effective medical intervention for many serious psychiatric conditions. Psychotherapy can also lead to savings in other medical and societal costs. It is at times the firstline and most important treatment and at other times augments the efficacy of psychotropic medication. Many patients are in need of more prolonged and intensive psychotherapy, including those with personality disorders and those with chronic complex psychiatric conditions often with severe anxiety and depression. Many patients with serious and complex psychiatric illness have experienced severe early life trauma in an atmosphere in which family members or caretakers themselves have serious psychiatric disorders. Children and adolescents with learning disabilities and those with severe psychiatric disorders can also require more than brief treatment. Other diagnostic groups for whom psychotherapy is effective and cost-effective include patients with schizophrenia, anxiety disorders (including posttraumatic stress disorder), depression, and substance abuse. In addition, psychotherapy for the medically ill with concomitant psychiatric illness often lowers medical costs, improves recovery from medical illness, and at times even prolongs life compared to similar patients not given psychotherapy. While "cost-effective" treatments can yield savings in healthcare costs, disability claims, and other societal costs, "cost-effective" by no means translates to "cheap" but instead describes treatments that are clinically effective and provided at a cost that is considered reasonable given the benefit they provide, even if the treatments increase direct expenses. In the current insurance climate in which Mental Health Parity is the law, insurers nonetheless often use their own non-research and non-clinically based medical necessity guidelines to subvert it and limit access to appropriate psychotherapeutic treatments. Many patients, especially those who need

  11. Bullying behaviour among Norwegian adolescents: psychiatric diagnoses and school well-being in a clinical sample.

    Science.gov (United States)

    Hansen, Hanne Hoff; Hasselgård, Cecilie Edh; Undheim, Anne Mari; Indredavik, Marit Sæbø

    2014-07-01

    Few studies have focused the association between bullying and psychiatric disorders in clinical samples. The aim of this study was to examine if bullying behaviour was associated with psychiatric disorders and school well-being. The cross-sectional study was part of a health survey at St. Olav's University Hospital. The sample consisted of 685 adolescent patients aged 13-18 years who completed an electronic questionnaire. Clinical diagnoses were collected from clinical records. In this clinical psychiatric sample, 19% reported being bullied often or very often, and 51% reported being bullied from time to time. Logistic regression analyses showed associations between being a victim and having a mood disorder, and between being involved in bullying behaviour and reporting lower scores on school well-being. No difference was found in bullying behaviour on gender, age and SES. The risk of being a victim was high among adolescents in this clinical sample, especially among patients with mood disorders. Any involvement in bullying behaviour was associated with reduced school well-being.

  12. Cross-sectional study to evaluate the longitudinal development of child and adolescent psychiatric diagnoses of inpatients in Vorarlberg, Austria.

    Science.gov (United States)

    Schwarz, Karoline; Fuchs, Martin; Veraar, Maria; Menz, Wolfgang; Kemmler, Georg; Simma, Burkhard

    2016-02-01

    Clinical experience has repeatedly shown evidence for continuity between mental disorders in children and adolescents and mental disorders in adulthood. Up to now, Austria has had no epidemiologic data on psychiatric diseases in children and adolescents and their development into adulthood. How often do children and adolescents with psychiatric diseases have psychiatric diseases in adulthood? Is there any association between psychiatric diagnoses in childhood/adolescence and adulthood? Electronic medical records provided us with data on 2210 children and adolescents who were admitted to any hospital in the State of Vorarlberg, Austria, between 1997 and 2012 because of psychiatric diseases. In this cross-sectional study, diagnoses were coded according to ICD-10 and ICD-9 criteria. The three main reasons for admission of children and adolescents were substance abuse, emotional disorders and conduct disorders. Of the admitted children and adolescents, 9.8 % were readmitted to a psychiatric institution in adulthood. The main reason for readmission in adulthood appears to be disorders due to psychoactive substances (42.1 %). Of young patients with psychoactive substance use, 9.7 % were rehospitalized in adulthood, 70.8 % of them showed a diagnosis in the same category (F1) on admission. Children and adolescents admitted for schizophrenia, schizotypal, and delusional disorders (F2) were significantly more likely to be readmitted in adulthood (40.9 %) compared to any other child psychiatric diagnosis. This study once again shows the continuity of psychiatric disorders from childhood and adolescence to adulthood. It also gives further information about the transmission of diagnoses when patients reached the age of 18 years and their outcome. Until now, there is hardly any information about the outcome of children and adolescents with psychiatric diagnoses in Austria. We want to bring up more knowledge on that issue. Research findings may improve prevention and clinical

  13. Predominant diagnoses, gender, and admission duration in an adult psychiatric inpatient hospital in United Kingdom

    Directory of Open Access Journals (Sweden)

    Carlo Lazzari

    2017-12-01

    Full Text Available Introduction: The study objective was to epidemiologically analyse patients presenting at an adult and mixed-gender psychiatric inpatient unit in Essex, Kingswood Centre, UK, to report the predominant diagnoses, gender, and admission duration. Method and material: Meta-analysis and descriptive statistics analysed the year 2016 discharge data on Excel® for 162 patients. ICD-10 codes classified their mental illnesses. Results: Meta-analysis evidenced statistically significant heterogeneity in numbers admissions (I2=95%; p≤0.001, length (I2=78%; p≤0.001, and gender (I2=76%; p≤0.001. The prevailing diagnosis was borderline personality disorder (BPD (rate, 95% CI=0.46 [0.38-0.54]. The longest admission was for schizoaffective disorder (mean duration, 95% CI=53 [22.65-83.34], p=0.001. Gender presented a prevalence of male over female admissions for schizophrenia (OR, 95% CI=0.14 [0.05-0.35], p≤0.001 and BPD with prevalence of female over male admissions (OR, 95% CI=2.79 [1.35-5.76], p=0.05. Conclusion: Female patients with BPD were the most represented category in non-forensic psychiatric inpatient wards in the population studied. Male patients with schizophrenia represented the other gender highly represented. The longest admission was recorded for schizoaffective disorder due to the complexity to treat both mood and psychotic symptoms. It is likely that women with BPD will be the future recipients of psychiatric inpatient and outpatient healthcare services.

  14. Social selection in cohort studies and later representation of childhood psychiatric diagnoses: The Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Madsen, Kathrine Bang; Hohwü, Lena; Zhu, Jin Liang

    2017-01-01

    AIM: This study aimed to estimate the relative representation of childhood psychiatric diagnoses and use of psychotropic medication in the Danish National Birth Cohort (DNBC) compared to the general population. METHODS: The general population was identified as all childbirths in Denmark during 1998......) with corresponding 95% confidence intervals (CI) were estimated for each psychiatric diagnosis and by sex. Age at first diagnosis presented as means were compared using the one-sample t-test. RESULTS: In the DNBC, the selected childhood psychiatric diagnoses were underrepresented by 3% (PR=0.97, 95% CI 0.......94-0.99), ranging from a 20% underrepresentation for schizophrenia (PR=0.80, 95% CI 0.59-1.09) to a 6% over-representation for anxiety disorder or obsessive-compulsive disorder (PR=1.06, 95% CI 0.97-1.17). The majority of the specific diagnoses were modestly underrepresented in the DNBC compared to the general...

  15. Function assertive community treatment (FACT) and psychiatric service use in patients diagnosed with severe mental illness.

    Science.gov (United States)

    Drukker, M; van Os, J; Sytema, S; Driessen, G; Visser, E; Delespaul, P

    2011-09-01

    Previous work suggests that the Dutch variant of assertive community treatment (ACT), known as Function ACT (FACT), may be effective in increasing symptomatic remission rates when replacing a system of hospital-based care and separate community-based facilities. FACT guidelines propose a different pattern of psychiatric service consumption compared to traditional services, which should result in different costing parameters than care as usual (CAU). South-Limburg FACT patients, identified through the local psychiatric case register, were matched with patients from a non-FACT control region in the North of the Netherlands (NN). Matching was accomplished using propensity scoring including, among others, total and outpatient care consumption. Assessment, as an important ingredient of FACT, was the point of departure of the present analysis. FACT patients, compared to CAU, had five more outpatient contacts after the index date. Cost-effectiveness was difficult to assess. Implementation of FACT results in measurable changes in mental health care use.

  16. Comorbid psychiatric diagnoses in suicide attempt by charcoal burning: a 10-year study in a general hospital in Taiwan.

    Science.gov (United States)

    Lin, Chemin; Yen, Tzung-Hai; Juang, Yeong-Yuh; Leong, Wa Cheong; Hung, Huei-Min; Ku, Chung-Hsuan; Lin, Ja-Liang; Lee, Shwu-Hua

    2012-01-01

    Over the last decade, charcoal burning has become a common method of suicide in Taiwan; however, the underlying psychiatric diagnoses and gender differences have yet to be examined. We conducted a retrospective chart review on inpatients after suicide attempt by charcoal burning during 2000-2010. The patients were referred to the psychiatric consultation team and diagnoses were made according to DSM-IV. We chose those who were admitted to the nephrology ward in the same period due to accidental carbon monoxide intoxication as controls. Demographic and laboratory data, psychiatric diagnoses and reasons for suicide were obtained and analyzed. Among seventy-three patients, major depressive disorder (49.3%) and adjustment disorder (41.1%) were most frequently diagnosed. Breaking-up, financial debt and physical/mental illnesses were the top three reasons for suicide (17.8% each). The male-to-female gender ratio was 1.5:1. Female patients had higher rates of major depressive disorders, while male patients presented more adjustment disorders comorbid with alcohol use disorders. There were gender differences in patients of suicide attempt by charcoal burning, in terms of demographic profiles and psychiatric diagnoses. Suicide risk assessment and prevention should be tailored by gender. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Treatment needs, diagnoses and use of services for acutely admitted psychiatric patients in northwest Russia and northern Norway

    Directory of Open Access Journals (Sweden)

    Sørgaard Knut W

    2013-01-01

    Full Text Available Abstract Background We compared demography, diagnoses and clinical needs in acutely admitted psychiatric hospital patients in northwest Russia and northern Norway. Method All acutely admitted psychiatric patients in 1 psychiatric hospital in north-west Russia and 2 in northern Norway were in a three months period assessed with HoNOS and a Norwegian form developed to study acute psychiatric services (MAP. Data from a total of 841 patients were analysed (377 Norwegian, 464 Russian with univariate and multivariate statistics. Results Russian patients were more often males who had paid work. 2/3 were diagnosed with alcohol and organic disorders, and 70% reported problems related to sleep. Depression was widespread, as were problems associated with occupation. Many more Norwegian patients were on various forms of social security and lived in community supported homes. They had a clinical profile of affective disorders, use of drugs, suicidality and problems with activities involved of daily life. Slightly more Norwegian patients were involuntary admitted. Conclusion Acutely admitted psychiatric patients in North West Russia and Northern Norwegian showed different clinical profiles: alcohol, depression and organic disorders characterised Russian patients, affective disorders, suicidality and use of drugs characterised the Norwegians. Whereas Norwegian patients are mainly referred from GPs the Russians come via 1.line psychiatric services (“dispensaries”. Average length of stay for Russian patients was 2.5 times longer than that of the Norwegian.

  18. The Effect of Violence on the Diagnoses and the Course of Illness Among Female Psychiatric Inpatients

    Science.gov (United States)

    TEMİZ, Meltem; BEŞTEPE, Emrem; YILDIZ, Özlem; KÜÇÜKGÖNCÜ, Suat; YAZICI, Ayla; ÇALIKUŞU, Celal; ERKOÇ, Şahap

    2014-01-01

    Introduction The aim of the study was to determine the rate of exposure to domestic violence among female inpatients at any period of their lives; to investigate the effect of different forms of violence on the diagnoses and the course of the illness. Method The study was conducted on 102 female inpatients treated at Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) was administered and socio-demographic and clinical data was collected. A form designed for the assessment of violence was used to evaluate domestic violence. Results Ninety patients reported that they had been subjected to some kind of violence at some period of their lives. The parents or husbands were the most frequently reported persecutors. Seventy-three patients reported that they had been subjected to violence before the onset of their illness. Seventy-one had been subjected to physical, 79 to verbal, 42 to sexual, 52 to economic violence, and 49 to constraints on social relationship formation. Comorbid diagnosis of post traumatic stress disorder (PTSD) was related to all types of violence. The rate of suicide attempt was found to be significantly related to verbal-emotional violence. Only 12 patients had previously reported being subjected to domestic violence to their psychiatrist. Conclusion Domestic violence, an often overlooked phenomenon, is prevalent among women with psychiatric disorders. Subjection to domestic violence is found to be correlated with PTSD and suicidal attempt. PMID:28360588

  19. Negative and positive childhood experiences across developmental periods in psychiatric patients with different diagnoses – an explorative study

    Directory of Open Access Journals (Sweden)

    Schauer Margarete

    2004-11-01

    Full Text Available Abstract Background A high frequency of childhood abuse has often been reported in adult psychiatric patients. The present survey explores the relationship between psychiatric diagnoses and positive and negative life events during childhood and adulthood in psychiatric samples. Methods A total of 192 patients with diagnoses of alcohol-related disorders (n = 45, schizophrenic disorders (n = 52, affective disorders (n = 54, and personality disorders (n = 41 completed a 42-item self-rating scale (Traumatic Antecedents Questionnaire, TAQ. The TAQ assesses personal positive experiences (competence and safety and negative experiences (neglect, separation, secrets, emotional, physical and sexual abuse, trauma witnessing, other traumas, and alcohol and drugs abuse during four developmental periods, beginning from early childhood to adulthood. Patients were recruited from four Psychiatric hospitals in Germany, Switzerland, and Romania; 63 subjects without any history of mental illness served as controls. Results The amount of positive experiences did not differ significantly among groups, except for safety scores that were lower in patients with personality disorders as compared to the other groups. On the other side, negative experiences appeared more frequently in patients than in controls. Emotional neglect and abuse were reported in patients more frequently than physical and sexual abuse, with negative experiences encountered more often in late childhood and adolescence than in early childhood. The patients with alcohol-related and personality disorders reported more negative events than the ones with schizophrenic and affective disorders. Conclusions The present findings add evidence to the relationship between retrospectively reported childhood experiences and psychiatric diagnoses, and emphasize the fact that a emotional neglect and abuse are the most prominent negative experiences, b adolescence is a more 'sensitive' period for negative

  20. Psychiatric disorders in adults diagnosed as children with atypical autism. A case control study

    DEFF Research Database (Denmark)

    Mouridsen, S.E.; Rich, B.; Isager, T.

    2008-01-01

    The prevalence and types of psychiatric disorders were studied in a clinical sample of 89 individuals with atypical autism (AA) first seen as children, and 258 matched controls from the general population using data from the nationwide Danish Psychiatric Central Register. The average observation...

  1. Gender Differences in Psychiatric Diagnoses among Inpatients with and without Intellectual Disabilities

    Science.gov (United States)

    Lunsky, Yona; Bradley, Elspeth A.; Gracey, Carolyn D.; Durbin, Janet; Koegl, Chris

    2009-01-01

    There are few published studies on the relationship between gender and psychiatric disorders in individuals with intellectual disabilities. Adults (N = 1,971) with and without intellectual disabilities who received inpatient services for psychiatric diagnosis and clinical issues were examined. Among individuals with intellectual disabilities,…

  2. Comparative utilization of pharmacotherapy for alcohol use disorder and other psychiatric disorders among U.S. Veterans Health Administration patients with dual diagnoses.

    Science.gov (United States)

    Rubinsky, Anna D; Chen, Cheng; Batki, Steven L; Williams, Emily C; Harris, Alex H S

    2015-10-01

    Patients with alcohol use disorder (AUD) and another co-occurring psychiatric disorder are a vulnerable population with high symptom severity. Such patients may benefit from a full arsenal of treatment options including pharmacotherapy. Receipt of AUD pharmacotherapy is generally very low despite recommendations that it be made available to every patient with AUD, including those with co-occurring disorders. Little is known about pharmacotherapy rates for AUD compared to other psychiatric disorders among patients with dual diagnoses. This study compared rates of pharmacotherapy for AUD to those for non-substance use psychiatric disorders and tobacco use disorder among patients with dual diagnoses in the U.S. Veterans Affairs (VA) healthcare system. VA data were used to identify patients with AUD and another psychiatric disorder in fiscal year 2012, and to estimate the proportion receiving pharmacotherapy for AUD and for each comorbid condition. Among subsets of patients with AUD and co-occurring schizophrenic, bipolar, posttraumatic stress or major depressive disorder, receipt of medications for AUD ranged from 7% to 11%, whereas receipt of medications for the comorbid disorder ranged from 69% to 82%. Among patients with AUD and co-occurring tobacco use disorder, 6% received medication for their AUD and 34% for their tobacco use disorder. Among patients with dual diagnoses, rates of pharmacotherapy for AUD were far lower than those for the comorbid disorders and contrary to evidence that medications for AUD are effective. Additional system-wide implementation efforts to identify and address patient- and provider-level barriers are needed to increase AUD pharmacotherapy in this high-need population. Published by Elsevier Ltd.

  3. Top-down or bottom-up: Contrasting perspectives on psychiatric diagnoses

    Directory of Open Access Journals (Sweden)

    Willem MA Verhoeven

    2008-09-01

    Full Text Available Willem MA Verhoeven1,2, Siegfried Tuinier1, Ineke van der Burgt31Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands; 2Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, The Netherlands; 3Department of Human Genetics, Radboud University Medical Centre, Nijmegen, The NetherlandsAbstract: Clinical psychiatry is confronted with the expanding knowledge of medical genetics. Most of the research into the genetic underpinnings of major mental disorders as described in the categorical taxonomies, however, did reveal linkage with a variety of chromosomes. This heterogeneity of results is most probably due to the assumption that the nosological categories as used in these studies are disease entities with clear boundaries. If the reverse way of looking, the so-called bottom-up approach, is applied, it becomes clear that genetic abnormalities are in most cases not associated with a single psychiatric disorder but with a certain probability to develop a variety of aspecific psychiatric symptoms. The adequacy of the categorical taxonomy, the so-called top-down approach, seems to be inversely related to the amount of empirical etiological data. This is illustrated by four rather prevalent genetic syndromes, fragile X syndrome, Prader-Willi syndrome, 22q11 deletion syndrome, and Noonan syndrome, as well as by some cases with rare chromosomal abnormalities. From these examples, it becomes clear that psychotic symptoms as well as mood, anxiety, and autistic features can be found in a great variety of different genetic syndromes. A psychiatric phenotype exists, but comprises, apart from the chance to present several psychiatric symptoms, all elements from developmental, neurocognitive, and physical characteristics.Keywords: genetic disorders, psychiatric symptoms, phenotype, mental disorders

  4. Parent Report of Community Psychiatric Comorbid Diagnoses in Autism Spectrum Disorders

    OpenAIRE

    Rosenberg, Rebecca E.; Kaufmann, Walter E.; Law, J. Kiely; Law, Paul A.

    2011-01-01

    We used a national online registry to examine variation in cumulative prevalence of community diagnosis of psychiatric comorbidity in 4343 children with autism spectrum disorders (ASD). Adjusted multivariate logistic regression models compared influence of individual, family, and geographic factors on cumulative prevalence of parent-reported anxiety disorder, depression, bipolar disorder, and attention deficit/hyperactivity disorder or attention deficit disorder. Adjusted odds of community-as...

  5. The association between adjustment disorder diagnosed at psychiatric treatment facilities and completed suicide

    DEFF Research Database (Denmark)

    Gradus, Jaimie L; Qin, Ping; Lincoln, Alisa K

    2010-01-01

    Adjustment disorder is a diagnosis given following a significant psychosocial stressor from which an individual has difficulty recovering. The individual's reaction to this event must exceed what would be observed among similar people experiencing the same stressor. Adjustment disorder is associa...... regression analyses revealed that those diagnosed with adjustment disorder had 12 times the rate of suicide as those without an adjustment disorder diagnosis, after controlling for history of depression diagnosis, marital status, income, and the matched factors....... is associated with suicidal ideation and suicide attempt. However the association between adjustment disorder and completed suicide has yet to be examined. The current study is a population-based case control study examining this association in the population of Denmark aged 15 to 90 years. All suicides...... in Denmark from 1994 to 2006 were included, resulting in 9,612 cases. For each case, up to 30 controls were matched on gender, exact date of birth, and calendar time, yielding 199,306 controls. Adjustment disorder diagnosis was found in 7.6% of suicide cases and 0.52% of controls. Conditional logistic...

  6. Prevalence of Attention-Deficit/Hyperactivity Disorder (ADHD symptomatology and psychiatric comorbidity among adolescents diagnosed with ADHD in childhood

    Directory of Open Access Journals (Sweden)

    Stephen Walker

    2011-03-01

    Full Text Available Objectives: Given the paucity of research on adolescent ADHD, this study aimed to establish the prevalence of DSM-IV ADHD in a cohort of South African adolescents who had been diagnosed with the disorder in childhood. It also aimed to establish the prevalence of psychiatric comorbidities and adjustment difficulties in this sample. Method: Data regarding age of diagnosis, current ADHD status, current ADHD-related pharmacological management, current psychopathology and current adjustment were gathered from 64 adolescents and their guardians via self-report questionnaire. Descriptive statistics were calculated with regard to current ADHD status, comorbid psychopathology and adjustment difficulties, as well as current ADHD-related medication. Results: According to parent reports, 59.38% of the sample met DSM-IV criteria for ADHD Inattentive subtype, while 37.50% met the criteria for ADHD Hyperactive/Impulsive subtype. Approximately sixty-four percent (64.06% of the adolescents were still using stimulant medication. Based on the adolescent self-report, 43.75% of the sample reported clinically significant symptoms of psychopathology or maladjustment. Furthermore, 39.28% of the adolescents met the diagnostic criteria for at least one psychiatric comorbidity. Conclusion: ADHD did persist into adolescence in the current sample. A significant psychopathological and maladjustment load appears evident amongst adolescents previously diagnosed with ADHD despite continuous pharmacological management of the condition.

  7. Delivery of mental health treatment to combat veterans with psychiatric diagnoses and TBI histories.

    Directory of Open Access Journals (Sweden)

    Shannon R Miles

    Full Text Available Traumatic brain injury (TBI and mental health (MH disorders are prevalent in combat veterans returning from Afghanistan and/or Iraq (hereafter referred to as returning veterans. Accurate estimates of service utilization for veterans with and without TBI exposure (referred to as TBI history are imperative in order to provide high quality healthcare to returning veterans. We examined associations between TBI history and MH service utilization in a subsample of returning veterans who were newly diagnosed with posttraumatic stress disorder (PTSD, depression, and/or anxiety in the 2010 fiscal year (N = 55,458. Data were extracted from the Veterans Health Administration (VHA National Patient Care Database. Veterans with MH diagnoses and TBI histories attended significantly more psychotherapy visits, (M = 8.32 visits, SD = 17.15 and were more likely to attend at least 8 psychotherapy visits, (15.7% than veterans with MH diagnoses but no TBI history (M = 6.48 visits, SD = 12.12; 10.1% attended at least 8 sessions. PTSD and TBI history, but not depression or anxiety, were associated with a greater number of psychotherapy visits when controlling for demographic and clinical variables. PTSD, anxiety, depression, and TBI history were associated with number of psychotropic medication-management visits. TBI history was related to greater MH service utilization, independent of MH diagnoses. Future research should examine what MH services are being utilized and if these services are helping veterans recover from their disorders.

  8. PERSONALITY TRAITS, ANGER AND PSYCHIATRIC SYMPTOMS RELATED TO QUALITY OF LIFE IN PATIENTS WITH NEWLY DIAGNOSED DIGESTIVE SYSTEM CANCER

    Directory of Open Access Journals (Sweden)

    Noemi Peres HONORATO

    2017-03-01

    Full Text Available ABSTRACT BACKGROUND The presence of psychiatric symptoms, anger, and personality characteristics are factors that affect the quality of life of newly diagnosed digestive system cancer patients. OBJECTIVE This study aims to identify which stable characteristics of the individual’s personality interfere with quality of life, even when reactive emotional characteristics of falling ill are controlled. METHODS A cross-sectional study was performed at the Oncology Clinic ( Hospital das Clínicas , Marília/SP, Brazil, in which 50 adult patients with digestive system cancer and diagnosed less than 6 months answered the State-Trait Anger Expression Inventory, Temperament and Character Inventory, Hospital Anxiety and Depression Scale and WHOQOL-BREF. Multiple regression was performed to verify if quality of life was related to stable characteristics of the subject’s personality (anger trait, temperament and character after controlling to the transient emotional aspects (anger state, psychiatric symptoms. RESULTS The quality of life psychological health score was higher in presence of self-directedness character and reward dependence temperament and quality of life environment score was higher in presence of self-directedness character and lower in presence of harm avoidance temperament. CONCLUSION The psychological well-being and the adaptive needs to the environment that favoring a better quality of life were reinforced mainly by the self-directedness character; which means that patients more autonomous cope better with the disease. On the other hand, the harm avoidance temperament (meaning the patient has fear of aversive situations impaired the adaptive capacity to deal with the changes of the day-to-day imposed by the disease. Understanding these personality traits is important to the health professionals drive the patient to more successful treatment.

  9. Coercion in patients who at their first contact with the psychiatric services system were diagnosed within the schizophrenia-spectrum in Denmark. A register study

    DEFF Research Database (Denmark)

    Øhlenschlaeger, Johan; Nordentoft, Merete

    2008-01-01

    The level of use of coercive measures in patients diagnosed with a schizophrenia-spectrum disorder at their first contact with the psychiatric services system in Denmark is not known. The aim of the study was to investigate the level of use of coercive measures during first year of contact in thi...

  10. Does Gender Influence Electroconvulsive Therapy Sessions Required across Psychiatric Diagnoses? A 5-Year Experience from a Single Center

    Science.gov (United States)

    Manohar, Harshini; Subramanian, Karthick; Menon, Vikas; Kattimani, Shivanand

    2017-01-01

    Context: There is a paucity of systematic data reflecting the practice of electroconvulsive therapy (ECT) from developing countries. Aim: We aimed to identify the number of ECT sessions required to yield response and gender diffeferences in the number of sessions across various diagnostic categories. Setting and Design: A record-based study from a teaching cum tertiary care hospital in South India. Subjects and Methods: Case records of patients who received modified ECT from January 2011 to January 2016 were reviewed. The sociodemographic details and ECT-related data were collected. Psychiatric diagnoses were ascertained as per the International Classification of Diseases, 10th Revision criteria. Statistical Analysis Used: Kruskal–Wallis test and Mann–Whitney U-test. Results: Among 148 patients, 82 (55.4%) had mood disorder (bipolar disorder and recurrent depressive disorder), 43 (29.1%) had schizophrenia, and 22 (14.9%) had other acute and transient psychotic disorders (ATPDs). Patients with mood disorders, schizophrenia, and other ATPD received 7.3 (± 3.8), 9.7 (± 6.1), and 5.4 (± 2.0) ECT sessions, respectively, to achieve response. There was no gender difference in the number of sessions received. Conclusion: Our findings show that number of ECT sessions required to yield response may be disorder-specific. Gender does not influence the ECT dose requirement. Variations in ECT parameters across settings may limit the generalizability of results. PMID:28694625

  11. Prevalence of Psychiatric Diagnoses and Challenging Behaviors in a Community-Based Population of Adults with Intellectual Disability

    Science.gov (United States)

    Grey, Ian; Pollard, Jill; McClean, Brian; MacAuley, Niall; Hastings, Richard

    2010-01-01

    Previous research has suggested substantial variation in prevalence rates of psychiatric disorders in individuals with intellectual disability (ID) and also differential patterns of associations between psychiatric disorders and challenging behaviors in people with ID. The aim of this study was to determine the prevalence rate of specific…

  12. Patient experienced continuity of care in the psychiatric healthcare system-a study including immigrants, refugees and ethnic danes.

    Science.gov (United States)

    Jensen, Natasja Koitzsch; Johansen, Katrine Schepelern; Kastrup, Marianne; Krasnik, Allan; Norredam, Marie

    2014-09-17

    The purpose of this study was to investigate continuity of care in the psychiatric healthcare system from the perspective of patients, including vulnerable groups such as immigrants and refugees. The study is based on 19 narrative interviews conducted with 15 patients with diverse migration backgrounds (immigrants, descendents, refugees, and ethnic Danes). Patients were recruited from a community psychiatric centre situated in an area with a high proportion of immigrants and refugees. Data were analysed through the lens of a theoretical framework of continuity of care in psychiatry, developed in 2004 by Joyce et al., which encompasses four domains: accessibility, individualised care, relationship base and service delivery. Investigating continuity of care, we found issues of specific concern to immigrants and refugees, but also commonalities across the groups. For accessibility, areas pertinent to immigrants and refugees include lack of knowledge concerning mental illness and obligations towards children. In terms of individualised care, trauma, additional vulnerability, and taboo concerning mental illness were of specific concern. In the domain of service delivery, social services included assistance with immigration papers for immigrants and refugees. In the relationship base domain, no differences were identified. Implications for priority area: The treatment courses of patients in the psychiatric field are complex and diverse and the patient perspective of continuity of care provides important insight into the delivery of care. The study highlights the importance of person-centred care irrespective of migration background though it may be beneficial to have an awareness of areas that may be of more specific concern to immigrants and refugees. The study sheds light on concerns specific to immigrants and refugees in a framework of continuity of care, but also commonalities across the patient groups.

  13. How does self stigma differ across people with psychiatric diagnoses and rheumatoid arthritis, and how does it impact on self-esteem and empowerment?

    Science.gov (United States)

    Corker, Elizabeth; Brown, June; Henderson, Claire

    2016-12-01

    Self stigmatising attitudes have been found in people who have psychiatric diagnoses, however, research assessing self stigma in physical illnesses is rare. It is known that receiving a diagnosis of rheumatoid arthritis (RA) can affect a person's identity and self esteem. This study aimed to compare levels of self stigma, self esteem and empowerment between people diagnosed with psychiatric illnesses and people diagnosed with RA to establish whether self stigma, and specifically endorsement of negative stereotypes, is associated with self esteem and empowerment across these two groups. A total of 202 participants (psychiatric group n = 102; RA group n = 100) were interviewed using the Internalised Stigma of Mental Illness scale (ISMI), or the Internalized Stigma of Mental Illness scale- Rheumatoid Arthritis (ISMI-RA), the Index of Self Esteem (ISE) and the Mental Health Confidence Scale (MHCS). Overall, the psychiatric group had higher self stigma scores (2.5 vs. 2.2, p < .01), lower self esteem (48.7 vs. 36.8, p < .001) and lower empowerment scores (3.8 vs. 4.3, p < .001) than the RA group. However, sizable proportions of both groups had high self stigma scores. ISMI/ISMI-RA was associated with the ISE and the MHCS. The stereotype endorsement subscale of the ISMI/ISMI-RA was not related to self esteem or empowerment in either group. Interventions that aim to decrease self stigma and increase self esteem could focus on alienation.

  14. Time trends in lifetime incidence rates of first-time diagnosed anorexia nervosa and bulimia nervosa across 16 years in a Danish nationwide psychiatric registry study.

    Science.gov (United States)

    Steinhausen, Hans-Christoph; Jensen, Christina Mohr

    2015-11-01

    To study recent time trends in the incidence of diagnosed anorexia nervosa (AN) and bulimia nervosa (BN) based on nationwide psychiatric register data. The Danish Psychiatric Central Research Registry was used to identify the incidence of diagnosed cases with AN and BN at the ages of 4-65 years from 1995 to 2010. Age- and sex-adjusted incidence rates per 100,000 person-years were calculated and were adjusted for time trends in the total number of people diagnosed in psychiatry. Time trends were analyzed using JoinPoint regression analysis. A total of N = 5,902 persons had a first-time incidence of AN, and a total of N = 5,113 had first-time incidence of BN. Incidence rates increased for AN from 6.4 to 12.6 per 100,000 person-years, and for BN from 6.3 to 7.2 per 100,000 person-years. In 2010, the male-to-female ratio was 1:8 for AN, and 1:20 for BN. There was an earlier onset for AN than for BN, and age at incidence decreased during the observation period for AN but not for BN. A sizeable part of the increasing incidence rates for AN and in particular, the younger AN age groups, could be attributed to an increase in the total number of N = 249,607 persons with first-time diagnoses in psychiatry. Incidence rates had increased slightly for AN, but were stable for BN across 16 years in this nationwide study and to a large extent were reflective of a general increase in diagnosed mental disorders. © 2015 Wiley Periodicals, Inc.

  15. Psychiatric features in perpetrators of homicide-unsuccessful ...

    African Journals Online (AJOL)

    2013-03-01

    Mar 1, 2013 ... The high rate of psychiatric disorders diagnosed is in keeping with court referrals occurring ... was collected if available, and included gender, age, employment history, marital ... psychiatric symptoms and of psychiatric illness and treatment, as reported by the ... The identity of alleged perpetrators was kept ...

  16. From feelings of imprisonment to group cohesion: A qualitative analysis of group analytic psychotherapy with dual diagnosed patients admitted to an acute inpatient psychiatric unit.

    Science.gov (United States)

    Sánchez Morales, Lidia; Eiroa-Orosa, Francisco José; Valls Llagostera, Cristina; González Pérez, Alba; Alberich, Cristina

    2018-05-01

    Group cohesion, the establishment of hope, and the expression of feelings have been said to be the basic ingredients of group psychotherapy. To date, there is few literature describing therapeutic processes in short stay settings such as acute psychiatric wards and with special patient groups such as addictions. Our goal with this study is to describe and analyze group processes in such contexts. We used a qualitative methodology combining constant comparative methods and hermeneutical triangulation to analyze therapeutic narratives in the context of a group analytic process carried following Foulkes' and Yalom's styles. The results provide a picture of the therapeutic process including the use of norms to strengthen group cohesion facilitating the expression of emotions in early stages of group development. This analysis is intended to be a guide for practitioners implementing group therapy in contexts involving several constraints, such as acute psychiatric wards.

  17. Psychiatric morbidity in perimenopausal women

    Directory of Open Access Journals (Sweden)

    Biswajit L Jagtap

    2016-01-01

    Full Text Available Background: Women in the perimenopausal period are reported to be vulnerable to psychiatric disorders. Aim: To assess the psychiatric morbidity in perimenopausal women aged 45–55 years. Materials and Methods: This cross-sectional, observational, hospital-based study was conducted at the Department of Psychiatry in a tertiary care hospital attached to a medical college. The study sample consisted of consecutive women in perimenopause as diagnosed by a gynecologist and written informed consent for inclusion in the study. Women with a previous history of psychiatric illnesses, with a major medical illness, or who had undergone surgical menopause were excluded from the study. All women were evaluated with a brief questionnaire for collecting demographic and clinical information and the Mini International Neuropsychiatric Interview for assessing psychiatric disorders. Results: Of the 108 women in perimenopause included in the study, 31% had depressive disorder, 7% had anxiety, while 5% had depressive disorder with anxiety features. Psychiatric morbidity was significantly more in women having lesser education, from rural background, with a history of psychiatric illness in the family, a later age of menarche, and in the late stage of perimenopause. Conclusions: Women in the perimenopause affected by psychiatric morbidity were most commonly diagnosed with depression. As perimenopause is a time of vulnerability in women, attention to signs and symptoms of depression may be required so that they may lead a more productive life.

  18. Designing and recruiting to UK autism spectrum disorder research databases: do they include representative children with valid ASD diagnoses?

    Science.gov (United States)

    Warnell, F; George, B; McConachie, H; Johnson, M; Hardy, R; Parr, J R

    2015-09-04

    (1) Describe how the Autism Spectrum Database-UK (ASD-UK) was established; (2) investigate the representativeness of the first 1000 children and families who participated, compared to those who chose not to; (3) investigate the reliability of the parent-reported Autism Spectrum Disorder (ASD) diagnoses, and present evidence about the validity of diagnoses, that is, whether children recruited actually have an ASD; (4) present evidence about the representativeness of the ASD-UK children and families, by comparing their characteristics with the first 1000 children and families from the regional Database of children with ASD living in the North East (Dasl(n)e), and children and families identified from epidemiological studies. Recruitment through a network of 50 UK child health teams and self-referral. Parents/carers with a child with ASD, aged 2-16 years, completed questionnaires about ASD and some gave professionals' reports about their children. 1000 families registered with ASD-UK in 30 months. Children of families who participated, and of the 208 who chose not to, were found to be very similar on: gender ratio, year of birth, ASD diagnosis and social deprivation score. The reliability of parent-reported ASD diagnoses of children was very high when compared with clinical reports (over 96%); no database child without ASD was identified. A comparison of gender, ASD diagnosis, age at diagnosis, school placement, learning disability, and deprivation score of children and families from ASD-UK with 1084 children and families from Dasl(n)e, and families from population studies, showed that ASD-UK families are representative of families of children with ASD overall. ASD-UK includes families providing parent-reported data about their child and family, who appear to be broadly representative of UK children with ASD. Families continue to join the databases and more than 3000 families can now be contacted by researchers about UK autism research. Published by the BMJ

  19. The effect of menstruation on psychiatric hospitalization.

    Science.gov (United States)

    Weston, Jaclyn; Speroni, Karen Gabel; Ellis, Terri; Daniel, Marlon G

    2012-07-01

    This study evaluated the effect of menstruation on psychiatric hospitalization. We conducted a retrospective chart review of the medical records of 177 women who met the eligibility criteria. Data collected included demographic details, primary and secondary diagnoses, date of last menstrual period (LMP), medication adherence, psychiatric hospitalization length of stay, previous psychiatric admissions (including those related to menstruation), discharge referrals, and readmissions. The majority of women were admitted for major depression, were single, Caucasian, and had a mean age of 34. A disproportionate percentage (37%) of women had their LMP within 5 days of psychiatric hospitalization (p = 0.0006). The overall average length of stay was 4.37 days, and 48.3% had a previous psychiatric admission. Medication adherence was routinely not documented (77.4%). Psychiatric hospitalizations for women are significantly greater within 5 days of their LMP. Nursing education and improved documentation are warranted to decrease the potential for readmission. Copyright 2012, SLACK Incorporated.

  20. Psychiatric Comorbidities among Female Adolescents with Anorexia Nervosa

    Science.gov (United States)

    Salbach-Andrae, Harriet; Lenz, Klaus; Simmendinger, Nicole; Klinkowski, Nora; Lehmkuhl, Ulrike; Pfeiffer, Ernst

    2008-01-01

    This study investigated current comorbid Axis I diagnoses associated with Anorexia Nervosa (AN) in adolescents. The sample included 101 female adolescents treated at a psychiatric unit for primary DSM-IV diagnoses of AN. 73.3% of the AN patients were diagnosed as having a current comorbidity of at least one comorbid Axis I diagnosis, with no…

  1. The relationship between stressful life events and Axis I diagnoses among adolescent offspring of probands with bipolar and non-bipolar psychiatric disorders and healthy controls

    Science.gov (United States)

    Pan, Lisa A.; Goldstein, Tina R.; Rooks, Brian T.; Hickey, Mary; Fan, Jie Yu; Merranko, John; Monk, Kelly; Diler, Rasim S.; Sakolsky, Dara J.; Hafeman, Daniella; Iyengar, Satish; Goldstein, Benjamin; Kupfer, David J.; Axelson, David; Brent, David A.; Birmaher, Boris

    2018-01-01

    Background Previous studies have explored the role of stressful life events in the development of mood disorders. We examined the frequency and nature of stressful life events as measured by the Stressful Life Events Scale(SLES) among three groups of adolescent offspring of probands: with bipolar(BD), with non-BD psychiatric disorders, and healthy control(HC). Furthermore, we examined the relationship between stressful life events and presence of DSM-IV Axis I disorders in these offspring. Stressful life events were characterized as dependent, independent, or uncertain (neither dependent or independent), and positive, negative, and neutral (neither positive or negative). Method Offspring of probands with BD aged 13–18 years(N=269), demographically-matched offspring of probands with non-BD Axis I disorders(N=88), and HC probands(N=81) from the Pittsburgh Bipolar Offspring Study were assessed from 2002–2007 with standardized instruments at intake. Probands completed the SLES for their offspring for life events within the prior year. Life events were evaluated with regard to current offspring Axis I diagnoses after adjusting for confounds. Results After adjusting for demographic and clinical between-group differences(in probands and offspring), offspring of BD probands had greater independent and neutral life events compared with HC offspring and greater number of more severe stressful life events than HC offspring, but not non-BD offspring. Offspring of BD probands with comorbid substance use disorder reported more independent stressful life events. Greater frequency and severity of stressful life events were associated with current Axis I disorder in offspring of both BD and non-BD affected probands regardless of dependency or valence. Greater frequency and severity of stressful life events were associated with greater current Axis I disorder in all offspring. Conclusions Offspring of BD probands have greater exposure to independent and neutral life events than

  2. Imagery rehearsal therapy in addition to treatment as usual for patients with diverse psychiatric diagnoses suffering from nightmares: a randomized controlled trial.

    Science.gov (United States)

    van Schagen, Annette M; Lancee, Jaap; de Groot, Izaäk W; Spoormaker, Victor I; van den Bout, Jan

    2015-09-01

    Nightmares are associated with psychopathology and daily distress. They are highly prevalent in a psychiatric population (30%). Currently, imagery rehearsal therapy (IRT) is the treatment of choice for nightmares. With IRT, the script of the nightmare is changed into a new dream, which is imagined during the day. However, the effects of IRT in a psychiatric population remain unknown. The aim of this study was to determine the effectiveness of IRT in a heterogeneous psychiatric population. Between January 2006 and July 2010, 90 patients with psychiatric disorders (DSM-IV-TR) were randomized to IRT or treatment-as-usual conditions. IRT consisted of 6 individual sessions added to the treatment as usual. Nightmare frequency was assessed using daily nightmare logs and the Nightmare Frequency Questionnaire. Nightmare distress was assessed using the Nightmare Distress Questionnaire and the Nightmare Effects Survey. General psychiatric symptoms were assessed using the Symptom Checklist-90 and a PTSD symptom questionnaire. Assessments were administered at the start of the trial, after the IRT and at follow-up 3 months later. IRT showed a moderate effect (Cohen d = 0.5-0.7, P effects were largely sustained at the 3-month follow-up (Cohen d = 0.4-0.6, P effective treatment for nightmares among patients with comorbid psychiatric disorders and can be employed in addition to the on-going treatment. ClinicalTrials.gov identifier: NCT00291031. © Copyright 2015 Physicians Postgraduate Press, Inc.

  3. HIV infection: psychiatric findings in The Netherlands

    NARCIS (Netherlands)

    Sno, H. N.; Storosum, J. G.; Swinkels, J. A.

    1989-01-01

    A psychiatric consultation was requested in 51 in-patient cases of HIV infection. Reasons for referral included counselling, the evaluation of depressive symptoms, and the treatment of delirium. The most common DSM-III diagnoses included: delirium (n = 13), major depressive disorders (n = 12),

  4. Newly Diagnosed Meniere's Disease: Clinical Course With Initiation of Noninvasive Treatment Including an Accounting of Vestibular Migraine.

    Science.gov (United States)

    Sbeih, Firas; Christov, Florian; Gluth, Michael B

    2018-05-01

    To describe the course of Meniere's disease with noninvasive treatment during the first few years after initial diagnosis. A retrospective review of consecutive patients with newly diagnosed definite Meniere's disease between 2013 and 2016 and a minimum follow-up of 1 year. Patients received a written plan for low sodium, water therapy, and treatment with a diuretic and/or betahistine. Subjects were screened and treated for vestibular migraine as needed. Vertigo control and hearing status at most recent follow-up were assessed. Forty-four subjects had an average follow up of 24.3 months. Thirty-four percent had Meniere's disease and vestibular migraine, and 84% had unilateral Meniere's disease. Seventy-five percent had vertigo well controlled at most recent follow-up, with only noninvasive treatments. Age, gender, body mass index, presence of vestibular migraine, bilateral disease, and duration of follow-up did not predict noninvasive treatment failure. Worse hearing threshold at 250 Hz and lower pure tone average (PTA) at the time of diagnosis did predict failure. Fifty-two percent of ears had improved PTA at most recent visit, 20% had no change, and 28% were worse Conclusions: Encountering excellent vertigo control and stable hearing after a new diagnosis of Meniere's disease is possible with noninvasive treatments. Worse hearing status at diagnosis predicted treatment failure.

  5. Occupational Outcome in Adult ADHD: Impact of Symptom Profile, Comorbid Psychiatric Problems, and Treatment--A Cross-Sectional Study of 414 Clinically Diagnosed Adult ADHD Patients

    Science.gov (United States)

    Halmoy, Anne; Fasmer, Ole Bernt; Gillberg, Christopher; Haavik, Jan

    2009-01-01

    Objective: To determine the effects of symptom profile, comorbid psychiatric problems, and treatment on occupational outcome in adult ADHD patients. Method: Adult ADHD patients (N = 414) responded to questionnaires rating past and present symptoms of ADHD, comorbid conditions, treatment history, and work status. Results: Of the patients, 24%…

  6. Imagery Rehearsal Therapy in Addition to Treatment as Usual for Patients With Diverse Psychiatric Diagnoses Suffering From Nightmares : A Randomized Controlled Trial

    NARCIS (Netherlands)

    van Schagen, Annette M; Lancee, Jaap|info:eu-repo/dai/nl/33304083X; de Groot, Izaäk W; Spoormaker, Victor I|info:eu-repo/dai/nl/304831298; van den Bout, Jan|info:eu-repo/dai/nl/071594094

    OBJECTIVE: Nightmares are associated with psychopathology and daily distress. They are highly prevalent in a psychiatric population (30%). Currently, imagery rehearsal therapy (IRT) is the treatment of choice for nightmares. With IRT, the script of the nightmare is changed into a new dream, which is

  7. ASD Symptom Severity in Adolescence of Individuals Diagnosed with PDD-NOS in Childhood: Stability and the Relation with Psychiatric Comorbidity and Societal Participation

    Science.gov (United States)

    Louwerse, A.; Eussen, M. L. J. M.; Van der Ende, J.; de Nijs, P. F. A.; Van Gool, A. R.; Dekker, L. P.; Verheij, C.; Verheij, F.; Verhulst, F. C.; Greaves-Lord, K.

    2015-01-01

    The current 7-year follow-up study investigated: (1) the stability of ASD severity, and (2) associations of ASD severity in adolescence with (a) childhood and concurrent psychiatric comorbidity, and (b) concurrent societal functioning. The Autism Diagnostic Observation Schedule (ADOS) and the Diagnostic Interview Schedule for Children were…

  8. Narcolepsy and Psychiatric Disorders: Comorbidities or Shared Pathophysiology?

    Directory of Open Access Journals (Sweden)

    Anne Marie Morse

    2018-02-01

    Full Text Available Narcolepsy and psychiatric disorders have a significant but unrecognized relationship, which is an area of evolving interest, but unfortunately, the association is poorly understood. It is not uncommon for the two to occur co-morbidly. However, narcolepsy is frequently misdiagnosed initially as a psychiatric condition, contributing to the protracted time to accurate diagnosis and treatment. Narcolepsy is a disabling neurodegenerative condition that carries a high risk for development of social and occupational dysfunction. Deterioration in function may lead to the secondary development of psychiatric symptoms. Inversely, the development of psychiatric symptoms can lead to the deterioration in function and quality of life. The overlap in pharmaceutical intervention may further enhance the difficulty to distinguish between diagnoses. Comprehensive care for patients with narcolepsy should include surveillance for psychiatric illness and appropriate treatment when necessary. Further research is necessary to better understand the underlying pathophysiology between psychiatric disease and narcolepsy.

  9. Psychiatric comorbidity in forensic psychiatry.

    Science.gov (United States)

    Palijan, Tija Zarković; Muzinić, Lana; Radeljak, Sanja

    2009-09-01

    For the past several years a numerous studies in the field of forensic psychiatry confirmed a close relationship between violent offenders and comorbid substance abuse. The comorbid substance abuse in violent offenders was usually unrecognized and misdiagnosed. Furthermore, comorbidity in forensic psychiatry describes the co-occurrence of two or more conditions or psychiatric disorder known in the literature as dual diagnosis and defined by World Health Organization (WHO). In fact, many violent offenders have multiple psychiatric diagnoses. Recent studies have confirmed causal relationship between major psychiatric disorders and concomitant substance abuse (comorbidity) in 50-80% of forensic cases. In general, there is a high level of psychiatric comorbidity in forensic patients with prevalence of personality disorders (50-90%), mood disorders (20-60%) and psychotic disorders (15-20%) coupled with substance abuse disorders. Moreover, the high prevalence of psychiatric comorbidities could be found in mentally retarded individuals, as well as, in epileptic patients. Drugs and alcohol abuse can produce serious psychotoxic effects that may lead to extreme violent behavior and consequently to serious criminal offence such as physical assault, rape, armed robbery, attempted murder and homicide, all due to an altered brain function and generating psychotic-like symptoms. Studies have confirmed a significant statistical relevance in causal relationship between substance abuse and violent offences. In terms of forensic psychiatry, the comorbidity strongly contributes in the process of establishing psychiatric diagnosis of diminished mental capacity or insanity at the time of the offence in the course of clinical assessment and evaluation of violent offenders. Today, the primary focus of forensic psychiatry treatment services (in-patient or community) is management of the violent offenders with psychiatric comorbidity which requires a multilevel, evidence based approach to

  10. Should We Expand the Toolbox of Psychiatric Treatment Methods to Include Repetitive Transcranial Magnetic Stimulation (rTMS)? A Meta-Analysis of the Efficacy of rTMS in Psychiatric Disorders

    NARCIS (Netherlands)

    Slotema, Christina W.; Blom, Jan Dirk; Hoek, Hans W.; Sommer, Iris E. C.

    Objective: Repetitive transcranial magnetic stimulation (rTMS) is a safe treatment method with few side effects However, efficacy for various psychiatric disorders is currently not clear Data sources: A literature search was performed from 1966 through October 2008 using PubMed, Ovid Medline, Embase

  11. Serial analysis of 3D H-1 MRSI for patients with newly diagnosed GBM treated with combination therapy that includes bevacizumab.

    Science.gov (United States)

    Nelson, Sarah J; Li, Yan; Lupo, Janine M; Olson, Marram; Crane, Jason C; Molinaro, Annette; Roy, Ritu; Clarke, Jennifer; Butowski, Nicholas; Prados, Michael; Cha, Soonmee; Chang, Susan M

    2016-10-01

    Interpretation of changes in the T1- and T2-weighted MR images from patients with newly diagnosed glioblastoma (GBM) treated with standard of care in conjunction with anti-angiogenic agents is complicated by pseudoprogression and pseudoresponse. The hypothesis being tested in this study was that 3D H-1 magnetic resonance spectroscopic imaging (MRSI) provides estimates of levels of choline, creatine, N-acetylaspartate (NAA), lactate and lipid that change in response to treatment and that metrics describing these characteristics are associated with survival. Thirty-one patients with newly diagnosed GBM and being treated with radiation therapy (RT), temozolomide, erlotinib and bevacizumab were recruited to receive serial MR scans that included 3-D lactate edited MRSI at baseline, mid-RT, post-RT and at specific follow-up time points. The data were processed to provide estimates of metrics representing changes in metabolite levels relative to normal appearing brain. Cox proportional hazards analysis was applied to examine the relationship of these parameters with progression free survival (PFS) and overall survival (OS). There were significant reductions in parameters that describe relative levels of choline to NAA and creatine, indicating that the treatment caused a decrease in tumor cellularity. Changes in the levels of lactate and lipid relative to the NAA from contralateral brain were consistent with vascular normalization. Metabolic parameters from the first serial follow-up scan were associated with PFS and OS, when accounting for age and extent of resection. Integrating metabolic parameters into the assessment of patients with newly diagnosed GBM receiving therapies that include anti-angiogenic agents may be helpful for tracking changes in tumor burden, resolving ambiguities in anatomic images caused by non-specific treatment effects and for predicting outcome.

  12. Associations between Pathological Gambling and Psychiatric Comorbidity among Help-Seeking Populations in Hong Kong

    Directory of Open Access Journals (Sweden)

    Daniel T. L. Shek

    2012-01-01

    Full Text Available Problem gambling is complex and often comorbid with other mental health problems. Unfortunately, gambling studies on comorbid psychiatric disorders among Chinese communities are extremely limited. The objectives of this study were to (a determine the prevalence of comorbid psychiatric disorders among treatment-seeking pathological gamblers; (b compare the demographic profiles and clinical features of pathological gamblers with and without comorbid psychiatric disorders; (c explore the associations between pathological gambling and psychiatric disorders and their temporal relationship. Participants (N=201 who sought gambling counseling were examined by making Axis-I diagnoses including mood disorders, schizophrenia spectrum disorders, substance use disorders, anxiety disorders, and adjustment disorder. Results showed that 63.7% of participants had lifetime comorbid psychiatric disorder. The most common comorbid psychiatric mental disorders were mood disorders, adjustment disorder, and substance use disorders. Pathological gamblers with psychiatric comorbidities were significantly more severe in psychopathology, psychosocial functioning impairment, and gambling problems than those without the disorders.

  13. Taking cognizance of mental illness in schizophrenics and its association with crime and substance-related diagnoses

    DEFF Research Database (Denmark)

    Munkner, R; Haastrup, S; Jørgensen, T

    2003-01-01

    OBJECTIVE: To analyse how committed crimes and substance-related diagnoses are associated with the age on the first contact with the psychiatric hospital system and the age at diagnosing of schizophrenia among schizophrenics. METHOD: In a register-based study including all Danes diagnosed with sc...

  14. The demographic, clinical and forensic profile of offenders diagnosed with epilepsy referred to the Free State Psychiatric Complex Observation Unit in terms of section 77 and/or 78 of the Criminal Procedure Act 51 of 1977

    Directory of Open Access Journals (Sweden)

    P J Marais

    2011-03-01

    Full Text Available Introduction. Limited information regarding the relation between psychopathology associated with epilepsy, crime and the legal aspects thereof is available in South Africa. Objectives: The demographic, clinical and forensic profile of alleged offenders diagnosed with epilepsy and referred to the Free State Psychiatric Complex (FSPC Observation Unit from 2001 to 2006, was investigated. Design A retrospective cross-sectional study was conducted. Results: Of the 69 alleged offenders, aged 17–79 years (median 30 years, 94.2% were male, 81.2% Black, 72.5% single, and 69.9% unemployed. The median qualification was grade six. Offences were violent in nature and committed against a person in 75% of cases. A direct link between epilepsy and the alleged offences occurred in 7% of cases. Generalised epilepsy (34.8% and interictal psychosis (20.3% were the most commonly diagnosed conditions. Twenty-nine (42% alleged offenders lacked criminal responsibility and were not fit to stand trial. Most observati (79.2% diagnosed with generalised epilepsy were criminally liable and fit to stand trial. The highest rate of criminal incapacity was found among observati with interictal psychoses (85.7% and comorbid mental retardation (90%. Almost 60% of referred cases were declared as state patients by the court. Conclusion: In only 16% of cases, observati were found unaccountable because of epilepsy (automatisms or postictal confusional states. Our findings confirmed an increased prevalence of violent behaviour during seizure-free periods. This contributes to evidence that factors associated with epilepsy, rather than the epilepsy itself, play an important role in the possible increased risk of violent behaviour in people with epilepsy.

  15. Magnetic resonance arthrography including ABER view in diagnosing partial-thickness tears of the rotator cuff: Accuracy, and inter- and intra-observer agreements

    International Nuclear Information System (INIS)

    Jung, Joon-Yong; Jee, Won-Hee; Chun, Ho Jong; Ahn, Myeong Im; Kim, Yang-Soo

    2010-01-01

    Background: Partial-thickness tear of the rotator cuff is a common cause of shoulder pain. Magnetic resonance (MR) arthrography has been described as a useful measure to diagnose rotator cuff abnormalities. Purpose: To determine the reliability and accuracy of MR arthrography with abduction and external rotation (ABER) view for the diagnosis of partial-thickness tears of the rotator cuff. Material and Methods: Among patients who underwent MR arthrographies, 22 patients (12 men, 10 women; mean age 45 years) who had either partial-thickness tear or normal tendon on arthroscopy were included. MR images were independently scored by two observers for partial-thickness tears of the rotator cuff. Interobserver and intraobserver agreements for detection of partial-thickness tears of the rotator cuff were calculated by using κ coefficients. The differences in areas under the receiver operating characteristic (ROC) curves were assessed with a univariate Z-score test. Differences in sensitivity and specificity for interpretations based on different imaging series were tested for significance using the McNemar statistic. Results: Sensitivity, specificity, and accuracy of each reader on MR imaging without ABER view were 83%, 90%, and 86%, and 83%, 80%, and 82%, respectively, whereas on overall interpretation including ABER view, the sensitivity, specificity, and accuracy of each reader were 92%, 70%, and 82%, and 92%, 80%, and 86%, respectively. Including ABER view, interobserver agreement for partial-thickness tear increased from κ=0.55 to κ=0.68. Likewise, intraobserver agreements increased from κ=0.79 and 0.53 to κ=0.81 and 0.70 for each reader, respectively. The areas under the ROC curves for each reader were 0.96 and 0.90, which were not significantly different. Conclusion: Including ABER view in routine sequences of MR arthrography increases the sensitivity, and inter- and intraobserver agreements for detecting partial-thickness tear of rotator cuff tendon

  16. Magnetic resonance arthrography including ABER view in diagnosing partial-thickness tears of the rotator cuff: Accuracy, and inter- and intra-observer agreements

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Joon-Yong; Jee, Won-Hee; Chun, Ho Jong; Ahn, Myeong Im (Dept. of Radiology, Seoul St. Mary' s Hospital, School of Medicine, Catholic Univ. of Korea, Seoul (Korea)), e-mail: whjee@catholic.ac.kr; Kim, Yang-Soo (Dept. of Orthopedic Surgery, Seoul St. Mary' s Hospital, School of Medicine, Catholic Univ. of Korea, Seoul (Korea))

    2010-03-15

    Background: Partial-thickness tear of the rotator cuff is a common cause of shoulder pain. Magnetic resonance (MR) arthrography has been described as a useful measure to diagnose rotator cuff abnormalities. Purpose: To determine the reliability and accuracy of MR arthrography with abduction and external rotation (ABER) view for the diagnosis of partial-thickness tears of the rotator cuff. Material and Methods: Among patients who underwent MR arthrographies, 22 patients (12 men, 10 women; mean age 45 years) who had either partial-thickness tear or normal tendon on arthroscopy were included. MR images were independently scored by two observers for partial-thickness tears of the rotator cuff. Interobserver and intraobserver agreements for detection of partial-thickness tears of the rotator cuff were calculated by using kappa coefficients. The differences in areas under the receiver operating characteristic (ROC) curves were assessed with a univariate Z-score test. Differences in sensitivity and specificity for interpretations based on different imaging series were tested for significance using the McNemar statistic. Results: Sensitivity, specificity, and accuracy of each reader on MR imaging without ABER view were 83%, 90%, and 86%, and 83%, 80%, and 82%, respectively, whereas on overall interpretation including ABER view, the sensitivity, specificity, and accuracy of each reader were 92%, 70%, and 82%, and 92%, 80%, and 86%, respectively. Including ABER view, interobserver agreement for partial-thickness tear increased from kappa=0.55 to kappa=0.68. Likewise, intraobserver agreements increased from kappa=0.79 and 0.53 to kappa=0.81 and 0.70 for each reader, respectively. The areas under the ROC curves for each reader were 0.96 and 0.90, which were not significantly different. Conclusion: Including ABER view in routine sequences of MR arthrography increases the sensitivity, and inter- and intraobserver agreements for detecting partial-thickness tear of rotator cuff

  17. Impulse control disorders in psychiatric inpatients.

    Science.gov (United States)

    Müller, Astrid; Rein, Katharina; Kollei, Ines; Jacobi, Andrea; Rotter, Andrea; Schütz, Patricia; Hillemacher, Thomas; de Zwaan, Martina

    2011-08-15

    The aim of this study was to examine the prevalence of impulse control disorders (ICDs) in a European psychiatric inpatient sample. Two hundred thirty four consecutive psychiatric inpatients (62% female) were examined using a module of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) that has been developed for ICDs (SCID-ICD). In addition to intermittent explosive disorder, pyromania, kleptomania, pathological gambling, and trichotillomania, the proposed ICDs not otherwise specified were assessed, including compulsive buying, nonparaphilic compulsive sexual behavior, pathological internet use, and pathological skin picking. Based on the SCID-ICD, a lifetime ICD rate of 23.5% and a current ICD rate of 18.8% were found. The most frequent ICDs were pathological skin picking (lifetime 7.3%, current 6.8%), compulsive buying (lifetime 6.8%, current 6.0%), and intermittent explosive disorder (lifetime 5.6%, current 3.4%). In contrast, referring to admission diagnoses taken from patients' charts only 3.8% of the inpatients were diagnosed with any current ICD. Individuals with comorbid ICD were significantly younger and had more admission diagnoses other than ICD. The results suggest high rates of ICDs among psychiatric inpatients that remain to be under-diagnosed in clinical routine. 2011 Elsevier Ireland Ltd. All rights reserved.

  18. Psychiatric disorders in myasthenia gravis

    Directory of Open Access Journals (Sweden)

    Mariana Inés Ybarra

    2011-04-01

    Full Text Available OBJECTIVE: To investigate the prevalence of psychiatric disorders in patients with myasthenia gravis (MG. METHOD: Forty-one patients with MG answered to a structured psychiatric interview (MINI-Plus. RESULTS: Eleven (26.1% patients were diagnosed with a depressive disorder and 19 (46.3% were diagnosed with an anxiety disorder. Patients with dysthymia were older (p=0.029 and had longer disease duration (p=0.006. Patients with social phobia also had longer disease duration (p=0.039. CONCLUSION: Psychiatric disorders in MG are common, especially depressive and anxiety disorders.

  19. Racial Bias in Personality Assessment: Using the MMPI-2 to Predict Psychiatric Diagnoses of African American and Caucasian Chemical Dependency Inpatients

    Science.gov (United States)

    Monnot, Matthew J.; Quirk, Stuart W.; Hoerger, Michael; Brewer, Linda

    2009-01-01

    An assessment of predictive bias was conducted on numerous scales of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; J. N. Butcher, W. G. Dahlstrom, J. R. Graham, A. Tellegen, & B. Kaemmer, 1989), including the Restructured Clinical (RC) scales, in the prediction of clinical diagnostic status for African American and Caucasian male…

  20. Psychiatric morbidity in prisoners

    Science.gov (United States)

    Kumar, Vinod; Daria, Usha

    2013-01-01

    Background: Prisoners are having high percentage of psychiatric disorders. Majority of studies done so far on prisoners are from Western countries and very limited studies from India. Aim: Study socio-demographic profile of prisoners of a central jail and to find out current prevalence of psychiatric disorders in them. Materials and Methods: 118 prisoners were selected by random sampling and interviewed to obtain socio-demographic data and assessed on Indian Psychiatric Interview Schedule (IPIS) with additional required questions to diagnose psychiatric disorders in prisoners. Results: Mean age of prisoners was 33.7 years with 97.5% males, 57.6% from rural areas and 65.3% were married. Average education in studied years was 6.6 years and 50.8% were unskilled workers. 47.4% were murderers while 20.3% of drugs related crimes. 47.5% were convicted and history of criminal behavior in family was in 32.2% prisoners. Current prevalence of psychiatric disorders was 33%. Psychotic, depressive, and anxiety disorders were seen in 6.7%, 16.1%, and 8.5% prisoners respectively. 58.8% had history of drug abuse/dependence prior to imprisonment. Conclusion: One prison of Hadoti region of Rajasthan is full of people with mental-health problems who collectively generate significant levels of unmet psychiatric treatment need. Prisons are detrimental to mental-health. Beginning of reforms is the immediate need. PMID:24459308

  1. Who's boarding in the psychiatric emergency service?

    Science.gov (United States)

    Simpson, Scott A; Joesch, Jutta M; West, Imara I; Pasic, Jagoda

    2014-09-01

    When a psychiatric patient in the emergency department requires inpatient admission, but no bed is available, they may become a "boarder." The psychiatric emergency service (PES) has been suggested as one means to reduce psychiatric boarding, but the frequency and characteristics of adult PES boarders have not been described. We electronically extracted electronic medical records for adult patients presenting to the PES in an urban county safety-net hospital over 12 months. Correlative analyses included Student's t-tests and multivariate regression. 521 of 5363 patient encounters (9.7%) resulted in boarding. Compared to non-boarding encounters, boarding patient encounters were associated with diagnoses of a primary psychotic, anxiety, or personality disorder, or a bipolar manic/mixed episode. Boarders were also more likely to be referred by family, friends or providers than self-referred; arrive in restraints; experience restraint/seclusion in the PES; or be referred for involuntary hospitalization. Boarders were more likely to present to the PES on the weekend. Substance use was common, but only tobacco use was more likely associated with boarding status in multivariate analysis. Boarding is common in the PES, and boarders have substantial psychiatric morbidity requiring treatment during extended PES stays. We question the appropriateness of PES boarding for seriously ill psychiatric patients.

  2. The shorter the better? A follow-up analysis of 10-session psychiatric treatment including the motive-oriented therapeutic relationship for borderline personality disorder.

    Science.gov (United States)

    Kramer, Ueli; Stulz, Niklaus; Berthoud, Laurent; Caspar, Franz; Marquet, Pierre; Kolly, Stéphane; De Roten, Yves; Despland, Jean-Nicolas

    2017-05-01

    There is little research on short-term treatments for borderline personality disorder (BPD). While the core changes may occur only in long-term treatments, short-term treatments may enable the study of early generic processes of engagement in therapy and thus inform about effective treatment components. It was shown that a 10-session version of a psychiatric treatment was effective in reducing borderline symptoms at the end of this treatment [Kramer, U., Kolly, S., Berthoud, L., Keller, S., Preisig, M., Caspar, F., … Despland, J.-N. (2014). Effects of motive-oriented therapeutic relationship in a ten-session general psychiatric treatment for borderline personality disorder: A randomized controlled trial. Psychotherapy and Psychosomatics, 83, 176-186.]. Also, it was demonstrated in a randomized design that adding the motive-oriented therapeutic relationship (MOTR), following an individualized case formulation based on Plan Analysis, further increased general outcome after session 10 and had a positive effect on the early changes in self-esteem and alliance. The present study focuses on the follow-up period after this initial treatment, examining treatment density and outcomes after 6 months and service utilization after 12 months. Outcome was measured using the OQ-45. Results on a sub-sample of N = 40 patients with available OQ-45 data at follow-up (n = 21 for MOTR-treatment, n = 19 for comparison treatment) showed maintenance of gains over the follow-up period, which did not differ between both conditions. It appeared for this sample that MOTR treatments, while using the same number of sessions, lasted more weeks (i.e., lower treatment density, defined as the number of sessions per week), when compared to the treatments without MOTR. Density marginally predicted symptom reduction at follow-up. Patients in MOTR treatments had a greater likelihood of entering structured psychotherapy after the initial sessions than patients in the comparison

  3. [THE PSYCHIATRIC DIAGNOSIS GUIDE - DSM-5 - INNOVATIONS AND CRITICISM].

    Science.gov (United States)

    Hess, Shmuel; Zemishlany, Zvi

    2015-05-01

    The Diagnostic and Statistical Manual of Mental Disorders (DSM) is published by the American Psychiatric Association (APA) as a guide for diagnosing psychiatric diseases and enables the alignment of psychiatric diagnoses with those of the psychologists, the social workers, the nursing staff and other mental health professionals. In addition, it helps bring cohesion to research, public health policy, education, the field of insurance and compensation and the legal system. After 14 years of hard work, the updated version of the DSM, the DSM-5, was published on May 2013. The current review aims to update the readers on the essence of the DSM and the methods of psychiatric diagnosing and to present the main changes in the field, as expressed in the 5th edition of the guide. In addition to details of those changes we included discussions of the criticisms brought against them. We hope that the review will contribute to broadening the readers' knowledge, broaden exposure and familiarity with the psychiatric lingo and to strengthening the professional ties between psychiatrists and professionals in other, tangential, medical fields.

  4. Psyche at the end of life: Psychiatric symptoms are prevalent in patients admitted to a palliative care unit.

    Science.gov (United States)

    Masel, Eva K; Berghoff, Anna S; Mladen, Aleksandra; Schur, Sophie; Maehr, Bruno; Kirchhoff, Magdalena; Simanek, Ralph; Bauer, Martin; Watzke, Herbert H; Amering, Michaela

    2016-06-01

    Our aim was to evaluate the frequency and treatment of psychiatric symptoms in patients at palliative care units (PCUs). Patients admitted to one of five participating PCUs in Austria were included. The short version of the Patient Health Questionnaire (PHQ-D) was used to evaluate their mental health status. Pain intensity was rated on a numeric rating scale (NRS) from 0 to 10 by patients and physicians. Patients with a previously diagnosed psychiatric disorder were compared to those without or with newly diagnosed psychiatric symptoms, based on PHQ-D results. Pain and psychopharmacological medication were assessed. Opioid doses were converted into oral morphine equivalents (OMEs). Some 68 patients were included. Previously undetected psychiatric symptoms were identified in 38% (26 of 68), preexisting psychiatric comorbidities were evident in 25% (17), and no psychiatric symptoms were observed in 37% (25). Patients with a preexisting psychiatric comorbidity received antidepressants and benzodiazepines significantly more often than patients without or with previously undetected psychiatric symptoms (p < 0.001). Patient and physician median NRS ratings of pain intensity correlated significantly (p = 0.001). Median NRS rating showed no significant difference between patients with preexisting, previously undetected, or without psychiatric symptoms. OMEs did not differ significantly between preexisting, without, or previously undetected psychiatric symptoms. Patients with undetected and preexisting psychiatric comorbidities had a greater impairment in their activities of daily living than patients without psychiatric symptoms (p = 0.003). Undetected psychiatric comorbidities are common in patients receiving palliative care. Screening for psychiatric symptoms should be integrated into standard palliative care to optimize treatment and reduce the psychosocial burden of the disease.

  5. Variants of psychiatric disorders in patients with systemic lupus erythematosus

    Directory of Open Access Journals (Sweden)

    T A Lisitsyna

    2008-01-01

    Full Text Available Objective. To analyze prevalence and structure of psychiatric disorders in pts with systemic lupus erythematosus (SLE examining in the Institute of rheumatology of RAMS. Material and methods. 115 pts with SLE with median age 34 [24; 45] years and median disease duration 8 [4; 17] years were included. SLE activity was assessed with SLEDAI. Psychiatric disorders were diagnosed by a psychiatrist according to ICD-10 using some psychiatric and psychological scales. Results. Psychiatric disorders were revealed in 76 from 115 (66% pts. Anxiety-depressive spectrum disorders prevailed (83%: depressive episode (40%, adjustment disorders (24%, generalized anxiety disorder (10%, dysthymia (9%. Severe cognitive dysfunction was revealed in 7% of pts. Pts with and without psychiatric disorders did not significantly differ in age, sex, duration and activity of the disease, duration of treatment and cumulative dose of prednisolone and cytotoxic drugs. Conclusion. Psychiatric disorders are frequent in pts with SLE (66%. Anxiety-depressive disorders prevail among them (83%. Relationship between SLE and psychiatric disorders requires further examination.

  6. Inpatient Suicide in a Chinese Psychiatric Hospital

    Science.gov (United States)

    Li, Jie; Ran, Mao-Sheng; Hao, Yuantao; Zhao, Zhenhuan; Guo, Yangbo; Su, Jinghua; Lu, Huixian

    2008-01-01

    Little is known about the risk factors for suicide among psychiatric inpatients in China. In this study we identified the risk factors of suicide among psychiatric inpatients at Guangzhou Psychiatric Hospital. All psychiatric inpatients who died by suicide during the 1956-2005 period were included in this study. Using a case-control design, 64…

  7. Psychiatric diagnosis and aggression before acute hospitalisation.

    Science.gov (United States)

    Colasanti, A; Natoli, A; Moliterno, D; Rossattini, M; De Gaspari, I F; Mauri, M C

    2008-09-01

    To examine the predictors of aggressive behaviours occurring before acute hospitalisation. We analysed 350 acute admissions to a psychiatric ward during a 12-month period. The diagnoses were formulated according to the DSM IV axis I and II criteria. Aggressive behaviours occurring in the week before admission were retrospectively assessed using the modified overt aggression scale. The patients' clinical and sociodemographic variables, concurrent drug or alcohol abuse, and admission status were recorded at the time of admission. Aggressive and violent behaviours were highly prevalent, respectively, in 45% and 33% of the cases. Violence before admission was independently associated with drug abuse, involuntary admission status, and severe psychopathology. A diagnosis of a psychotic disorder did not increase the risk of aggression or violence, compared to the other psychiatric diagnoses. Personality disorders were significantly more associated to aggressive behaviours than psychotic disorders. The diagnosis of psychotic disorder is a poor predictor of aggression in a sample of psychiatric patients. Other clinical and non-clinical variables are associated to aggression before hospitalisation: they include drug abuse, involuntary admission status, general severity of symptoms, and diagnosis of personality disorder.

  8. Consequences of receipt of a psychiatric diagnosis for completion of college.

    Science.gov (United States)

    Hunt, Justin; Eisenberg, Daniel; Kilbourne, Amy M

    2010-04-01

    The purpose of this study was to evaluate the independent associations between DSM-IV psychiatric disorders and the failure to complete college among college entrants. Data were from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). The sample included 15,800 adults, aged 22 years and older, who at least entered college. Diagnoses were made with the NESARC survey instrument, the Alcohol Use Disorder and Associated Disability Interview Schedule-DSM-IV Version. The large sample permitted analysis of multiple psychiatric disorders in the same multivariable logistic regression models. Given the frequent comorbidity of these disorders, this approach is an important step toward disentangling the independent roles of disorders in postsecondary educational outcomes. Evaluation of the independent associations between specific psychiatric disorders and postsecondary educational attainment showed that five diagnoses were positively and significantly associated with the failure to graduate from college. Four were axis I diagnoses: bipolar I disorder, marijuana use disorder, amphetamine use disorder, and cocaine use disorder. One was an axis II diagnosis: antisocial personality disorder. This study provides new data on DSM-IV diagnoses associated with the failure to complete postsecondary education. The findings suggest that psychiatric factors play a significant role in college academic performance, and the benefits of prevention, detection, and treatment of psychiatric illness may therefore include higher college graduation rates.

  9. Increase in depression diagnoses and prescribed antidepressants among young girls

    DEFF Research Database (Denmark)

    Skovlund, Charlotte Wessel; Kessing, Lars Vedel; Mørch, Lina Steinrud

    2017-01-01

    AIMS: To analyse trends in depression diagnoses and antidepressant use according to age and gender. METHODS: Nationwide cohort study including all women and men of 10-49 years living in Denmark during 2000-2013. The Psychiatric Registry and Prescription Registry provided data on depression...... diagnoses and antidepressant medication, respectively. Incidence rates as well as 1-year prevalence rates were calculated. RESULTS: The incidence and 1-year prevalence rates of depression diagnoses increased during 2000-2013. The women/men rates were 2.0 for both 1-year prevalence of depressions diagnoses...... and antidepressant use. For adolescent girls, the absolute increase was 3 per 1000 for depression diagnoses and 8 per 1000 for first use of antidepressants, compared to boys who had an increase of 1.1 and 3 per 1000, respectively. Before puberty, boys and girls had almost the same incidence rates of both depression...

  10. Taking cognizance of mental illness in schizophrenics and its association with crime and substance-related diagnoses.

    Science.gov (United States)

    Munkner, R; Haastrup, S; Jørgensen, T; Andreasen, A H; Kramp, P

    2003-02-01

    To analyse how committed crimes and substance-related diagnoses are associated with the age on the first contact with the psychiatric hospital system and the age at diagnosing of schizophrenia among schizophrenics. In a register-based study including all Danes diagnosed with schizophrenia born after November 1, 1963, data on criminality, substance-related diagnoses and contacts with the psychiatric hospital system were analysed. Compared with the non-convicted schizophrenics the convicted were older on first contact with the psychiatric hospital system and older when the diagnosis of schizophrenia was first given. In contrast, having a substance-related diagnosis was associated with a younger age on first contact but did not influence the age at which the diagnosis of schizophrenia was given. It is important that both psychiatrists and the judicial system are aware of possible psychotic symptoms in criminal and abusing individuals to enable earlier detection and treatment.

  11. Self-Esteem Deficits Among Psychiatric Patients

    Directory of Open Access Journals (Sweden)

    Muhammad Rizwan

    2015-04-01

    Full Text Available The objective of the present study was to investigate the difference in the level of self-esteem among patients with psychiatric disorders and normal controls. After a detailed literature review, it was hypothesized that there would be a significant difference in the level of self-esteem among patients with psychiatric disorders and normal controls. The sample of the present study consisted of 260 participants, who were further divided into two groups: clinical group (n = 140 and normal controls (n = 120. The age range of the participants in both the samples were 18 to 25 years (with the mean age of 22.14 years for psychiatric patients and 21.18 years for normal controls, and they belonged to middle socioeconomic status. The clinical group consisted of diagnosed psychiatric patients according to Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR criteria and further divided into four subgroups, including patients of (a schizophrenia (n = 40, (b major depressive disorder (n = 40, (c obsessive-compulsive disorder (n = 40, and (d opioid dependence disorder (n = 20. The semi-structured interview form of Institute of Clinical Psychology, University of Karachi, and Rosenberg Self-Esteem Scale were used. Descriptive Statistics and one-way ANOVA were applied to analyze and interpret the data in statistical terminology. Results indicate significant differences among patients with psychiatric disorders and normal controls on the variable of self-esteem (F = 30.513, df = 4, 255, p< .05. The finding has implications for clinical interventions and also suggests avenues for future research.

  12. STUDY ON PSYCHIATRIC CO - MORBIDITY IN PSORIASIS

    Directory of Open Access Journals (Sweden)

    Shrikant B.

    2015-06-01

    Full Text Available BACKGROUND: Psoriasis is relatively common , chronic inflammatory and hyper - proliferative skin disease that affects 1.4% to 2.0% of the population. Presence of itching , chronic recurrent course of disease and incomplete cure may contribute to great deal of psychiatric co - morbidity in these patients. the most persuasive indications of a link between stress and psoriasis comes from patients themselves , with studies illustrating that the majority of patients believe that stress or psychological distress is a factor in the manifestations of their condition . Depression and anxiety are the most common disorders that are associated with psoriasis , but the proportion of patient also having other psychiatric co - morbid diseases which include social phobia , generalize anxiety disorder , panic disorder , psychotic diso rder , etc. Moreover , symptoms of psoriasis , especially pruritus , are related to depression. OBJECTIVES : To evaluate different psychiatric illnesses their prevalence and severity in psoriasis patients. METHODOLOGY : This was cross - sectional observational stu dy comprised of 70 consecutive patients of psoriasis attending the out - patient department of Dermatology. All the patients were subjected to detailed examinations including the elicitation of dermatological and psychiatric profile after getting written con sent for study . Data was collected using self - developed , pre tested , semi structured Pro format by interview method. RESULTS : The profile of psychiatric diagnoses obtained in the present study depressive disorder 31.4% {18.57% depression , 12.85% Depression with anxiety symptoms} , anxiety disorder 25.7% (7.14% GAD , 8.17% panic disorder , 5.71% social phobia , 4.28 specific phobia. Severity of major depressive disorder was determined with HAM - D score 53.8% had mild depression , 30.7% moderate depression and 15. 5% severe depression. Similarly when HAM - A scale was used to determined severity of generalized

  13. Anxiety disorders: Psychiatric comorbidities and psychosocial ...

    African Journals Online (AJOL)

    2018-05-24

    May 24, 2018 ... psychiatric disorders, including other anxiety disorders, mood disorders, substance use disorders ... psychiatric comorbidities present among adults at a tertiary ..... clinical files as well as unclear handwriting and missing.

  14. Psychiatric morbidity and quality of life in skin diseases: A comparison of alopecia areata and psoriasis

    Directory of Open Access Journals (Sweden)

    Sagar B Karia

    2015-01-01

    Full Text Available Background: Alopecia areata (AA and psoriasis are associated with various psychiatric comorbidities. Both greatly affect the quality of life (QOL of patients and psychiatric comorbidities can further worsen it. Thus there is need to recognise psychiatric comorbidities and treat them in these patients. Aims: To determine the psychiatric morbidity and the QOL in these patients to study the factors affecting them. Methodology: 50 patients each of psoriasis and AA were included. 50 people accompanying these patients served as control group. They were diagnosed for psychiatric disorders by clinical interview. Scales used were severity of alopecia tool for AA, psoriasis area and severity index for psoriasis, WHO-QOL scale, Hamilton Rating Scale for anxiety and depression. Results: 22% and 38% patients in AA and psoriasis group respectively suffered from psychiatric disorder, depression was present in 18% and 24% of patients and 4% and 12% had anxiety disorders in respective groups. The control group had only 6% of psychiatric comorbidities. QOL scores had negative correlation with Hamilton-A, Hamilton-D and severity of psoriasis scores and they were statistically significant but not with severity of AA. Conclusion: Thus AA and psoriasis patients had more prevalence of psychiatric comorbidities and it had bearing on their QOL.

  15. [A case of focal epilepsy manifesting multiple psychiatric auras].

    Science.gov (United States)

    Ezura, Michinori; Kakisaka, Yosuke; Jin, Kazutaka; Kato, Kazuhiro; Iwasaki, Masaki; Fujikawa, Mayu; Aoki, Masashi; Nakasato, Nobukazu

    2015-01-01

    We present a case of epilepsy with multiple types of focal seizures that were misdiagnosed as psychiatric disorders. A 20-year-old female patient presented with a variety of episodes, including loss of consciousness, deja vu, fear, delusion of possession, violent movements, and generalized convulsions. Each of these symptoms appeared in a stereotypic manner. She was initially diagnosed with a psychiatric disorder and treated with psychoactive medications, which had no effect. Long-term video electroencephalography revealed that her episodes of violent movement with impaired consciousness and secondarily generalized seizure were epileptic events originating in the right hemisphere. High-field brain magnetic resonance imaging for detecting subtle lesions revealed bilateral lesions from periventricular nodular heterotopia. Her final diagnosis was right hemispheric focal epilepsy. Carbamazepine administration was started, which successfully controlled all seizures. The present case demonstrates the pitfall of diagnosing focal epilepsy when it presents with multiple types of psychiatric aura. Epilepsy should thus be included in differential diagnoses, considering the stereotypic nature of symptoms, to avoid misdiagnosis.

  16. Two Cases Of Multiple Sclerosis Accompanying Psychiatric Symptoms

    Directory of Open Access Journals (Sweden)

    Ayşegül Şengel

    2007-10-01

    Full Text Available Scientific bacground: It has been reported that; Multiple Sclerosis (MS may be presented with many psychiatric symptoms such as anxiety, depression, mania and psychosis. MS cases, presented with psychiatric symptoms were also reported. Cases: Two MS cases, diagnosed as psychotic and bipolar disorder respectively, were reported in this paper. Both of the cases were responded to the steroid treatment, and neurological and psychiatric examinations were found to be normal after one month. CONCLUSION: MS cases might be presented with psychiatric complaints and symptoms except neurological ones. We conclude that; psychiatric evaluation as well as the neurological evaluation is important in the MS cases presented with psychiatric symptoms

  17. Psychiatric disorders among individuals who drive after the recent use of alcohol and drugs.

    Science.gov (United States)

    Faller, Sibele; Webster, J Matthew; Leukefeld, Carl G; Bumaguin, Daniela Benzano; Duarte, Paulina do Carmo Arruda Vieira; De Boni, Raquel; Pechansky, Flavio

    2012-10-01

    This cross-sectional study assessed the prevalence of psychiatric disorders among drivers , as well as the association between recent alcohol and drug use and psychiatric diagnoses using telephone interviews. Drivers (n = 1,134) included in a roadside survey from 25 Brazilian state capitals were given a breathalyzer test, and their saliva was tested for psychoactive drugs. A telephone interview was conducted to perform psychiatric disorder evaluations using the MINI. This association was analyzed with a Poisson regression model. The prevalence of any psychiatric disorder was 40.5% among drivers with recent alcohol or drug use, compared with 12.9% among the other drivers. Alcohol/drug-positive drivers reported a higher prevalence of depression (19.4%), mania (6.5%), hypomania (5.4%), post-traumatic stress disorder (8.6%), antisocial personality (7.8%), and substance/alcohol abuse or dependence (48.1%) compared with other drivers (3.5, 2.5, 2.1, 0.5, 1.3 and 18.3% [p < 0.001], respectively). Drivers with recent alcohol or drug use were 2.5 times more likely to have a psychiatric diagnosis (CI: 1.8-3.6, p < 0.001). This is the first study in a low-/middle-income country to evaluate psychiatric disorders in drivers with recent alcohol or drug using telephone interviews. Psychiatric disorders were found to be associated with drug and alcohol use. This type of epidemiological information for curtailing related driving problems, as these psychiatric conditions are diagnosable. The results of this study can aid in the design of interventions, treatment programs and focused psychiatric evaluations, both in Brazil and abroad.

  18. Who’s Boarding in the Psychiatric Emergency Service?

    Science.gov (United States)

    Simpson, Scott A.; Joesch, Jutta M.; West, Imara I.; Pasic, Jagoda

    2014-01-01

    Introduction When a psychiatric patient in the emergency department requires inpatient admission, but no bed is available, they may become a “boarder.” The psychiatric emergency service (PES) has been suggested as one means to reduce psychiatric boarding, but the frequency and characteristics of adult PES boarders have not been described. Methods We electronically extracted electronic medical records for adult patients presenting to the PES in an urban county safety-net hospital over 12 months. Correlative analyses included Student’s t-tests and multivariate regression. Results 521 of 5363 patient encounters (9.7%) resulted in boarding. Compared to non-boarding encounters, boarding patient encounters were associated with diagnoses of a primary psychotic, anxiety, or personality disorder, or a bipolar manic/mixed episode. Boarders were also more likely to be referred by family, friends or providers than self-referred; arrive in restraints; experience restraint/seclusion in the PES; or be referred for involuntary hospitalization. Boarders were more likely to present to the PES on the weekend. Substance use was common, but only tobacco use was more likely associated with boarding status in multivariate analysis. Conclusion Boarding is common in the PES, and boarders have substantial psychiatric morbidity requiring treatment during extended PES stays. We question the appropriateness of PES boarding for seriously ill psychiatric patients. PMID:25247041

  19. Who’s Boarding in the Psychiatric Emergency Service?

    Directory of Open Access Journals (Sweden)

    Scott A. Simpson

    2014-09-01

    Full Text Available Introduction: When a psychiatric patient in the emergency department requires inpatient admission, but no bed is available, they may become a “boarder.” The psychiatric emergency service (PES has been suggested as one means to reduce psychiatric boarding, but the frequency and characteristics of adult PES boarders have not been described. Methods: We electronically extracted electronic medical records for adult patients presenting to the PES in an urban county safety-net hospital over 12 months. Correlative analyses included Student’s t-tests and multivariate regression. Results: 521 of 5363 patient encounters (9.7% resulted in boarding. Compared to non-boarding encounters, boarding patient encounters were associated with diagnoses of a primary psychotic, anxiety, or personality disorder, or a bipolar manic/mixed episode. Boarders were also more likely to be referred by family, friends or providers than self-referred; arrive in restraints; experience restraint/ seclusion in the PES; or be referred for involuntary hospitalization. Boarders were more likely to present to the PES on the weekend. Substance use was common, but only tobacco use was more likely associated with boarding status in multivariate analysis. Conclusion: Boarding is common in the PES, and boarders have substantial psychiatric morbidity requiring treatment during extended PES stays. We question the appropriateness of PES boarding for seriously ill psychiatric patients. [West J Emerg Med. 2014;15(6:669-674

  20. Risk of psychiatric disorders in offspring of parents with a history of homelessness during childhood and adolescence in Denmark

    DEFF Research Database (Denmark)

    Nilsson, Sandra Feodor; Laursen, Thomas Munk; Hjorthøj, Carsten

    2017-01-01

    Background Children and adolescents from deprived backgrounds have high rates of psychiatric problems. Parental and social factors are crucial for children's healthy and positive development, but whether psychiatric morbidity is associated with parental social marginalisation is unknown. We aimed...... of homelessness, and 56 330 (5%) children and adolescents were diagnosed with any psychiatric disorder during the study period. The incidence of any psychiatric disorder was 15·1 cases per 1000 person-years (95% CI 14·4–15·8) in offspring with at least one parent with a history of homelessness, compared with 6...... to analyse the association between mother's and father's history of homelessness and the offspring's risk of psychiatric disorders, including substance use disorder, during childhood and adolescence. Methods We did a nationwide, register-based cohort study of 1 072 882 children and adolescents aged 0...

  1. Psychiatric outcomes after pediatric sports-related concussion.

    Science.gov (United States)

    Ellis, Michael J; Ritchie, Lesley J; Koltek, Mark; Hosain, Shahid; Cordingley, Dean; Chu, Stephanie; Selci, Erin; Leiter, Jeff; Russell, Kelly

    2015-12-01

    The objectives of this study were twofold: (1) to examine the prevalence of emotional symptoms among children and adolescents with a sports-related concussion (SRC) who were referred to a multidisciplinary pediatric concussion program and (2) to examine the prevalence, clinical features, risk factors, and management of postinjury psychiatric outcomes among those in this clinical population. The authors conducted a retrospective chart review of all patients with SRC referred to a multidisciplinary pediatric concussion program between September 2013 and October 2014. Clinical assessments carried out by a single neurosurgeon included clinical history, physical examination, and Post-Concussion Symptom Scale (PCSS) scoring. Postinjury psychiatric outcomes were defined as a subjective worsening of symptoms of a preinjury psychiatric disorder or new and isolated suicidal ideation or diagnosis of a novel psychiatric disorder (NPD). An NPD was defined as a newly diagnosed psychiatric disorder that occurred in a patient with or without a lifetime preinjury psychiatric disorder after a concussion. Clinical resources, therapeutic interventions, and clinical and return-to-play outcomes are summarized. One hundred seventy-four patients (mean age 14.2 years, 61.5% male) were included in the study. At least 1 emotional symptom was reported in 49.4% of the patients, and the median emotional PCSS subscore was 4 (interquartile range 1-8) among those who reported at least 1 emotional symptom. Overall, 20 (11.5%) of the patients met the study criteria for a postinjury psychiatric outcome, including 14 patients with an NPD, 2 patients with isolated suicidal ideation, and 4 patients with worsening symptoms of a preinjury psychiatric disorder. Female sex, a higher initial PCSS score, a higher emotional PCSS subscore, presence of a preinjury psychiatric history, and presence of a family history of psychiatric illness were significantly associated with postinjury psychiatric outcomes

  2. Liability for Diagnosing Malingering.

    Science.gov (United States)

    Weiss, Kenneth J; Van Dell, Landon

    2017-09-01

    Malingering is a medical diagnosis, but not a psychiatric disorder. The label imputes that an evaluee has intentionally engaged in false behavior or statements. By diagnosing malingering, psychiatrists pass judgment on truthfulness. Evaluees taking exception to the label may claim that the professional has committed defamation of character (libel or slander) when the diagnosis is wrong and costs the claimant money or benefits. Clinicians may counter by claiming immunity or that the diagnosis was made in good faith. This problem has come into focus in military and veterans' contexts, where diagnoses become thresholds for benefits. Through historical and literary examples, case law, and military/veterans' claims of disability and entitlement, the authors examine the potency of the malingering label and the potential liability for professionals and institutions of making this diagnosis. © 2017 American Academy of Psychiatry and the Law.

  3. Psychiatric morbidities among mentally ill wives of Nepalese men working abroad

    Directory of Open Access Journals (Sweden)

    Dhana Ratna Shakya

    2014-01-01

    Full Text Available Introduction: Husband working abroad may have not only favorable outcomes for wives and other family members but also adverse consequences, including psychological problems. Present study intended to look into psychiatric morbidity profiles of the Nepalese female psychiatric patients and the stressors related with their husband working abroad. Materials and Methods: This is a hospital-based descriptive study with convenient sampling method. Hundred consecutive female psychiatric patients, with the particular stressor, coming into the contact of the investigating team were enrolled within the study period of 12 months. The psychiatric morbidities/diagnoses were sorted out according to the International classification of disease and infirmity, 10 th edition (ICD-10 criteria. Results: Average age of the enrolled cases was 29 years. Nearly half of the women were illiterate or barely literate. Some other stressors, besides the one of husband working abroad were found to precipitate the illness in about 60%, main being relational and health problems. Common presenting complaints were mood, anxiety, and physical symptoms. Almost 30% of the subjects had some mental illness in their past too and similar proportion had in their blood relatives. About one-third admitted to use substances, mainly alcohol and cigarettes. The common psychiatric diagnoses were mood, anxiety, neurotic, and stress-related disorders. Nearly 10% had presented for suicide attempt. Conclusions: The status of husband working abroad may have adverse consequences in mental health of women. Mood affect, anxiety, and stress-related disorders are common psychiatric illness among them.

  4. Migraine and its psychiatric comorbidities.

    Science.gov (United States)

    Minen, Mia Tova; Begasse De Dhaem, Olivia; Kroon Van Diest, Ashley; Powers, Scott; Schwedt, Todd J; Lipton, Richard; Silbersweig, David

    2016-07-01

    Migraine is a highly prevalent and disabling neurological disorder associated with a wide range of psychiatric comorbidities. In this manuscript, we provide an overview of the link between migraine and several comorbid psychiatric disorders, including depression, anxiety and post-traumatic stress disorder. We present data on psychiatric risk factors for migraine chronification. We discuss the evidence, theories and methods, such as brain functional imaging, to explain the pathophysiological links between migraine and psychiatric disorders. Finally, we provide an overview of the treatment considerations for treating migraine with psychiatric comorbidities. In conclusion, a review of the literature demonstrates the wide variety of psychiatric comorbidities with migraine. However, more research is needed to elucidate the neurocircuitry underlying the association between migraine and the comorbid psychiatric conditions and to determine the most effective treatment for migraine with psychiatric comorbidity. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. Greenlandic adoptees' psychiatric inpatient contact. A comparative register-based study

    DEFF Research Database (Denmark)

    Laubjerg, Merete; Petersson, Birgit

    2010-01-01

      The aim is to highlight adoptees' and stepchildren's psychiatric contact and diagnoses compared to non-adoptees. The setting is Greenland and the methodology is a comparative in-ward patient register-based study. The background is the Greenlandic tradition for adoption and community child care...... and international research stressing that adoptees demonstrate reverse health outcomes. The cohort is in-ward patients (> 24 hours), born between 1973 and 2005. Correlation between various dependent and independent variables are analysed. The research makes different comparative statements of psychiatric admissions...... and diagnoses related to adoptees and stepchildren compared to non-adoptees with respect to demographic and socio-economic indicators. The psychiatric data material is collected from 1992 to 2008 and the socio-economic indicators are included from 1996. The findings show, contrary to findings related...

  6. Substance abuse treatment and psychiatric comorbidity: do benefits spill over? analysis of data from a prospective trial among cocaine-dependent homeless persons

    Directory of Open Access Journals (Sweden)

    Kertesz Stefan G

    2006-09-01

    Full Text Available Abstract Background Comorbid psychiatric illness can undermine outcomes among homeless persons undergoing addiction treatment, and psychiatric specialty care is not always readily available. The prognosis for nonsubstance abuse psychiatric diagnoses among homeless persons receiving behaviorally-based addiction treatment, however, is little studied. Results Data from an addiction treatment trial for 95 cocaine-dependent homeless persons (1996–1998 were used to profile psychiatric diagnoses at baseline and 6 months, including mood-related disorders (e.g. depression and anxiety-related disorders (e.g. post-traumatic stress disorder. Treatment interventions, including systematic reinforcement for goal attainment, were behavioral in orientation. There was a 32% reduction in the prevalence of comorbid non-addiction psychiatric disorder from baseline to 6 months, with similar reductions in the prevalence of mood (-32% and anxiety-related disorders (-20% (p = 0.12. Conclusion Among cocaine-dependent homeless persons with psychiatric comorbidity undergoing behavioral addiction treatment, a reduction in comorbid psychiatric disorder prevalence was observed over 6 months. Not all participants improved, suggesting that even evidence-based addiction treatment will prove insufficient for a meaningful proportion of the dually diagnosed homeless population.

  7. Maternal Smoking During Pregnancy and the Risk of Psychiatric Morbidity in Singleton Sibling Pairs

    Science.gov (United States)

    Lehtonen, Liisa; Korkeila, Jyrki; Gissler, Mika

    2017-01-01

    Abstract Introduction: Maternal smoking during pregnancy has been associated with an increased risk for psychiatric morbidity. We further studied this with Finnish siblings to control for genetic/familial factors. Methods: From the Finnish Medical Birth Register, sibling pairs were selected as the first two children born 1987–1995 to the same mother (n = 150 168 pairs), along with information on maternal smoking (no smoking/smoking). Information on the children’s psychiatric diagnoses related to outpatient care visits (1998–2013) and inpatient care (1987–2013), and the mothers’ psychiatric morbidity (1969–2013) was derived from the Finnish Hospital Discharge Register. The first pair analysis compared siblings of mothers who only smoked in the first pregnancy (Quitters, 4.7%) and mothers who smoked in both pregnancies (Smokers, 9.6%); the second analysis included mothers who smoked only in the second pregnancy (Starters, 3.3%) and mothers who did not smoke in either pregnancy (Nonsmokers, 77.5%). Smoking information was missing for 5.0% of pairs. Psychiatric morbidity of the siblings and mother was included in the statistical analyses. Results: The risk of psychiatric diagnoses was significantly lower for the second child of quitters (adjusted OR 0.77, 95% CI 0.72–0.83) compared to the risk among smokers. A higher risk for psychiatric diagnoses was found for the second child of starters (1.39, 1.30–1.49) compared to the risk among nonsmokers. The effect of smoking was more robust for externalizing diagnoses. Conclusions: Maternal smoking was independently associated with a higher risk for psychiatric morbidity in children, even when controlling thoroughly for genetic and familial factors. Implications: Maternal smoking during pregnancy has an independent effect on the risk of psychiatric morbidity in children, even after controlling for non-measurable genetic/familial factors by using a sibling pair design. The effect of maternal smoking was robust

  8. The nature of psychiatric disorders.

    Science.gov (United States)

    Kendler, Kenneth S

    2016-02-01

    A foundational question for the discipline of psychiatry is the nature of psychiatric disorders. What kinds of things are they? In this paper, I review and critique three major relevant theories: realism, pragmatism and constructivism. Realism assumes that the content of science is real and independent of human activities. I distinguish two "flavors" of realism: chemistry-based, for which the paradigmatic example is elements of the periodic table, and biology-based, for which the paradigm is species. The latter is a much better fit for psychiatry. Pragmatism articulates a sensible approach to psychiatric disorders just seeking categories that perform well in the world. But it makes no claim about the reality of those disorders. This is problematic, because we have a duty to advocate for our profession and our patients against other physicians who never doubt the reality of the disorders they treat. Constructivism has been associated with anti-psychiatry activists, but we should admit that social forces play a role in the creation of our diagnoses, as they do in many sciences. However, truly socially constructed psychiatric disorders are rare. I then describe powerful arguments against a realist theory of psychiatric disorders. Because so many prior psychiatric diagnoses have been proposed and then abandoned, can we really claim that our current nosologies have it right? Much of our current nosology arose from a series of historical figures and events which could have gone differently. If we re-run the tape of history over and over again, the DSM and ICD would not likely have the same categories on every iteration. Therefore, we should argue more confidently for the reality of broader constructs of psychiatric illness rather than our current diagnostic categories, which remain tentative. Finally, instead of thinking that our disorders are true because they correspond to clear entities in the world, we should consider a coherence theory of truth by which disorders

  9. Substance Use Disorders in Elderly Admissions to an Academic Psychiatric Inpatient Service over a 10-Year Period

    Directory of Open Access Journals (Sweden)

    Dennis Dombrowski

    2016-01-01

    Full Text Available Objective. There is a paucity of research on substance use disorders (SUDs in the elderly psychiatric population. This study examines SUDs in a geriatric psychiatry inpatient service over a 10-year period. Methods. Data from 1788 elderly psychiatric inpatients from a ten-year period was collected. Variables collected included psychiatric diagnoses, SUD, number of psychiatric admissions, and length of stay. Those with and without a SUD were compared using Chi-Square or Student’s t-test as appropriate using SPSS. Results. 11.7% (N=210 of patients had a SUD, and the most common substance was alcohol at 73.3% (N=154 or 8.6% of all admissions. Other SUDs were sedative-hypnotics (11%, opiate (2.9%, cannabis (1%, tobacco (1.4%, and unspecified SUD (38.6%. SUD patients were significantly younger, divorced, male, and less frequently readmitted and had shorter lengths of stay. The most common comorbid diagnoses were major depression (26.1%, bipolar disorder (10.5%, and dementia (17.1%. Conclusions. Over 10% of psychogeriatric admissions were associated with a SUD, with alcohol being the most common. Considering the difficulties in diagnosing SUD in this population and the retrospective study design, the true prevalence in elderly psychiatric inpatients is likely higher. This study adds to sparse literature on SUD in elderly psychiatric patients.

  10. Comprehensive Psychiatric Evaluation

    Science.gov (United States)

    ... Facts for Families Guide Facts for Families - Vietnamese Comprehensive Psychiatric Evaluation No. 52; Updated October 2017 Evaluation ... with serious emotional and behavioral problems need a comprehensive psychiatric evaluation. Comprehensive psychiatric evaluations usually require a ...

  11. Diagnosing Flu

    Science.gov (United States)

    ... Types Seasonal Avian Swine Variant Pandemic Other Diagnosing Flu Questions & Answers Language: English (US) Español Recommend on ... How do I know if I have the flu? Your respiratory illness might be the flu if ...

  12. ADHD severity as it relates to comorbid psychiatric symptomatology in children with Autism Spectrum Disorders (ASD).

    Science.gov (United States)

    Mansour, Rosleen; Dovi, Allison T; Lane, David M; Loveland, Katherine A; Pearson, Deborah A

    2017-01-01

    Comorbid diagnoses identified in pediatric samples have been correlated with a range of outcomes, including greater levels of emotional, behavioral, and educational impairment and the need for more intensive treatment. Given that previous research has documented high levels of comorbid Attention-Deficit/Hyperactivity Disorder (ADHD) in children with Autism Spectrum Disorders (ASD), this study closely examines the relationship between parent-reported ADHD symptoms (i.e., Conners' Parent Rating Scale, Revised [CPRS-R]) and the prevalence of additional comorbid psychiatric diagnoses in a pediatric ASD sample (n=99). Regression analyses revealed that greater severity of ADHD symptomatology was significantly related to a greater number of comorbid psychiatric diagnoses, as identified using the Diagnostic Interview for Children and adolescents, 4th Edition (DICA-IV). Additionally, more severe ADHD symptoms were also associated with higher levels of symptom severity on Child Behavior Checklist (CBCL) syndrome subscales. Interestingly, increasing severity of ASD symptomatology, as measured by the Autism Diagnostic Interview, Revised (ADI-R), was not associated with a higher prevalence of comorbid psychiatric diagnoses or CBCL syndrome severity. Our study concluded that higher levels of ADHD severity-not ASD severity-were associated with a higher prevalence of comorbid psychiatric symptomatology in school-age children with ASD. These findings may encourage clinicians to thoroughly assess ADHD symptomatology in ASD children to better inform treatment planning. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Pregnant Adolescents Admitted to an Inpatient Child and Adolescent Psychiatric Unit: An Eight-Year Review.

    Science.gov (United States)

    Fletcher, Teresa M; Markley, Laura A; Nelson, Dana; Crane, Stephen S; Fitzgibbon, James J

    2015-12-01

    To assess patient outcomes and describe demographic data of pregnant adolescents admitted to an inpatient child and adolescent psychiatric unit, as well as to determine if it is safe to continue to admit pregnant adolescents to such a unit. A descriptive retrospective chart review conducted at a free-standing pediatric hospital in northeast Ohio of all pregnant adolescents aged 13 to 17 years admitted to the inpatient child and adolescent psychiatric unit from July 2005 to April 2013. Data collection included details on demographic, pregnancy status, and psychiatric diagnoses. Eighteen pregnant adolescents were admitted to the psychiatric unit during the time frame. Sixteen of those were in the first trimester of pregnancy. Pregnancy was found to be a contributing factor to the adolescent's suicidal ideation and admission in 11 of the cases. Admission to an inpatient psychiatric facility did not lead to adverse effects in pregnancy. Pregnant adolescents did not have negative pregnancy outcomes related to admission to an inpatient psychiatric unit. Results of this study suggest that it is safe to continue to admit uncomplicated pregnant adolescents in their first trimester to an inpatient child and adolescent psychiatric unit for an acute stay. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  14. The cerebellum and psychiatric disorders

    Directory of Open Access Journals (Sweden)

    Joseph ePhillips

    2015-05-01

    Full Text Available The cerebellum has been considered for a long time to play a role solely in motor coordination. However, studies over the past two decades have shown that the cerebellum also plays a key role in many motor, cognitive, and emotional processes. In addition, studies have also shown that the cerebellum is implicated in many psychiatric disorders including attention deficit hyperactivity disorder, autism spectrum disorders, schizophrenia, bipolar disorder, major depressive disorder and anxiety disorders. In this review, we discuss existing studies reporting cerebellar dysfunction in various psychiatric disorders. We will also discuss future directions for studies linking the cerebellum to psychiatric disorders.

  15. Common Use of Electroconvulsive Therapy for Chinese Adolescent Psychiatric Patients.

    Science.gov (United States)

    Zhang, Qing-E; Wang, Zhi-Min; Sha, Sha; Ng, Chee H; Seiner, Stephen J; Welch, Charles A; Lok, Grace K I; Chow, Ines H I; Wang, Fei; Li, Lu; Xiang, Yu-Tao

    2016-12-01

    Little is known about the use of electroconvulsive therapy (ECT) for adolescent psychiatric patients in China. This study examined the frequency of ECT and the demographic and clinical correlates of adolescent psychiatric patients hospitalized in a tertiary psychiatric hospital in China. This was a retrospective chart review of 954 inpatients aged between 13 and 17 years treated over a period of 8 years (2007-2013). Sociodemographic and clinical data were collected from the electronic chart management system for discharged patients. The rate of ECT use was 42.6% in the whole sample (46.5% for patients with schizophrenia, 41.8% for major depressive disorder, 57.8% for bipolar disorders, and 23.9% for other diagnoses). Use of ECT was independently and positively associated with older age, high aggression risk at time of admission, and use of antipsychotics and antidepressants. Compared with patients with schizophrenia, those with other psychiatric diagnoses were less likely to receive ECT. The above significant correlates explained 32% of the variance of ECT use (P < 0.001). Limitations of this study included the lack of data regarding the efficacy and side effects of ECT. Furthermore, the high rate of ECT applied only to 1 setting which limits the ability to extrapolate the implications of the results to other populations. The use of ECT was exceedingly high in adolescent patients treated in a tertiary clinical centre in China. It is unlikely that such a high rate of ECT use is found across China or that such practice reflects standard of care for psychiatrically ill adolescents. The underlying reasons for the high use of ECT at this center warrant urgent investigations.

  16. Parental psychiatric hospitalisation and offspring schizophrenia

    DEFF Research Database (Denmark)

    Sørensen, Holger J; Mortensen, Erik L; Reinisch, June M

    2009-01-01

    The risk of schizophrenia has been linked with a family history of schizophrenia and less strongly with other psychiatric disorders in family members. Using data from the Copenhagen Perinatal Cohort and from the Danish Psychiatric Case Register, we studied the relationship between offspring risk...... of schizophrenia and a range of psychotic and non-psychotic psychiatric diagnoses in parents. Psychiatric admission data after 1969 were available for 7047 cohort members born between 1959 and 1961, and for 7006 mothers and 6993 fathers. Univariate analysis showed that neurosis, alcohol and substance dependence...... in both parents were associated with elevated risk of offspring schizophrenia; in addition, maternal schizophrenia, affective disorder and personality disorder were associated with elevated risk. Controlling for parental age, parental social status, and parental psychiatric co-diagnosis, offspring risk...

  17. [Differences between patients in consultation psychiatry and psychiatric inpatients].

    Science.gov (United States)

    Unterecker, Stefan; Maloney, Julia; Pfuhlmann, Bruno; Deckert, Jürgen; Warrings, Bodo

    2014-05-01

    To optimize psychiatric consultation service epidemiological information is needed. We compared data on gender, age and diagnoses of patients in the consultation service to psychiatric inpatients. In psychiatric consultation service patients are older (56.6 vs. 44.9 years, p psychiatric consultation service is contacted more often in cases of organic disorders, for females in adjustment disorders (p psychiatric consultation service is different for males and females with relevance for diagnostic and therapeutic procedures. © Georg Thieme Verlag KG Stuttgart · New York.

  18. [Tinnitus and psychiatric comorbidities].

    Science.gov (United States)

    Goebel, G

    2015-04-01

    Tinnitus is an auditory phantom phenomenon characterized by the sensation of sounds without objectively identifiable sound sources. To date, its causes are not well understood. The perceived severity of tinnitus correlates more closely to psychological and general health factors than to audiometric parameters. Together with limbic structures in the ventral striatum, the prefrontal cortex forms an internal "noise cancelling system", which normally helps to block out unpleasant sounds, including the tinnitus signal. If this pathway is compromised, chronic tinnitus results. Patients with chronic tinnitus show increased functional connectivity in corticolimbic pathways. Psychiatric comorbidities are common in patients who seek help for tinnitus or hyperacusis. Clinicians need valid screening tools in order to identify patients with psychiatric disorders and to tailor treatment in a multidisciplinary setting.

  19. Psychiatric aspects of induced abortion.

    Science.gov (United States)

    Stotland, Nada L

    2011-08-01

    Approximately one third of the women in the United States have an abortion during their lives. In the year 2008, 1.21 million abortions were performed in the United States (Jones and Koolstra, Perspect Sex Reprod Health 43:41-50, 2011). The psychiatric outcomes of abortion are scientifically well established (Adler et al., Science 248:41-43, 1990). Despite assertions to the contrary, there is no evidence that abortion causes psychiatric problems (Dagg, Am J Psychiatry 148:578-585, 1991). Those studies that report psychiatric sequelae suffer from severe methodological defects (Lagakos, N Engl J Med 354:1667-1669, 2006). Methodologically sound studies have demonstrated that there is a very low incidence of frank psychiatric illness after an abortion; women experience a wide variety of feelings over time, including, for some, transient sadness and grieving. However, the circumstances that lead a woman to terminate a pregnancy, including previous and/or ongoing psychiatric illness, are independently stressful and increase the likelihood of psychiatric illness over the already high baseline incidence and prevalence of mood and anxiety disorders among women of childbearing age. For optimal psychological outcomes, women, including adolescents, need to make autonomous and supported decisions about problem pregnancies. Clinicians can help patients facing these decisions and those who are working through feelings about having had abortions in the past.

  20. The arsonists portrait- as seen by forensic psychiatric examination

    Directory of Open Access Journals (Sweden)

    Radulescu Simona Delia

    2016-12-01

    Full Text Available OBJECTIVES The aim of our study is to determine the mental state of the arsonists that have undergone forensic psychiatric evaluation. MATERIALS AND METHODS We have examined the mental health records between years 2014-2015. Only subjects who committed fire setting crimes and were referred to the Legal Medicine Institute from Timișoara for a psychiatric evaluation were selected for the study. We analysed the following data: socio-demographic parameters, psychiatric diagnosis, motivation for the perpetrated crime, alcohol and drug addiction, the applied safety measure, the administrated neuroleptic and complementary treatment and the social support network. RESULTS The portrait of the arsonist is mainly male, young, single, poorly educated, unskilled and unemployed, living mostly in rural areas and with alcohol or drugs additction at the time of comitting the fire setting. Regarding the mental state of the patient, the most common diagnoses among the subjects were: psychoses, toxic substance delusional disorder, mixed personality disorder and intellectual disabilities. In most cases, arsonists lost discerment at the time of comitting the criminal act and they were not held accountable for it. CONCLUSIONS Our study established the most common psychiatric disturbances of arsonists as seen by forensic psychiatric examination. Different reasons for setting up fire have also been discussed. Patients were both delusional and irritated. We attempted to sketch a "portrait" of the arsonist and suggestions were included in order to ensure further "profiling" information gathering. REFERENCES 1. Rasanen P, Hakko H, Vaisanen E. The mental state of arsonists as determined by forensic psychiatric examinations. Bull Am Acad Psychiatry Law. 1995;23:547-553. 2. Tyler N, Gannon TA. Explanations of firesetting in mentally disordered offenders: A review of the literature. Psychiatry: Interpersonal and Biological Processes. 2012;75:150-166. 3. Inciardi JA. The adult

  1. Adverse life events increase risk for postpartum psychiatric episodes: A population-based epidemiologic study.

    Science.gov (United States)

    Meltzer-Brody, S; Larsen, J T; Petersen, L; Guintivano, J; Florio, A Di; Miller, W C; Sullivan, P F; Munk-Olsen, T

    2018-02-01

    Trauma histories may increase risk of perinatal psychiatric episodes. We designed an epidemiological population-based cohort study to explore if adverse childhood experiences (ACE) in girls increases risk of later postpartum psychiatric episodes. Using Danish registers, we identified women born in Denmark between January 1980 and December 1998 (129,439 childbirths). Exposure variables were ACE between ages 0 and 15 including: (1) family disruption, (2) parental somatic illness, (3) parental labor market exclusion, (4) parental criminality, (5) parental death, (6) placement in out-of-home care, (7) parental psychopathology excluding substance use, and (8) parental substance use disorder. Primary outcome was first occurrence of in- or outpatient contact 0-6 months postpartum at a psychiatric treatment facility with any psychiatric diagnoses, ICD-10, F00-F99 (N = 651). We conducted survival analyses using Cox proportional hazard regressions of postpartum psychiatric episodes. Approximately 52% of the sample experienced ACE, significantly increasing risk of any postpartum psychiatric diagnosis. Highest risks were observed among women who experienced out-of-home placement, hazard ratio (HR) 2.57 (95% CI: 1.90-3.48). Women experiencing two adverse life events had higher risks of postpartum psychiatric diagnosis HR: 1.88 (95% CI: 1.51-2.36), compared to those with one ACE, HR: 1.24 (95% CI: 1.03-49) and no ACE, HR: 1.00 (reference group). ACE primarily due to parental psychopathology and disability contributes to increased risk of postpartum psychiatric episodes; and greater numbers of ACE increases risk for postpartum psychiatric illness with an observed dose-response effect. Future work should explore genetic and environmental factors that increase risk and/or confer resilience. © 2017 Wiley Periodicals, Inc.

  2. Psychiatric comorbidity and psychosocial impairment among patients with vertigo and dizziness.

    Science.gov (United States)

    Lahmann, Claas; Henningsen, Peter; Brandt, Thomas; Strupp, Michael; Jahn, Klaus; Dieterich, Marianne; Eckhardt-Henn, Annegret; Feuerecker, Regina; Dinkel, Andreas; Schmid, Gabriele

    2015-03-01

    Vertigo and dizziness are often not fully explained by an organic illness, but instead are related to psychiatric disorders. This study aimed to evaluate psychiatric comorbidity and assess psychosocial impairment in a large sample of patients with a wide range of unselected organic and non-organic (ie, medically unexplained) vertigo/dizziness syndromes. This cross-sectional study involved a sample of 547 patients recruited from a specialised interdisciplinary treatment centre for vertigo/dizziness. Diagnostic evaluation included standardised neurological examinations, structured clinical interview for major mental disorders (SCID-I) and self-report questionnaires regarding dizziness, depression, anxiety, somatisation and quality of life. Neurological diagnostic workup revealed organic and non-organic vertigo/dizziness in 80.8% and 19.2% of patients, respectively. In 48.8% of patients, SCID-I led to the diagnosis of a current psychiatric disorder, most frequently anxiety/phobic, somatoform and affective disorders. In the organic vertigo/dizziness group, 42.5% of patients, particularly those with vestibular paroxysmia or vestibular migraine, had a current psychiatric comorbidity. Patients with psychiatric comorbidity reported more vertigo-related handicaps, more depressive, anxiety and somatisation symptoms, and lower psychological quality of life compared with patients without psychiatric comorbidity. Almost half of patients with vertigo/dizziness suffer from a psychiatric comorbidity. These patients show more severe psychosocial impairment compared with patients without psychiatric disorders. The worst combination, in terms of vertigo-related handicaps, is having non-organic vertigo/dizziness and psychiatric comorbidity. This phenomenon should be considered when diagnosing and treating vertigo/dizziness in the early stages of the disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  3. [Psychiatric expert opinions on asylum seekers in Germany].

    Science.gov (United States)

    Sieberer, Marcel; Ziegenbein, Marc; Eckhardt, Gudrun; Machleidt, Wielant; Calliess, Iris T

    2011-01-01

    To investigate the frequency of traumatisation, suicidality and given diagnoses in expert opinions on asylum seekers and to describe the sociodemographic characteristics of this population. The psychiatric expert opinions on asylum seekers, furnished in an 8-year-period at Hannover Medical School, were analysed retrospectively for qualitative and quantitative characteristics. 62 psychiatric expert opinions on asylum seekers were included in this study. The asylum seekers originated from 18 different countries, mainly from Turkey and former Yugoslavia. Most expert opinions were given in secondary asylum procedures, i. e. after the initial asylum request had been rejected. The asylum seekers reported on traumatisation in 82.3 %. The most frequently reported forms of traumatisation were rape in female, and torture in male persons. According to ICD-10 or DSM-IV-R criteria posttraumatic stress disorder (PTSD) was the most frequent diagnosis (74.1 %) in this study. The second most common diagnoses were depressive disorders (ICD-10: F32.x in 33.9 % and ICD-10: F33.x in 25.9 %). Suicidal tendency was found in 56.5 % of the asylum seekers. Cultural differences, language barriers, a heavy burden by psychological symptoms, and clinical severity are difficulties in the process of psychiatric assessment of refugees in legal asylum procedures. © Georg Thieme Verlag KG Stuttgart · New York.

  4. PREVALENCE OF ALCOHOLISM IN HOSPITALIZATIONS OF PSYCHIATRIC EMERGENCY

    Directory of Open Access Journals (Sweden)

    Robsmeire Calvo Melo Zurita

    2013-03-01

    Full Text Available The psychiatric emergency is used to treat people with mental disordersworking 24 hours followed the new model of mental health care recommended by theMinistry of Health, creating care options, with a focus centered on reintegration of the patientto their social and family. The study aimed to characterize the hospitalizations of patients inthe Psychiatric Emergency Municipal Hospital of Maringa in the period January 2009 to June2010. Were selected and included a total of 1548 hospitalizations, behavioral disorder due toalcohol use. Predominance in male admissions with 88.6%, the predominant age group inboth sexes was 41-51 years with 59.75%, with the majority of hospitalizations of patientsliving in Maringá. Referred to the Psychiatric Hospital were46.18% of hospitalizations,diagnosed mostly in mental and behavioral disorders due to alcohol use,CID-10 F10, with720 (46.51% of admissions. The legal framework of the Psychiatric Reform, ratified,guaranteeing the universal right to access and assistance as well as to its completeness;decentralization of the service model, configuring networks care more attentive toinequalities, setting fair and democratic way of their actions to needs of the population

  5. Psychiatric disorders in single and multiple sexual murderers.

    Science.gov (United States)

    Hill, Andreas; Habermann, Niels; Berner, Wolfgang; Briken, Peer

    2007-01-01

    Sexual homicides - and particularly offenders with multiple victims - receive much attention in the general public as well as among forensic experts. The aim of this study was to assess psychiatric disorders in a large sample of sexual murderers and to identify disorders related to multiple sexual homicides. Psychiatric court reports from 20 German forensic psychiatrists on 166 men who had committed a sexual homicide were evaluated for psychiatric disorders according to DSM-IV, including standardized instruments for personality disorders (criteria from the Structured Clinical Interview) and psychopathy (Psychopathy Checklist-Revised). Offenders with a single sexual homicide victim (n = 130) were compared to those with multiple victims (n = 36). High lifetime prevalence rates were found for substance abuse or dependence, paraphilias (especially sexual sadism), sexual dysfunctions and personality disorders (especially antisocial, borderline, sadistic and schizoid). In the multiple sexual murderer group sexual sadism, voyeurism, sadistic, antisocial and schizoid personality disorders were more frequent than in the single-victim group; none of the multiple offenders was diagnosed with a mood disorder. Multiple sexual murderers are characterized by disorders in three major psychopathological domains: sexual as well as 'character' sadism, antisociality and schizoid personality. A thorough diagnostic evaluation of Axis I as well as Axis II disorders should be part of risk assessments in sexual homicide perpetrators. Although the study was a retrospective investigation on psychiatric court reports, the size of the sample and consistency with results from previous studies give confidence that the identified group differences are unlikely to be due to methodological limitations.

  6. Culture and psychiatric diagnosis.

    Science.gov (United States)

    Lewis-Fernández, Roberto; Aggarwal, Neil Krishan

    2013-01-01

    Since the publication of DSM-IV in 1994, neurobiologists and anthropologists have criticized the rigidity of its diagnostic criteria that appear to exclude whole classes of alternate illness presentations, as well as the lack of attention in contemporary psychiatric nosology to the role of contextual factors in the emergence and characteristics of psychopathology. Experts in culture and mental health have responded to these criticisms by revising the very process of diagnosis for DSM-5. Specifically, the DSM-5 Cultural Issues Subgroup has recommended that concepts of culture be included more prominently in several areas: an introductory chapter on Cultural Aspects of Psychiatric Diagnosis - composed of a conceptual introduction, a revised Outline for Cultural Formulation, a Cultural Formulation Interview that operationalizes this Outline, and a glossary on cultural concepts of distress - as well as material directly related to culture that is incorporated into the description of each disorder. This chapter surveys these recommendations to demonstrate how culture and context interact with psychiatric diagnosis at multiple levels. A greater appreciation of the interplay between culture, context, and biology can help clinicians improve diagnostic and treatment planning. Copyright © 2013 APA*

  7. Increased psychiatric morbidity before and after the diagnosis of hypothyroidism

    DEFF Research Database (Denmark)

    Thvilum, Marianne; Brandt, Frans; Pedersen, Dorthe Almind

    2014-01-01

    Background: Thyroid hormones are necessary for fetal brain development, while hypothyroidism in adults has been associated with mood symptoms and reduced quality of life. Nevertheless, our knowledge regarding the association and temporal relation between hypothyroidism and mental disorders...... is ambiguous. Our objective was to investigate, at a nationwide level, whether a diagnosis of hypothyroidism is associated with psychiatric morbidity. Methods: Observational cohort study. Based on record-linkage between different Danish health registers, 2822 hypothyroid singletons each matched with 4 non......-hypothyroid controls were identified and followed over a mean period of 6 years (range 1-13). Additionally, we included 385 same sex twin pairs discordant for hypothyroidism. Diagnoses of psychiatric disorders as well as treatment with antidepressants, antipsychotics and anxiolytics were recorded. Logistic and cox...

  8. [Psychiatric disturbances in five patients with MELAS syndrome].

    Science.gov (United States)

    Magner, Martin; Honzik, Tomas; Tesarova, Marketa; Dvorakova, Veronika; Hansiková, Hana; Raboch, Jiři; Zeman, Jiři

    2014-01-01

    Mitochondrial disorders of energetic metabolism (MD) represent a heterogeneous group of diseases manifesting at any age with a broad spectrum of clinical symptoms, including psychiatric disorders. The aim of the study was to characterize psychiatric symptoms and diagnoses in five patients with MELAS syndrome between the ages of 17 and 53 years. Four of MELAS patients them harbored the prevalent mitochondrial DNA (mtDNA) mutation 3243A>G, and one patient had the mtDNA mutation 12706T>C. Three patients had positive family histories for MELAS syndrome. In one patient, depression was diagnosedas the first symptom ofMELAS syndrome. Depression also preceded a stroke-like episode in one patient. Four patients had disturbed cognitive functions, confusional states occurred in three patients. One patient manifested psychotic (schizophrenia-like) symptoms. Mitochondrial disorders deserve consideration as part of the differential diagnosis, especially, if there is suspected involvement of other organ groups or positive family history of MD.

  9. Psychiatric emergencies (part II): psychiatric disorders coexisting with organic diseases.

    Science.gov (United States)

    Testa, A; Giannuzzi, R; Sollazzo, F; Petrongolo, L; Bernardini, L; Dain, S

    2013-02-01

    substances producing an addiction status may be assembled in depressants (alcohol, benzodiazepines, opiates), stimulants (cocaine, amphetamines, nicotine, caffeine, modafinil), hallucinogens (mescaline, LSD, ecstasy) and other substances (cannabis, dissociatives, inhalants). Anxiety disorders can occur in intoxication by stimulants, as well as in withdrawal syndrome, both by stimulants and sedatives. Substance induced mood disorders and psychotic symptoms are as much frequent conditions in ED, and the recognition of associated organic symptoms may allow to achieve diagnosis. Finally, psychiatric and organic symptoms may be caused by prescription and doping medications, either as a direct effect or after withdrawal. Adverse drug reactions can be divided in type A, dose dependent and predictable, including psychotropic drugs and hormones; and type B, dose independent and unpredictable, usually including non psychotropic drugs, more commonly included being cardiovascular, antibiotics, anti-inflammatory and antineoplastic medications.

  10. Psychiatric Symptoms in Teachers from Danwon High School after Exposure to the Sinking of the Motor Vessel Sewol.

    Science.gov (United States)

    Lee, Mi-Sun; Bhang, Soo-Young; Lee, Cheol-Soon; Chang, Hyoung Yoon; Kim, Ji-Youn; Lee, Ju-Hyun; Kim, Eunji; Bae, Seung-Min; Park, Jang-Ho; Kim, Hye-Jin; Hwang, Jun-Won

    2017-11-01

    The goal of this study was to describe the psychiatric symptoms in the teachers from Danwon High School who were exposed to the sinking of the Motor Vessel Sewol. Data were collected from 32 teachers who underwent psychiatric interventions by 16 volunteer psychiatrists for 3 months after the sinking of the Motor Vessel Sewol. The most commonly diagnosed clinical diagnosis in the teachers were normal reaction, acute stress disorder and adjustment disorder. Psychiatric symptoms including anxiety, depressed mood and sleep disturbances were also observed. In the acute aftermath of the Sewol Ferry sinking on April 16, 2014, psychiatrists volunteered to provide professional psychiatric interventions to Danwon High School teachers. These results suggest the importance of crisis intervention focused on the teachers who are exposed to disasters. The implications for future research and interventions are discussed.

  11. Childhood Trauma and Psychiatric Disorders as Correlates of School Dropout in a National Sample of Young Adults

    Science.gov (United States)

    Porche, Michelle V.; Fortuna, Lisa R.; Lin, Julia; Alegria, Margarita

    2010-01-01

    The effect of childhood trauma, psychiatric diagnoses, and mental health services on school dropout among U.S. born and immigrant youth is examined using data from the Collaborative Psychiatric Epidemiology Surveys (CPES), a nationally representative probability sample of African Americans, Afro-Caribbeans, Asians, Latinos, and non-Latino Whites, including 2532 young adults, ages 21 to 29. The dropout prevalence rate was 16% overall, with variation by childhood trauma, childhood psychiatric diagnosis, race/ethnicity, and nativity. Childhood substance and conduct disorders mediated the relationship between trauma and school dropout. Likelihood of dropout was decreased for Asians, and increased for African Americans and Latinos, compared to non-Latino Whites as a function of psychiatric disorders and trauma. Timing of U.S. immigration during adolescence increased risk of dropout. PMID:21410919

  12. The Puzzle of Neuroimaging and Psychiatric Diagnosis: Technology and Nosology in an Evolving Discipline.

    Science.gov (United States)

    Farah, Martha J; Gillihan, Seth J

    2012-10-01

    Brain imaging provides ever more sensitive measures of structure and function relevant to human psychology and has revealed correlates for virtually every psychiatric disorder. Yet it plays no accepted role in psychiatric diagnosis beyond ruling out medical factors such as tumors or traumatic brain injuries. Why is brain imaging not used in the diagnosis of primary psychiatric disorders, such as depression, bipolar disease, schizophrenia, and ADHD? The present article addresses this question. It reviews the state of the art in psychiatric imaging, including diagnostic and other applications, and explains the nonutility of diagnostic imaging in terms of aspects of both the current state of imaging and the current nature of psychiatric nosology. The likely future path by which imaging-based diagnoses will be incorporated into psychiatry is also discussed. By reviewing one well-known attempt to use SPECT-scanning in psychiatric diagnosis, the article examines a real-world practice that illustrates several related points: the appeal of the idea of image-assisted diagnosis for physicians, patients and families, despite a lack of proven effectiveness, and the mismatch between the categories and dimensions of current nosology and those suggested by imaging.

  13. Psychiatric Consultation and Substance Use Disorders

    Directory of Open Access Journals (Sweden)

    Sheila Specker

    2009-01-01

    Full Text Available Background A substantial number of patients in general hospitals will evince substance abuse problems but a majority is unlikely to be adequately identified in the referral-consultation process. This failure may preclude patients from receiving effective interventions for substance use disorders. Objectives 1. To evaluate all referred patients for possible substance use disorders. 2. To ascertain the degree of convergence between patients referred for chemical problems and the corresponding DSM diagnosis. 3. To compare demographic data for substance abusing patients and referrals not so classified. 4. To evaluate conditions concomitant with substance use disorders. Method Consecutive one-year referrals (524 to consultation-liaison psychiatric services were scrutinized for chemically-related problems by psychiatric consultants. Results Of the referrals, 176 met criteria for substance use disorders (SUD (57% alcohol; 25% other drugs; 18% both alcohol and other drugs. Persons diagnosed with SUD tended to be younger, male, non-Caucasian, unmarried, and unemployed. They were more likely to be depressed, have liver and other gastrointestinal problems, and to have experienced traumatic events; they also tended to have current financial difficulties. Most were referred for SUD evaluation by personnel in general medicine and family practice. Following psychiatric consultation, SUD designated patients were referred mainly to substance abuse treatment programs. The only variable related to recommended inpatient versus outpatient services for individuals with SUD was the Global Assessment of Functioning Axis (GAF with persons having lower estimated functioning more likely to be referred for inpatient interventions. Conclusions These data are similar to the results of past studies in this area. Unlike previous investigations in the domain of consultative-liaison psychiatry, financial stressors and specific consultant recommendations were included in data

  14. Psychiatric Consultation and Substance Use Disorders

    Directory of Open Access Journals (Sweden)

    Sheila Specker

    2009-11-01

    Full Text Available Background: A substantial number of patients in general hospitals will evince substance abuse problems but a majority is unlikely to be adequately identified in the referral-consultation process. This failure may preclude patients from receiving effective interventions for substance use disorders. Objectives: 1. To evaluate all referred patients for possible substance use disorders. 2. To ascertain the degree of convergence between patients referred for chemical problems and the corresponding DSM diagnosis. 3. To compare demographic data for substance abusing patients and referrals not so classified. 4. To evaluate conditions concomitant with substance use disorders. Method: Consecutive one-year referrals (524 to consultation-liaison psychiatric services were scrutinized for chemically-related problems by psychiatric consultants. Results: Of the referrals, 176 met criteria for substance use disorders (SUD (57% alcohol; 25% other drugs; 18% both alcohol and other drugs. Persons diagnosed with SUD tended to be younger, male, non-Caucasian, unmarried, and unemployed. They were more likely to be depressed, have liver and other gastrointestinal problems, and to have experienced traumatic events; they also tended to have current financial difficulties. Most were referred for SUD evaluation by personnel in general medicine and family practice. Following psychiatric consultation, SUD designated patients were referred mainly to substance abuse treatment programs. The only variable related to recommended inpatient versus outpatient services for individuals with SUD was the Global Assessment of Functioning Axis (GAF with persons having lower estimated functioning more likely to be referred for inpatient interventions. Conclusions: These data are similar to the results of past studies in this area. Unlike previous investigations in the domain of consultative-liaison psychiatry, financial stressors and specific consultant recommendations were included in

  15. Psychiatric adverse effects of chloroquine

    Directory of Open Access Journals (Sweden)

    Anna Bogaczewicz

    2017-06-01

    Full Text Available Chloroquine is a prototype antimalarial drug, widely used in several branches of medicine. Antimalarial drugs are used in the treatment of various dermatological, immunological, rheumatological and infectious diseases. Examples of off-labelled indications for chloroquine analogues use include dermatomyositis, sarcoidosis, polymorphous light eruption, disseminated granuloma annulare and porfiria cutanea tarda. There is a relatively small number of adverse effects related to chloroquine analogues used in standard doses, such as gastrointestinal disturbances, headaches, skin reactions, hypotension, convulsions, extrapyramidal symptoms and visual disturbances. Psychiatric side effects of chloroquine seem to be rare, but may manifest in a wide range of symptoms, such as confusion, disorientation, ideas of persecution, agitation, outbursts of violence, loss of interest, feeling sad, suicidal ideas and impaired insight. There is also a report of a manic episode with psychotic features in the course of bipolar disorder, and another case report of persecutory delusions, anxiety, derealisation and visual illusions triggered by chloroquine. The duration of psychiatric symptoms usually ranges from one to two weeks, and symptoms usually disappear within several days following cessation of chloroquine usage and starting psychiatric treatment where indicated. This article reviews the case studies of patients diagnosed with mental disorders resulting from the use of chloroquine, and discusses the management in such cases.

  16. Euthanasia requests, procedures and outcomes for 100 Belgian patients suffering from psychiatric disorders: a retrospective, descriptive study

    Science.gov (United States)

    Thienpont, Lieve; Verhofstadt, Monica; Van Loon, Tony; Distelmans, Wim; Audenaert, Kurt; De Deyn, Peter P

    2015-01-01

    Objectives To identify patterns in euthanasia requests and practices relating to psychiatric patients; to generate recommendations for future research. Design Retrospective analysis of data obtained through medical file review. Setting Outpatient psychiatric clinical setting in the Dutch-speaking region of Belgium, between October 2007 and December 2011; follow-up at the end of December 2012. Participants 100 consecutive psychiatric patients requesting euthanasia based on psychological suffering associated with psychiatric disorders (77 women, 23 men; mean age 47 years; age range 21–80 years). Main outcome measures Patient sociodemographic characteristics; diagnoses; decisions on euthanasia requests; circumstances of euthanasia procedures; patient outcomes at follow-up. Results Most patients had been referred for psychiatric counselling by their physician (n=55) or by LEIF (Life End Information Forum) (n=36). 90 patients had >1 disorder; the most frequent diagnoses were depression (n=58) and personality disorder (n=50). 38 patients required further testing and/or treatment, including 13 specifically tested for autism spectrum disorder (ASD); 12 received an ASD diagnosis (all Asperger syndrome). In total, 48 of the euthanasia requests were accepted and 35 were carried out. Of the 13 remaining patients whose requests were accepted, 8 postponed or cancelled the procedure, because simply having this option gave them enough peace of mind to continue living. In December 2012, 43 patients had died, including 35 by euthanasia; others died by suicide (6), palliative sedation (1) and anorexia nervosa (1). Conclusions Depression and personality disorders are the most common diagnoses in psychiatric patients requesting euthanasia, with Asperger syndrome representing a neglected disease burden. Further research is needed, especially prospective quantitative and qualitative studies, to obtain a better understanding of patients with psychiatric disorders who request

  17. Prevalence of irritable bowel syndrome among psychiatric patients ...

    African Journals Online (AJOL)

    About 70-90% of patients with IBS have psychiatric comorbidity, such as depression, anxiety disorders, sexual dysfunction and somatoform disorders. Many studies had been ... The most common psychiatric diagnosis in the subjects was schizophrenia, which was diagnosed in 51 (54.8%) subjects. Using the Rome III ...

  18. Relational Aggression in Children with Preschool-Onset Psychiatric Disorders

    Science.gov (United States)

    Belden, Andy C.; Gaffrey, Michael S.; Luby, Joan L.

    2012-01-01

    Objective: The role of preschool-onset (PO) psychiatric disorders as correlates and/or risk factors for relational aggression during kindergarten or first grade was tested in a sample of 146 preschool-age children (age 3 to 5.11 years). Method: Axis-I diagnoses and symptom scores were derived using the Preschool Age Psychiatric Assessment.…

  19. Risk of psychiatric disorders following polycystic ovary syndrome: a nationwide population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Jeng-Hsiu Hung

    Full Text Available BACKGROUND: Polycystic ovary syndrome (PCOS is one of the most common endocrine disorders among women of reproductive age. A higher prevalence of psychiatric comorbidities, including depressive disorder, anxiety disorder, and bipolar disorder has been proved in patients with PCOS. However, a clear temporal causal relationship between PCOS and psychiatric disorders has not been well established. OBJECTIVE: We explored the relationship between PCOS and the subsequent development of psychiatric disorders including schizophrenia, bipolar disorder, depressive disorder, anxiety disorder, and sleep disorder. METHODS: We identified patients who were diagnosed with PCOS by an obstetrician-gynecologist in the Taiwan National Health Insurance Research Database. A comparison cohort was constructed of patients without PCOS who were matched according to age and sex. The occurrence of subsequent new-onset psychiatric disorders was evaluated in both cohorts based on diagnoses made by psychiatrists. RESULTS: The PCOS cohort consisted of 5431 patients, and the comparison cohort consisted of 21,724 matched control patients without PCOS. The incidence of depressive disorder (hazard ratio [HR] 1.296, 95% confidence interval [CI] 1.084-.550, anxiety disorder (HR 1.392, 95% CI 1.121-1.729, and sleep disorder (HR 1.495, 95% CI 1.176-1.899 were higher among the PCOS patients than among the patients in the comparison cohort. In addition, a higher incidence of newly diagnosed depressive disorder, anxiety disorder, and sleep disorder remained significantly increased in all of the stratified follow-up durations (0-1, 1-5, ≥5 y. CONCLUSIONS: PCOS might increase the risk of subsequent newly diagnosed depressive disorder, anxiety disorder, and sleep disorder. The risk of newly diagnosed bipolar disorder, which has often been reported in the literature to be comorbid with PCOS, was not significantly elevated.

  20. Familiality of Psychiatric Disorders and Risk of Postpartum Psychiatric Episodes

    DEFF Research Database (Denmark)

    Bauer, Anna E; Maegbaek, Merete L; Liu, Xiaoqin

    2018-01-01

    OBJECTIVE: Postpartum psychiatric disorders are common and morbid complications of pregnancy. The authors sought to evaluate how family history of psychiatric disorders is associated with postpartum psychiatric disorders in proband mothers with and without a prior psychiatric history by assessing...

  1. Clinical features and therapeutic management of patients admitted to Italian acute hospital psychiatric units: the PERSEO (psychiatric emergency study and epidemiology survey

    Directory of Open Access Journals (Sweden)

    Russo Federico

    2007-11-01

    Full Text Available Abstract Background The PERSEO study (psychiatric emergency study and epidemiology is a naturalistic, observational clinical survey in Italian acute hospital psychiatric units, called SPDCs (Servizio Psichiatrico Diagnosi e Cura; in English, the psychiatric service for diagnosis and management. The aims of this paper are: (i to describe the epidemiological and clinical characteristics of patients, including sociodemographic features, risk factors, life habits and psychiatric diagnoses; and (ii to assess the clinical management, subjective wellbeing and attitudes toward medications. Methods A total of 62 SPDCs distributed throughout Italy participated in the study and 2521 patients were enrolled over the 5-month study period. Results Almost half of patients (46% showed an aggressive behaviour at admission to ward, but they engaged more commonly in verbal aggression (38%, than in aggression toward other people (20%. A total of 78% of patients had a psychiatric diagnosis at admission, most frequently schizophrenia (36%, followed by depression (16% and personality disorders (14%, and no relevant changes in the diagnoses pattern were observed during hospital stay. Benzodiazepines were the most commonly prescribed drugs, regardless of diagnosis, at all time points. Overall, up to 83% of patients were treated with neuroleptic drugs and up to 27% received more than one neuroleptic either during hospital stay or at discharge. Atypical and conventional antipsychotics were equally prescribed for schizophrenia (59 vs 65% during stay and 59 vs 60% at discharge, while atypical drugs were preferred in schizoaffective psychoses (72 vs 49% during stay and 70 vs 46% at discharge and depression (41 vs 32% during stay and 44 vs 25% at discharge. Atypical neuroleptics were slightly preferred to conventional ones at hospital discharge (52 vs 44%. Polypharmacy was in general widely used. Patient attitudes toward medications were on average positive and self

  2. The Contextual Nature of Psychiatric Diagnosis

    Science.gov (United States)

    Rosenhan, David L.

    1975-01-01

    Psychiatric diagnoses are powerfully influenced by the contexts in which patients are found and the expectations of diagnosticians. The observations of Millon, Spitzer, and Weiner on Rosenhan's "On Being Sane in Insane Places" (AA 521 951) were examined for the implications they held for the meanings of sanity and insanity. (Editor/RK)

  3. Psychiatric comorbidity in gender dysphoric adolescents

    NARCIS (Netherlands)

    de Vries, A.L.C.; Doreleijers, T.A.H.; Steensma, T.D.; Cohen-Kettenis, P.T.

    2011-01-01

    Background: This study examined psychiatric comorbidity in adolescents with a gender identity disorder (GID). We focused on its relation to gender, type of GID diagnosis and eligibility for medical interventions (puberty suppression and cross-sex hormones). Methods: To ascertain DSM-IV diagnoses,

  4. [Long-term psychiatric hospitalizations].

    Science.gov (United States)

    Plancke, L; Amariei, A

    2017-02-01

    Long-term hospitalizations in psychiatry raise the question of desocialisation of the patients and the inherent costs. Individual indicators were extracted from a medical administrative database containing full-time psychiatric hospitalizations for the period 2011-2013 of people over 16 years old living in the French region of Nord-Pas-de-Calais. We calculated the proportion of people who had experienced a hospitalization with a duration of 292 days or more during the study period. A bivariate analysis was conducted, then ecological data (level of health-care offer, the deprivation index and the size of the municipalities of residence) were included into a multilevel regression model in order to identify the factors significantly related to variability of long-term hospitalization rates. Among hospitalized individuals in psychiatry, 2.6% had had at least one hospitalization of 292 days or more during the observation period; the number of days in long-term hospitalization represented 22.5% of the total of days of full-time hospitalization in psychiatry. The bivariate analysis revealed that seniority in the psychiatric system was strongly correlated with long hospitalization rates. In the multivariate analysis, the individual indicators the most related to an increased risk of long-term hospitalization were: total lack of autonomy (OR=9.0; 95% CI: 6.7-12.2; P<001); diagnoses of psychological development disorders (OR=9.7; CI95%: 4.5-20.6; P<.001); mental retardation (OR=4.5; CI95%: 2.5-8.2; P<.001): schizophrenia (OR=3.0; CI95%: 1.7-5.2; P<.001); compulsory hospitalization (OR=1.7; CI95%: 1.4-2.1; P<.001); having experienced therapeutic isolation (OR=1.8; CI95%: 1.5-2.1; P<.001). Variations of long-term hospitalization rates depending on the type of establishment were very high, but the density of hospital beds or intensity of ambulatory activity services were not significantly linked to long-term hospitalization. The inhabitants of small urban units had

  5. Brain tumors in patients primarly treated psychiatrically

    Directory of Open Access Journals (Sweden)

    Ignjatović-Ristić Dragana

    2011-01-01

    Full Text Available Introduction. Psychiatric symptoms are not rare manifestations of brain tumors. Brain tumors presented by symptoms of raised intracranial pressure, focal neurological signs, or convulsions are usually first seen by the neurologist or less frequently by the neurosurgeon in routine diagnostic procedures. On the other hand, when psychiatric symptoms are the first manifestation in “neurologically silent” brain tumors, the patients are sent to the psychiatrist for the treatment of psychiatric symptoms and brain tumors are left misdiagnosed for a long period of time. Case Report. We presented three patients with the diagnosed brain tumor where psychiatrist had been the first specialist to be consulted. In all three cases neurological examination was generally unremarkable with no focal signs or features of raised intracranial pressure. CT scan demonstrated right insular tumor in a female patient with obsessive-compulsive disorder (OCD; right parietal temporal tumor in a patient with delusions and depression and left frontal tumor in a patient with history of alcohol dependency. Conclusion. Psychiatric symptoms/disorders in patients with brain tumors are not specific enough and can have the same clinical presentation as the genuine psychiatric disorder. Therefore, we emphasize the consideration of neuroimaging in patients with abrupt beginning of psychiatric symptoms, in those with a change in mental status, or when headaches suddenly appear or in cases of treatment resistant psychiatric disorders regardless the lack of neurological symptoms.

  6. Psychiatric disorders in bone marrow transplant patients

    International Nuclear Information System (INIS)

    Khan, A.G.; Irfan, M.; Shamsi, T.S.; Hussain, M.

    2007-01-01

    To identify the psychiatric illnesses in patients with hematological/oncological disorders encountered during blood and bone marrow transplantation. All consecutive patients, aged 15 years and above, who fulfilled inclusion and exclusion criteria and underwent blood and bone marrow transplantation, were enrolled in this study. Psychiatric assessment comprised of a semi-structured interview based on Present Status Examination (PSE). The psychiatric diagnosis was made on the basis of International Classification of Diseases (ICD-10) system of classification devised by W.H.O. Eighty patients, who fulfilled the inclusion criteria, were inducted in this study. Thirty (37.5%) cases were found to have psychiatric disorders. Out of the total, 60 (75%) were males and 20 (25%) females. Adjustment disorder was the most frequent diagnosis (n=12), followed by major depression (n=7). Rest of the diagnoses made were generalized anxiety disorder, acute psychotic disorder, delirium and depressive psychosis. High psychiatric morbidity associated with blood and bone marrow transplantation was observed. It indicates the importance of psychiatric intervention during the isolation period of BMT as well as pre-transplant psychiatric assessment and counseling regarding procedure. (author)

  7. [Psychiatric manifestations of lupus erythematosus systemic and Sjogren's syndrome].

    Science.gov (United States)

    Ampélas, J F; Wattiaux, M J; Van Amerongen, A P

    2001-01-01

    . There were disturbances of memory and orientation. He felt sad and guilty about accusation of sexual abuse on his daughter. He presented typical histrionic symptoms: he had catatonic attitudes only in public areas such as the corridors. Cerebral computer tomography and electroencephalogram were normal. There was no biological abnormality. Signs of confusion rapidly disappeared. He felt better after reintroduction of fluoxetine 40 mg/day. Diagnosis was non-specified depressive disorder, but this episode could be retrospectively seen as delirium. After being hospitalized on these four occasions in one year in our psychiatric department, the diagnosis of his systemic disease was revised by rheumatologists. The patient was diagnosed as suffering from systemic lupus erythematosus associated with secondary Sjögren's syndrome. From September 1997, he received cyclophosphamide 2 g intraveinously per month during 6 months. His vision improved dramatically. His ocular dryness became milder. His mood is now stable. He has not suffered from hallucinations or delusion since. Psychiatric disorders in SLE--During the course of SLE, the occurrence of psychiatric manifestations varies widely from 5 to 83%. They include psychotic disorders, major depressive disorders, subtle cognitive disorders and personality disorders of histrionic type. Etiopathogenic hypothesis are: direct activity of the disease on the central nervous system by autoantibodies (antiphospholipide and antiribosome P autoantibodies) (18, 19) or cytokines (interleukin 2, interleukin 6, alpha interferon) (38, 59), side-effects of glucocorticosteroids and hydroxychloroquine (16) or anxious reaction to a chronic and potentially lethal illness (43, 54). Nevertheless, immunologic and cerebral imagery research suggests that psychiatric disorders are related to vasculitis and non-inflammatory vasculopathy of the small cerebral blood vessels. The management of the patients should include treatment of the disease itself and

  8. Clinical Overlap and Psychiatric Comorbidity in Autism Spectrum Disorder in Adulthood: A Case Report

    Directory of Open Access Journals (Sweden)

    João Picoito

    2018-01-01

    Full Text Available Background: Autism Spectrum Disorder (ASD is an early neurodevelopmental disorder that accompanies the individual throughout life. There is a significant clinical overlap of ASD with other psychiatric disorders including personality disorders, psychotic disorders, obsessive-compulsive disorder and depression. Additionally, the presence of high rates of psychiatric comorbidity, often with atypical presentations, delays the ASD diagnosis and makes it more difficult to manage. Aims: To illustrate the complexity of ASD diagnosis and approach in adults. Methods: Report of a clinical case and review of the literature. Results and Conclusion: This paper presents the case of a 46-year-old patient, with ASD, with a long history of interpersonal difficulties and psychiatric symptomatology. Over the years, different diagnoses have been made, particularly schizoid and schizotypal personality disorders, psychosis not otherwise specified and paranoid schizophrenia, which led to poor adherence to treatment, and prevented a full understanding of the patient’s clinical presentation and lifelong struggles.

  9. Psychiatric Characteristics of the Cardiac Outpatients with Chest Pain.

    Science.gov (United States)

    Lee, Jea-Geun; Choi, Joon Hyouk; Kim, Song-Yi; Kim, Ki-Seok; Joo, Seung-Jae

    2016-03-01

    A cardiologist's evaluation of psychiatric symptoms in patients with chest pain is rare. This study aimed to determine the psychiatric characteristics of patients with and without coronary artery disease (CAD) and explore their relationship with the intensity of chest pain. Out of 139 consecutive patients referred to the cardiology outpatient department, 31 with atypical chest pain (heartburn, acid regurgitation, dyspnea, and palpitation) were excluded and 108 were enrolled for the present study. The enrolled patients underwent complete numerical rating scale of chest pain and the symptom checklist for minor psychiatric disorders at the time of first outpatient visit. The non-CAD group consisted of patients with a normal stress test, coronary computed tomography angiogram, or coronary angiogram, and the CAD group included those with an abnormal coronary angiogram. Nineteen patients (17.6%) were diagnosed with CAD. No differences in the psychiatric characteristics were observed between the groups. "Feeling tense", "self-reproach", and "trouble falling asleep" were more frequently observed in the non-CAD (p=0.007; p=0.046; p=0.044) group. In a multiple linear regression analysis with a stepwise selection, somatization without chest pain in the non-CAD group and hypochondriasis in the CAD group were linearly associated with the intensity of chest pain (β=0.108, R(2)=0.092, p=0.004; β= -0.525, R(2)=0.290, p=0.010). No differences in psychiatric characteristics were observed between the groups. The intensity of chest pain was linearly associated with somatization without chest pain in the non-CAD group and inversely linearly associated with hypochondriasis in the CAD group.

  10. Asthma and psychiatric disorders in male army recruits and soldiers.

    Science.gov (United States)

    Lev-Tzion, Raffi; Friedman, Tal; Shochat, Tzippy; Gazala, Eliyahu; Wohl, Yonit

    2007-05-01

    Numerous studies have shown an association between asthma and mental disorders. While elevated rates of asthma have been noted among psychiatric patients with anxiety disorders and post-traumatic stress disorder, several studies have found elevated rates of mental disorders among asthma patients. Such studies, however, have generally relied upon questionnaires and assessment by non-specialist physicians to diagnose mental disorders and asthma. To examine a possible association between asthma and psychiatric diagnoses in Israeli military recruits and soldiers. In this cross-sectional study we compared the prevalence of mental diagnoses in asthmatic recruits and soldiers with that in non-asthmatic recruits and soldiers. A total of 195,903 recruits and soldiers were examined by Israel Defense Forces recruiting offices and fitness boards. Diagnoses of asthma were based on a pulmonologist's diagnosis, including spirometry at rest and exercise testing as indicated; diagnoses of mental disorders were based on examination by a psychiatrist. The prevalence of asthma was found to be 7.8% (current) and 9.8% (lifetime). The prevalence of mental disorders was 13.4%. Current asthma was associated with an increased likelihood of any mental disorder (OR = 1.20, 95% Cl = 1.15-1.26), and specifically with mood and anxiety disorders (1.31, 1.19-1.46), introvert personality disorders (1.20, 1.12-1.28) and adjustment disorder (1.43, 1.26-1.62). Lifetime asthma was associated with an increased likelihood of the same disorders, but the association was not as powerful. The results validate the previously documented association between asthma and mental disorders, using a sample of unprecedented size and improved methodology. A multidisciplinary approach to asthma that incorporates mental health professionals in the treatment of poorly controlled asthma and perhaps of asthma in general is recommended.

  11. Frequency of Different Psychiatric Disorders in Patients With Functional Bowel Disorders: A Short Report

    Directory of Open Access Journals (Sweden)

    Fakhraei

    2015-06-01

    Full Text Available Background Functional gastrointestinal (GI disorders are very common and many patients with such disorders are not satisfied with treatment outcomes. Psychological aspects of functional disorders need special attention that may play an important role in patient management. Objectives In this study, psychology evaluation was performed for a population of patients with functional bowel disorders. Patients and Methods One hundred patients with functional bowel disorders including 50 patients with irritable bowel syndrome (IBS referred to GI clinics were candidates for psychiatry evaluation; of those 60 patients completed the study. Psychiatric disorders were diagnosed using a structured clinical interview based on diagnostic and statistical manual of mental disorders IV (DSM IV. Results Of 60 patients with functional bowel disorders (including 39 IBS, 51 (85% were diagnosed with at least one psychiatry disorder. The most common disorders were dysthymia (25% and obsessive-compulsive disorder (20%. There was no significant difference between IBS patients and other functional bowel disorders regarding the prevalence of psychiatric disorders. Conclusions Psychiatric disorders are very prevalent among patients with functional bowel disorders. Prompt diagnosis and appropriate management of associated psychiatric disorders along with GI targeted treatments may lead to a better outcome in these patients.

  12. Results of the psychiatric, select-out evaluation of US astronaut applications

    Science.gov (United States)

    Faulk, D. M.; Santy, P. A.; Holland, A. W.; Marsh, R.

    1992-01-01

    The psychiatric exclusion criteria for astronauts are based on NASA Medical Psychiatric Standards for space flight. Until recently, there were no standardized methods to evaluate disqualifying psychopathology in astronaut applicants. Method: One hundred and six astronaut applicants who had passed the intitial screening were evaluated for Axis 1 and Axis 2 DSM-3-R diagnoses using the NASA structured psychiatric interview. The interview consisted of three parts: (1) an unstructured portion for obtaining biographical and historical information, (2) the schedule for effective disorders-lifetime version (SASDL), specially modified to include all disqualifying Axis 1 mental disorders; and, (3) the personality assessment schedule (PAS) also modified to evaluate for Axis 2 disorders. Results: Nine of 106 candidates (8.5 percent) met diagnostic criteria for six Axis 1 disorders (including V code) or Axis 2 disorders. Two of these disorders were disqualifying for the applicants. 'Near' diagnoses (where applicants met at least 50 percent of the listed criteria) were assessed to demonstrate that clinicians using the interview were able to overcome applicants' reluctance to report symptomatomatology. Conclusion: The use of the NASA structured interview was effective in identifying past and present psychopathology in a group of highly motivated astronaut applicants. This was the first time a structured psychiatric interview had been used in such a setting for this purpose.

  13. Syphilis sero-positivity in recently admitted and long-term psychiatric ...

    African Journals Online (AJOL)

    Background. Syphilis research has neglected the prevalence of the disease among psychiatric patients, and traditional syphilis screening has been reported as inadequate. Objectives. (i) To assess the syphilis prevalence among psychiatric patients; (ii) to compare psychiatric diagnoses of syphilis-infected and -uninfected ...

  14. Stability of Comorbid Psychiatric Diagnosis among Youths in Treatment and Aftercare for Alcohol Use Disorders

    Science.gov (United States)

    Hawke, Josephine M.; Kaminer, Yifrah; Burke, Rebecca; Burleson, Joseph A.

    2008-01-01

    Objectives: To examine the stability of comorbid psychiatric diagnoses among a sample of 50 adolescents in cognitive-behaviorally-based treatment for alcohol and other substance use disorders (AOSUD). Methods: A standardized psychiatric interview was administered at baseline and 12 month later to obtain current comorbid psychiatric disorders. Chi…

  15. Psychiatric disorders and symptoms severity in preschool children with atopic eczema.

    Science.gov (United States)

    Catal, F; Topal, E; Soylu, N; Ozel Ozcan, O; Celiksoy, M H; Babayiğit, A; Karakoç, H T E; Erge, D; Sancak, R

    2016-01-01

    To compare with a control group the frequency of psychiatric disorders and severity of psychiatric symptoms in preschool children with atopic eczema. The study included children between the ages of 3-5 who were diagnosed to have atopic eczema. The parents of the children with atopic eczema were interviewed in person and were asked to fill in "The Early Childhood Inventory-4" form. This form assesses the psychiatric disorders and symptoms severity in children between the ages of 3-5. The atopic eczema group included 80 patients (38 male, 42 female) with a mean age of 48.4 ± 15.7 months and the control group included 74 patients (41 male, 33 female) with a mean age of 49.9 ± 15.19 months. It was established that 68.8% of the group with atopic eczema received at least one psychiatric diagnosis. Between the psychiatric disorders, ADHD (Odds ratio: 2.57, 95% CI: 1.049-6.298, p=0.035), enuresis and encopresis (Odds ratio: 2.39, 95% CI: 1.121-5.097, p=0.022) and attachment disorder (Odds ratio: 2.03, 95% CI: 1.046-3.953, p=0.035) were found to be significantly higher when compared with the healthy control group. When the groups were compared in terms of psychiatric symptom severity scores calculated by using ECI-4, ADHD severity (p=0.043), conduct disorder severity (p=0.001), anxiety disorders severity (p<0.001), eating disorders severity (p=0.011) and tic disorder severity (p=0.01) were found to be higher in the atopic eczema group. Psychiatric illnesses are frequent in preschool children with atopic eczema. Copyright © 2015 SEICAP. Published by Elsevier Espana. All rights reserved.

  16. Psychiatric and family functioning in children with leukemia and their parents

    Directory of Open Access Journals (Sweden)

    Goodarzi A

    1999-07-01

    Full Text Available The present study reports data from a cross-sectional investigation of the psychiatric and psychosocial functioning of 55 children diagnosed with acute lymphocytic leukemia and their families at three points in time: diagnosis (newly diagnosed, 1 year postdiagnosis, and 1 year after the completion of chemotherapy (offtherapy. Results reveal minimal psychopathology in these children and their parents based on self-and informantreports and structured diagnostic interviews. These families appear to be functioning adequately and report more family cohesiveness and marital satisfaction after chemotherapy was completed. Coping strategies commonly used by children and their parents include problem solving, a positive outlook, and good communication. Implications for psychiatric consultation are presented.

  17. Illness perspectives of Thais diagnosed with schizophrenia.

    Science.gov (United States)

    Sanseeha, Ladda; Chontawan, Ratanawadee; Sethabouppha, Hunsa; Disayavanish, Chamlong; Turale, Sue

    2009-09-01

    This study explored the perceptions of 18 people diagnosed with schizophrenia from 1-10 years to uncover how they perceived themselves and their illness. It also involved 12 family members who added their perceptions. The data were collected using in-depth interviews, reflective journaling, and observations. The data were analyzed through the lens of Heidegger's hermeneutic phenomenology. Four themes emerged: perceptions of mental illness, perceptions of the causes of illness, perceptions of discrimination, and attempting to live with schizophrenia. The findings included strong underlying cultural and spiritual beliefs, and attitudes unique to the Thai participants, including the causation of schizophrenia by supernatural powers, black magic, and bad karma stemming from past deeds. Understanding the perceptions of the participants might help health-care providers to be more sensitive to those living with schizophrenia in Thailand and elsewhere. In particular, the findings could be useful in informing psychiatric careproviders about developing better caring systems for clients diagnosed with schizophrenia. This should help the sufferers of schizophrenia to live their lives to their own satisfaction and as normally as possible.

  18. Long-term follow-up of individuals undergoing sex reassignment surgery: Psychiatric morbidity and mortality

    DEFF Research Database (Denmark)

    Simonsen, Rikke Kildevæld; Giraldi, Annamaria; Kristensen, Ellids

    2016-01-01

    the period of 1978–2010. Method: Psychiatric morbidity and mortality were identified by data from the Danish Psychiatric Central Research Register and the Cause of Death Register through a retrospective register study of 104 sex-reassigned individuals. Results: Overall, 27.9% of the sample were registered...... as deceased post-SRS with an average age of death of 53.5 years. Conclusions: No significant difference in psychiatric morbidity or mortality was found between male to female and female to male (FtM) save for the total number of psychiatric diagnoses where FtM held a significantly higher number of psychiatric...... diagnoses overall. Despite the over-representation of psychiatric diagnoses both pre- and post-SRS the study found that only a relatively limited number of individuals had received diagnoses both prior to and after SRS. This suggests that generally SRS may reduce psychological morbidity for some individuals...

  19. Utility of CSF biomarkers in psychiatric disorders: a national multicentre prospective study.

    Science.gov (United States)

    Paquet, Claire; Magnin, Eloi; Wallon, David; Troussière, Anne-Cécile; Dumurgier, Julien; Jager, Alain; Bellivier, Frank; Bouaziz-Amar, Elodie; Blanc, Frédéric; Beaufils, Emilie; Miguet-Alfonsi, Carole; Quillard, Muriel; Schraen, Susanna; Pasquier, Florence; Hannequin, Didier; Robert, Philippe; Hugon, Jacques; Mouton-Liger, François

    2016-06-13

    Affective and psychotic disorders are mental or behavioural patterns resulting in an inability to cope with life's ordinary demands and routines. These conditions can be a prodromal event of Alzheimer's disease (AD). The prevalence of underlying AD lesions in psychiatric diseases is unknown, and it would be helpful to determine them in patients. AD cerebrospinal fluid (CSF) biomarkers (amyloid β, tau and phosphorylated tau) have high diagnostic accuracy, both for AD with dementia and to predict incipient AD (mild cognitive impairment due to AD), and they are sometimes used to discriminate psychiatric diseases from AD. Our objective in the present study was to evaluate the clinical utility of CSF biomarkers in a group of patients with psychiatric disease as the main diagnosis. In a multicentre prospective study, clinicians filled out an anonymous questionnaire about all of their patients who had undergone CSF biomarker evaluation. Before and after CSF biomarker results were obtained, clinicians provided a diagnosis with their level of confidence and information about the treatment. We included patients with a psychiatric disorder as the initial diagnosis. In a second part of the study conducted retrospectively in a followed subgroup, clinicians detailed the psychiatric history and we classified patients into three categories: (1) psychiatric symptoms associated with AD, (2) dual diagnosis and (3) cognitive decline not linked to a neurodegenerative disorder. Of 957 patients, 69 had an initial diagnosis of a psychiatric disorder. Among these 69 patients, 14 (20.2 %) had a CSF AD profile, 5 (7.2 %) presented with an intermediate CSF profile and 50 (72.4 %) had a non-AD CSF profile. Ultimately, 13 (18.8 %) patients were diagnosed with AD. We show that in the AD group psychiatric symptoms occurred later and the delay between the first psychiatric symptoms and the cognitive decline was shorter. This study revealed that about 20 % of patients with a primary

  20. The use of EEG Biofeedback/Neurofeedback in psychiatric rehabilitation.

    Science.gov (United States)

    Markiewcz, Renata

    2017-12-30

    The aim of the systematic review was to evaluate the use of EEG Biofeedback/Neurofeedback in patients treated for mental disorders. The review covered publications analyzing influences and effects of therapy in patients receiving psychiatric treatment based on EEG Biofeedback/Neurofeedback. Selection of publications was made by searching PubMed and Scopus databases. 328 records concerning applications of the presented method were identified in total, including 84 records for patients diagnosed with mental disorders. The analysis of studies indicates that EEG Biofeedback/Neurofeedback is used for treatment of neurological, somatic and mental disorders. Its psychiatric applications for clinically diagnosed disorders include treatmentof depression, anorexia, dyslexia, dysgraphia, ADD, ADHD, schizophrenia, abuse of substances, neuroses, PTSD, and Alzheimer's disease. Research results imply that the neuromodulating effect of the therapy positively influences cognitive processes, mood, and anxiety levels. Positive effects of EEG Biofeedback confirm usefulness of this method as a main or auxiliary method in treatment of people with mental disorders. On the basis of conducted studies, it is worthwhile to consider inclusion of this method into the comprehensive neurorehabilitation activities.

  1. Getting Diagnosed

    Science.gov (United States)

    ... heart rhythm. An eye examination , including a “slit lamp” evaluation to see if the lenses in your ... is Marfan Syndrome? If you suspect Marfan syndrome Day-to-Day CALL OUR HELP CENTER: 800-8- ...

  2. Dual psychiatric diagnosis and substance abuse in pathological gamblers: a preliminary gender comparison study.

    Science.gov (United States)

    Dannon, Pinhas N; Lowengrub, Katherine; Shalgi, Bosmat; Sasson, Marina; Tuson, Lali; Saphir, Yafa; Kotler, Moshe

    2006-01-01

    Pathological Gambling (PG) is a highly prevalent and disabling impulse control disorder. Recent studies have consistently shown that PG patients have responded well to treatment with SSRI's, mood stabilizers, and opioid antagonists. These findings have supported the observation that PG is strongly associated with both mood and anxiety disorders as well as substance abuse. The aim of the study is to evaluate the comorbid psychiatric diagnoses in our sample. Thirty-six female, and forty-two male PG's were enrolled in our study. A comprehensive psychiatric diagnostic evaluation was performed on all patients, and patients were screened for symptoms of depression and anxiety using the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, the Yale-Brown Obsessive Compulsive Scale, and the Frost Multidimensional Perfectionism Scale. In addition, the patients completed self-report questionnaires about their demographic status and substance abuse. The majority of patients were married with full or part-time employment. The study results demonstrated that PG in males is correlated with substance and alcohol abuse. Diagnoses, which were prevalent among our cohort of female PG's included major depression, affective disorders, anxiety disorders, and eating disorders. In our sample of PGs, the men and women had different patterns of psychiatric comorbidity. The different patterns of psychiatric comorbidity seen in our male versus female PG's raises the question of whether the underlying etiopathology in PG may differ according to gender.

  3. [Personality disorders and psychiatric morbidity in adolescent anorexia nervosa. Results of a prospective 10 year catamnesis].

    Science.gov (United States)

    Müller, B; Herpertz, S; Heussen, N; Neudörfl, A; Wewetzer, C; Remschmidt, H; Herpertz-Dahlmann, B

    2000-05-01

    The aim of the current prospective study was to examine at regular intervals the course of the eating disorder symptoms and the psychiatric (co-) morbidity including personality disorders among juvenile patients who fulfilled the DSM-III-R criteria for anorexia nervosa. Ten years after release from hospital all 39 patients (100%), as well as a control group parallelized for age, gender and occupational status were personally followed-up. Symptoms of eating disorders were documented by means of the Standardized Interview for Anorexia and Bulimia nervosa (SIAB, Fichter et al., 1991), the Composite International Diagnostic Interview (WHO, 1990) was applied to diagnose psychiatric (co-) morbidity, and the Structured Clinical Interview (SKID-II, Spitzer et al., 1993) to assess personality disorders. Compared to the control group, at the time of follow-up a significantly greater number of patients were suffering from a psychiatric disorder, primarily an anxiety disorder, an affective disorder or from drug, respectively alcohol abuse. Personality disorders, chiefly anxious-avoidant types on the DSM-III-R were diagnosed among almost one-fourth of the patients. Our findings indicate that anorexia nervosa is not a developmental disorder limited to puberty but a disorder associated both cross-sectionally as well as longitudinally with other psychiatric disorders.

  4. [Prescription drug abuse in elderly psychiatric patients].

    Science.gov (United States)

    Wetterling, Tilman; Schneider, Barbara

    2012-08-01

    Due to demographic changes there will be a fraction of elderly patients with substance use disorders. However, only a few data have been published about elderly abusers of prescription drugs. Since substance abuse is frequently comorbid with psychiatric disorders, treatment in a psychiatric hospital is often needed. In this explorative study elderly people with prescription drug abuse who required psychiatric inpatient treatment should be characterized. This study was part of the gerontopsychiatry study Berlin (Gepsy-B), an investigation of the data of all older inpatients (≥ 65 years) admitted to a psychiatric hospital within a period of 3 years. Among 1266 documented admissions in 110 cases (8.7 %) (mean age: 75.7 ± 7.1 years) prescription drug abuse, mostly of benzodiazepines was diagnosed. Females showed benzodiazepine abuse more often than males. In only a small proportion of the cases the reason for admission was withdrawal of prescribed drugs. 85.5 % suffered from psychiatric comorbidity, mostly depression. As risk factors for abuse depressive symptoms (OR: 3.32) as well as concurrent nicotine (OR: 2.69) or alcohol abuse (OR: 2.14) were calculated. Psychiatric inpatient treatment was primarily not necessary because of prescription drug abuse but because of other psychopathological symptoms. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Early weaning and hospitalization with alcohol-related diagnoses in adult life

    DEFF Research Database (Denmark)

    Sørensen, Holger J; Mortensen, Erik Lykke; Reinisch, June M

    2006-01-01

    OBJECTIVE: This study attempted to determine whether lack of breast-feeding or a short duration of breast-feeding during infancy is associated with an elevated risk of hospitalization with alcohol-related diagnoses in adult life. METHOD: The study was a prospective longitudinal birth cohort design...... conducted in a sample of 6,562 men and women, all of whom were born in Copenhagen, Denmark, between October 1959 and December 1961. The sample was divided into two categories based on duration of breast-feeding, as assessed by a physician interview with mothers at a 1-year examination. Psychiatric...... hospitalizations with alcohol-related diagnoses according to ICD-8 or ICD-10 were identified in the Danish Psychiatric Central Register in 1999. Nine potential confounders were included as covariates: gender of the cohort member, maternal age, parental social status, maternal prenatal smoking, unwanted pregnancy...

  6. Early weaning and hospitalization with alcohol-related diagnoses in adult life

    DEFF Research Database (Denmark)

    Sørensen, Holger J; Mortensen, Erik L; Reinisch, June M

    2006-01-01

    hospitalizations with alcohol-related diagnoses according to ICD-8 or ICD-10 were identified in the Danish Psychiatric Central Register in 1999. Nine potential confounders were included as covariates: gender of the cohort member, maternal age, parental social status, maternal prenatal smoking, unwanted pregnancy...... of early weaning was 1.47. Elevated relative risks were also associated with maternal smoking during pregnancy (1.52) and unwanted pregnancy status (1.59). Other independent predictors were male gender, maternal psychiatric hospitalization with alcohol-related diagnosis, and low parental social status......OBJECTIVE: This study attempted to determine whether lack of breast-feeding or a short duration of breast-feeding during infancy is associated with an elevated risk of hospitalization with alcohol-related diagnoses in adult life. METHOD: The study was a prospective longitudinal birth cohort design...

  7. Cushing Disease Presenting as Primary Psychiatric Illness: A Case Report and Literature Review.

    Science.gov (United States)

    Rasmussen, Sean A; Rosebush, Patricia I; Smyth, Harley S; Mazurek, Michael F

    2015-11-01

    We report the case of a woman with long-standing refractory depression and psychotic features who was eventually diagnosed with Cushing disease. After surgical treatment of a pituitary adenoma, she experienced gradual psychiatric recovery and was eventually able to discontinue all psychotropic medication. We review the psychiatric components of Cushing disease, implications of psychiatric illnesses for the treatment and prognosis of Cushing disease, and potential pathophysiological mechanisms linking glucocorticoid excess to psychiatric illness.

  8. Exposure to violence: associations with psychiatric disorders in Brazilian youth

    Directory of Open Access Journals (Sweden)

    Thiago M. Fidalgo

    2018-02-01

    Full Text Available Objective: The effects of exposure to violent events in adolescence have not been sufficiently studied in middle-income countries such as Brazil. The aims of this study are to investigate the prevalence of psychiatric disorders among 12-year-olds in two neighborhoods with different socioeconomic status (SES levels in São Paulo and to examine the influence of previous violent events and SES on the prevalence of psychiatric disorders. Methods: Students from nine public schools in two neighborhoods of São Paulo were recruited. Students and parents answered questions about demographic characteristics, SES, urbanicity and violent experiences. All participants completed the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS to obtain DSM-IV diagnoses. The data were analyzed using weighted logistic regression with neighborhood stratification after adjusting for neighborhood characteristics, gender, SES and previous traumatic events. Results: The sample included 180 individuals, of whom 61.3% were from low SES and 39.3% had experienced a traumatic event. The weighted prevalence of psychiatric disorders was 21.7%. Having experienced a traumatic event and having low SES were associated with having an internalizing (adjusted OR = 5.46; 2.17-13.74 or externalizing disorder (adjusted OR = 4.33; 1.85-10.15. Conclusions: Investment in reducing SES inequalities and preventing violent events during childhood may improve the mental health of youths from low SES backgrounds.

  9. 28 CFR 551.114 - Medical, psychiatric and psychological.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Medical, psychiatric and psychological... MANAGEMENT MISCELLANEOUS Pretrial Inmates § 551.114 Medical, psychiatric and psychological. (a) Staff shall provide the pretrial inmate with the same level of basic medical (including dental), psychiatric, and...

  10. Job satisfaction in psychiatric nursing.

    Science.gov (United States)

    Ward, M; Cowman, S

    2007-08-01

    In recent years, mental health services across Europe have undergone major organizational change with a move from institutional to community care. In such a context, the impact of change on the job satisfaction of psychiatric nurses has received little attention in the literature. This paper reports on the job satisfaction of psychiatric nurses and data were collected in 2003. The population of qualified psychiatric nurses (n = 800) working in a defined geographical health board area was surveyed. Methodological triangulation with a between-methods approach was used in the study. Data were collected on job satisfaction using a questionnaire adopted from the Occupational Stress Indicator. A response rate of 346 (43%) was obtained. Focus groups were used to collect qualitative data. Factors influencing levels of job satisfaction predominantly related to the nurses work location. Other factors influencing job satisfaction included choice of work location, work routine, off duty/staff allocation arrangements, teamwork and working environment. The results of the study highlight to employers of psychiatric nurses the importance of work location, including the value of facilitating staff with choices in their working environment, which may influence the recruitment and retention of nurses in mental health services.

  11. Predictors of psychiatric boarding in the pediatric emergency department: implications for emergency care.

    Science.gov (United States)

    Wharff, Elizabeth A; Ginnis, Katherine B; Ross, Abigail M; Blood, Emily A

    2011-06-01

    Patients who present to the emergency department (ED) and require psychiatric hospitalization may wait in the ED or be admitted to a medical service because there are no available inpatient psychiatric beds. These patients are psychiatric "boarders." This study describes the extent of the boarder problem in a large, urban pediatric ED, compares characteristics of psychiatrically hospitalized patients with boarders, and compares predictors of boarding in 2 ED patient cohorts. A retrospective cohort study was conducted in 2007-2008. The main outcome measure was placement into a psychiatric facility or boarding. Predictors of boarding in the present analysis were compared with predictors from a similar study conducted in the same ED in 1999-2000. Of 461 ED patient encounters requiring psychiatric admission, 157 (34.1%) boarded. Mean and median boarding duration for the sample were 22.7(SD, 8.08) and 21.18 hours, respectively. Univariate generalized estimating equations demonstrated increased boarding odds for patients carrying Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnoses of autism, mental retardation, and/or developmental delay (P = 0.01), presenting during the weekend (P = 0.03) or presenting during months without school vacation (P = 0.02). Suicidal ideation (SI) significantly predicted boarding status, with increased likelihood of boarding for severe SI (P = 0.02). Age, race, insurance status, and homicidal ideation did not significantly predict boarding in the 2007-2008 patient cohort, although they did in the earlier study. Systemic factors and SI predicted boarding status in both cohorts. Suicidal patients continue to board. Limits within the system, including timing of ED presentation and a dearth of specialized services, still exist, elevating the risk of boarding for some populations. Implications for pediatric ED psychiatric care delivery are discussed.

  12. Psychiatric disorders of patients seeking obesity treatment

    Directory of Open Access Journals (Sweden)

    Lin Hung-Yen

    2013-01-01

    Full Text Available Abstract Background Obese and overweight people have a higher risk of both chronic physical illness and mental illness. Obesity is reported to be positively associated with psychiatric disorders, especially in people who seek obesity treatment. At the same time, obesity treatment may be influenced by psychological factors or personality characteristics. This study aimed to understand the prevalence of mental disorders among ethnic Chinese who sought obesity treatment. Methods Subjects were retrospectively recruited from an obesity treatment center in Taiwan. The obesity treatments included bariatric surgery and non-surgery treatment. All subjects underwent a standardized clinical evaluation with two questionnaires and a psychiatric referral when needed. The psychiatric diagnosis was made thorough psychiatric clinic interviews using the SCID. A total of 841 patients were recruited. We compared the difference in psychiatric disorder prevalence between patients with surgical and non-surgical treatment. Results Of the 841 patients, 42% had at least one psychiatric disorder. Mood disorders, anxiety disorders and eating disorders were the most prevalent categories of psychiatric disorders. Females had more mood disorders and eating disorders than males. The surgical group had more binge-eating disorder, adjustment disorder, and sleep disorders than the non-surgical group. Conclusion A high prevalence of psychiatric disorders was found among ethnic Chinese seeking obesity treatment. This is consistent with study results in the US and Europe.

  13. Police-registered offenses and psychiatric disorders among young males : the Finnish "From a boy to a man" birth cohort study.

    Science.gov (United States)

    Elonheimo, Henrik; Niemelä, Solja; Parkkola, Kai; Multimäki, Petteri; Helenius, Hans; Nuutila, Ari-Matti; Sourander, Andre

    2007-06-01

    To study associations between crime and psychiatric disorders among adolescent males in a representative population-based cohort study. The sample includes 2,712 Finnish boys born in 1981. Information on criminality consists of offenses registered in the Finnish National Police Register 1998-2001. Crime was classified according to frequency and type (drug, violent, property, traffic, and drunk driving offenses). Information on psychiatric diagnoses between 1999 and 2004 was collected from the Finnish National Military Register. Of the 2,712 boys, 22% had a crime registration during the 4-year period, and 10% had at least one psychiatric disorder according to the Military Register. Those with psychiatric disorders accounted for 49% of all crimes. Of those with more than five crimes (n = 98), 59% had psychiatric diagnoses. After adjusting for other crime types and childhood socio-economic status, property crime was independently associated with several diagnoses: antisocial personality (APD), substance use (SUD), psychotic, anxiety, and adjustment disorders. Drug offending was independently associated with APD, SUD, and psychotic disorder, and traffic offenses with APD. Youth crime is predominantly associated with antisocial personality and substance use disorders. Crime prevention efforts should focus on boys showing a risk for antisocial and substance use problems. In particular, property, drug, and repeat offenders need mental health and substance use assessment. There is a need to develop integrated mental health and substance use treatment services for young offenders within or alongside the criminal justice system.

  14. Psychiatric Diagnoses of Self-Reported Child Abusers.

    Science.gov (United States)

    Dinwiddie, Stephen H.; Bucholz, Kathleen K.

    1993-01-01

    Subjects who self-reported episodes of abusing a child were compared to those without a history of child battery. It was concluded that self-identified child abusers have increased lifetime rates of antisocial personality disorder, alcoholism, and depression. (DB)

  15. The Experience of Being Diagnosed with a Psychiatric Disorder ...

    African Journals Online (AJOL)

    denise

    intersubjectivity', the overarching aim of this article is to provide an accurate illumination of the experience of ... lonely, misunderstood and viewed as somehow defective, disabled and wrong ..... from within the scientific paradigm as discernible.

  16. Diagnosing ADHD in Danish primary school children

    DEFF Research Database (Denmark)

    Tegtmejer, Thyge; Hjörne, Eva; Säljö, Roger

    2018-01-01

    This study of institutional categorization reports an investigation of the practices, procedures and assumptions of psychiatric staff members when diagnosing ADHD. The main data upon which the study is based consist of transcribed audio recordings of meetings in the psychiatric clinic. Here...... children referred from primary schools on the suspicion of ADHD are attended to. The tools and procedures for gathering information are shown to produce decontextualized and individualizing representations of children’s conduct. The evaluation against a number of norms is found to be central. Finally...

  17. A comprehensive psychiatric service

    DEFF Research Database (Denmark)

    Wang, A G

    1984-01-01

    A comprehensive psychiatric service was established in 1969 in the Faroe Islands. This service was created as a department of a general hospital. The spheres covered by this department, operating in the midst of the community were: acute and chronic patients, a liaison-psychiatric service...

  18. Behavioural and psychiatric symptoms in cognitive neurology.

    Science.gov (United States)

    Robles Bayón, A; Gude Sampedro, F

    2017-03-01

    Behavioural and psychiatric symptoms (BPS) are frequent in neurological patients, contribute to disability, and decrease quality of life. We recorded BPS prevalence and type, as well as any associations with specific diagnoses, brain regions, and treatments, in consecutive outpatients examined in a cognitive neurology clinic. A retrospective analysis of 843 consecutive patients was performed, including a review of BPS, diagnosis, sensory impairment, lesion topography (neuroimaging), and treatment. The total sample was considered, and the cognitive impairment (CI) group (n=607) was compared to the non-CI group. BPS was present in 59.9% of the patients (61.3% in the CI group, 56.4% in the non-CI group). One BPS was present in 31.1%, two in 17.4%, and three or more in 11.4%. BPS, especially depression and anxiety, are more frequent in women than in men. Psychotic and behavioural symptoms predominate in subjects aged 65 and older, and anxiety in those younger than 65. Psychotic symptoms appear more often in patients with sensory impairment. Psychotic and behavioural symptoms are more prevalent in patients with degenerative dementia; depression and anxiety in those who suffer a psychiatric disease or adverse effects of substances; emotional lability in individuals with a metabolic or hormonal disorder; hypochondria in those with a pain syndrome; and irritability in subjects with chronic hypoxia. Behavioural symptoms are more frequent in patients with anomalies in the frontal or right temporal or parietal lobes, and antipsychotics constitute the first line of treatment. Leaving standard treatments aside, associations were observed between dysthymia and opioid analgesics, betahistine and statins, and between psychotic symptoms and levodopa, piracetam, and vasodilators. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Psychiatric comorbidity and its impact on mortality in patients who attempted suicide by paraquat poisoning during 2000-2010.

    Directory of Open Access Journals (Sweden)

    Chemin Lin

    Full Text Available Paraquat poisoning is a lethal method of suicide used around the world. Although restricting its accessibility had been widely discussed, the underlying psychopathological mechanism of paraquat self-poisoning and its association with mortality have not yet been explicitly evaluated.We included all patients admitted to a tertiary general hospital in Taiwan between 2000 and 2010 following a suicide attempt by paraquat self-administration. Diagnoses were made upon psychiatric consultation based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV criteria. The risk of mortality was calculated by logistic regression with various psychiatric or medical covariates.The consultation-liaison psychiatry team assessed 157 patients who attempted suicide by paraquat poisoning. Mood disorders (54.0%, including dysthymic (26.7% and major depressive disorders (24.7%, were the most common psychiatric diagnoses among the self-poisoning patients. Among those who attempted suicide, 87 patients (58.0% died and dysthymic disorder (OR = 5.58, 95% CI: 1.13-27.69; p < 0.05 significantly increased the mortality risk after adjustment for relevant medical variables, including age, gender, severity index of paraquat poisoning (SIPP, and risk for respiratory failure.Awareness of comorbid psychiatric illnesses, especially dysthymic disorder, is vital in the prevention and treatment of suicide by paraquat poisoning.

  20. Association between childhood abuse and psychiatric morbidities among hospitalized patients

    Directory of Open Access Journals (Sweden)

    Kshirod Kumar Mishra

    2016-01-01

    Full Text Available Background: Childhood abuse has been linked with increased risk of adult psychiatric disorders including major depression, substance abuse, anxiety disorders, posttraumatic stress disorder, and personality disorders. However, only a few from India attempted to study long-term consequences of childhood abuse. Our study aimed to understand the role of physical, sexual, and emotional abuse along with psychiatric co-morbidities in hospitalized patients. Materials and Methods: Patients admitted to psychiatric inpatient services in the age group of 14-45 years for the 1 st time were evaluated for a history of physical, sexual, and emotional abuse on the basis of retrospective chart review. Semi-structured Performa was used to evaluate the patient with a history of child abuse, and they were diagnosed according to International Classification of Diseases-10 diagnostic criteria. Result: The prevalence of child abuse in our inpatient services was 43.29%; emotional abuse (61.9% was most commonly reported among patient followed by physical (21.43% and sexual abuse (16.67%. We observed a significant difference in terms of length of hospital stay between abuse (10.29 ± 6.01 days and nonabuse group (5.90 ± 2.43 days (t = 4.902, df = 95, P < 0.0001. The boys experienced physical abuse at a younger age (7.43 ± 2.50 years than girls (13.50 ± 0.70 years. The sexual abuse and emotional abuse were reported at a younger age in girls than boys. We found high prevalence of substance use disorders (40.47%, psychosis (19.04%, and mood disorder (28.57% among abuse group. Conclusions: The study findings highlight the developing importance of the different forms of abuse on adult psychiatric diagnosis in India. The abused patients are at high risk of the development of psychiatric disorder than the nonabuse group. The increased length of hospitalization among abused group reflects severity and complexity of child abuse. The early detection of social factors

  1. Los diagnósticos y las historias clínicas de mujeres en los hospicios de Buenos Aires entre 1900-1930 The diagnoses and clinical histories of women in the psychiatric hospital of Buenos Aires between 1900-1930

    Directory of Open Access Journals (Sweden)

    Vanesa Eva Navarlaz

    2010-12-01

    Full Text Available Este trabajo analiza la singularidad de los aspectos ligados a los diagnósticos psiquiátricos en las mujeres alienadas entre los años 1900 y 1930 en Argentina; que permiten ubicar diferencias en los supuestos etiológicos que explican la enfermedad mental entre hombres y mujeres. Se analizan los diseños de las historias clínicas de mujeres del Hospital Nacional de Alienadas (actual Hospital Moyano y del Asilo de Lomas de Zamora (actual Hospital Interzonal Esteves de Temperley. Se cruzan los datos obtenidos con fuentes primarias del campo de la medicina y la psiquiatría que trabajan sobre la particularidad de la alienación en la mujer. Se indagan las causas y explicaciones singulares que se han sostenido en éste contexto histórico y su diferencia con las de los enfermos varones para la misma época.This paper analyzes the uniqueness of the associated issues with psychiatric diagnoses in alienated women between 1900 and 1930 in Argentina that allow locating differences in the etiological assumptions that explain the mental illness between men and women. Designs of clinical records of women in the Hospital Nacional de Alienadas (now Hospital Moyano and the Asilo de Lomas de Zamora (now Hospital Interzonal Esteves de Temperley are analyzed. Data obtained with primary sources of medicine and psychiatry is intersected, which work on the particularity of alienation in women. It is inquired the causes and singular explanations that have been held in this historical context and their difference in those male patients for the same period.

  2. Individual and parental psychiatric history and risk for suicide among adolescents and young adults in Denmark: a population-based study.

    Science.gov (United States)

    Stenager, Kirstina; Qin, Ping

    2008-11-01

    Both individual and familial histories of mental illness are substantial risk factors for suicide in young people. To explore suicide risk among adolescents and young adults according to detailed aspects of individual and parental psychiatric admission history. A nested case-control study was undertaken using data from Danish population registers to include 4,142 suicide cases and 82,840 matched controls aged 9-35 years. Data were analyzed with conditional logistic regression. A history of hospitalized psychiatric illness was a strong risk factor for suicide in adolescents and young adults, and the effect of such a history was greater in females than males. The elevated risk peaked in the two periods immediately after admission and discharge for both sexes, and exceeded in females who had multiple admissions and in males who were diagnosed with schizophrenia, affective disorders or substance abuse disorders. At the same time, a parental psychiatric history constituted a substantial risk factor for suicide in young people, in particular, if having a mother admitted for psychiatric illness. The elevated risk associated with parental psychiatric history was greater in females than in males, and tended to be more prominent during the first few years after admission of a parent. Prevention strategies should aim at improving treatment and care to young people with psychiatric problems and at providing social support and psychological consultation to children with parental psychiatric illness.

  3. Increased psychiatric morbidity before and after the diagnosis of hypothyroidism: a nationwide register study.

    Science.gov (United States)

    Thvilum, Marianne; Brandt, Frans; Almind, Dorthe; Christensen, Kaare; Brix, Thomas Heiberg; Hegedüs, Laszlo

    2014-05-01

    Thyroid hormones are necessary for fetal brain development, and hypothyroidism in adults has been associated with mood symptoms and reduced quality of life. Nevertheless, our knowledge regarding the association and temporal relation between hypothyroidism and mental disorders is ambiguous. Our objective was to investigate, at a nationwide level, whether a diagnosis of hypothyroidism is associated with psychiatric morbidity. This is an observational cohort study. On the basis of record linkage between different Danish health registers, 2822 hypothyroid singletons each matched with 4 nonhypothyroid controls were identified and followed over a mean period of 6 years (range 1-13). Additionally, we included 385 same-sex twin pairs discordant for hypothyroidism. Diagnoses of psychiatric disorders as well as treatment with antidepressants, antipsychotics, and anxiolytics were recorded. Logistic and cox regression models were used to assess the risk of psychiatric morbidity before and after the diagnosis of hypothyroidism, respectively. Before the diagnosis of hypothyroidism, such individuals had an increased prevalence of diagnoses with psychiatric disorders (odds ratio, OR, 1.51; 95% confidence interval [CI 1.12-2.04]) and increased prevalence of treatment with antipsychotics (OR 1.49 [CI 1.29-1.73]), antidepressants (OR 1.50 [CI 1.35-1.67]), and anxiolytics (OR 1.28 [CI 1.16-1.41]). After the diagnosis of hypothyroidism, patients had a higher risk of being diagnosed with a psychiatric disorder (hazard ratio, HR, 2.40 [CI 1.81-3.18]), and an increased risk of being treated with antidepressants (HR 1.30 [CI 1.15-1.47]) and anxiolytics (HR 1.27 [CI 1.10-1.47]), but not antipsychotics (HR 1.13 [CI 0.91-1.41]). On the basis of the twin data, we could not demonstrate genetic confounding. Subjects with hypothyroidism have an increased risk of being diagnosed with a psychiatric disorder as well as being treated with antidepressants, antipsychotics, and anxiolytics both before

  4. Technological Advances in Psychiatric Nursing: An update.

    Science.gov (United States)

    Bostrom, Andrea C

    2016-06-01

    Understanding and treating mental illness has improved in many ways as a result of the fast pace of technological advances. The technologies that have the greatest potential impact are those that (1) increase the knowledge of how the brain functions and changes based on interventions, (2) have the potential to personalize interventions based on understanding genetic factors of drug metabolism and pharmacodynamics, and (3) use information technology to provide treatment in the absence of an adequate mental health workforce. Technologies are explored for psychiatric nurses to consider. Psychiatric nurses are encouraged to consider the experiences of psychiatric patients, including poor health, stigmatization, and suffering. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Oxytocin and Psychiatric Disorders

    Directory of Open Access Journals (Sweden)

    Gokce Nur Say

    2016-06-01

    Full Text Available Oxytocin is a neuropeptide that plays critical role in mother-infant bonding, pair bonding and prosocial behaviors. Several neuropsychiatric disorders such as autism, schizophrenia, affective disorders, anxiety disorders, attention deficit/hyperactivity disorder, alcohol/substance addiction, aggression, suicide, eating disorders and personality disorders show abnormalities of oxytocin system. These findings have given rise to the studies searching therapeutic use of oxytocin for psychi-atric disorders. The studies of oxytocin interventions in psychiatric disorders yielded potentially promising findings. This paper reviews the role of oxytocin in emotions, behavior and its effects in psychiatric disorders. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(2: 102-113

  6. Dysfunctions in public psychiatric bureaucracies.

    Science.gov (United States)

    Marcos, L R

    1988-03-01

    The author describes common dysfunctions in public psychiatric organizations according to the model of bureaucracy articulated by Max Weber. Dysfunctions are divided into the categories of goal displacement, outside interference, unclear authority structure and hierarchy, and informal relations in the work place. The author emphasizes the bureaucratic nature of public psychiatry and the need for mental health professionals to understand the dysfunctions of the organizations in which they work, including the impact of these dysfunctions on the provision of quality care.

  7. Marriage and other psychological stressors in the causation of psychiatric disorder

    Directory of Open Access Journals (Sweden)

    Mohammad S. I. Mullick

    2016-09-01

    Full Text Available The aim of this study was to compare the specific psychiatric diagnosis, frequency, and types of stressors, and the level of awareness about marriage law between married (cases; n=80 and unmarried girls (control; n=80 with one or more psychiatric disorders below the age of 18 years. The psychiatric diseases were diagnosed according to Axis One of ICD-10 clinical diagnoses of multi-axial classification of childhood and adolescent psychiatric disorder. Psychosocial stressors were considered on the basis of Axis Five of this classification. Of the cases, major depressive disorder was the highest (n=47 and next was a dissociative (conversion disorder (n=24. Among the controls, generalized anxiety disorder (n=31 was the most prevalent followed by obsessive-compulsive disorder (n=17. The difference was highly significant (p>0.001. The cases reported a significant excess of psychosocial stressors than that of the controls to the onset of the psychiatric disorder. All the cases had associated stressors. In contrast, 77 out of 80 control patients had stressors. Marriage itself played as a stressor in the 78 cases. Beside this, other highly frequent stressors were marital discord followed by drop out from study and trouble with in-laws. Among the controls, the highest reported stressor was increased academic workload and next two commonest stressors were poor academic performance and discord with peers. Interestingly, 52.5% of the cases were having knowledge about the law on the age of marriage and that was 32.5% among the controls. It was significant that most of the girls breached their continuity of education after marriage (p>0.001. In conclusion, psychosocial stressors including marriage have a causal relationship with depressive and conversion disorder. 

  8. [Compulsive buying and psychiatric comorbidity].

    Science.gov (United States)

    Mueller, Astrid; Mühlhans, Barbara; Silbermann, Andrea; Müller, Ulrike; Mertens, Christian; Horbach, Thomas; Mitchell, James E; de Zwaan, Martina

    2009-08-01

    Compulsive buying is an excessive behavior that has begun to receive attention from researchers in recent years. The current study provides an overview of research on compulsive buying and examines the psychiatric co-morbidity in a German female treatment seeking compulsive buying sample in comparison with age and gender-matched normal buying control groups. Thirty women suffering from compulsive buying disorder, 30 community controls, and 30 bariatric surgery candidates were assessed with the German versions of the Structured Clinical Interview for DSM-IV diagnoses (SCID). Women with compulsive buying disorder showed significantly higher prevalence rates of affective, anxiety, and eating disorders compared to community controls, and suffered significantly more often from affective and anxiety disorders compared to bariatric surgery candidates. The compulsive buying group presented with the highest rates of personality disorders, most commonly avoidant, depressive, obsessive-compulsive, and borderline personality disorder, and reported the highest prevalence rates of other impulse control disorders, especially for intermittent explosive disorder. The findings suggest an elevated psychiatric co-morbidity in patients with compulsive buying disorder.

  9. Animal cruelty and psychiatric disorders.

    Science.gov (United States)

    Gleyzer, Roman; Felthous, Alan R; Holzer, Charles E

    2002-01-01

    Animal cruelty in childhood, although generally viewed as abnormal or deviant, for years was not considered symptomatic of any particular psychiatric disorder. Although animal cruelty is currently used as a diagnostic criterion for conduct disorder, research establishing the diagnostic significance of this behavior is essentially nonexistent. In the current study, investigators tested the hypothesis that a history of substantial animal cruelty is associated with a diagnosis of antisocial personality disorder (APD) and looked for associations with other disorders commonly diagnosed in a population of criminal defendants. Forty-eight subjects, criminal defendants who had histories of substantial animal cruelty, were matched with defendants without this history. Data were systematically obtained from the files by using four specifically designed data retrieval outlines. A history of animal cruelty during childhood was significantly associated with APD, antisocial personality traits, and polysubstance abuse. Mental retardation, psychotic disorders, and alcohol abuse showed no such association.

  10. [Psychiatric disorders and neurological comorbidity in children with intellectual disability].

    Science.gov (United States)

    Wriedt, Elke; Wiberg, Anja; Sakar, Vehbi; Noterdaeme, Michele

    2010-05-01

    This article gives an overview of the consultant child and adolescent psychiatric services in the region of Upper Bavaria (Germany). The data of 257 children and adolescents with intellectual disability and psychiatric disorders were evaluated. About 14% of the children with ID in special schools or day care centers, and 40% of the children with ID in residential care showed a definite psychiatric disorder. The most frequently diagnosed disorders were adjustment disorders, hyperkinetic disorders and conduct disorders, as well as emotional problems and pervasive developmental disorders. Children with severe intellectual disability had more additional somatic disorders and were more impaired in their psychosocial functions. The results show the need for psychiatric services for children and adolescents with intellectual disability and psychiatric disorders. The development and implementation of integrative and interdisciplinary models is necessary to allow for adequate medical care for these patients.

  11. Chromosomal abnormalities in a psychiatric population

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, K.E.; Lubetsky, M.J.; Wenger, S.L.; Steele, M.W. [Univ. of Pittsburgh Medical Center, PA (United States)

    1995-02-27

    Over a 3.5 year period of time, 345 patients hospitalized for psychiatric problems were evaluated cytogenetically. The patient population included 76% males and 94% children with a mean age of 12 years. The criteria for testing was an undiagnosed etiology for mental retardation and/or autism. Cytogenetic studies identified 11, or 3%, with abnormal karyotypes, including 4 fragile X positive individuals (2 males, 2 females), and 8 with chromosomal aneuploidy, rearrangements, or deletions. While individuals with chromosomal abnormalities do not demonstrate specific behavioral, psychiatric, or developmental problems relative to other psychiatric patients, our results demonstrate the need for an increased awareness to order chromosomal analysis and fragile X testing in those individuals who have combinations of behavioral/psychiatric, learning, communication, or cognitive disturbance. 5 refs., 1 fig., 2 tabs.

  12. Development of a Social Skills Assessment Screening Scale for Psychiatric Rehabilitation Settings: A Pilot Study.

    Science.gov (United States)

    Bhola, Poornima; Basavarajappa, Chethan; Guruprasad, Deepti; Hegde, Gayatri; Khanam, Fatema; Thirthalli, Jagadisha; Chaturvedi, Santosh K

    2016-01-01

    Deficits in social skills may present in a range of psychiatric disorders, particularly in the more serious and persistent conditions, and have an influence on functioning across various domains. This pilot study aimed at developing a brief measure, for structured evaluation and screening for social skills deficits, which can be easily integrated into routine clinical practice. The sample consisted of 380 inpatients and their accompanying caregivers, referred to Psychiatric Rehabilitation Services at a tertiary care government psychiatric hospital. The evaluation included an Inpatient intake Proforma and the 20-item Social Skills Assessment Screening Scale (SSASS). Disability was assessed using the Indian Disability Evaluation and Assessment Scale (IDEAS) for a subset of 94 inpatients. The analysis included means and standard deviations, frequency and percentages, Cronbach's alpha to assess internal consistency, t -tests to assess differences in social skills deficits between select subgroups, and correlation between SSASS and IDEAS scores. The results indicated the profile of social skills deficits assessed among the inpatients with varied psychiatric diagnoses. The "psychosis" group exhibited significantly higher deficits than the "mood disorder" group. Results indicated high internal consistency of the SSASS and adequate criterion validity demonstrated by correlations with select IDEAS domains. Modifications were made to the SSASS following the pilot study. The SSASS has potential value as a measure for screening and individualised intervention plans for social skills training in mental health and rehabilitation settings. The implications for future work on the psychometric properties and clinical applications are discussed.

  13. Psychiatric Disorders and Substance Use in Homeless Youth: A Preliminary Comparison of San Francisco and Chicago

    Directory of Open Access Journals (Sweden)

    Ernika G. Quimby

    2012-08-01

    Full Text Available Youth homelessness is a growing problem in the United States. The experience of homelessness appears to have numerous adverse consequences, including psychiatric and substance use disorders. This study compared the frequencies of psychiatric disorders, including substance use, between homeless youth (18–24 years-old in San Francisco (N = 31 and Chicago (N = 56. Subjects were administered the Mini International Neuropsychiatric Interview (M.I.N.I. to assess DSM-IV-TR diagnoses and substance use disorders. Eighty-seven percent of the San Francisco youth, and 81% of the Chicago youth met criteria for at least one M.I.N.I. psychiatric diagnosis. Nearly two-thirds of the youth in both samples met criteria for a mood disorder. Approximately one-third met criteria for an anxiety disorder. Thirty-two percent of the San Francisco sample and 18% of the Chicago met criteria for Antisocial Personality Disorder. Approximately 84% of the San Francisco youth and 48% of the Chicago youth met criteria for a substance-related disorder, and more substances were used by San Francisco youth. In conclusion, the high rate of psychiatric disorders in homeless youth provides clear evidence that the mental health needs of this population are significant. Implications are discussed.

  14. Suicide with psychiatric diagnosis and without utilization of psychiatric service

    Directory of Open Access Journals (Sweden)

    Wong Paul WC

    2010-07-01

    Full Text Available Abstract Background Considerable attention has been focused on the study of suicides among those who have received help from healthcare providers. However, little is known about the profiles of suicide deceased who had psychiatric illnesses but made no contact with psychiatric services prior to their death. Behavioural model of health service use is applied to identify factors associated with the utilization of psychiatric service among the suicide deceased. Methods With respect to completed suicide cases, who were diagnosed with a mental disorder, a comparison study was made between those who had (contact group; n = 52; 43.7% and those who had not made any contact (non-contact group; n = 67; 56.3% with a psychiatrist during the final six months prior to death. A sample of 119 deceased cases aged between 15 and 59 with at least one psychiatric diagnosis assessed by the Structured Clinical Interview for DSM-IV-TR (SCID I were selected from a psychological autopsy study in Hong Kong. Results The contact and non-contact group could be well distinguished from each other by "predisposing" variables: age group & gender, and most of the "enabling", and "need" variables tested in this study. Multiple logistic regression analysis has found four factors are statistically significantly associated with non-contact suicide deceased: (i having non-psychotic disorders (OR = 13.5, 95% CI:2.9-62.9, (ii unmanageable debts (OR = 10.5, CI:2.4-45.3, (iii being full/partially/self employed at the time of death (OR = 10.0, CI:1.6-64.1 and (iv having higher levels of social problem-solving ability (SPSI (OR = 2.0, CI:1.1-3.6. Conclusion The non-contact group was clearly different from the contact group and actually comprised a larger proportion of the suicide population that they could hardly be reached by usual individual-based suicide prevention efforts. For this reason, both universal and strategic suicide prevention measures need to be developed specifically in non

  15. Relational Aggression in Children with Preschool Onset (PO) Psychiatric Disorders

    Science.gov (United States)

    Belden, Andy C.; Gaffrey, Michael S.; Luby, Joan L.

    2012-01-01

    Objective The role of preschool onset (PO) psychiatric disorders as correlates and/or risk factors for relational aggression during kindergarten or 1st grade was tested in a sample of N = 146 preschool-age children (3 to 5.11). Method Axis-I diagnoses and symptom scores were derived using the Preschool Age Psychiatric Assessment. Children’s roles in relational aggression as aggressor, victim, aggressive-victim, or non-aggressor/non-victim were determined at preschool and again 24 months later at elementary school entry. Results Preschoolers diagnosed with PO-psychiatric disorders were 3 times as likely as the healthy preschoolers to be classified aggressors, victims, or aggressive-victims. Children diagnosed with PO-disruptive, depressive, and/or anxiety disorders were at least 6 times as likely as children without PO-psychiatric disorders to become aggressive-victims during elementary school after covarying for other key risk factors. Conclusions Findings suggested that PO-psychiatric disorders differentiated preschool and school-age children’s roles in relational aggression based on teacher-report. Recommendations for future research and preventative intervention aimed at minimizing the development of relational aggression in early childhood by identifying and targeting PO-psychiatric disorders are made. PMID:22917202

  16. Hyperthyroidism and psychiatric morbidity

    DEFF Research Database (Denmark)

    Brandt, Frans; Thvilum, Marianne; Pedersen, Dorthe Almind

    2014-01-01

    Thyroid hormones are essential for the normal development of the fetal brain, while hyperthyroidism in adults is associated with mood symptoms and reduced quality of life. We aimed to investigate the association and temporal relation between hyperthyroidism and psychiatric morbidity.......Thyroid hormones are essential for the normal development of the fetal brain, while hyperthyroidism in adults is associated with mood symptoms and reduced quality of life. We aimed to investigate the association and temporal relation between hyperthyroidism and psychiatric morbidity....

  17. Impact of boarding pediatric psychiatric patients on a medical ward.

    Science.gov (United States)

    Claudius, Ilene; Donofrio, J Joelle; Lam, Chun Nok; Santillanes, Genevieve

    2014-05-01

    Psychiatric disorders account for an increasing number of pediatric hospitalizations. Due to lack of psychiatric beds, patients on involuntary psychiatric holds may be admitted to medical units. Our objectives were to evaluate the rate of admission of psychiatric patients to a medical unit, psychiatric care provided, and estimated cost of care. The study involved retrospective chart review of all patients on involuntary psychiatric holds presenting to 1 pediatric emergency department from July 2009 to December 2010. We determined the rate of admission to a medical unit, the rate of counseling or psychiatric medication administration, and the estimated cost of nonmedical admissions (boarding) of patients on the medical unit. A total of 555 (50.1%) of 1108 patients on involuntary psychiatric holds were admitted to the pediatric medical unit. The majority (523 [94.2%]) were admitted for boarding because no psychiatric bed was available. Thirty-two (6.1%) patients admitted for isolated psychiatric reasons had counseling documented, and 105 (20.1%) received psychiatric medications. Patients admitted to an affiliated psychiatric hospital were significantly more likely to receive counseling and medications. Psychiatric patients were boarded in medical beds for 1169 days at an estimated cost of $2 232 790 or $4269 per patient over the 18-month period. We found high admission rates of patients on involuntary psychiatric holds to a pediatric medical unit with little psychiatric treatment in 1 hospital. Further research in other centers is required to determine the extent of the issue. Future studies of longer term outcomes (including readmission rates and assessments of functioning) are needed.

  18. Psychiatric family history and schizophrenia risk in Denmark: which mental disorders are relevant?

    Science.gov (United States)

    Mortensen, P B; Pedersen, M G; Pedersen, C B

    2010-02-01

    A family history of schizophrenia is the strongest single indicator of individual schizophrenia risk. Bipolar affective disorder and schizo-affective disorders have been documented to occur more frequently in parents and siblings of schizophrenia patients, but the familial occurrence of the broader range of mental illnesses and their role as confounders have not been studied in large population-based samples. All people born in Denmark between 1955 and 1991 (1.74 million) were followed for the development of schizophrenia (9324 cases) during 28 million person-years at risk. Information of schizophrenia in cohort members and psychiatric history in parents and siblings was established through linkage with the Danish Psychiatric Central Register. Data were analysed using log-linear Poisson regression. Schizophrenia was, as expected, strongly associated with schizophrenia and related disorders among first-degree relatives. However, almost any other psychiatric disorder among first-degree relatives increased the individual's risk of schizophrenia. The population attributable risk associated with psychiatric family history in general was 27.1% whereas family histories including schizophrenia only accounted for 6.0%. The general psychiatric family history was a confounder of the association between schizophrenia and urbanization of place of birth. Clinically diagnosed schizophrenia is associated with a much broader range of mental disorders in first-degree relatives than previously reported. This may suggest risk haplotypes shared across many disorders and/or shared environmental factors clustering in families. Failure to take the broad range of psychiatric family history into account may bias results of all risk-factor studies of schizophrenia.

  19. Psychiatric morbidity develops after onset of pediatric multiple sclerosis

    DEFF Research Database (Denmark)

    Spangsberg Boesen, Magnus; Thygesen, Lau Caspar; Uldall, Peter Vilhelm

    2018-01-01

    BACKGROUND: Pediatric-onset multiple sclerosis (MS) affects life at a stage vital for social and educational achievements and psychiatric co-morbidity is common after MS onset. Few studies have examined psychiatric morbidity before MS onset. METHODS: In this nationwide study, detailed case...... with psychiatric morbidity as exposure and MS as outcome, and a matched cohort study with MS as exposure and psychiatric co-morbidity as outcome. Hazard ratios (HR) including 95% confidence intervals (CI) were estimated using Cox regression. RESULTS: We identified 212 children with MS and 1060 controls....... No association between psychiatric morbidity and the rate of MS was found before MS onset. After MS onset, children with MS had two times higher hazard for psychiatric co-morbidity compared with children without MS (HR=2.0; 95% CI=1.3-3.1; pPsychiatric morbidity seems to commence after MS...

  20. The effectiveness of anticonvulsants in psychiatric disorders

    Science.gov (United States)

    Grunze, Heinz C. R.

    2008-01-01

    Anticonvulsant drugs are widely used in psychiatric indications. These include mainly alcohol and benzodiazepine withdrawal syndromes, panic and anxiety disorders, dementia, schizophrenia, affective disorders, bipolar affective disorders in particular, and, to some extent, personality disorders, A further area in which neurology and psychiatry overlap is pain conditions, in which some anticonvulsants, and also typical psychiatric medications such as antidepressants, are helpful. From the beginning of their psychiatric use, anticonvulsants have also been used to ameliorate specific symptoms of psychiatric disorders independently of their causality and underlying illness, eg, aggression, and, more recently, cognitive impairment, as seen in affective disorders and schizophrenia. With new anticonvulsants currently under development, it is likely that their use in psychiatry will further increase, and that psychiatrists need to learn about their differential efficacy and safety profiles to the same extent as do neurologists. PMID:18472486

  1. [History of psychiatric legislation in Italy].

    Science.gov (United States)

    Stocco, Ester; Dario, Claudia; Piazzi, Gioia; Fiori Nastro, Paolo

    2009-01-01

    The different models of mental illness which have followed one another in Italian psychiatry have been linked to the history of psychiatric legislation and its various attempts at reform. The first law of the newly United State which unified legislations and former procedures, whose prevalent psychiatric theories were those that referred to degeneration, was the law 36/1904 that set up the asylums. Accordingly psychiatric praxis was focused on social protection and custody, given that the mentally ill was seen as incurable; Fascism added the inmate's obligation to be enrolled in the judicial register. Afterwards numerous attempts to reform the psychiatric legislation were made that eventually gave rise to law 431/1968 which paved the way to territorial psychiatry. Law 180/1978 changed the organization of Italian psychiatry abolishing asylums and the concept of dangerousness, including psychiatry in the National Health Service but adopting an idea of mental illness as simply social unease.

  2. [Negative symptoms in patients with non schizophrenic psychiatric disorders].

    Science.gov (United States)

    Donnoli, Vicente F; Moroni, María V; Cohen, Diego; Chisari Rocha, Liliana; Marleta, María; Sepich Dalmeida, Tomás; Bonani, Matías; D'Alessio, Luciana

    2011-01-01

    The presence of negative symptoms (NS) in different clinical entities other than schizophrenia, with a dimensional approach of negative symptoms, was considered in this work. Determine the presence and distribution of NS, in a population of patients with non schizophrenic psychiatric disorders attending ambulatory treatment at public hospitals. Patients with define DSM IV diagnosis criteria for different disorders; affective, alimentary, substance abuse, anxiety, personality disorders and patients with ILAE diagnoses criteria for temporal lobe epilepsy were included. All patients underwent the subscale PANNS for negative symptoms of schizophrenia. Student T test was calculated to determine the differences of frequency for NS among psychiatric disorders. 106 patients were included; 60 women, 46 men, 38 years +/- 12.1. The 90% of patients have a low score of NS. Media 11.6, Max/min 9.38 -14.29. Emotional withdrawal and passive social withdrawal were more frequent in alimentary disorders than in affective disorder and than in epilepsy. Emotional withdrawal was more frequent in substance disorders than epilepsy. According this study, negative symptoms are present in a low to moderate intensity in non schizophrenic psychiatry entities and in the temporal lobe epilepsy.

  3. What kinds of things are psychiatric disorders?

    Science.gov (United States)

    Kendler, K S; Zachar, P; Craver, C

    2011-06-01

    This essay explores four answers to the question 'What kinds of things are psychiatric disorders?' Essentialist kinds are classes whose members share an essence from which their defining features arise. Although elegant and appropriate for some physical (e.g. atomic elements) and medical (e.g. Mendelian disorders) phenomena, this model is inappropriate for psychiatric disorders, which are multi-factorial and 'fuzzy'. Socially constructed kinds are classes whose members are defined by the cultural context in which they arise. This model excludes the importance of shared physiological mechanisms by which the same disorder could be identified across different cultures. Advocates of practical kinds put off metaphysical questions about 'reality' and focus on defining classes that are useful. Practical kinds models for psychiatric disorders, implicit in the DSM nosologies, do not require that diagnoses be grounded in shared causal processes. If psychiatry seeks to tie disorders to etiology and underlying mechanisms, a model first proposed for biological species, mechanistic property cluster (MPC) kinds, can provide a useful framework. MPC kinds are defined not in terms of essences but in terms of complex, mutually reinforcing networks of causal mechanisms. We argue that psychiatric disorders are objectively grounded features of the causal structure of the mind/brain. MPC kinds are fuzzy sets defined by mechanisms at multiple levels that act and interact to produce the key features of the kind. Like species, psychiatric disorders are populations with central paradigmatic and more marginal members. The MPC view is the best current answer to 'What kinds of things are psychiatric disorders?'

  4. Diagnostic ambivalence: psychiatric workarounds and the Diagnostic and Statistical Manual of Mental Disorders.

    Science.gov (United States)

    Whooley, Owen

    2010-03-01

    In 1980 the American Psychiatric Association (APA), faced with increased professional competition, revised the Diagnostic and Statistical Manual of Mental Disorders (DSM). Psychiatric expertise was redefined along a biomedical model via a standardised nosology. While they were an integral part of capturing professional authority, the revisions demystified psychiatric expertise, leaving psychiatrists vulnerable to infringements upon their autonomy by institutions adopting the DSM literally. This research explores the tensions surrounding standardisation in psychiatry. Drawing on in-depth interviews with psychiatrists, I explore the 'sociological ambivalence' psychiatrists feel towards the DSM, which arises from the tension between the desire for autonomy in practice and the professional goal of legitimacy within the system of mental health professions. To carve a space for autonomy for their practice, psychiatrists develop 'workarounds' that undermine the DSM in practice. These workarounds include employing alternative diagnostic typologies, fudging the numbers (or codes) on official paperwork and negotiating diagnoses with patients. In creating opportunities for patient input and resistance to fixed diagnoses, the varied use of the DSM raises fundamental questions for psychiatrists about the role of the biomedical model of mental illness, especially its particular manifestation in the DSM.

  5. Psychiatric disorders and their correlates among young adult MDMA users in Ohio.

    Science.gov (United States)

    Falck, Russel S; Carlson, Robert G; Wang, Jichuan; Siegal, Harvey A

    2006-03-01

    This study describes the lifetime prevalence, correlates, and age of onset of selected psychiatric disorders among a community sample of MDMA users (n = 402), aged 18 to 30, in Ohio. Participants responded to interviewer-administered questionnaires, including sections of the computerized Diagnostic Interview Schedule for DSM-IV. Fifty-five percent of the sample had at least one lifetime disorder, with major depression (35.3%) and antisocial personality disorder (ASPD) (25.4%) the most common. Proportionately more women were diagnosed with depression, generalized anxiety disorder, and posttraumatic stress disorder (PTSD), while proportionately more men were diagnosed with ASPD. Proportionately more non-White participants had attention deficit/hyperactivity disorder (AD/HD). Higher levels of education were associated with proportionately less PTSD, ASPD, and AD/HD. Higher frequencies of MDMA use were associated with proportionately more ASPD and AD/HD. Comparing the age of first MDMA use with the age of onset for selected psychiatric disorders revealed that for most participants disorders preceded use. Multivariate analysis revealed participants with more than a high school education were less likely to have experienced a lifetime disorder, while those who had used MDMA more than 50 times were more likely. Variations in the prevalence of psychiatric disorders have practical implications for drug abuse prevention and treatment programs.

  6. [A naturalistic study: 100 consecutive episodes of acute agitation in a psychiatric emergency department].

    Science.gov (United States)

    Pascual, J C; Madre, M; Puigdemont, D; Oller, S; Corripio, I; Díaz, A; Faus, G; Perez, V; Alvarez, E

    2006-01-01

    Psychomotor agitation is a common event in psychiatric emergency services (PES) with a prevalence of approximately 10 %. There is no general consensus on to how to manage psychomotor agitation; benzodiazepines, typical antipsychotics and now atypical antipsychotics have demonstrated similar efficacy. The aim of our study was to describe the epidemiology and clinical management of agitation in "real-life" in a psychiatric emergency service. A naturalistic study was performed in acutely agitated patients recruited consecutively in a psychiatric emergency service. Demographics, clinical and therapeutic characteristics were analyzed. Efficacy was assessed by the Excitement Component of the Positive and Negative Syndrome Scale (PANSS-EC) and the Agitation-Calmness Evaluation Scale (ACES). Pragmatic variables such as the need for second pharmacological intervention and the need for physical restraints were assessed. The study included 100 patients with psychomotor agitation. Mean age was 36.2 % and 54% were women. The most prevalent diagnoses were psychotic disorder (48 %) and personality disorder (24 %). Physical restraint was required in 39 % of patients and 52 % accepted oral treatment. Haloperidol was the most frequent oral treatment and olanzapine was the most frequent intramuscular treatment. A naturalistic approach provides data based on clinical reality in psychiatric emergency services. Strict research designs of clinical trials of efficacy imply sample selection biases and are generally distanced from the clinical reality. Atypical antipsychotics have become the first-line treatment in acute agitation

  7. Implementation and outcome of child psychotherapy compared with other psychiatric treatments in a naturalistic clinical setting.

    Science.gov (United States)

    Ryynänen, Taimi; Alen, Markku; Koivumaa-Honkanen, Heli; Joskitt, Leena; Ebeling, Hanna

    2015-04-01

    Mental health problems of children are commonly treated by psychotherapy and other psychosocial treatments. Studies comparing different treatments in naturalistic clinical settings are few, however. We assessed the differences: 1) in symptoms and diagnoses; 2) in treatment outcome between psychotherapy and other psychosocial treatments; and 3) evaluated the effect of family background and life circumstances on the outcome. The data were collected from the psychiatric hospital records of Oulu University Hospital, Finland. All 118 children (aged psychotherapy from the Department of Child Psychiatry in 1996-2005 and 118 age- and sex-matched children undergoing other psychosocial treatments were included. A lack of later recorded psychiatric problems was used as an indicator of good treatment outcome. On referral, functional ability was severely impaired in almost half of the children (Children's Global Assessment Scale score psychotherapy group, while no difference was found in externalizing symptoms between the groups. In both groups, later psychiatric problems were associated with a child's low functional ability and poor parental coping with their responsibilities. Children with internalizing problems had impaired prognosis if they had psychosocial treatments other than psychotherapy. Individual psychotherapy should especially be considered for children with internalizing symptoms, but the outcome of psychiatric treatment depends not only on children's own functional abilities, but also on parental abilities.

  8. Religiousness, religious coping methods and distress level among psychiatric patients in Malaysia.

    Science.gov (United States)

    Nurasikin, M S; Khatijah, L A; Aini, A; Ramli, M; Aida, S A; Zainal, N Z; Ng, C G

    2013-06-01

    Patients having psychiatric diagnoses often experience high level of distress. Religiousness is often used by them as part of their coping mechanism and problem-solving strategies. To determine the level of religious commitment and coping methods in psychiatric patients and its relationship with distress level. Religious commitment and coping patterns were measured with the Duke University Religious Index (DUREL) and Brief RCOPE, respectively. Psychopathology was assessed using the Brief Psychiatric Rating Scale (BPRS) and distress level was assessed with the Depressive, Anxiety and Stress Scale (DASS). Social support and experiences of recent threatening events were measured with the Multidimensional Scale of Perceived Social Support (MSPSS) and Life Threatening Events (LTE). A total of 228 patients were included in this study with a mean age of 40.2 years. The majority were male, Malay, Muslim, single and with psychotic disorder. The subjects had a high level of religious commitment and had used more positive coping methods. Negative religious coping, psychiatric symptoms and diagnosis of anxiety disorder or major depression were significantly associated with high distress level. Higher religious commitment was significantly associated with lower distress (p depression were associated with higher distress.

  9. Psychiatric aspects of Parkinson′s disease

    Directory of Open Access Journals (Sweden)

    Sandeep Grover

    2015-01-01

    Full Text Available Parkinson′s disease (PD is essentially characterized by the motor symptoms in the form of resting tremor, rigidity and bradykinesia. However, over the years it has been recognized that motor symptoms are just the "tip of the iceberg" of clinical manifestations of PD. Besides motor symptoms, PD characterized by many non-motor symptoms, which include cognitive decline, psychiatric disturbances (depression, psychosis and impulse control, sleep difficulties, autonomic failures (gastrointestinal, cardiovascular, urinary, thermoregulation and pain syndrome. This review evaluates the various aspects of psychiatric disorders including cognitive decline and sleep disturbances in patients with PD. The prevalence rate of various psychiatric disorders is high in patients with PD. In terms of risk factors, various demographic, clinical and treatment-related variables have been shown to be associated with higher risk of development of psychiatric morbidity. Evidence also suggests that the presence of psychiatric morbidity is associated with poorer outcome. Randomized controlled trials, evaluating the various pharmacological and non-pharmacological treatments for management of psychiatric morbidity in patients with PD are meager. Available evidence suggests that tricyclic antidepressants like desipramine and nortriptyline are efficacious for management of depression. Among the antipsychotics, clozapine is considered to be the best choice for management of psychosis in patients with PD. Among the various cognitive enhancers, evidence suggest efficacy of rivastigmine in management of dementia in patients with PD. To conclude, this review suggests that psychiatric morbidity is highly prevalent in patients with PD. Hence, a multidisciplinary approach must be followed to improve the overall outcome of PD. Further studies are required to evaluate the efficacy of various other measures for management of psychiatric morbidity in patients with PD.

  10. Pituitary gland in psychiatric disorders: a review of neuroimaging findings.

    Science.gov (United States)

    Atmaca, Murad

    2014-08-01

    In this paper, it was reviewed neuroimaging results of the pituitary gland in psychiatric disorders, particularly schizophrenia, mood disorders, anxiety disorders, and somatoform disorders. The author made internet search in detail by using PubMed database including the period between 1980 and 2012 October. It was included in the articles in English, Turkish and French languages on pituitary gland in psychiatric disorders through structural or functional neuroimaging results. After searching mentioned in the Methods section in detail, investigations were obtained on pituitary gland neuroimaging in a variety of psychiatric disorders. There have been so limited investigations on pituitary neuroimaging in psychiatric disorders including major psychiatric illnesses like schizophrenia and mood disorders. Current findings are so far from the generalizability of the results. For this reason, it is required to perform much more neuroimaging studies of pituitary gland in all psychiatric disorders to reach the diagnostic importance of measuring it.

  11. [General considerations on psychiatric interconsultation].

    Science.gov (United States)

    Carpinacci, J A

    1975-03-01

    This paper attempts to follow the evolution of some general ideas on Psychiatric Interconsulting. It is the result of six years' work at Ramos Mejía Hospital, Buenos Aires. Progressive transformations were imposed by daily practice on our team's theoretical and technical conceptions. We started with an individualistic-phenomenical approach, and we were forced to switch to a dynamical-situational one. The general working model we use at present is briefly summarized, emphasizing the important role played by Psychiatric Interconsulting in the change of the medical cultural patterns prevailing at present in our milieu. Two main factors for the role of privilege played by the Interconsulting team are set forth: one is conceptual, the other is pragmatic. From a conceptual standpoint, the theoretical basis of Psychiatric Interconsulting is much broader than those of other specialities, like clinical practice or surgery, for it includes, besides Biology, the Psychological and Socio-Historical determinants of the disturbance the diseases man suffers. From a pragmatic standpoint, the boundaries of human and physical fields within which Psychiatric Interconsulting is operating, go beyond the scope of daily medical practice. Their place could be located in between formal traditional wefts, relating to institutional structures as well as to specific medical practice. Professionals working at Interconsulting are usually required at general wards, at consulting offices, at emergency wards, in corridors, or even at the bar. They are interested not only in specific medical problems; they encompass the whole range of personal and institutional framework, and consider the whole situation in a comprehensive approach. Knowledge acquired in this widened professional field, together with actual experience in dealing with people in distress, are the main sources for theoretical conceptualization of new activities, as well as for building pragmatic tools to modify the official medical

  12. The Internalizing and Externalizing Structure of Psychiatric Comorbidity in Combat Veterans

    Science.gov (United States)

    Miller, Mark W.; Fogler, Jason M.; Wolf, Erika J.; Kaloupek, Danny G.; Keane, Terence M.

    2013-01-01

    This study examined the latent structure of psychiatric disorders in a sample with a high prevalence of PTSD. A series of confirmatory factor analyses tested competing models for the covariation between SCID diagnoses among 1,325 Vietnam veterans. The best fitting solution was a three-factor model that included two correlated internalizing factors: anxious-misery, defined by PTSD and major depression, and fear, defined by panic disorder/agoraphobia and obsessive-compulsive disorder. The third factor, externalizing, was defined by antisocial personality disorder, alcohol abuse/dependence, and drug abuse/dependence. Both substance-related disorders also showed significant, albeit smaller, cross-loadings on the anxious-misery factor. These findings shed new light on the structure of psychiatric comorbidity in a treatment-seeking sample characterized by high rates of PTSD. PMID:18302181

  13. Childhood Maltreatment as Predictor of Pathological Personality Traits Using PSY-5 in an Adult Psychiatric Sample.

    Science.gov (United States)

    Choi, Ji Young; Park, Soo Hyun

    2018-02-01

    Extant literature indicates that childhood maltreatment is significantly associated with personality disorders. With the recent call for a more dimensional approach to understanding personality and pathological personality traits, the aim of the present study was to examine whether the experience of childhood maltreatment is associated with pathological personality traits as measured by the Personality Psychopathology Five (PSY-5). We analyzed data from 557 adult psychiatric patients with diverse psychiatric diagnoses, including mood disorders, schizophrenia spectrum disorders, and anxiety disorders. Hierarchical multiple regression analyses were conducted to determine the degree to which childhood maltreatment explained the five trait dimensions after controlling for demographic variables, presence of psychotic symptoms, and degree of depressive symptoms. Childhood maltreatment significantly predicted all of the five trait dimensions of the PSY-5. This suggests that childhood maltreatment may negatively affect the development of an adaptive adjustment system, thereby potentially contributing to the emergence of pathological personality traits.

  14. Psychiatric and neurologic aspects of war: an overview and perspective.

    Science.gov (United States)

    Difede, JoAnn; Barchas, Jack D

    2010-10-01

    The growing number of soldiers returning home with psychiatric and neurologic disorders, notably posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI), underscores the need for an interdisciplinary framework for understanding the emergent consequences of combat. Among the challenges facing the scientific community is the development of effective treatment strategies for TBI from blast and other injuries, given the confounding effects of comorbid psychological symptoms on accurate diagnoses. At the individual level, emerging technologies-including virtual reality, the use of genetic biomarkers to inform treatment response, and new brain imaging methodology-are playing an important role in the development of differential therapeutics to best address a soldier's particular clinical needs. At the macro level, new approaches toward understanding the political, cultural, and ideological contexts of mass conflict, the decision to join in violence, and ways of preventing genocide are discussed. © 2010 Association for Research in Nervous and Mental Disease.

  15. Psychiatric Aspects of Infertility

    Directory of Open Access Journals (Sweden)

    Hacer Sezgin

    2014-06-01

    Full Text Available Infertility can be defined as a crisis with cultural, religious, and class related aspects, which coexists with medical, psychiatric, psychological, and social problems. Relation between psychiatric and psychological factors stem from a mutual interaction of both. Family is an important institution in maintaining human existence and raising individuals in line with society's expectations. Fertility and reproduction are seen as universal functions unique to women with raising children as the expected result of the family institution. Incidence of infertility has increased recently and can become a life crisis for a couple. Even though not being able to have a child affects both sexes emotionally, women feel greater amounts of stress, pressure, anxiety, and depression.Consequences of infertility arise from short and long-term devastating effects on both individual's physical and mental health, and marital system. Many studies focus on infertility related psychological and psychiatric disorders (depression, anxiety, grief, marital conflict, gender differences, relation between the causes of infertility and psychopathology, the effects of psychiatric evaluation and intervention -when necessaryon the course of infertility treatment, pregnancy rates, and childbirth. The most important underlying causes of high levels of stress and anxiety that infertile women experience are the loss of maternity, reproduction, sense of self, and genetic continuity. In this review article is to investigate the relationship between medically unexplained symptoms and psychiatric symptoms. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(2.000: 165-185

  16. Psychiatric referrals in two general hospitals.

    Directory of Open Access Journals (Sweden)

    Doongaji D

    1989-07-01

    Full Text Available A prospective study was undertaken to compare the patterns of psychiatric referrals in two general hospitals in Bombay viz. the King Edward Memorial Hospital (64 cases and the Jaslok Hospital and Research Centre (62 cases. It was observed that depressive symptoms were the most common presenting symptoms in these patients attending either of the hospitals. Similarly, the commonest diagnoses were depression and organic mental disorder. Attempted suicide with organophosphorous compounds was the commonest reason for hospitalization at K.E.M. Hospital (p less than 0.001. A significant number of these patients were females (p less than 0.05. The psychiatric referrals at Jaslok had been hospitalized mainly for suspected medical or neurological illness (p less than 0.001. These patients belonged to higher economic strata and hence had a better paying capacity compared to patients at KEM hospital, a significant number of whom were unemployed (p less than 0.001. The duration of pre-referred illness of patients and their stay at Jaslok hospital were longer as compared to those at KEM Hospital (p less than 0.01. The number of non-relevant special investigations carried out on patients in Jaslok was more (p less than 0.01. Further analysis of diagnoses revealed that a significant number of patients at KEM Hospital were admitted as primary psychiatric illness (p less than 0.05.

  17. Psychiatric disorders associated with Cushing's syndrome.

    Science.gov (United States)

    Bratek, Agnieszka; Koźmin-Burzyńska, Agnieszka; Górniak, Eliza; Krysta, Krzysztof

    2015-09-01

    Cushing's syndrome is the term used to describe a set of symptoms associated with hypercortisolism, which in most cases is caused by hypophysial microadenoma over-secreting adrenocorticotropic hormone. This endocrine disorder is often associated with psychiatric comorbidities. The most important include mood disorders, psychotic disorders, cognitive dysfunctions and anxiety disorders. The aim of this article was to review the prevalence, symptoms and consequences of psychiatric disorders in the course of Cushing's syndrome. We therefore performed a literature search using the following keywords: Cushing's syndrome and psychosis, Cushing's syndrome and mental disorders, Cushing's syndrome and depression, Cushing's syndrome and anxiety. The most prevalent psychiatric comorbidity of Cushing's syndrome is depression. Psychiatric manifestations can precede the onset of full-blown Cushing's syndrome and therefore be misdiagnosed. Despite the fact that treatment of the underlying endocrine disease in most cases alleviates psychiatric symptoms, the loss of brain volume persists. It is important to be alert to the symptoms of hypercortisolism in psychiatric patients to avoid misdiagnosis and enable them receiving adequate treatment.

  18. Sociodemographic and medical characteristics of involuntary psychiatric inpatients--retrospective study of five-year experience with Croatian Act on Mental Health.

    Science.gov (United States)

    Potkonjak, Jelena; Karlović, Dalibor

    2008-09-01

    The aim of this study was to analyze sociodemographic and medical characteristics of involuntary psychiatric inpatients treated during the five-year period of implementation of the Croatian Act on Mental Health. Data on involuntarily hospitalized patients according to the Croatian Act on Mental Health were singled out from the pool of inpatients treated at University Department of Psychiatry, Sestre milosrdnice University Hospital from January 1, 1998 till December 31, 2002. Data were collected from medical records. Patients were diagnosed according to the International Classification of Diseases, 10th revision criteria. The prevalence of involuntary hospitalization was 2%, including a comparative number of male and female patients. Most patients had secondary school, were living alone, were unmarried, widowed or divorced, and did not work at the time of hospitalization; however, most patients had some kind of health insurance. Schizophrenia was the most common diagnosis in involuntary psychiatric inpatients. In conclusion, scientific evaluation of involuntary hospitalization poses a major problem because of the many different factors that can influence the prevalence of involuntary hospitalization. Some of this factors are type of institution (psychiatric hospital or psychiatry department at a general hospital), organization of psychiatric care in the region, psychiatric morbidity and dynamics of changes in psychiatric morbidity in a specific region, public opinion about people with mental disorders, legal provisions on this very sensitive topic, etc.

  19. Insight and its relationship with stigma in psychiatric patients

    Directory of Open Access Journals (Sweden)

    Deepak K Mishra

    2009-01-01

    Full Text Available Background: The literature on insight has paid insufficient attention to the social experiences that are associated with receiving and endorsing a diagnosis of mental illness. The psychological and behavioral commitments associated with insight extend beyond agreeing with a diagnosis and accepting treatment to include taking on the identity of an individual diagnosed with mental illness. This study sought to examine the relationship between insight and stigma in psychiatric patients. Materials and Methods: Cross-sectional assessment of insight and stigma was done using the system adopted by Kaplan and Sadock in their comprehensive textbook of psychiatry and Felt Stigma Scale in 100 psychiatric patients (40 patients suffering from Bipolar affective disorder, 30 Schizophrenics, 20 Substance dependents and 10 with Obsessive Compulsive disorder. Results: It was found that the level of stigma felt by patients with insight was significantly higher than that felt by patients without insight. Conclusion: Though there is a certain extent of stigma present in patients without insight, as is expected, the level of stigma increases as the patients develop insight.

  20. Psychiatric Disorders in Smokers Seeking Treatment for Tobacco Dependence: Relations with Tobacco Dependence and Cessation

    Science.gov (United States)

    Piper, Megan E.; Smith, Stevens S.; Schlam, Tanya R.; Fleming, Michael F.; Bittrich, Amy A.; Brown, Jennifer L.; Leitzke, Cathlyn J.; Zehner, Mark E.; Fiore, Michael C.; Baker, Timothy B.

    2010-01-01

    Objective: The present research examined the relation of psychiatric disorders to tobacco dependence and cessation outcomes. Method: Data were collected from 1,504 smokers (58.2% women; 83.9% White; mean age = 44.67 years, SD = 11.08) making an aided smoking cessation attempt as part of a clinical trial. Psychiatric diagnoses were determined with…

  1. Patterns Of Aggression Among Psychiatric In-Patients At The Jos ...

    African Journals Online (AJOL)

    Aggression in the form of violence has been reportedly associated with a variety of psychiatric diagnoses, and in some cases, serious consequences have resulted form such assault. The study was aimed at determining the ranges and target of aggressive behaviour among Psychiatric in-patients at Jos University Teaching ...

  2. [Comorbid psychiatric disorders and differential diagnosis of patients with autism spectrum disorder without intellectual disability].

    Science.gov (United States)

    Strunz, Sandra; Dziobek, Isabel; Roepke, Stefan

    2014-06-01

    Autism spectrum conditions (ASC) without intellectual disability are often diagnosed late in life. Little is known about co-occurring psychiatric disorders and differential diagnosis of ASC in adulthood, particularly with regard to personality disorders. What kind of comorbid psychiatric disorders occur in ASC? Which are the most prevalent differential diagnoses in a sample of patients who seek autism specific clinical diagnostics? 118 adults who were referred with a presumed diagnosis of autistic disorder, were diagnosed with autism specific instruments and the prevalence of further psychiatric disorders was investigated. 59 (50%) fulfilled the criteria of ASC. 36% of the individuals with ASC fulfilled also criteria for a DSM-IV axis-I psychiatric disorder. Affective disorders (24%) and social phobia (14%) were the most prevalent comorbid disorders. The most frequent differential diagnoses were depression, social phobia, paranoid, avoidant and narcissistic personality disorder. © Georg Thieme Verlag KG Stuttgart · New York.

  3. "Psychiatric disorders in smokers seeking treatment for tobacco dependence: Relations with tobacco dependence and cessation": Correction to Piper et al. (2010).

    Science.gov (United States)

    2017-09-01

    Reports an error in "Psychiatric disorders in smokers seeking treatment for tobacco dependence: Relations with tobacco dependence and cessation" by Megan E. Piper, Stevens S. Smith, Tanya R. Schlam, Michael F. Fleming, Amy A. Bittrich, Jennifer L. Brown, Cathlyn J. Leitzke, Mark E. Zehner, Michael C. Fiore and Timothy B. Baker ( Journal of Consulting and Clinical Psychology , 2010[Feb], Vol 78[1], 13-23). There was an error in the Method section in the World Mental Health Survey Initiative version of the CIDI subsection. The authors characterized one of the anxiety conditions analyzed as "panic disorder". However, this should have been labeled as "panic attacks", consequently making the occurrence rates and relations the authors reported actually pertain to panic attacks, social phobia, and generalized anxiety disorder. (The following abstract of the original article appeared in record 2010-00910-005.) Objective: The present research examined the relation of psychiatric disorders to tobacco dependence and cessation outcomes. Data were collected from 1,504 smokers (58.2% women; 83.9% White; mean age = 44.67 years, SD = 11.08) making an aided smoking cessation attempt as part of a clinical trial. Psychiatric diagnoses were determined with the Composite International Diagnostic Interview structured clinical interview. Tobacco dependence was assessed with the Fagerström Test of Nicotine Dependence (FTND) and the Wisconsin Inventory of Smoking Dependence Motives (WISDM). Diagnostic groups included those who were never diagnosed, those who had ever been diagnosed (at any time, including in the past year), and those with past-year diagnoses (with or without prior diagnosis). Some diagnostic groups had lower follow-up abstinence rates than did the never diagnosed group ( ps < .05). At 8 weeks after quitting, strong associations were found between cessation outcome and both past-year mood disorder and ever diagnosed anxiety disorder. At 6 months after quitting, those ever

  4. Measures of motivation for psychiatric treatment based on self-determination theory: psychometric properties in Dutch psychiatric outpatients.

    Science.gov (United States)

    Jochems, Eline C; Mulder, Cornelis L; Duivenvoorden, Hugo J; van der Feltz-Cornelis, Christina M; van Dam, Arno

    2014-08-01

    Self-determination theory is potentially useful for understanding reasons why individuals with mental illness do or do not engage in psychiatric treatment. The current study examined the psychometric properties of three questionnaires based on self-determination theory-The Treatment Entry Questionnaire (TEQ), Health Care Climate Questionnaire (HCCQ), and the Short Motivation Feedback List (SMFL)-in a sample of 348 Dutch adult outpatients with primary diagnoses of mood, anxiety, psychotic, and personality disorders. Structural equation modeling showed that the empirical factor structures of the TEQ and SMFL were adequately represented by a model with three intercorrelated factors. These were interpreted as identified, introjected, and external motivation. The reliabilities of the Dutch TEQ, HCCQ, and SMFL were found to be acceptable but can be improved on; congeneric estimates ranged from 0.66 to 0.94 depending on the measure and patient subsample. Preliminary support for the construct validities of the questionnaires was found in the form of theoretically expected associations with other scales, including therapist-rated motivation and treatment engagement and with legally mandated treatment. Additionally, the study provides insights into the relations between measures of motivation based on self-determination theory, the transtheoretical model and the integral model of treatment motivation in psychiatric outpatients with severe mental illness. © The Author(s) 2013.

  5. Premenstrual Syndrome and Psychiatric Co-morbidities.

    Directory of Open Access Journals (Sweden)

    Ziba Taghizadeh

    2009-04-01

    Full Text Available "n    "nObjective: Premenstrual syndrome (PMS is a common disorder with prevalence rate of approximately 30%; its concurrence with psychiatric symptoms will make it a disabling condition that resists usual treatment. Objective: This study was enrolled to assess the co-morbidity of PMS and psychiatric disorders in a sample of girls with PMS compared to those without PMS. "n    "nMaterial and method : This study was conducted through a cross sectional method with 362 participants (166 with PMS and 196 healthy girls who were selected randomly and completed the demographic questionnaire, premenstrual syndrome symptom daily record scale and the symptom checklist 90-revised (SCL-90-R. "n    "nResult: According to the result of the independent t test, the mean score of all the psychiatric symptoms in the PMS group was significantly higher than those in healthy group (P<0.001. According to SCL-90-R measurement, most of the participants in the PMS group were categorized as extremely sick for somatization (44% ,obsessive-compulsive (59%, depression (58.4%, anxiety (64.5%, hostility (47% and psychoticism (69.3%; most of the participants were diagnosed as having borderline severity of disorders for interpersonal sensitivity (44.6% and paranoid (42.8% and most of the respondents with PMS (46.4% were diagnosed as healthy only for phobic anxiety. "n    "nConclusion: There is a considerable relationship between PMS and different psychiatric symptoms that can complicate the diagnosis of PMS and its treatment for the health care providers. Therefore, all health care providers who are in contact with women in their reproductive age should be sensitive to mental health status in women with PMS.

  6. Psychiatric care in the German prison system.

    Science.gov (United States)

    Lehmann, Marc

    2012-01-01

    The purpose of this paper is to describe the nature of medical care within the German penal system. German prison services provide health care for all inmates, including psychiatric care. The reached level of equivalence of care and ethical problems and resource limitations are discussed and the way of legislation in this field since 2006 reform on federal law is described. The article summarizes basic data on German prison health care for mentally ill inmates. The legislation process and factors of influence are pointed out. A description of how psychiatric care is organized in German prisons follows. It focuses on the actual legal situation including European standards of prison health care and prevention of torture, psychiatric care in German prisons themselves, self harm and addiction. Associated problems such as blood born diseases and tuberculosis are included. The interactions between prison staff and health care personal and ethic aspects are discussed. The legislation process is still going on and there is still a chance to improve psychiatric care. Mental health problems are the major challenge for prison health care. Factors such as special problems of migrants, shortage of professionals and pure statistic data are considered. The paper provides a general overview on psychiatric services in prison and names weak points and strengths of the system.

  7. Psychiatric diagnosis in legal settings

    Directory of Open Access Journals (Sweden)

    Alfred Allan

    2005-12-01

    Full Text Available When asked to give a diagnosis in legal settings practitioners should be mindful of the tentative nature of psychiatric diag- noses and that courts require that such a diagnosis must have scientific credibility. South African courts are not explicit about the test they will apply to determine whether a diagno- sis is scientifically credible, but some guidance can be found in United States case law. This paper examines these criteria with reference to the disorders included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR.

  8. Aggression in Psychiatric Wards

    DEFF Research Database (Denmark)

    Hvidhjelm, Jacob; Sestoft, Dorte; Skovgaard, Lene Theil

    2016-01-01

    Health care workers are often exposed to violence and aggression in psychiatric settings. Short-term risk assessments, such as the Brøset Violence Checklist (BVC), are strong predictors of such aggression and may enable staff to take preventive measures against aggression. This study evaluated...

  9. [Psychiatric treatment sentences.

    DEFF Research Database (Denmark)

    Stevens, Hanne; Nordentoft, Merete; Agerbo, Esben

    2010-01-01

    INTRODUCTION: Previous Danish studies of the increasing number of sentences to psychiatric treatment (SPT) have compared prevalent populations of persons undergoing treatment with incident measures of reported crimes. Examining the period 1990-2006, we studied incident sentences, taking the type...

  10. Eponymous Psychiatric Syndromes Revisited.

    Science.gov (United States)

    Naguy, Ahmed

    2018-02-22

    This report provides an anthology of psychiatric eponyms. Clinically, many of these described syndromes represent valid diagnostic constructs and may accommodate the atypical cases that defy the official diagnostic designation in the current classificatory systems in psychiatry. © Copyright 2018 Physicians Postgraduate Press, Inc.

  11. A prospective study of smoking in young women and risk of later psychiatric hospitalization

    DEFF Research Database (Denmark)

    Sørensen, Holger J; Mortensen, Erik L; Reinisch, June M

    2011-01-01

    It is not known whether smoking is a risk factor for mental disorders. Aims: To investigate the prospective associations between cigarette smoking in pregnant women and a range of psychiatric hospital diagnoses.......It is not known whether smoking is a risk factor for mental disorders. Aims: To investigate the prospective associations between cigarette smoking in pregnant women and a range of psychiatric hospital diagnoses....

  12. Prevalence of Psychiatric Disorders in Patients with Diabetes Type 2

    Directory of Open Access Journals (Sweden)

    S. Alireza Sajjadi

    2012-03-01

    Full Text Available Background: Psychiatric disorders are important complications of chronic diseases such as diabetes mellitus.Materials and method: In this descriptive study, 80 patients with diabetes type 2 referred to diabetes clinic of Zahedan in 2009. They were selected by simple randomized method, screened by General Health Questionnaire and assessed by psychiatric interview, if it was necessary.Results: Totally, 67.5% required an interview and 43.75% were diagnosed with a psychiatric disorder. Major depression were more prevalent (13.5% than adjustment disorders (15%.Conclusion: High prevalence of depression and adjustment disorder in diabetic patients needs psychiatric assessment and treatment as the main part, in the diabetes clinics

  13. The ICD diagnoses of fetishism and sadomasochism.

    Science.gov (United States)

    Reiersøl, Odd; Skeid, Svein

    2006-01-01

    In this article we discuss psychiatric diagnoses of sexual deviation as they appear in the International Classification of Diseases (ICD-10), the internationally accepted classification and diagnostic system of the World Health Organization (WHO). Namely, we discuss the background of three diagnostic categories: Fetishism (F65.0), Fetishistic Transvestism (F65.1), and Sadomasochism (F65.5). Pertinent background issues regarding the above categories are followed by a critique of the usefulness of diagnosing these phenomena today. Specifically, we argue that Fetishism, Fetishistic Transvestism, and Sadomasochism, also labeled Paraphilia or perversion, should not be considered illnesses. Finally, we present the efforts of an initiative known as ReviseF65, which was established in 1997, to abolish these diagnoses.

  14. Psychiatric Advance Directives: Getting Started

    Science.gov (United States)

    ... News Legal Issues Search for: About PADs A psychiatric advance directive (PAD) is a legal document that ... decisions during a mental health crisis. Getting Started Psychiatric advance directives (PADs) are relatively new legal instruments ...

  15. Risk of psychiatric disorders in offspring of parents with a history of homelessness during childhood and adolescence in Denmark: a nationwide, register-based, cohort study.

    Science.gov (United States)

    Nilsson, Sandra Feodor; Laursen, Thomas Munk; Hjorthøj, Carsten; Thorup, Anne; Nordentoft, Merete

    2017-12-01

    Children and adolescents from deprived backgrounds have high rates of psychiatric problems. Parental and social factors are crucial for children's healthy and positive development, but whether psychiatric morbidity is associated with parental social marginalisation is unknown. We aimed to analyse the association between mother's and father's history of homelessness and the offspring's risk of psychiatric disorders, including substance use disorder, during childhood and adolescence. We did a nationwide, register-based cohort study of 1 072 882 children and adolescents aged 0-16 years, who were living or born in Denmark between Jan 1, 1999, and Dec 31, 2015. Parental homelessness was the primary exposure, data on which were obtained from the Danish Homeless Register. The Danish Civil Registration System was used to extract the population and link offspring to parental information, and the outcome, psychiatric disorders in the offspring, was obtained from the Danish Psychiatric Central Research Register and the Danish National Patient Register. We analysed the association between parental history of homelessness and risk of psychiatric disorders in offspring by survival analysis using Poisson regression and incidence rate ratios (IRRs), adjusted for year and offspring characteristics, and additionally adjusted for parental factors (age at offspring's birth and parental psychiatric disorders). 17 238 (2%) offspring had either one or two parents with a history of homelessness, and 56 330 (5%) children and adolescents were diagnosed with any psychiatric disorder during the study period. The incidence of any psychiatric disorder was 15·1 cases per 1000 person-years (95% CI 14·4-15·8) in offspring with at least one parent with a history of homelessness, compared with 6·0 per 1000 person-years (95% CI 6·0-6·1) in those whose parents had no such history (IRR 2·5 [95% CI 2·3-2·7] for mother homeless, 2·3 [2·2-2·5] for father homeless, and 2·8 [2·4-3·2

  16. Risk of psychiatric disorders in offspring of parents with a history of homelessness during childhood and adolescence in Denmark: a nationwide, register-based, cohort study

    Directory of Open Access Journals (Sweden)

    Sandra Feodor Nilsson, MSc

    2017-12-01

    Full Text Available Summary: Background: Children and adolescents from deprived backgrounds have high rates of psychiatric problems. Parental and social factors are crucial for children's healthy and positive development, but whether psychiatric morbidity is associated with parental social marginalisation is unknown. We aimed to analyse the association between mother's and father's history of homelessness and the offspring's risk of psychiatric disorders, including substance use disorder, during childhood and adolescence. Methods: We did a nationwide, register-based cohort study of 1 072 882 children and adolescents aged 0–16 years, who were living or born in Denmark between Jan 1, 1999, and Dec 31, 2015. Parental homelessness was the primary exposure, data on which were obtained from the Danish Homeless Register. The Danish Civil Registration System was used to extract the population and link offspring to parental information, and the outcome, psychiatric disorders in the offspring, was obtained from the Danish Psychiatric Central Research Register and the Danish National Patient Register. We analysed the association between parental history of homelessness and risk of psychiatric disorders in offspring by survival analysis using Poisson regression and incidence rate ratios (IRRs, adjusted for year and offspring characteristics, and additionally adjusted for parental factors (age at offspring's birth and parental psychiatric disorders. Findings: 17 238 (2% offspring had either one or two parents with a history of homelessness, and 56 330 (5% children and adolescents were diagnosed with any psychiatric disorder during the study period. The incidence of any psychiatric disorder was 15·1 cases per 1000 person-years (95% CI 14·4–15·8 in offspring with at least one parent with a history of homelessness, compared with 6·0 per 1000 person-years (95% CI 6·0–6·1 in those whose parents had no such history (IRR 2·5 [95

  17. Diagnosing Tic Disorders

    Science.gov (United States)

    ... Submit" /> Information For… Media Policy Makers Diagnosing Tic Disorders Language: English (US) Español (Spanish) Recommend on ... or postviral encephalitis). Persistent (Chronic) Motor or Vocal Tic Disorder To be diagnosed with a persistent tic ...

  18. The nursing process in crisis-oriented psychiatric home care.

    Science.gov (United States)

    Boomsma, J; Dingemans, C A; Dassen, T W

    1997-08-01

    Crisis-oriented psychiatric home care is a recent development in the Dutch mental health care system. Because of the difference between psychiatric care in the home and in the hospital, an action research project was initiated. This project was directed at the nursing process and the nurses' role and skills in psychiatric home care. The main goal of the project was to describe and to standardize nursing diagnoses and interventions used in crisis-oriented and long-term psychiatric home care. The development of supporting methods of assessment and intervention were also important aspects of this project. In this article a crisis-oriented psychiatric home care programme and the first developmental research activities within this programme are described. To support the nursing process, the development of a nursing record and an assessment-format, based on Gordon's Functional Health Patterns (FHP), took place. By means of content analysis of 61 nursing records, the most frequently stated nursing diagnoses, based upon the North American Nursing Diagnosis Association (NANDA) taxonomy, were identified. The psychiatric diagnostic categories of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) were also collected. The most common categories found were those of mood disorders and schizophrenia or psychotic disorders. Seventy-five per cent of the nursing diagnoses showed up within four FHP: role-relationship, coping-stress tolerance, self-perception/self-concept and activity-exercise. The nursing diagnosis of 'ineffective individual coping' was stated most frequently. This is not surprising because of the similarities in the definitions of this nursing diagnosis and the concept of 'crisis' to which the psychiatric home care programme is oriented. Further research activities will be focused on standardization of nursing diagnosis and the interventions that nurses undertake in this type of care.

  19. A randomized trial of dialectical behavior therapy versus general psychiatric management for borderline personality disorder.

    Science.gov (United States)

    McMain, Shelley F; Links, Paul S; Gnam, William H; Guimond, Tim; Cardish, Robert J; Korman, Lorne; Streiner, David L

    2009-12-01

    The authors sought to evaluate the clinical efficacy of dialectical behavior therapy compared with general psychiatric management, including a combination of psychodynamically informed therapy and symptom-targeted medication management derived from specific recommendations in APA guidelines for borderline personality disorder. This was a single-blind trial in which 180 patients diagnosed with borderline personality disorder who had at least two suicidal or nonsuicidal self-injurious episodes in the past 5 years were randomly assigned to receive 1 year of dialectical behavior therapy or general psychiatric management. The primary outcome measures, assessed at baseline and every 4 months over the treatment period, were frequency and severity of suicidal and nonsuicidal self-harm episodes. Both groups showed improvement on the majority of clinical outcome measures after 1 year of treatment, including significant reductions in the frequency and severity of suicidal and nonsuicidal self-injurious episodes and significant improvements in most secondary clinical outcomes. Both groups had a reduction in general health care utilization, including emergency visits and psychiatric hospital days, as well as significant improvements in borderline personality disorder symptoms, symptom distress, depression, anger, and interpersonal functioning. No significant differences across any outcomes were found between groups. These results suggest that individuals with borderline personality disorder benefited equally from dialectical behavior therapy and a well-specified treatment delivered by psychiatrists with expertise in the treatment of borderline personality disorder.

  20. Pitfalls in diagnosing limbic encephalitis - a case report.

    Science.gov (United States)

    Kerling, F; Blümcke, I; Stefan, H

    2008-11-01

    The syndrome of limbic encephalitis (LE) is characterized by subacute onset of temporal lobe epilepsy, loss of short-term memory, cognitive confusion and psychiatric symptoms. We report a patient with pharmacoresistant epilepsy who underwent presurgical video-electroencephalogram (EEG)-monitoring with normal psychiatric and neuropsychological findings. Magnetic resonance imaging (MRI) revealed a hyperintense lesion within the right amygdala but no contrast enhancement. Analysis of cerebrospinal fluid (CSF) showed pleocytosis and positive oligoclonal bands, but all tests for neurotropic viruses or borrelia antibodies were negative. Presurgical evaluation identified a right mesiotemporal focus. As a tumour was the most likely differential diagnosis, we performed selective amygdalohippocampectomy of the right hemisphere. Subsequent histopathological examination revealed the surprising diagnosis of LE. As a consequence, tumour screening was initiated and a testicular carcinoma with high anti-Ma2-antibody titres was detected. Following surgical and chemotherapeutical treatment, the patient was seizure-free and Ma2-antibodies decreased below detection limits. Conclusion - This case report highlights that LE has to be considered even in patients with atypical clinical presentation, i.e. without neuropsychological deficits, if CSF analysis reveals an inflammatory response. When LE is diagnosed, extensive tumour search is mandatory to detect and treat the paraneoplastic origin of LE. Therapeutic strategies of LE include surgical treatment as well as early immunosuppression.

  1. Substance Misuse in the Psychiatric Emergency Service; A Descriptive Study

    Directory of Open Access Journals (Sweden)

    Yves Chaput

    2014-01-01

    Full Text Available Substance misuse is frequently encountered in the psychiatric emergency service (PES and may take many forms, ranging from formal DSM-IV diagnoses to less obvious entities such as hazardous consumption. Detecting such patients using traditional screening instruments has proved problematic. We therefore undertook this study to more fully characterize substance misuse in the PES and to determine whether certain variables might help better screen these patients. We used a prospectively acquired database of over 18,000 visits made to four PESs during a 2-year period in the province of Quebec, Canada. One of the variables acquired was a subjective rating by the nursing staff as to whether substance misuse was a contributing factor to the visit (graded as direct, indirect, or not at all. Substance misuse accounted for 21% of all diagnoses and alcohol was the most frequent substance used. Patients were divided into those with primary (PSM, comorbid (CSM or no substance misuse (NSM. Depressive disorders were the most frequent primary diagnoses in CSM, whereas personality and substance misuse disorders were frequent secondary diagnoses in PSM. Although many variables significantly differentiated the three groups, few were sufficiently detailed to be used as potential screening tools. Those situations that did have sufficient details included those with a previous history of substance misuse, substance misuse within 48 hours of the visit, and visits graded by the nursing staff as being directly and/or indirectly related to substance misuse. Variables related to substance misuse itself were the primary predictors of PSM and, less significantly, CSM. The nursing staff rating, although promising, was obtained in less than 30% of all visits, rendering its practical use difficult to assess.

  2. Pre-surgical predictors for psychiatric disorders following epilepsy surgery in patients with refractory temporal lobe epilepsy and mesial temporal sclerosis.

    Science.gov (United States)

    Filho, Gerardo Maria de Araújo; Mazetto, Lenon; Gomes, Francinaldo Lobato; Marinho, Murilo Martinez; Tavares, Igor Melo; Caboclo, Luís Otávio Sales Ferreira; Centeno, Ricardo Silva; Yacubian, Elza Márcia Targas

    2012-11-01

    Psychiatric outcomes of patients submitted to epilepsy surgery have gained particular interest given the high prevalence of pre-surgical psychiatric disorders (PD) in this population. The present study aimed to verify the possible pre-surgical predictors for psychiatric disorders following epilepsy surgery in a homogeneous series of patients with refractory temporal lobe epilepsy and mesial temporal sclerosis (TLE-MTS). Data from 115 TLE-MTS patients (65 females; 56.5%) who underwent cortico-amygdalohippocampectomy were included. Pre- and post-surgical psychiatric evaluations were performed using DSM-IV criteria. Pre-surgical PD - particularly mood, anxiety and psychotic disorders - were diagnosed in 47 patients (40.8%). Twenty-seven patients (54% of those with pre-surgical PD) demonstrated a remission of psychiatric symptoms on post-surgical psychiatric evaluation. Eleven patients (9.6%) developed de novo PD. The presence of pre-surgical depression (OR=3.32; p=0.008), pre-surgical interictal psychosis (OR=4.39; p=0.009) and epileptiform discharges contralateral to the epileptogenic zone (OR=2.73; p=0.01) were risk factors associated with post-surgical PD. Although epilepsy surgery is considered to be the best treatment option for patients with refractory TLE-MTS, the relatively high psychiatric comorbidities observed in surgical candidates and their possible negative impact on post-surgical outcomes require a careful pre-surgical evaluation of clinical, sociodemographic and psychiatric factors. Copyright © 2012 Elsevier B.V. All rights reserved.

  3. Vestibular vertigo and comorbid cognitive and psychiatric impairment: the 2008 National Health Interview Survey.

    Science.gov (United States)

    Bigelow, Robin T; Semenov, Yevgeniy R; du Lac, Sascha; Hoffman, Howard J; Agrawal, Yuri

    2016-04-01

    Patients with vestibular disease have been observed to have concomitant cognitive and psychiatric dysfunction. We evaluated the association between vestibular vertigo, cognitive impairment and psychiatric conditions in a nationally representative sample of US adults. We performed a cross-sectional analysis using the 2008 National Health Interview Survey (NHIS), which included a Balance and Dizziness Supplement, and questions about cognitive function and psychiatric comorbidity. We evaluated the association between vestibular vertigo, cognitive impairment (memory loss, difficulty concentrating, confusion) and psychiatric diagnoses (depression, anxiety and panic disorder). We observed an 8.4% 1-year prevalence of vestibular vertigo among US adults. In adjusted analyses, individuals with vestibular vertigo had an eightfold increased odds of 'serious difficulty concentrating or remembering' (OR 8.3, 95% CI 4.8 to 14.6) and a fourfold increased odds of activity limitation due to difficulty remembering or confusion (OR 3.9, 95% CI 3.1 to 5.0) relative to the rest of the US adults. Individuals with vestibular vertigo also had a threefold increased odds of depression (OR 3.4, 95% CI 2.9 to 3.9), anxiety (OR 3.2, 95% CI 2.8 to 3.6) and panic disorder (OR 3.4, 95% CI 2.9 to 4.0). Our findings indicate that vestibular impairment is associated with increased risk of cognitive and psychiatric comorbidity. The vestibular system is anatomically connected with widespread regions of the cerebral cortex, hippocampus and amygdala. Loss of vestibular inputs may lead to impairment of these cognitive and affective circuits. Further longitudinal research is required to determine if these associations are causal. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. High psychiatric comorbidity in adolescents with dissociative disorders.

    Science.gov (United States)

    Bozkurt, Hasan; Duzman Mutluer, Tuba; Kose, Cigdem; Zoroglu, Salih

    2015-06-01

    The aim of this study was to evaluate psychiatric comorbidity rates and patterns in a sample of clinically referred adolescents diagnosed with dissociative disorders (DD) by using a structured interview. All participants completed a comprehensive test battery, which consisted of a questionnaire for sociodemographic data and clinical history, Child Posttraumatic Stress Reaction Index, Childhood Abuse and Neglect Questionnaire and the Adolescent Dissociative Experiences Scale. Diagnosis was made by the Structured Clinical Interview for DSM-IV Dissociative Disorders. Psychiatric comorbidity was assessed using the Schedule for Affective Disorders and Schizophrenia for School Age Children - Present and Lifetime Version. A total of 25 adolescent subjects aged 12-18 years participated in the study. Ten adolescents were diagnosed as having dissociative identity disorder and 15 of them were diagnosed as having dissociative disorder-not otherwise specified based on the Structured Clinical Interview for DSM-IV Dissociative Disorders findings. Adolescents with dissociative identity disorder were found to have higher scores on the Adolescent Dissociative Experiences Scale and Child Posttraumatic Stress Reaction Index than the dissociative disorder-not otherwise specified group. Sexual and physical abuses were also found to be among the main traumatic events. Incest was reported in six cases of the study sample. All subjects had at least one comorbid psychiatric disorder. The most common psychiatric diagnoses were major depressive disorder (n = 25; 100%) and post-traumatic stress disorder (n = 22; 88%). High psychiatric comorbidity rates were found in adolescents diagnosed with DD. A prevalent history of abuse and traumatic events was represented. Clinicians should be aware of the impacts of DD on adolescents' mental health. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

  5. Associations between self-rated mental health and psychiatric disorders among older adults: do racial/ethnic differences exist?

    Science.gov (United States)

    Kim, Giyeon; DeCoster, Jamie; Chiriboga, David A; Jang, Yuri; Allen, Rebecca S; Parmelee, Patricia

    2011-05-01

    [corrected] This study examined racial/ethnic differences in the association between self-rated mental health (SRMH) and psychiatric disorders among community-dwelling older adults in the United States. Cross-sectional analyses of nationally representative data from the Collaborative Psychiatric Epidemiology Surveys (2001-2003). In-person household interviews. Older adults aged 60 and older (N = 1,840), including non-Hispanic Whites (N = 351), Blacks (N = 826), Hispanics (N = 406), and Asians (N = 257). SRMH was measured with a single item, "How would you rate your own mental health?" Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), diagnoses for mood and anxiety disorders were measured with the World Health Organization's World Mental Health version of the Composite International Diagnostic Interview. Results from logistic regression analyses showed significant main effects of both SRMH and race/ethnicity on the presence of mood and anxiety disorders: people who have poor SRMH and are non-Hispanic Whites were more likely to have mood and anxiety disorders. There were also significant interaction effects between SRMH and race/ethnicity, such that the relation of SRMH with diagnoses of psychiatric disorders was strongest in non-Hispanic Whites. Racial/ethnic variations were found in the relationship between self-perception of mental health and DSM-IV psychiatric disorders. The findings suggest the need to develop race/ethnicity-specific strategies to screen psychiatric disorders in diverse elderly populations. Future studies are needed to investigate possible reasons for the racial/ethnic group differences.

  6. Risk of Psychiatric Disorders Among Individuals With the 22q11.2 Deletion or Duplication

    DEFF Research Database (Denmark)

    Hoeffding, Louise K; Trabjerg, Betina B; Olsen, Line

    2017-01-01

    ) age at diagnosis of any psychiatric disorder was 12.5 (8.3) years for individuals with deletions and 6.1 (0.9) years for duplication carriers. A parental diagnosis of schizophrenia-but not of other psychiatric diagnoses-was associated with a 22q11.2 deletion, and parental psychiatric diagnoses other.......2 deletion or duplicationwas performed. A total of 3 768 943 individuals born in Denmark from 1955 to 2012 were followed up during the study period (total follow-up, 57.1 million person-years). Indicators of 22q11.2 deletion or duplication and cumulative incidenceswere estimated using a nested case...

  7. Higher incidence of hip fracture in newly diagnosed schizophrenic ...

    African Journals Online (AJOL)

    Higher incidence of hip fracture in newly diagnosed schizophrenic patients in Taiwan. Hip fracture is a major public health concern due to its poor outcome and serious socioeconomic burden in older people (1). Evidence has shown that many factors are related to increased risk of hip fracture, but psychiatric diseases are ...

  8. The psychiatric interview

    DEFF Research Database (Denmark)

    Frederiksen, Julie Elisabeth Nordgaard; Sass, Louis A; Parnas, Josef

    2012-01-01

    interview. We address the ontological status of pathological experience, the notions of symptom, sign, prototype and Gestalt, and the necessary second-person processes which are involved in converting the patient's experience (originally lived in the first-person perspective) into an "objective" (third......There is a glaring gap in the psychiatric literature concerning the nature of psychiatric symptoms and signs, and a corresponding lack of epistemological discussion of psycho-diagnostic interviewing. Contemporary clinical neuroscience heavily relies on the use of fully structured interviews...... person), actionable format, used for classification, treatment, and research. Our central thesis is that psychiatry targets the phenomena of consciousness, which, unlike somatic symptoms and signs, cannot be grasped on the analogy with material thing-like objects. We claim that in order to perform...

  9. Diagnosing night sweats.

    Science.gov (United States)

    Viera, Anthon J; Bond, Michael M; Yates, Scott W

    2003-03-01

    Night sweats are a common outpatient complaint, yet literature on the subject is scarce. Tuberculosis and lymphoma are diseases in which night sweats are a dominant symptom, but these are infrequently found to be the cause of night sweats in modern practice. While these diseases remain important diagnostic considerations in patients with night sweats, other diagnoses to consider include human immunodeficiency virus, gastroesophageal reflux disease, obstructive sleep apnea, hyperthyroidism, hypoglycemia, and several less common diseases. Antihypertensives, antipyretics, other medications, and drugs of abuse such as alcohol and heroin may cause night sweats. Serious causes of night sweats can be excluded with a thorough history, physical examination, and directed laboratory and radiographic studies. If a history and physical do not reveal a possible diagnosis, physicians should consider a purified protein derivative, complete blood count, human immunodeficiency virus test, thyroid-stimulating hormone test, erythrocyte sedimentation rate evaluation, chest radiograph, and possibly chest and abdominal computed tomographic scans and bone marrow biopsy.

  10. ABO blood groups and psychiatric disorders: a Croatian study.

    Science.gov (United States)

    Pisk, Sandra Vuk; Vuk, Tomislav; Ivezić, Ena; Jukić, Irena; Bingulac-Popović, Jasna; Filipčić, Igor

    2018-02-15

    The prevalence of ABO alleles is different in different populations, and many studies have shown a correlation between the occurrences of some diseases and different genotypes of ABO blood groups. The aim of this study was to determine whether there is a significant association between psychiatric syndromes and ABO blood groups. This case-control study involved 156 psychiatric patients and 303 healthy, unrelated, voluntary blood donors. Genomic DNA was isolated from blood on a QIAcube device using a QIAamp DNA Blood mini QIAcube kit. ABO genotyping on five basic ABO alleles was performed using allele-specific polymerase chain reaction analysis. Compared with healthy subjects, a significantly higher proportion of psychiatric patients had AB blood group (χ 2 =9.359, df=3, p=0.025) and, accordingly, a significantly higher incidence of A1B genotype (χ 2 =8.226, df=3, p=0.042). The odds ratio showed that psychiatric disorders occur almost three times more frequently in carriers of AB group compared to other blood groups. However, no statistically significant difference was found in the distribution of ABO blood groups among patients with different psychiatric diagnoses. Likewise, no correlations were found between ABO blood groups and other characteristics of the psychiatric patients (sex, psychiatric heredity, somatic comorbidity, suicidality). The results of this study support the hypothesis of an association between psychiatric disorders and ABO blood groups. The probability is that psychiatric disorders will occur almost three times more frequently in carriers of AB group compared to other ABO blood groups in the Croatian population.

  11. Agitation in the inpatient psychiatric setting: a review of clinical presentation, burden, and treatment.

    Science.gov (United States)

    Hankin, Cheryl S; Bronstone, Amy; Koran, Lorrin M

    2011-05-01

    Agitation among psychiatric inpatients (particularly those diagnosed with schizophrenia or bipolar disorder) is common and, unless recognized early and managed effectively, can rapidly escalate to potentially dangerous behaviors, including physical violence. Inpatient aggression and violence have substantial adverse psychological and physical consequences for both patients and providers, and they are costly to the healthcare system. In contrast to the commonly held view that inpatient violence occurs without warning or can be predicted by "static" risk factors, such as patient demographics or clinical characteristics, research indicates that violence is usually preceded by observable behaviors, especially non-violent agitation. When agitation is recognized, staff should employ nonpharmacological de-escalation strategies and, if the behavior continues, offer pharmacological treatment to calm patients rapidly. Given the poor therapeutic efficacy and potential for adverse events associated with physical restraint and seclusion, and the potential adverse sequelae of involuntary drug treatment, these interventions should be considered last resorts. Pharmacological agents used to treat agitation include benzodiazepines and first- and second-generation antipsychotic drugs. Although no currently available agent is ideal, recommendations for selecting among them are provided. There remains an unmet need for a non-invasive and rapidly acting agent that effectively calms without excessively sedating patients, addresses the patient's underlying psychiatric symptoms, and is reasonably safe and tolerable. A treatment with these characteristics could substantially reduce the clinical and economic burden of agitation in the inpatient psychiatric setting.

  12. Psychiatric disorders and clinical correlates of suicidal patients admitted to a psychiatric hospital in Tokyo

    Directory of Open Access Journals (Sweden)

    Ishimoto Kayo

    2010-12-01

    Full Text Available Abstract Background Patients admitted to a psychiatric hospital with suicidal behavior (SB are considered to be especially at high risk of suicide. However, the number of studies that have addressed this patient population remains insufficient compared to that of studies on suicidal patients in emergency or medical settings. The purpose of this study is to seek features of a sample of newly admitted suicidal psychiatric patients in a metropolitan area of Japan. Method 155 suicidal patients consecutively admitted to a large psychiatric center during a 20-month period, admission styles of whom were mostly involuntary, were assessed using Structured Clinical Interviews for DSM-IV Axis I and II Disorders (SCID-I CV and SCID-II and SB-related psychiatric measures. Associations of the psychiatric diagnoses and SB-related characteristics with gender and age were examined. Results The common DSM-IV axis I diagnoses were affective disorders 62%, anxiety disorders 56% and substance-related disorders 38%. 56% of the subjects were diagnosed as having borderline PD, and 87% of them, at least one type of personality disorder (PD. SB methods used prior to admission were self-cutting 41%, overdosing 32%, self-strangulation 15%, jumping from a height 12% and attempting traffic death 10%, the first two of which were frequent among young females. The median (range of the total number of SBs in the lifetime history was 7 (1-141. Severity of depressive symptomatology, suicidal intent and other symptoms, proportions of the subjects who reported SB-preceding life events and life problems, and childhood and adolescent abuse were comparable to those of the previous studies conducted in medical or emergency service settings. Gender and age-relevant life-problems and life events were identified. Conclusions Features of the studied sample were the high prevalence of affective disorders, anxiety disorders and borderline PD, a variety of SB methods used prior to admission

  13. Ayahuasca in adolescence: a preliminary psychiatric assessment.

    Science.gov (United States)

    Da Silveira, Dartiu Xavier; Grob, Charles S; de Rios, Marlene Dobkin; Lopez, Enrique; Alonso, Luisa K; Tacla, Cristiane; Doering-Silveira, Evelyn

    2005-06-01

    Ayahuasca is believed to be harmless for those (including adolescents) drinking it within a religious setting. Nevertheless controlled studies on the mental/ psychiatric status of ritual hallucinogenic ayahuasca concoction consumers are still lacking. In this study, 40 adolescents from a Brazilian ayahuasca sect were compared with 40 controls matched on sex, age, and educational background for psychiatric symptomatology. Screening scales for depression, anxiety, alcohol consumption patterns (abuse), attentional problems, and body dysmorphic disorders were used. It was found that, compared to controls, considerable lower frequencies of positive scoring for anxiety, body dismorphism, and attentional problems were detected among ayahuasca-using adolescents despite overall similar psychopathological profiles displayed by both study groups. Low frequencies of psychiatric symptoms detected among adolescents consuming ayahuasca within a religious context may reflect a protective effect due to their religious affiliation. However further studies on the possible interference of other variables in the outcome are necessary.

  14. Ecological momentary assessment and smartphone application intervention in adolescents with substance use and comorbid severe psychiatric disorders: study protocol

    Directory of Open Access Journals (Sweden)

    Xavier Benarous

    2016-09-01

    Full Text Available Context: Substance Use Disorders (SUDs are highly prevalent among inpatient adolescents with psychiatric disorders. In this population, substance use and other psychiatric outcomes can reinforce one another. Despite the need for integrated interventions in youths with dual diagnoses, few specific instruments are available. App-based technologies have shown promising results to help reduce substance use in adolescents, but their applicability in youths with associated severe psychiatric disorders is poorly documented. We aim to evaluate the feasibility of an ecological momentary assessment (EMA intervention for all substance users, and of a smart-phone application for cannabis users (Stop-Cannabis, for outpatient treatment after hospital discharge. Methods and analysis: All inpatient adolescents with psychiatric disorders hospitalized between 2016 and 2018 in a university hospital will be systematically screened for SUD and, if positive, will be assessed by an independent specialist addiction team. Participants with confirmed SUDs will be invited and helped to download an EMA app and, if required, the Stop-Cannabis app the week preceding hospital discharge. Information about the acceptability and use of both apps and the validity of EMA data in comparison to clinical assessments will be assessed after 6 months and one year.Discussion: This research has been designed to raise specific issues for consideration regarding the sequence between substance use, contextual factors, and other psychiatric symptoms among adolescents with comorbid severe psychiatric disorders. A better understanding of the mechanisms involved will inform the development of integrated treatment for dual disorders at that age.Ethics and dissemination: The study has already been approved and granted. Dissemination will include presentations at international congresses as well as publications in peer-reviewed journals.Trial registration: European Clinical Trials Database: Number

  15. Increase in sickness absence with psychiatric diagnosis in Norway: a general population-based epidemiologic study of age, gender and regional distribution

    Directory of Open Access Journals (Sweden)

    Brage Sören

    2006-08-01

    Full Text Available Abstract Background The aim of this study was to assess the incidence of sickness absence with psychiatric diagnoses from 1994–2000, and the distribution across gender, age groups, diagnostic groups and regions in a general population. Methods The population at risk was defined as all individuals aged 16–66 years who were entitled to sickness benefits in 1994, 1996, 1998 and 2000 (n = 2,282,761 in 2000. All individuals with a full-time disability pension were excluded. The study included approximately 77% of the Norwegian population aged 16–66 years. For each year, the study base started on 1 January and ended on 31 December. Individuals that were sick-listed for more than 14/16 consecutive days with a psychiatric diagnosis on their medical certificate were selected as cases. Included in this study were data for Norway, the capital city Oslo and five regions in the southeast of the country. Results Sickness absence with psychiatric diagnoses increased in all age groups, in women and men, and in all regions. At the national level, the cumulative incidence increased in women from 1.7% in 1994 to 4.6% in 2000, and in men from 0.8% in 1994 to 2.2% in 2000. The highest cumulative incidence was found in middle-aged women and men (30–59 years. Women had a higher incidence than men in all stratification groups. The cumulative incidences in 2000 varied between 4.6% to 5.6% in women in the different regions, and for men the corresponding figures were 2.1% to 3.2%. Throughout the four years studied, women in Oslo had more than twice as high incidence levels of sickness absence with alcohol and drug diagnoses as the country as a whole. There were some differences between regions in sickness absence with specific psychiatric diagnoses, but they were small and most comparisons were non-significant. Conclusion Sickness absence with psychiatric diagnoses increased between 1994 and 2000 in Norway. The increase was highest in the middle-aged, and in women

  16. Sexual Attitude Reassessment for Psychiatric Patients.

    Science.gov (United States)

    Dincin, Jerry; Wise, Shirley

    1979-01-01

    Sexuality programs are one part of the program at Thresholds, a rehabilitation center for psychiatric patients (17 to 50 years old). A 16 week sexuality group includes seven phases: initial interview; beginning group development (health care, contraception, reproduction, sexuality); masturbation; intercourse; homosexuality; coed group discussion;…

  17. Data preparation techniques for a perinatal psychiatric study based on linked data.

    Science.gov (United States)

    Xu, Fenglian; Hilder, Lisa; Austin, Marie-Paule; Sullivan, Elizabeth A

    2012-06-08

    In recent years there has been an increase in the use of population-based linked data. However, there is little literature that describes the method of linked data preparation. This paper describes the method for merging data, calculating the statistical variable (SV), recoding psychiatric diagnoses and summarizing hospital admissions for a perinatal psychiatric study. The data preparation techniques described in this paper are based on linked birth data from the New South Wales (NSW) Midwives Data Collection (MDC), the Register of Congenital Conditions (RCC), the Admitted Patient Data Collection (APDC) and the Pharmaceutical Drugs of Addiction System (PHDAS). The master dataset is the meaningfully linked data which include all or major study data collections. The master dataset can be used to improve the data quality, calculate the SV and can be tailored for different analyses. To identify hospital admissions in the periods before pregnancy, during pregnancy and after birth, a statistical variable of time interval (SVTI) needs to be calculated. The methods and SPSS syntax for building a master dataset, calculating the SVTI, recoding the principal diagnoses of mental illness and summarizing hospital admissions are described. Linked data preparation, including building the master dataset and calculating the SV, can improve data quality and enhance data function.

  18. Queer diagnoses revisited: The past and future of homosexuality and gender diagnoses in DSM and ICD.

    Science.gov (United States)

    Drescher, Jack

    2015-01-01

    The American Psychiatric Association (APA) recently completed a several year process of revising the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). During that time, there were objections raised to retaining DSM's gender identity disorder diagnoses and calls to remove them, just as homosexuality had been removed from DSM-II in 1973. At the conclusion of the DSM-5 revision process, the gender diagnoses were retained, albeit in altered form and bearing the new name of 'gender dysphoria'. The author of this paper was a member of the DSM-5 Workgroup on Sexual and Gender Identity Disorders and presently serves on the WHO Working Group on Sexual Disorders and Sexual Health. Both groups faced similar tasks: reconciling patients' needs for access to care with the stigma of being given a psychiatric diagnosis. The differing nature of the two diagnostic manuals led to two different outcomes. As background, this paper updates the history of homosexuality and the gender diagnoses in the DSM and in the International Statistical Classification of Diseases and Related Health Problems (ICD) as well as what is expected to happen to the homosexuality and gender diagnoses following the current ICD-11 revision process.

  19. Boys with Asperger Syndrome Grow Up: Psychiatric and Neurodevelopmental Disorders 20 Years After Initial Diagnosis.

    Science.gov (United States)

    Gillberg, I Carina; Helles, Adam; Billstedt, Eva; Gillberg, Christopher

    2016-01-01

    We examined comorbid psychiatric and neurodevelopmental disorders in fifty adult males (mean age 30 years) with Asperger syndrome (AS) diagnosed in childhood and followed up prospectively for almost two decades (13-26 years). Only three of the 50 men had never met criteria for an additional psychiatric/neurodevelopmental diagnosis and more than half had ongoing comorbidity (most commonly either ADHD or depression or both). Any psychiatric comorbidity increased the risk of poorer outcome. The minority of the AS group who no longer met criteria for a full diagnosis of an autism spectrum disorder were usually free of current psychiatric comorbidity. The high rate of psychiatric/neurodevelopmental comorbidities underscores the need for a full psychiatric/neurodevelopmental assessment at follow-up of males with AS.

  20. PSYCHIATRIC MORBIDITY AND PERSONALITY PROFILE IN DIVORCE SEEKING COUPLES

    Science.gov (United States)

    Batra, Lalit; Gautam, Shiv

    1995-01-01

    To what extent psychiatric morbidity and personality factors contribute to marital disharmony and decision to divorce is still an unanswered question in Indian setting. This study was undertaken with aims to find out (1) the prevalence of psychiatric morbidity in persons seeking divorce; (2) the prevalence of psychiatric morbidity in persons who had good marital adjustment; (3) the nature of psychiatric morbidity observed in these subjects, and (4) the personality profile of these subjects. Fifty randomly selected divorce seeking couples (n=100) from the matrimonial court of Jaipur City and thirty couples with good marital adjustment (n=60) selected from the community were studied. Probable psychiatric cases identified by administering GHQ (Hindi version) were diagnosed according to ICD-10 and personality profile of all cases was studied by using 16 PF. High psychiatric morbidity (50%) was found among divorce seeking couples in comparison to control group (13%). There was a high prevalence of neurone disorders (22%) and mood disorders (16%) in experimental group. Schizophrenia and related disorders (10%) and substance abuse disorder (2%) were seen only in the experimental group. Specific personality factors related to divorce seeking individuals and persons with stable marriage have been identified. The implications of this study are highlighted. PMID:21743746

  1. Assessing the reliability, predictive and construct validity of historical, clinical and risk management-20 (HCR-20) in Mexican psychiatric inpatients.

    Science.gov (United States)

    Sada, Andrea; Robles-García, Rebeca; Martínez-López, Nicolás; Hernández-Ramírez, Rafael; Tovilla-Zarate, Carlos-Alfonso; López-Munguía, Fernando; Suárez-Alvarez, Enrique; Ayala, Xochitl; Fresán, Ana

    2016-08-01

    Assessing dangerousness to gauge the likelihood of future violent behaviour has become an integral part of clinical mental health practice in forensic and non-forensic psychiatric settings, one of the most effective instruments for this being the Historical, Clinical and Risk Management-20 (HCR-20). To examine the HCR-20 factor structure in Mexican psychiatric inpatients and to obtain its predictive validity and reliability for use in this population. In total, 225 patients diagnosed with psychotic, affective or personality disorders were included. The HCR-20 was applied at hospital admission and violent behaviours were assessed during psychiatric hospitalization using the Overt Aggression Scale (OAS). Construct validity, predictive validity and internal consistency were determined. Violent behaviour remains more severe in patients classified in the high-risk group during hospitalization. Fifteen items displayed adequate communalities in the original designated domains of the HCR-20 and internal consistency of the instruments was high. The HCR-20 is a suitable instrument for predicting violence risk in Mexican psychiatric inpatients.

  2. A case of Gorlin-Goltz syndrome presented with psychiatric features.

    Science.gov (United States)

    Mufaddel, Amir; Alsabousi, Mouza; Salih, Badr; Alhassani, Ghanem; Osman, Ossama T

    2014-01-01

    We report a case of a 34-year-old male who presented with an acute onset of pleomorphic psychiatric features. Upon examination we later diagnosed him with Gorlin-Goltz syndrome based on clinical and radiological findings that are characteristic for this rare autosomal dominant syndrome. His psychiatric manifestations included irritability, aggressive behavior, labile mood, hallucinations, paranoid delusions, and transient cognitive impairment. His past history indicated surgical excision of pigmented lesion in the left lower eyelid which turned out to be a basal cell carcinoma. His past visits to dermatology clinics indicated pitted keratosis involving hands, callosities, and seborrheic dermatitis. There were numerous palmar pits, and Brain CT Head scan revealed extensive calcification along falx cerebri and around the cerebellar vermis. He had low (20 ng/L) vitamin D level and high parathyroid hormone level. The patient improved using antipsychotic medications and vitamin D supplementations for symptomatic management and was discharged with a plan for multispecialty outpatient follow-up. This case highlights the importance of considering rare organic etiologies in the differential diagnosis of patients presenting with psychiatric symptoms. This is of vital importance for early intervention to prevent complications and for better outcomes of the coexistent diseases.

  3. Intimate partner violence perpetrators in a forensic psychiatric outpatient setting: criminal history, psychopathology, and victimization.

    Science.gov (United States)

    Henrichs, Jens; Bogaerts, Stefan; Sijtsema, Jelle; Klerx-van Mierlo, Fanny

    2015-07-01

    This study investigated criminological, psychopathological, and victimological profiles of intimate partner violence (IPV) perpetrators in a sample of 119 Dutch female and male forensic psychiatric outpatients aged 18 to 58 years. In addition, differences in criminological, psychopathological, and victimological factors between IPV perpetrators (n = 61, 51.3%) and non-intimate violence (NIV) perpetrators (n = 58, 48.7%) were examined. All data, including information on demographics, criminal history, history of psychological, sexual, and physical victimization during childhood or adolescence, family history of psychopathology, history of psychopathology in childhood and adolescence, and mental disorders, were derived from archival electronic medical records. Mental disorders were measured using structured psychiatric interviews and final consensus diagnoses were established during weekly case consultations. Both IPV and NIV perpetrators displayed high rates of criminal history, psychopathology, and previous victimization, but the two groups did not differ in these factors with two exceptions. IPV perpetrators were significantly more likely to have higher rates of previous physical victimization and intermittent explosive disorder than NIV perpetrators. The current study suggests that a history of physical victimization and intermittent explosive disorder are specific characteristics of IPV perpetrators in a forensic psychiatric outpatient setting. Future research should focus on mechanisms explaining the association of childhood victimization and IPV and increase our understanding of the role of intermittent explosive disorder in IPV. © The Author(s) 2014.

  4. Substance Use and Mental Health Outcomes for Comorbid Patients in Psychiatric Day Treatment

    Directory of Open Access Journals (Sweden)

    Stephen Magura

    2009-10-01

    Full Text Available The study’s purpose was to determine treatment outcomes for patients who present with drug use vs. those presenting with no drug use at admission to a psychiatric day treatment program. Consecutively admitted patients completed confidential interviews which included psychological distress and quality of life measures and provided urine specimens for toxicology at admission and six month follow-up. Subjects positive by past 30 day self-report or urinalysis were categorized as drug users. Major psychiatric diagnoses were: major depression 25%; bipolar, 13%; other mood 13%; schizoaffective 13%; schizophrenia 13%. Drug use at admission was: cocaine 35%; marijuana 33%; opiates 18%, (methamphetamines, 6% For each of these drugs, the percentage of patients positive at admission who remitted from using the drug significantly exceeded the percentage negative at baseline who initiated using the drug. Overall, there were significant decreases in psychological distress and significant improvement on quality of life, but no change on positive affect. There were no significant differences between drug users and non-drug users on symptom reduction and improvement in quality of life. Psychiatric day treatment appears to benefit comorbid patients by reducing the net number of patients who actively use certain common drugs and by improving psychological status and quality of life to the same degree as for non-drug using patients.

  5. Substance Use and Mental Health Outcomes for Comorbid Patients in Psychiatric Day Treatment

    Directory of Open Access Journals (Sweden)

    Stephen Magura

    2009-01-01

    Full Text Available The study's purpose was to determine treatment outcomes for patients who present with drug use vs. those presenting with no drug use at admission to a psychiatric day treatment program. Consecutively admitted patients completed confidential interviews which included psychological distress and quality of life measures and provided urine specimens for toxicology at admission and six month follow-up. Subjects positive by past 30 day self-report or urinalysis were categorized as drug users. Major psychiatric diagnoses were: major depression 25%; bipolar, 13%; other mood 13%; schizoaffective 13%; schizophrenia 13%. Drug use at admission was: cocaine 35%; marijuana 33%; opiates 18%, (methamphetamines, 6% For each of these drugs, the percentage of patients positive at admission who remitted from using the drug significantly exceeded the percentage negative at baseline who initiated using the drug. Overall, there were significant decreases in psychological distress and significant improvement on quality of life, but no change on positive affect. There were no significant differences between drug users and non-drug users on symptom reduction and improvement in quality of life. Psychiatric day treatment appears to benefit comorbid patients by reducing the net number of patients who actively use certain common drugs and by improving psychological status and quality of life to the same degree as for non-drug using patients.

  6. A Case of Gorlin-Goltz Syndrome Presented with Psychiatric Features

    Directory of Open Access Journals (Sweden)

    Amir Mufaddel

    2014-01-01

    Full Text Available We report a case of a 34-year-old male who presented with an acute onset of pleomorphic psychiatric features. Upon examination we later diagnosed him with Gorlin-Goltz syndrome based on clinical and radiological findings that are characteristic for this rare autosomal dominant syndrome. His psychiatric manifestations included irritability, aggressive behavior, labile mood, hallucinations, paranoid delusions, and transient cognitive impairment. His past history indicated surgical excision of pigmented lesion in the left lower eyelid which turned out to be a basal cell carcinoma. His past visits to dermatology clinics indicated pitted keratosis involving hands, callosities, and seborrheic dermatitis. There were numerous palmar pits, and Brain CT Head scan revealed extensive calcification along falx cerebri and around the cerebellar vermis. He had low (20 ng/L vitamin D level and high parathyroid hormone level. The patient improved using antipsychotic medications and vitamin D supplementations for symptomatic management and was discharged with a plan for multispecialty outpatient follow-up. This case highlights the importance of considering rare organic etiologies in the differential diagnosis of patients presenting with psychiatric symptoms. This is of vital importance for early intervention to prevent complications and for better outcomes of the coexistent diseases.

  7. Birth order and postpartum psychiatric disorders.

    Science.gov (United States)

    Munk-Olsen, Trine; Jones, Ian; Laursen, Thomas Munk

    2014-05-01

    Primiparity is a well-established and significant risk factor for postpartum psychosis and especially bipolar affective disorders. However, no studies have, to our knowledge, quantified the risk of psychiatric disorders after the first, second, or subsequent births. The overall aim of the present study was to study the risk of first-time psychiatric episodes requiring inpatient treatment after the birth of the first, second, or third child. A cohort comprising 750,127 women was defined using information from Danish population registries. Women were followed individually from the date of birth of their first, second, or third child through the following 12 months over the period 1970-2011. The outcome of interest was defined as first-time admissions to a psychiatric hospital with any type of psychiatric disorder. Women who had a first psychiatric episode which required inpatient treatment after their first (n = 1,327), second (n = 735), or third (n = 238) delivery were included. The highest risk was found in primiparous mothers 10-19 days postpartum [relative risk (RR) = 8.65; 95% confidence interval (CI): 6.89-10.85]. After the second birth, the highest risk was at 60-89 days postpartum (RR = 2.01; 95% CI: 1.52-2.65), and there was no increased risk after the third birth. The effect of primiparity was strongest for bipolar disorders. Primiparity is a significant risk factor for experiencing a first-time episode with a psychiatric disorder, especially bipolar disorders. A second birth was associated with a smaller risk, and there was no increased risk after the third birth. The risk of postpartum episodes after the second delivery increased with increasing inter-pregnancy intervals, a result which warrants further investigation. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Psychiatric comorbidity distribution and diversities in children and adolescents with attention deficit/hyperactivity disorder: a study from Turkey

    Directory of Open Access Journals (Sweden)

    Yüce M

    2013-11-01

    Full Text Available Murat Yüce,1 Süleyman Salih Zoroglu,2 Mehmet Fatih Ceylan,3 Hasan Kandemir,4 Koray Karabekiroglu5 1Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey; 2Department of Child and Adolescent Psychiatry, Medical Faculty of Istanbul, Istanbul University, Istanbul, Turkey; 3Department of Child and Adolescent Psychiatry, Dr Sami Ulus Children's Hospital, Ankara, Turkey; 4Department of Child and Adolescent Psychiatry, Faculty of Medicine, Harran University, Sanliurfa, Turkey; 5Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey Objective: We aimed to determine distribution and diversities of psychiatric comorbidities in children and adolescents with attention deficit/hyperactivity disorder (ADHD in terms of age groups, sex, and ADHD subtype. Materials and methods: The sample included 6–18 year old children and adolescents from Turkey (N=108; 83 boys, 25 girls diagnosed with ADHD. All comorbid diagnoses were determined based on the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version assessment. Results: 96.3% of the cases were found to have at least one psychiatric comorbid diagnosis. The most frequent psychiatric comorbid disorder was oppositional defiant disorder (69.4% followed by anxiety disorders (49% and elimination disorders (27.8%. Disruptive behavior disorders were more common in ADHD-combined type. Depression and anxiety disorders were more common in girls. Separation anxiety disorder and elimination disorder were more common in children, whereas depression, bipolar disorder, obsessive–compulsive disorder, and social phobia were more common in the adolescents. Conclusion: According to our results, when a diagnostic tool was used to assess the presence of comorbid psychiatric disorders in children and adolescents diagnosed with ADHD, almost all cases had at least one

  9. Psychiatric morbidity and non-participation in breast cancer screening.

    Science.gov (United States)

    Jensen, Line Flytkjær; Pedersen, Anette Fischer; Bech, Bodil Hammer; Andersen, Berit; Vedsted, Peter

    2016-02-01

    Organised breast cancer screening is currently one of the best strategies for early-stage breast cancer detection. However, early detection has proven challenging for women with psychiatric disease. This study aims to investigate psychiatric morbidity and non-participation in breast cancer screening. We conducted an observational cohort study including women invited to the first organised screening round in the Central Denmark Region. Data on psychiatric diagnosis, psychoactive prescription medicine and consultation with private psychiatrists were obtained from Danish registries and assessed for a period of up to 10 years before the screening date. The cohort comprised 144,264 women whereof 33.0% were registered with an indication of psychiatric morbidity. We found elevated non-participation propensity among women with a psychiatric diagnosis especially for women with schizophrenia and substance abuse. Also milder psychiatric morbidity was associated with higher non-participation likelihood as women who had redeemed psychoactive prescription medicine or have had minimum one consultation with a private psychiatrist were more likely not to participate. Finally, we found that the chronicity of psychiatric morbidity was associated with non-participation and that woman who had a psychiatric morbidity defined as 'persistent' had higher likelihood of non-participation than women with recently active morbidity or inactive psychiatric morbidity. This study showed a strong association between psychiatric morbidity and an increased likelihood of non-participation in breast cancer screening in a health care system with universal and tax-funded health services. This knowledge may inform interventions targeting women with psychiatric morbidity as they have poorer breast cancer prognosis. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Life History of Aggression scores are predicted by childhood hyperactivity, conduct disorder, adult substance abuse, and low cooperativeness in adult psychiatric patients.

    Science.gov (United States)

    Hofvander, Björn; Ståhlberg, Ola; Nydén, Agneta; Wentz, Elisabet; degl'Innocenti, Alessio; Billstedt, Eva; Forsman, Anders; Gillberg, Christopher; Nilsson, Thomas; Rastam, Maria; Anckarsäter, Henrik

    2011-01-30

    The prevention of aggressive behaviours is a core priority for psychiatric clinical work, but the association between the diagnostic concepts used in psychiatry and aggression remains largely unknown. Outpatients referred for psychiatric evaluations of childhood-onset neuropsychiatric disorders (n=178) and perpetrators of violent crimes referred to pre-trial forensic psychiatric investigations (n=92) had comprehensive, instrument-based, psychiatric assessments, including the Life History of Aggression (LHA) scales. Total and subscale LHA scores were compared to the categorical and dimensional diagnoses of childhood and adult DSM-IV axis I and II mental disorders, general intelligence (IQ), Global Assessment of Functioning (GAF), and personality traits according to the Temperament and Character Inventory (TCI). Overall, the two groups had similar LHA scores, but the offender group scored higher on the Antisocial subscale. Higher total LHA scores were independently associated with the hyperactivity facet of attention-deficit/hyperactivity disorder (AD/HD), childhood conduct disorder, substance-related disorders, and low scores on the Cooperativeness character dimension according to the TCI. IQ and GAF-scores were negatively correlated with the LHA subscale Self-directed aggression. Autistic traits were inversely correlated with aggression among outpatients, while the opposite pattern was noted in the forensic group. The findings call for assessments of aggression-related behaviours in all psychiatric settings. Copyright © 2010 Elsevier Ltd. All rights reserved.

  11. Prevalence of psychiatric co-morbidity among patients attending dental OPD and the role of consultation-liaison psychiatry in dental practice in a tertiary care general hospital.

    Science.gov (United States)

    Ray, Pradip K; Ray Bhattacharya, Sampa; Makhal, Manabendra; Majumder, Uttam; De, Shantanu; Ghosh, Subhankar

    2015-01-01

    Psychiatric co-morbidities are frequent among patients attending dental OPD, some of which go unrecognized and hence untreated. The present study has been carried out to detect the psychiatric co-morbidities among dental patients and determine the scope of consultation-liaison (C-L) psychiatry in a rural teaching hospital regarding comprehensive management of the patients. This cross-sectional, descriptive type study was conducted in a multi-speciality tertiary care teaching hospital in the northern part of West Bengal, India. One hundred patients attending the dental OPD were randomly included in the study and every patient was consecutively referred to psychiatry department for assessment, during the period from 1(st) November 2013 to 30(th) April 2014. All referred patients were clinically examined and psychiatric co-morbidity was assessed by the help of General Health Questionnaire (GHQ)-28 and Mental Status Examination. The data were subjected to statistical package for social sciences (SPSS), version 16, and statistically analyzed using Cross tab and Chi test. P psychiatric co-morbidity according to GHQ-28 total score. Sixty-eight patients were diagnosed to have mental disorder on mental status examination. Somatoform disorder (25%) was the commonest type of mental disorder, followed by mixed anxiety and depression (14%). This study has pointed the need for psychological examination of patients visiting dental specialty with unexplained physical symptoms. Such patients can be identified and treated, provided a psychiatric consultation service exists.

  12. Psychiatric disorders in ASEAN-migrants in Malaysia--a university hospital experience.

    Science.gov (United States)

    Krahl, W; Hashim, A

    1998-09-01

    Malaysia's workforce presently includes 13% foreigners most coming from the neighboring ASEAN-countries. No data of the prevalence of psychiatric disorders amongst this population is currently available. All patients from ASEAN-countries admitted to the University Hospital, Kuala Lumpur between January 1994 and June 1996 were included in a prospective study. During the study period 39 patients were admitted. Five patients were male (12.8%) and 34 female (87.2%). Most came from Indonesia (51.3%) and the Philippines (41.0%), while one each was from Brunei, Singapore and Thailand. Thirty (76.9%) were working in Malaysia as unskilled workers, 23 (59.0%) as maids. Six of the patients (15.4%) were married to Malaysians and only three (7.2%) held white-collar jobs. Three patients (7.2%) received the diagnosis schizophrenia and ten (25.6%) acute and transient psychotic disorder. Two (5.1%) were diagnosed as bipolar affective disorder--manic and two (5.1%) as depression without psychotic features. Five patients (12.8%) were depressed and had as well presence of psychotic features. Adjustment disorders mostly with depressed mood was diagnosed in fourteen (35.9%), three (7.2%) received another diagnosis. The study showed high rates of acute and transient psychosis as well as adjustment disorders indicating high stress level in this population. In particular maids from Indonesia and the Philippines with their dependent and isolated situation seem vulnerable to develop psychiatric disorders. However, overall the rates of psychiatric admissions (only 1.3%) in the ASEAN-nationals is relatively low and tends to support the view that migrants do not suffer from an excess of mental disorders.

  13. Effectiveness of psychiatric and counseling interventions On fertility rate in infertile couples

    Directory of Open Access Journals (Sweden)

    Ramezanzadeh F.

    2007-10-01

    Full Text Available Background: Considering the psycho-social model of diseases, the aim of this study was to evaluate the effect of psychiatric intervention on the pregnancy rate of infertile couples.Methods: In a randomized clinical trial, 638 infertile patients referred to a university infertility clinic were evaluated. Among them, 140 couples with different levels of depression in at least one of the spouses were included in this substudy. These couples were divided randomly into two groups. The patients in the case group received 6-8 sessions of psychotherapy before starting infertility treatment and were given fluoxetine 20-60 mg per day during the same period. The control group did not receive any intervention. Three questionnaires including the Beck Depression Inventory (BDI, Holmes-Rahe stress scale and a socio-demographic questionnaire were applied for all patients. The clinical pregnancy rates of the two groups, based on sonographic detection of the gestational sac six weeks after LMP, were compared. The data were analyzed by paired-T test, T-test, χ2 and the logistic regression method. Results: The pregnancy rate was 47.1% in the case group and 7.1% in the control group. The pregnancy rate was significantly related to the duration and cause of infertility and the level of stress in both groups (p< 0.001. The pregnancy rate was shown to be higher in couples in which the male has a secondary level of education (p< 0.001.Conclusions: Psychiatric interventions greatly improve pregnancy rates, and it is therefore crucial to mandate psychiatric counseling in all fertility centers in order to diagnose and treat infertile patients with psychiatric disorders and help couples deal with stress.

  14. Gaucher's disease diagnosed by splenectomy.

    Science.gov (United States)

    Adas, Mine; Adas, Gokhan; Karatepe, Oguzhan; Altiok, Merih; Ozcan, Deniz

    2009-08-01

    Splenectomy continues to find common therapeutic indications for hematologic disorders. In addition, recently it is also performed in surgical clinics to assist diagnose of some illnesses. Gaucher's disease, especially Type I, is the most frequently encountered lysosomal storage disorder in man. Manifestations of it are highly variable. The most frequently found symptoms include splenomegaly with anaemia and thrombocytopenia, mostly due to hypersplenism, hepatomegaly and bone disease. Four patients were reported in the present study. Three of them were easily diagnosed with Gaucher's disease via bone marrow cytology, and one with Gaucher's disease was detected by pathological examination following the splenectomy. For the pouse of diagnosis of the Gaucher's disease, performing surgery is generally not necessary. However, for the cases of difficult to diagnose by classical methods, the corect diagnosis of Gaucher's disease can only be made by a special operation.

  15. Predictive and associated factors of psychiatric disorders after traumatic brain injury: a prospective study.

    Science.gov (United States)

    Gould, Kate Rachel; Ponsford, Jennie Louise; Johnston, Lisa; Schönberger, Michael

    2011-07-01

    Psychiatric disorders are common and often debilitating following traumatic brain injury (TBI). However, there is little consensus within the literature regarding the risk factors for post-injury psychiatric disorders. A 1-year prospective study was conducted to examine which pre-injury, injury-related, and concurrent factors were associated with experiencing a psychiatric disorder, diagnosed using the Structured Clinical Interview for DSM-IV-TR Axis I Disorders, at 1 year post-injury. Participants were 122 adults with TBI and 88 proxy informants. Psychiatric disorders were common both pre-injury (54.1%) and at 12 months post-injury (45.9%). Results of regression analyses indicated individuals without a pre-injury psychiatric disorder or psychiatric symptomatology in the acute post-injury period were less likely to have a psychiatric disorder at 12 months post-injury. These findings confirm the importance of pre-injury history for the prediction of post-injury psychiatric disorders. Limb injury also emerged as a useful early indicator of later psychiatric disorder. Post-injury psychiatric disorders were associated with concurrent unemployment, pain, poor quality of life, and use of unproductive coping skills. The clinical implications of these findings are discussed.

  16. PSYCHIATRIC CO - MORBIDITY IN PERSONS WITH HANSEN’S DISEASE

    Directory of Open Access Journals (Sweden)

    Anita

    2015-05-01

    Full Text Available OBJECTIVE: To estimate prevalence of psychiatric co - morbidity and its effect on quality of life in persons with Hansen’s disease. METHOD: The study was conducted on around 80 persons above 18 year age with Hansen’s disease in out - patient department dermatology and i n leprosy home. Participants were diagnosed cases of Hansen’s disease, selected randomly and were evaluated with socio demographic questionnaire, Duke’s general health questionnaire, DSM - 5 self rated level 1 cross cutting symptom measure – adult and WHO - QO L - BREF. The period of data collection was from October 2014 to March 2015. RESULTS: The assessment showed that prevalence of at least one psychiatric co morbidity was 83.75% (67/80 patients and of these 67 patients 18(26.86% have one diagnosis, 26(38.80% have two diagnoses and 23(34.32% have 3 or more psychiatric diagnoses. Among all depression was most prevalent (28.35% mental disorder; followed by anxiety disorder (23.88%. Quality of life was significantly impaired in almost all persons with Hansen’ s disease. CONCLUSION: Persons with Hansen’s disease have significantly high prevalence of mental disorders which have much impact on their quality of life which were under diagnosed and thus remained untreated

  17. [The attitudes nurses working at psychiatric hospitals in Turkey have towards forensic psychiatric patients and the associated factors].

    Science.gov (United States)

    Baysan Arabacı, Leyla; Çam, M Olcay

    2013-01-01

    To determine the attitudes nurses working at psychiatric hospitals in Turkey have towards forensic psychiatric patients and the associated factors. This cross-sectional study included 620 nurses working at 8 psychiatric hospitals in Turkey that completed ≥80% of the Nurses' Attitudes Towards Forensic Psychiatric Patients Scale (NAFPPS). Data were evaluated based on number-percentage distribution, and the relationship between variables was examined via t-test, variance analysis, and correlation analysis. Mean age of the nurses was 34.37 ± 7.48 years and 79.4% were female. Mean NAFPPS total and subscale scores were as follows: Xtotal = 69.07 ± 12.46 (max: 125); Xfeelingthreatened = 15.98 ± 3.61 (max: 30); Xtrust = 20.49 ± 5.24 (max: 20); Xsocialdistance = 10.45 ± 3.33 (max: 20); Xwillingnesstoprovidecare = 22.31 ± 4.25 (max: 40). Gender, place of employment, method of obtaining current position, employment status, level of satisfaction working as a psychiatric nurse, history of providing treatment to forensic psychiatric patients, having knowledge of Turkish laws regarding the treatment of forensic psychiatric patients, and thinking that nurses should treat forensic psychiatric patients were correlated with the nurses' attitudes towards forensic psychiatric patients, whereas age, marital status, place of longest residence, level of education, duration of working in the profession, and duration at current hospital were not. Despite the fact that the nurses working at 8 psychiatric hospitals in Turkey considered forensic psychiatric patients threatening, didn't trust them, and had a tendency to be socially distant with them, they had a moderate level of willingness to provide them proper care.

  18. Difficult diagnoses in the skeletal radiology

    International Nuclear Information System (INIS)

    Freyschmidt, Juergen

    2013-01-01

    The book on difficult diagnoses in the skeletal radiology discusses the path from symptom to diagnoses including image interpretation. Specific case studies concern the skull, the spinal cord, pelvis, shoulder and chest, upper and lower extremities. The used radiological techniques include projecting radiography, computerized tomography, scintiscanning, PET/CT, NNR imaging and ultrasonography.

  19. Psychiatric Symptoms in Teachers from Danwon High School after Exposure to the Sinking of the Motor Vessel Sewol

    OpenAIRE

    Lee, Mi-Sun; Bhang, Soo-Young; Lee, Cheol-Soon; Chang, Hyoung Yoon; Kim, Ji-Youn; Lee, Ju-Hyun; Kim, Eunji; Bae, Seung-Min; Park, Jang-Ho; Kim, Hye-Jin; Hwang, Jun-Won

    2017-01-01

    Objective The goal of this study was to describe the psychiatric symptoms in the teachers from Danwon High School who were exposed to the sinking of the Motor Vessel Sewol. Methods Data were collected from 32 teachers who underwent psychiatric interventions by 16 volunteer psychiatrists for 3 months after the sinking of the Motor Vessel Sewol. Results The most commonly diagnosed clinical diagnosis in the teachers were normal reaction, acute stress disorder and adjustment disorder. Psychiatric...

  20. Electroconvulsive therapy and its relationships with clinical characteristics and quality of life in Chinese psychiatric patients.

    Science.gov (United States)

    An, Feng-Rong; Zhang, Ling; Zhang, Qing-E; Ungvari, Gabor S; Ng, Chee H; Chiu, Helen F K; Wu, Ping-Ping; Jin, Xin; Li, Lu; Lok, Grace K I; Xiang, Yu-Tao

    2016-12-30

    Little is known about the pattern of electroconvulsive therapy (ECT) use in the clinical population in China. This study examined the percentage of ECT use and its association with clinical characteristics and quality of life (QOL) in a psychiatric center in China that caters for a population of 20 million. A total sample of 1364 inpatients was consecutively recruited for the study. Demographic and clinical data including the use of ECT were collected. Psychopathology, activity of daily living and QOL were measured using standardized instruments. The percentage of ECT use was 52.1% in the whole sample; 53.4% in major depression, 57.8% in bipolar disorder, 57.0% in schizophrenia and 32.4% in other diagnoses. There was no significant difference between the ECT and non-ECT groups in any domain of QOL. Multivariate analyses revealed that ECT was independently associated with the diagnoses of major depression, bipolar disorder and schizophrenia, physical restraint, severe aggression, better activity of daily living skills, more frequent use of antipsychotics and less frequent use of benzodiazepines. The percentage of ECT use was much greater in a major psychiatric center in China than those reported from other parts of the world. Use of ECT had no influence on the short-term QOL. Further investigations are warranted to explore the reasons for the high percentage of ECT use. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. Prototype diagnosis of psychiatric syndromes

    Science.gov (United States)

    WESTEN, DREW

    2012-01-01

    The method of diagnosing patients used since the early 1980s in psychiatry, which involves evaluating each of several hundred symptoms for their presence or absence and then applying idiosyncratic rules for combining them for each of several hundred disorders, has led to great advances in research over the last 30 years. However, its problems have become increasingly apparent, particularly for clinical practice. An alternative approach, designed to maximize clinical utility, is prototype matching. Instead of counting symptoms of a disorder and determining whether they cross an arbitrary cutoff, the task of the diagnostician is to gauge the extent to which a patient’s clinical presentation matches a paragraph-length description of the disorder using a simple 5-point scale, from 1 (“little or no match”) to 5 (“very good match”). The result is both a dimensional diagnosis that captures the extent to which the patient “has” the disorder and a categorical diagnosis, with ratings of 4 and 5 corresponding to presence of the disorder and a rating of 3 indicating “subthreshold” or “clinically significant features”. The disorders and criteria woven into the prototypes can be identified empirically, so that the prototypes are both scientifically grounded and clinically useful. Prototype diagnosis has a number of advantages: it better captures the way humans naturally classify novel and complex stimuli; is clinically helpful, reliable, and easy to use in everyday practice; facilitates both dimensional and categorical diagnosis and dramatically reduces the number of categories required for classification; allows for clinically richer, empirically derived, and culturally relevant classification; reduces the gap between research criteria and clinical knowledge, by allowing clinicians in training to learn a small set of standardized prototypes and to develop richer mental representations of the disorders over time through clinical experience; and can help

  2. Pre-existing psychiatric disorder in the burn patient is associated with worse outcomes.

    Science.gov (United States)

    Hudson, Alexandra; Al Youha, Sarah; Samargandi, Osama A; Paletz, Justin

    2017-08-01

    To compare patient and burn characteristics between patients who had a pre-existing psychiatric diagnosis and patients who did not in a Burn Unit at an academic hospital. Psychosocial issues are common in patients recovering from a burn; however, little is known regarding hospital course and discharge outcomes in patients with a pre-existing psychiatric diagnosis presenting with a burn. Baseline medical comorbidities of burn patients have been shown to be a significant risk for in-hospital mortality. A retrospective chart review of 479 consecutive patients admitted to the Burn Unit of an academic hospital in Halifax, Nova Scotia between March 2nd 1995 and June 1st 2013 was performed. Extensive data regarding patient and burn characteristics and outcomes was collected. Patients with and without pre-existing psychiatric diagnoses at the time of hospital admission were compared. Sixty-three (13%) patients had a psychiatric diagnosis, with the most common being depression (52%). Forty-percent (n=25/63) of these patients had multiple pre-existing psychiatric diagnoses. Patients with a psychiatric diagnosis had a greater total-body-surface-area (TBSA)% covered by a third-degree burn (p=0.001), and were more likely to have an inhalation injury (pBurn Unit (p=0.01). The risk of death in burn patients with pre-existing psychiatric disorders was about three times the risk of death in patients with no psychiatric disorders when adjusting for other potential confounders (95% CI, 1.13-9.10; p-value 0.03). Presence of a pre-existing psychiatric disorder in the burn patient was associated with worse outcomes and was a significant predictor of death. Psychiatric diagnoses should be identified early in burn treatment and efforts should be made to ensure a comprehensive approach to inpatient support and patient discharge to reduce unfavorable burn outcomes and placement issues. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  3. Childhood Trauma and Psychiatric Disorders as Correlates of School Dropout in a National Sample of Young Adults

    Science.gov (United States)

    Porche, Michelle V.; Fortuna, Lisa R.; Lin, Julia; Alegria, Margarita

    2011-01-01

    The effect of childhood trauma, psychiatric diagnoses, and mental health services on school dropout among U.S.-born and immigrant youth is examined using data from the Collaborative Psychiatric Epidemiology Surveys, a nationally representative probability sample of African Americans, Afro-Caribbeans, Asians, Latinos, and non-Latino Whites,…

  4. Boys with Asperger Syndrome Grow Up: Psychiatric and Neurodevelopmental Disorders 20 Years after Initial Diagnosis

    Science.gov (United States)

    Gillberg, I. Carina; Helles, Adam; Billstedt, Eva; Gillberg, Christopher

    2016-01-01

    We examined comorbid psychiatric and neurodevelopmental disorders in fifty adult males (mean age 30 years) with Asperger syndrome (AS) diagnosed in childhood and followed up prospectively for almost two decades (13-26 years). Only three of the 50 men had "never" met criteria for an additional psychiatric/neurodevelopmental diagnosis and…

  5. Predictors of Diagnosis of Child Psychiatric Disorder in Adult-Infant Social-Communicative Interaction at 12 Months

    Science.gov (United States)

    Marwick, H.; Doolin, O.; Allely, C. S.; McConnachie, A.; Johnson, P.; Puckering, C.; Golding, J.; Gillberg, C.; Wilson, P.

    2013-01-01

    To establish which social interactive behaviours predict later psychiatric diagnosis, we examined 180 videos of a parent-infant interaction when children were aged one year, from within the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort. Sixty of the videos involved infants who were later diagnosed with a psychiatric disorder at…

  6. Psychiatric disorders in Norwegian 8- to 10-year-olds: an epidemiological survey of prevalence, risk factors, and service use

    DEFF Research Database (Denmark)

    Heiervang, Einar; Stormark, Kjell M; Lundervold, Astri J

    2007-01-01

    population included all 9,430 children attending grades 2 to 4 in Bergen schools during the academic year 2002/2003. The main screening instrument was the Strengths and Difficulties Questionnaire, whereas diagnoses were based on the Development and Well-Being Assessment. Information about child and family......%) were assessed with the Development and Well-Being Assessment in the second phase. The weighted prevalence for any DSM-IV psychiatric disorder was 7.0% (95% confidence interval 5.6%-8.5%). Disorders were associated with age, gender, learning difficulties, family type, and poverty. Although 75...

  7. College Students with Psychiatric Disabilities

    Science.gov (United States)

    Singh, Delar K.

    2011-01-01

    This paper focuses on college students with psychiatric disabilities. It defines and discusses various psychiatric conditions such as mood disorders, anxiety disorders, eating disorders, and personality disorders. It concludes with accommodations that a college professor can make to help these students succeed in higher education. (Contains 1…

  8. Psychiatric comorbidity : fact or artifact?

    NARCIS (Netherlands)

    van Loo, Hanna; Romeijn, Johannes

    The frequent occurrence of comorbidity has brought about an extensive theoretical debate in psychiatry. Why are the rates of psychiatric comorbidity so high and what are their implications for the ontological and epistemological status of comorbid psychiatric diseases? Current explanations focus

  9. Psychiatric morbidity in stroke patients attending a neurology clinic ...

    African Journals Online (AJOL)

    EB

    2013-09-03

    Sep 3, 2013 ... Conclusion: Psychiatric disorders are often associated with stroke. Identifying and ... include post stroke depression (PSD), mania, Bipolar disorder, anxiety ..... diagnosis and therapy: Report of the WHO Task force on stroke ...

  10. Potentially inappropriate prescribing in older patients admitted to psychiatric hospital

    NARCIS (Netherlands)

    Rongen, S.; Kramers, C.; O'Mahony, D.; Feuth, T.; Olde Rikkert, M.G.M.; Ahmed, A.I.A.

    2016-01-01

    OBJECTIVES: The objectives of this study are to determine the prevalence of potentially inappropriate prescribing including potentially inappropriate medications (PIMs) and potential prescription omissions (PPOs) and to assess related risk factors in older people with major psychiatric illness.

  11. Preceding diagnoses to young adult bipolar disorder and schizophrenia in a nationwide study

    Science.gov (United States)

    2013-01-01

    Background The aim of this comparative study was to investigate the type and frequency of diagnoses preceding adult bipolar disorder (BD) and schizophrenia (SZ). Methods A follow-back study of all preceding diagnoses in all patients aged 21–34 years with a primary, first time diagnosis of BD (N = 784) or SZ (N = 1667) in 2008 to 2010. Data were taken from the Danish Psychiatric Central Research Register (DPCRR) including ICD-10 and ICD-8 diagnoses. Results The numbers of patients with any preceding diagnoses amounted to 69.3% in BD and 76.6% in SZ with affective disorders (excluding BD) being the most frequent preceding diagnosis (46.6 vs. 28.0%), followed by psychoses (PSY) other than SZ (14.2 vs. 41.5%, p adolescence. Overall patients with SZ had a minor but statistically significant earlier onset of any psychiatric disorder compared to BD (mean age: 23.3 vs. 22.5, p < .001). Regression analyses indicated that BD was associated with an increased risk of having experienced preceding affective disorders and ADHD, while SZ was associated with an increased risk of preceding substance use disorders, psychosis, anxiety disorders, and personality disorders. Conclusions Specific developmental trajectories of preceding disorders were delineated for BD and SZ with affective disorders being more specific for BD and both SUD and PSY more specific to SZ. There are different patterns of vulnerability in terms of preceding diagnosis in young adults with BD and SZ. PMID:24359146

  12. Psychiatric morbidity among adult patients in a semi-urban primary care setting in Malaysia

    Directory of Open Access Journals (Sweden)

    Omar Khairani

    2009-06-01

    Full Text Available Abstract Background Screening for psychiatric disorders in primary care can improve the detection rate and helps in preventing grave consequences of unrecognised and untreated psychiatric morbidity. This is relevant to the Malaysian setting where mental health care is now also being provided at primary care level. The aim of this paper is to report the prevalence of psychiatric illness in a semi-urban primary care setting in Malaysia using the screening tool Patient Health Questionnaire (PHQ. Methods This is a cross-sectional study carried out in a semi-urban primary healthcare centre located south of Kuala Lumpur. Systematic random sampling was carried out and a total of 267 subjects completed the PHQ during the study period. Results The proportion of respondents who had at least one PHQ positive diagnosis was 24.7% and some respondents had more than one diagnosis. Diagnoses included depressive illness (n = 38, 14.4%, somatoform disorder (n = 32, 12.2%, panic and anxiety disorders (n = 17, 6.5%, binge eating disorder (n = 9, 3.4% and alcohol abuse (n = 6, 2.3%. Younger age (18 to 29 years and having a history of stressors in the previous four weeks were found to be significantly associated (p = 0.036 and p = 0.044 respectively with PHQ positive scores. Conclusion These findings are broadly similar to the findings of studies done in other countries and are a useful guide to the probable prevalence of psychiatric morbidity in primary care in other similar settings in Malaysia.

  13. Regional aspects of long-term public sector psychiatric care in the Eastern Cape

    Directory of Open Access Journals (Sweden)

    Kiran Sukeri

    2017-05-01

    Full Text Available Objectives: The objective of this research was to determine regional aspects (such as clinical, geographic and socio-demographic influencing the use of public sector long-term psychiatric services in the Eastern Cape. This is important in improving service delivery, to assist policy developers with evidence-based research and in providing equitable and efficient resource utilisation. Methodology: A situational analysis of Tower Psychiatric Hospital and Psychosocial Rehabilitation Centre (TPHPRC in the Eastern Cape was conducted. Patient administrative data were utilised to determine geographic origin, date and age at admission, gender and diagnosis as of December 2015. The number of admissions from each region for the years 2010–2015 was also extracted from these data. Results: As of December 2015, there were a total of 390 patients at TPHPRC. Of these, 87% were male patients. The average age at admission for male and female patients was 36 years and 44 years, respectively. Of the patients, 53% originated from the western regions and 57% of female patients presented with a dual diagnosis. The highest number of admissions was in 2015, with the majority originating from Port Elizabeth. Conclusion: Despite higher access to public psychiatric care in the western region, the majority of patients originated from there. Contributing factors to this include diagnoses, insufficient bed numbers and the absence of admission criteria and referral pathways. It is recommended that the provincial Department of Health set up a task team to determine a standardised working framework for all public sector psychiatric institutions. This should be informed by national policies, legislation and provincial norms and indicators.

  14. Psychiatric comorbidity in patients with conversion disorder and prevalence of dissociative symptoms.

    Science.gov (United States)

    Yayla, Sinan; Bakım, Bahadır; Tankaya, Onur; Ozer, Omer Akil; Karamustafalioglu, Oguz; Ertekin, Hulya; Tekin, Atilla

    2015-01-01

    The 1st objective of the current study was to investigate the frequency and types of dissociative symptoms in patients with conversion disorder (CD). The 2nd objective of the current study was to determine psychiatric comorbidity in patients with and without dissociative symptoms. A total of 54 consecutive consenting patients primarily diagnosed with CD according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria who were admitted to the psychiatric emergency outpatient clinic of Sisli Etfal Research and Teaching Hospital (Istanbul, Turkey) were included in the study. The Structured Clinical Interview for DSM-IV Axis I Disorders, Structured Interview for DSM-IV Dissociative Disorders, and Dissociative Experiences Scale were administered. Study groups consisted of 20 patients with a dissociative disorder and 34 patients without a diagnosis of any dissociative disorder. A total of 37% of patients with CD had any dissociative diagnosis. The prevalence of dissociative disorders was as follows: 18.5% dissociative disorder not otherwise specified, 14.8% dissociative amnesia, and 3.7% depersonalization disorder. Significant differences were found between the study groups with respect to comorbidity of bipolar disorder, past hypomania, and current and past posttraumatic stress disorder (ps = .001, .028, .015, and .028, respectively). Overall comorbidity of bipolar disorder was 27.8%. Psychiatric comorbidity was higher and age at onset was earlier among dissociative patients compared to patients without dissociative symptoms. The increased psychiatric comorbidity and early onset of conversion disorder found in patients with dissociative symptoms suggest that these patients may have had a more severe form of conversion disorder.

  15. Animal-assisted therapy with chronic psychiatric inpatients: equine-assisted psychotherapy and aggressive behavior.

    Science.gov (United States)

    Nurenberg, Jeffry R; Schleifer, Steven J; Shaffer, Thomas M; Yellin, Mary; Desai, Prital J; Amin, Ruchi; Bouchard, Axel; Montalvo, Cristina

    2015-01-01

    Animal-assisted therapy (AAT), most frequently used with dogs, is being used increasingly as an adjunctive alternative treatment for psychiatric patients. AAT with larger animals, such as horses, may have unique benefits. In this randomized controlled study, equine and canine forms of AAT were compared with standard treatments for hospitalized psychiatric patients to determine AAT effects on violent behavior and related measures. The study included 90 patients with recent in-hospital violent behavior or highly regressed behavior. Hospitalization at the 500-bed state psychiatric hospital was two months or longer (mean 5.4 years). Participants were randomly selected to receive ten weekly group therapy sessions of standardized equine-assisted psychotherapy (EAP), canine-assisted psychotherapy (CAP), enhanced social skills psychotherapy, or regular hospital care. Participants' mean age was 44, 37% were female, 76% had diagnoses of schizophrenia or schizoaffective disorder, and 56% had been committed involuntarily for civil or forensic reasons. Violence-related incident reports filed by staff in the three months after study intake were compared with reports two months preintake. Interventions were well tolerated. Analyses revealed an intervention group effect (F=3.00, df=3 and 86, p=.035); post hoc tests showed specific benefits of EAP (p<.05). Similar AAT effects were found for the incidence of 1:1 clinical observation (F=2.70, df=3 and 86, p=.051); post hoc tests suggested benefits of CAP (p=.058) as well as EAP (p=.082). Covariance analyses indicated that staff can predict which patients are likely to benefit from EAP (p=.01). AAT, and perhaps EAP uniquely, may be an effective therapeutic modality for long-term psychiatric patients at risk of violence.

  16. Stress load during childhood affects psychopathology in psychiatric patients

    Directory of Open Access Journals (Sweden)

    Popov Tzvetan

    2008-07-01

    Full Text Available Abstract Background Childhood stress and trauma have been related to adult psychopathology in different psychiatric disorders. The present study aimed at verifying this relationship for stressful experiences during developmental periods by screening stress load across life in adult psychiatric inpatients with different diagnoses compared to healthy subjects. In addition, a relationship between the amount of adverse experiences and the severity of pathology, which has been described as a 'building block' effect in posttraumatic stress disorder (PTSD, was explored for non-traumatic events in psychiatric disorders other than PTSD. Methods 96 patients with diagnoses of Major Depressive Disorder (MDD, schizophrenia, drug addiction, or personality disorders (PD and 31 subjects without psychiatric diagnosis were screened for adverse experiences in childhood (before the age of six years, before onset of puberty, and in adulthood using the Early Trauma Inventory and the Posttraumatic Stress Diagnostic Scale. Effects of stress load on psychopathology were examined for affective symptoms, PTSD, and severity of illness by regression analyses and comparison of subgroups with high and low stress load. Results High stress load in childhood and before puberty, but not in adulthood, was related to negative affect in all participants. In patients, high stress load was related to depressive and posttraumatic symptoms, severity of disorder, and the diagnoses of MDD and PD. Conclusion Results support the hypothesis of stress-sensitive periods during development, which may interact with genetic and other vulnerability factors in their influence on the progress of psychiatric disorders. A 'dose' effect of stress load on the severity of psychopathology is not restricted to the relationship between traumata and PTSD.

  17. Alcohol Abuse and Other Psychiatric Disorders

    Science.gov (United States)

    ... Psychiatric Disorders Other Substance Abuse HIV/AIDS Other Psychiatric Disorders In the current Diagnostic and Statistical Manual ... and other substance use disorders are defined as psychiatric disorders. Many individuals who misuse alcohol also abuse ...

  18. Police referrals at the psychiatric emergency service in Taiwan.

    Science.gov (United States)

    Wang, Jen-Pang; Wu, Chia-Yi; Chiu, Chih-Chiang; Yang, Tsu-Hui; Liu, Tzong-Hsien; Chou, Pesus

    2015-12-01

    The police are the frontline workers in crisis situations involving patients with severe mental illness and act as a primary referral source for psychiatric emergency services (PES) in the community. The aims of this study were to investigate the distribution and characteristics of police referral among psychiatric patients in Taiwan. The study cohort consisted of patients who visited the PES of Taipei City Psychiatric Center from January 2009 to December 2010. The associations between the factors of demographics, clinical characteristics, and psychiatric service utilization and police referral were evaluated. Among the 7656 psychiatric emergency visits, 3029 (39.6%) were referred by the police. These patients referred by police were more likely to be male and aged between 30 to 49 years. Clinical factors related to police referrals including a higher triage assessment level, chief problems included violence, disturbance, substance use, less anxiety, and a diagnosis of unspecified psychosis. The triage assessment level and chief problems assessed by nurses were major predictors. These patients tended to be referred from the catchment area and during the nighttime shift, were discharged during the daytime shift, and stayed longer in the PES. Disposition arrangements such as discharge against medical advice and involuntary admission were also associated with police referrals. Patients referred by the police to the PES were those with more severe psychiatric problems and illnesses assessed by psychiatric nurses and psychiatrists. They tended to have more complex service utilization at the PES. © 2015 Wiley Publishing Asia Pty Ltd.

  19. Taking cognizance of mental illness in schizophrenics and its association with crime and substance-related diagnoses

    DEFF Research Database (Denmark)

    Munkner, R; Haastrup, S; Jørgensen, T

    2003-01-01

    with schizophrenia born after November 1, 1963, data on criminality, substance-related diagnoses and contacts with the psychiatric hospital system were analysed. RESULTS: Compared with the non-convicted schizophrenics the convicted were older on first contact with the psychiatric hospital system and older when...... are aware of possible psychotic symptoms in criminal and abusing individuals to enable earlier detection and treatment....

  20. Psychiatric disorders in Danish children aged 5-7 years

    DEFF Research Database (Denmark)

    Elberling, Hanne; Linneberg, Allan; Ulrikka Rask, Charlotte

    2016-01-01

    BACKGROUND: Knowledge about the presentation of psychopathology in preschool age and associated risk factors is fundamental to preventive intervention before schooling. AIMS: To investigate the full spectrum of psychiatric diagnoses in general population children at the period of transition from.......4-1.6), respectively. Emotional disorders were found in 2.9% (95%CI: 1.9-40). More boys were diagnosed with PDD, behavioural disorders and tics. No gender differences were found in hyperactivity disorders (HD) and emotional disorders. Co-morbidity was frequent, in particular between HD and PDD, but also between HD...

  1. Current psychiatric disorders in patients with epilepsy are predicted by maltreatment experiences during childhood.

    Science.gov (United States)

    Labudda, Kirsten; Illies, Dominik; Herzig, Cornelia; Schröder, Katharina; Bien, Christian G; Neuner, Frank

    2017-09-01

    Childhood maltreatment has been shown to be a risk factor for the development of psychiatric disorders. Although the prevalence of psychiatric disorders is high in epilepsy patients, it is unknown if childhood maltreatment experiences are elevated compared to the normal population and if early maltreatment is a risk factor for current psychiatric comorbidities in epilepsy patients. This is the main purpose of this study. Structured interviews were used to assess current Axis I diagnoses in 120 epilepsy patients from a tertiary Epilepsy Center (34 TLE patients, 86 non-TLE patients). Childhood maltreatment in the family and peer victimization were assessed with validated questionnaires. Patients' maltreatment scores were compared with those of a representative matched control group. Logistic regression analysis was conducted to assess the potential impact of childhood maltreatment on current psychiatric comorbidity in epilepsy patients. Compared to a matched control group, epilepsy patients had higher emotional and sexual maltreatment scores. Patients with a current psychiatric diagnosis reported more family and peer maltreatment than patients without a psychiatric disorder. Family maltreatment scores predicted the likelihood of a current psychiatric disorder. TLE patients did not differ from non-TLE patients according to maltreatment experiences and rates of current psychiatric disorders. Our findings suggest that in epilepsy patients emotional and sexual childhood maltreatment is experienced more often than in the normal population and that early maltreatment is a general risk factor for psychiatric comorbidities in this group. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Psychiatric symptomatology after delirium: a systematic review.

    Science.gov (United States)

    Langan, Clare; Sarode, Deep P; Russ, Tom C; Shenkin, Susan D; Carson, Alan; Maclullich, Alasdair M J

    2017-09-01

    Delirium is an acute and usually transient severe neuropsychiatric syndrome associated with significant long-term physical morbidity. However, its chronic psychiatric sequelae remain poorly characterized. To investigate the prevalence of psychiatric symptoms, namely anxiety, depressive, and post-traumatic stress disorder (PTSD) symptoms after delirium, a systematic literature search of MEDLINE, EMBASE and PsycINFO databases was performed independently by two authors in March 2016. Bibliographies were hand-searched, and a forward- and backward-citation search using Web of Science was performed for all included studies. Of 6411 titles, we included eight prospective cohort studies, including 370 patients with delirium and 1073 without delirium. Studies were heterogeneous and mostly included older people from a range of clinical groups. Consideration of confounders was variable. The prevalence of depressive symptoms was almost three times higher in patients with delirium than in patients without delirium (22.2% vs 8.0%, risk ratio = 2.79; 95% confidence interval = 1.36-5.73). There was no statistically significant difference between the prevalence of anxiety symptoms between patients with and without delirium. The prevalence of PTSD symptoms after delirium was inconclusive: only one study investigated this and no association between PTSD symptoms after delirium was reported. There is limited published evidence of the prevalence of psychiatric symptoms after non-ICU delirium and the strongest evidence is for depressive symptoms. Further longitudinal studies are warranted to investigate the prevalence of anxiety and PTSD symptoms. © 2017 Japanese Psychogeriatric Society.

  3. Understanding migraine and psychiatric comorbidity.

    Science.gov (United States)

    Seng, Elizabeth K; Seng, Cynthia D

    2016-06-01

    This article describes recent trends in our understanding of the role of psychiatric disorders in the experience and treatment of migraine, and the role of migraine in the experience and treatment of psychiatric disorders. Although the majority of studies evaluating psychiatric comorbidity in migraine have focused on depression, anxiety, and bipolar disorders are highly associated with migraine and relevant for prognosis and treatment planning. Comorbid psychiatric disorders may be associated with poorer treatment response for some acute pharmacotherapies; however, people with comorbid migraine and mood or anxiety disorders can achieve large responses to preventive pharmacologic and behavioral therapies. Emerging research is developing and evaluating behavioral treatments designed to manage cooccurring migraine and mood or anxiety disorders. Stigma related to psychiatric disorders has been well characterized, and could exacerbate extant migraine-related stigma. Anxiety and mood disorders are prevalent in people with migraine, although not ubiquitous. Psychiatric comorbidity is associated with greater migraine symptoms and disability; however, people with comorbid depression or anxiety are amenable to preventive migraine treatment. Research regarding migraine treatment strategies optimized for people with comorbid psychiatric disorders is critical to advancing care and reducing stigma for this important subpopulation of people with migraine.

  4. Being publicly diagnosed

    DEFF Research Database (Denmark)

    Konradsen, Hanne; Lillebaek, Troels; Wilcke, Torgny

    2014-01-01

    a patient with TB, and finally being in medical treatment. Before being diagnosed with TB, patients were weighing between biding their time and deciding to undergo an examination. Social pressure and feelings of social responsibility tended to affect the decision. Having undergone the examination......INTRODUCTION: Tuberculosis (TB) is a disease which affects people worldwide, but there is knowledge lacking about patients' experiences in low-prevalence and high-income countries. AIM: To provide a theoretical framework for the process of being diagnosed with tuberculosis in a Danish setting....... METHOD: A grounded theory design with field studies and qualitative interviews, following the recommendations from Glaser and Strauss. RESULT: A process of being publicly diagnosed was identified, which developed during the patient's trajectory from being on the way to becoming a patient, becoming...

  5. Psychiatric co-morbidity in chronic pain disorder

    International Nuclear Information System (INIS)

    Yaqoob, N.; Sharif, A.; Shoaib, A.

    2013-01-01

    Objective: To determine the psychiatric co-morbidity in patients with chronic pain disorder in hospital setting. Design: Cross sectional descriptive study. Place and duration of study: This study was conducted at Combined Military Hospital (CMH) Okara from June 2011 to May 2012. Patients and Methods: A purposive sample of 400 patients (males=117; females=283) gathered from pain clinic and other outpatient departments of the hospital and were interviewed in detail and Present State Examination was carried out. Demographic variables were scored using descriptive statistics and results were analyzed using correlation methods. Results: It was revealed that psychiatric illness in overall sample prevailed among 266 participants (67%). Among which 164 participants (62%) were diagnosed with depression, 67 patients (25.2%) of chronic pain were diagnosed with anxiety disorders, 28 patients (11%) with adjustment disorder and 1.5% and 1.1% diagnosed with drug dependence and somatization disorder, respectively. Conclusion: Psychiatric co-morbidity especially the incidence of depression, anxiety and adjustment disorders were high amongst patients suffering from chronic pain disorder. (author)

  6. PSYCHIATRIC EVALUATION OF LIMB FRACTURE PATIENTS

    OpenAIRE

    CHAUDHURY, S; JOHN, TR; KUMAR, A; SINGH, HARCHARAN

    2002-01-01

    The study included 70 consecutive patients with fracture of the lower and upper limbs each and an equal number of age and sex matched normal control subjects. All the subjects were screened using the General Health Questionnaire (GHQ), the Michigan Alcoholism Screening Test (MAST), Carroll Rating Scale for Depression (CRSD), State-Trait Anxiety Inventory (STAI), Impact of Events Scale (IES), Fatigue Scale (FS) and the Perceived Stress Questionnaire (PSQ). Probable “Psychiatric cases” identifi...

  7. Psychiatric disorders among a sample of internally displaced persons in South Darfur.

    Science.gov (United States)

    Elhabiby, Mahmoud M; Radwan, Doaa N; Okasha, Tarek A; El-Desouky, Eman D

    2015-06-01

    The violent armed conflict in Darfur has been ongoing for years getting the attention of human rights activists and mental health professionals. The aim of this study was to assess psychiatric disorders in a sample of internally displaced persons (IDPs) in South Darfur. A cross-sectional observational study, as a part of the 'Darfur Campaign' organized by Arab Federation of Psychiatrists, assessing psychiatric disorders in a sample of internally displaced women using the Structured Clinical Interview for DSM-IV (SCID-I) (clinical version). Up to 25.7% of participants had lost a close family member or more in the violent clashes. Psychiatric diagnoses were found in 62.2% of the participants. The most frequently reported was post-traumatic stress disorder (PTSD) reaching 14.9%, followed by depression 13.5% (among which 2.7% with psychotic features), while comorbid PTSD and depression reached 8.1% of participants. Patients with psychiatric diagnoses had an older age (36.6 years) (p = .024). Suffering from a psychiatric disorder was found to be associated with losing a family member in the conflict (p = .015), being 35.6% in patients with psychiatric diagnoses compared to 10.3% in those without losing a family member in the conflict (odds ratio (OR) =  .7, 95% confidence interval (CI) = 1.25-18.28). This study used a standardized tool for diagnosing psychiatric morbidity among refugees in Darfur to give as much as possible an actual description of the problems and psychiatric morbidity caused by human-made disasters. This study can help to lead to a more detailed and specific mental health service program much needed by this population. © The Author(s) 2014.

  8. Sodium pentothal hypnosis: a procedure for evaluating medical patients with suspected psychiatric co-morbidity.

    Science.gov (United States)

    Russo, M B; Brooks, F R; Fontenot, J P; Dopler, B M; Neely, E T; Halliday, A W

    1997-03-01

    The cases presented here were patients referred for neurologic disability evaluations. They met the three selection criteria presented and underwent the four-phase pentothal hypnosis procedure described and at the conclusion were diagnosed as having psychiatric morbidity. We recommend that the sodium pentothal hypnosis procedure be considered for use whenever there is concern for psychiatric co-morbidity in a patient with presumed physiologic disease.

  9. Prevalence of serum anti-neuronal autoantibodies in patients admitted to acute psychiatric care

    DEFF Research Database (Denmark)

    Schou, M; Sæther, S G; Borowski, K

    2016-01-01

    BACKGROUND: Autoimmune encephalitis associated with anti-neuronal antibodies may be challenging to distinguish from primary psychiatric disorders. The significance of anti-neuronal antibodies in psychiatric patients without clear evidence of autoimmune encephalitis is unknown. We investigated...... the serum prevalence of six anti-neuronal autoantibodies in a cohort of unselected patients admitted to acute psychiatric care. METHOD: Serum was drawn from 925 patients admitted to acute psychiatric in-patient care. Psychiatric diagnoses were set according to International Classification of Diseases (ICD......)-10 criteria. Antibody analysis was performed with an indirect immunofluorescence test for N-methyl d-aspartate receptor (NMDAR) antibodies and five other anti-neuronal autoantibodies of the immunoglobulin (Ig) classes IgA, IgG and IgM isotype. RESULTS: Anti-neuronal autoantibodies were found in 11...

  10. Psychiatric comorbidities in asperger syndrome and high functioning autism: diagnostic challenges

    Directory of Open Access Journals (Sweden)

    Mazzone Luigi

    2012-06-01

    Full Text Available Abstract Several psychiatric conditions, both internalizing and externalizing, have been documented in comorbidity with Asperger Syndrome (AS and High Functioning Autism (HFA. In this review we examine the interplay between psychiatric comorbidities and AS/HFA. In particular, we will focus our attention on three main issues. First, we examine which psychiatric disorders are more frequently associated with AS/HFA. Second, we review which diagnostic tools are currently available for clinicians to investigate and diagnose the associated psychiatric disorders in individuals with AS/HFA. Third, we discuss the challenges that clinicians and researchers face in trying to determine whether the psychiatric symptoms are phenotypic manifestations of AS/HFA or rather they are the expression of a distinct, though comorbid, disorder. We will also consider the role played by the environment in the manifestation and interpretation of these symptoms. Finally, we will propose some strategies to try to address these issues, and we will discuss therapeutic implications.

  11. Psychiatric comorbidities in asperger syndrome and high functioning autism: diagnostic challenges

    Science.gov (United States)

    2012-01-01

    Several psychiatric conditions, both internalizing and externalizing, have been documented in comorbidity with Asperger Syndrome (AS) and High Functioning Autism (HFA). In this review we examine the interplay between psychiatric comorbidities and AS/HFA. In particular, we will focus our attention on three main issues. First, we examine which psychiatric disorders are more frequently associated with AS/HFA. Second, we review which diagnostic tools are currently available for clinicians to investigate and diagnose the associated psychiatric disorders in individuals with AS/HFA. Third, we discuss the challenges that clinicians and researchers face in trying to determine whether the psychiatric symptoms are phenotypic manifestations of AS/HFA or rather they are the expression of a distinct, though comorbid, disorder. We will also consider the role played by the environment in the manifestation and interpretation of these symptoms. Finally, we will propose some strategies to try to address these issues, and we will discuss therapeutic implications. PMID:22731684

  12. Advances in Psychiatric Diagnosis: Past, Present, and Future

    Directory of Open Access Journals (Sweden)

    Carol S. North

    2017-04-01

    Full Text Available This editorial examines controversies identified by the articles in this special issue, which explore psychopathology in the broad history of the classification of selected psychiatric disorders and syndromes over time through current American criteria. Psychiatric diagnosis has a long history of scientific investigation and application, with periods of rapid change, instability, and heated controversy associated with it. The articles in this issue examine the history of psychiatric nomenclature and explore current and future directions in psychiatric diagnosis through the various versions of accepted diagnostic criteria and accompanying research literature addressing the criteria. The articles seek to guide readers in appreciating the complexities of psychiatric diagnosis as the field of psychiatry pushes forward toward future advancements in diagnosis. Despite efforts of many scientists to advance a diagnostic classification system that incorporates neuroscience and genetics, it has been argued that it may be premature to attempt to move to a biologically-based classification system, because psychiatric disorders cannot yet be fully distinguished by any specific biological markers. For now, the symptom-based criteria that the field has been using continue to serve many essential purposes, including selection of the most effective treatment, communication about disease with colleagues, education about psychiatric illness, and support for ongoing research.

  13. Primary prevention of psychiatric illness in special populations.

    Science.gov (United States)

    Sajatovic, Martha; Sanders, Renata; Alexeenko, Lada; Madhusoodanan, Subramoniam

    2010-11-01

    Some populations appear to be particularly vulnerable to the development of psychiatric symptomatology related to life events and biologic or social/cultural factors. Such groups include individuals who have experienced traumatic events, military personnel, individuals with serious medical conditions, postpartum women, and immigrants. This study reviews the literature regarding primary prevention of psychiatric disorders in special populations and identifies a variety of universal, selective, and indicated prevention measures aimed at minimizing the psychiatric sequelae in these groups. The authors reviewed the literature regarding the prevention of psychiatric symptoms in trauma/abuse victims, individuals in the military, oncology patients, patients with diabetes, pregnant/postpartum women, and immigrants. The literature on primary prevention of psychiatric illness in the special populations identified is rather limited. Universal prevention may be beneficial in some instances through public awareness campaigns and disaster planning. In other instances, more specific and intensive interventions for individuals at high risk of psychiatric illness may improve outcomes, for example, crisis counseling for those who have experienced severe trauma. Primary prevention of psychiatric illness may be an attainable goal via implementation of specific universal, selected, and indicated primary prevention measures in special populations.

  14. Care systematization in psychiatric nursing within the psychiatric reform context.

    Science.gov (United States)

    Hirdes, A; Kantorski, L P

    2002-02-01

    The aim of this study was to approach care systematization in psychiatric nursing in two psychiatric disorder patients who attended 'Nossa Casa', São Lourenço do Sul, RS, Brazil. Nossa Casa services psychiatric patients in the community, focussing on: (i) permanence in their environment, allowing patients to remain close to their families and social spheres; (ii) integral attendance to meet individual needs; (iii) respecting individual differences; (iv) rehabilitation practices; and (v) social reinsertion. Concepts and assumptions of the psychiatric reform and the Irving's nursing process were used as theoretical-methodological references to elaborate this systematization. A therapeutic project for the psychiatric patient was elaborated, in accordance with the interdisciplinary proposal accepted by Nossa Casa. Interdisciplinary team intervention, guided by a previously discussed common orientation and defined through an individualized therapeutic project, allowed for an effective process of psychosocial rehabilitation. The authors concluded that a therapeutic project based on the mentioned premises leads to consistent, comprehensive, dialectical and ethical assistance in mental health, thereby reinstating the citizenship of psychiatric patients.

  15. Diagnosing plant problems

    Science.gov (United States)

    Cheryl A. Smith

    2008-01-01

    Diagnosing Christmas tree problems can be a challenge, requiring a basic knowledge of plant culture and physiology, the effect of environmental influences on plant health, and the ability to identify the possible causes of plant problems. Developing a solution or remedy to the problem depends on a proper diagnosis, a process that requires recognition of a problem and...

  16. Psychiatric disorders in patients with multidrug resistant tuberculosis (MDR-TB in Sardjito Hospital, Yogyakarta, Indonesia

    Directory of Open Access Journals (Sweden)

    Irwan Supriyanto

    2017-08-01

    Full Text Available Introduction: Tuberculosis has become a chronic debilitating disease in developing countries, particularly after the emergence of multidrug resistant tuberculosis (MDR-TB. Second line treatments for the disease which were subsequently developed were associated with psychiatric disorders among patients. Psychiatric disorder can either be induced by treatment regiments or psychosocial factors. Cycloserine administration is frequently reported to be associated with psychiatric disorders. In this study, we examined the prevalence and characteristics of psychiatric disorders among MDR-TB patients in Sardjito Hospital, Yogyakarta, Indonesia. Methods: In this descriptive study, we studied medical records of MDR-TB patients admitted for MDR-TB treatments to Sardjito Hospital from January 2014 to July 2016 and screened for psychiatric disorders. Results: We found that 32.8% of the patients had psychiatric disorders, some of which had multiple psychiatric diagnoses (14.1%. The diagnoses were medication induced delirium, substance/medication induced psychotic disorder, substance/medication use depressive disorder, depressive type schizoaffective disorder, bipolar I disorder current episode severe manic with psychotic features, mild depression, moderate depression, major depression without psychotic features, major depression with psychotic features, adjustment disorders with mixed anxiety and depressed mood, adjustment disorder with anxiety, acute stress disorder, and insomnia. Psychiatric disorders were significantly associated with cycloserine dose and sex. Psychotic symptoms were significantly associated with sex and level of education. Conclusion: The presence of psychiatric disorders might disturb MDR-TB treatment resulting in poor outcomes. Precaution and prompt managements are required for psychiatric disorders in patients receiving MDR-TB treatment regiments.

  17. Psychiatric sequelae of induced abortion.

    Science.gov (United States)

    Gibbons, M

    1984-03-01

    An attempt is made to identify and document the problems of comparative evaluation of the more recent studies of psychiatric morbidity after abortion and to determine the current consensus so that when the results of the joint RCGP/RCOG study of the sequelae of induced abortion become available they can be viewed in a more informed context. The legalization of abortion has provided more opportunities for studies of subsequent morbidity. New laws have contributed to the changing attitudes of society, and the increasing acceptability of the operation has probably influenced the occurrence of psychiatric sequelae. The complexity of measuring psychiatric sequelae is evident from the many terms used to describe symptomatology and behavioral patterns and from the number of assessment techniques involved. Numerous techniques have been used to quantify psychiatric sequelae. Several authors conclude that few psychiatric problems follow an induced abortion, but many studies were deficient in methodology, material, or length of follow-up. A British study in 1975 reported a favorable outcome for a "representative sample" of 50 National Health Service patients: 68% of these patients had an absence of or only mild feelings of guilt, loss, or self reproach and considered abortion as the best solution to their problem. The 32% who had an adverse outcome reported moderate to severe feelings of guilt, regret, loss, and self reproach, and there was evidence of mental illness. In most of these cases the adverse outcome was related to the patient's environment since the abortion. A follow-up study of 126 women, which compared the overall reaction to therapeutic abortion between women with a history of previous mild psychiatric illness and those without reported that a significantly different emotional reaction could not be demonstrated between the 2 groups. In a survey among women seeking an abortion 271 who were referred for a psychiatric opinion regarding terminations of pregnancy

  18. Nurses' attitudes toward ethical issues in psychiatric inpatient settings.

    Science.gov (United States)

    Eren, Nurhan

    2014-05-01

    Nursing is an occupation that deals with humans and relies upon human relationships. Nursing care, which is an important component of these relationships, involves protection, forbearance, attention, and worry. The aim of this study is to evaluate the ethical beliefs of psychiatric nurses and ethical problems encountered. The study design was descriptive and cross-sectional. RESEARCH CONTEXT: Methods comprised of a questionnaire administered to psychiatric nurses (n=202) from five psychiatric hospitals in Istanbul, Turkey, instruction in psychiatric nursing ethics, discussion of reported ethical problems by nursing focus groups, and analysis of questionnaires and reports by academicians with clinical experience. PARTICIPANTS consist of the nurses who volunteered to take part in the study from the five psychiatric hospitals (n=202), which were selected with cluster sampling method. Ethical considerations: Written informed consent of each participant was taken prior to the study. The results indicated that nurses needed additional education in psychiatric ethics. Insufficient personnel, excessive workload, working conditions, lack of supervision, and in-service training were identified as leading to unethical behaviors. Ethical code or nursing care -related problems included (a) neglect, (b) rude/careless behavior, (c) disrespect of patient rights and human dignity, (d) bystander apathy, (e) lack of proper communication, (f) stigmatization, (g) authoritarian attitude/intimidation, (h) physical interventions during restraint, (i) manipulation by reactive emotions, (j) not asking for permission, (k) disrespect of privacy, (l) dishonesty or lack of clarity, (m) exposure to unhealthy physical conditions, and (n) violation of confidence. The results indicate that ethical codes of nursing in psychiatric inpatient units are inadequate and standards of care are poor. In order to address those issues, large-scale research needs to be conducted in psychiatric nursing with a

  19. Factors related to positive and negative outcomes in psychiatric inpatients in a General Hospital Psychiatric Unit: a proposal for an outcomes index

    Directory of Open Access Journals (Sweden)

    HUGO KARLING MORESCHI

    2015-02-01

    Full Text Available Background General Hospital Psychiatric Units have a fundamental importance in the mental health care systems. However, there is a lack of studies regarding the level of improvement of patients in this type of facility. Objective To assess factors related to good and poor outcomes in psychiatric inpatients using an index composed by clinical parameters easily measured. Methods Length of stay (LOS, Global Assessment of Functioning (variation and at discharge and Clinical Global Impression (severity and improvement were used to build a ten-point improvement index (I-Index. Records of psychiatric inpatients of a general hospital during an 18-month period were analyzed. Three groups (poor, intermediate and good outcomes were compared by univariate and multivariate models according to clinical and sociodemographic variables. Results Two hundred and fifty patients were included, with a percentage in the groups with poor, regular and good outcomes of 16.4%, 59,6% and 24.0% respectively. Poor outcome at the discharge was associated mainly with lower education, transient disability, antipsychotics use, chief complaint “behavioral change/aggressiveness” and psychotic features. Multivariate analysis found a higher OR for diagnoses of “psychotic disorders” and “personality disorders” and others variables in relation to protective categories in the poor outcome group compared to the good outcome group. Discussion Our I-Index proved to be an indicator of that allows an easy and more comprehensive evaluation to assess outcomes of inpatients than just LOS. Different interventions addressed to conditions such as psychotic disorders and disruptive chief complaints are necessary.

  20. Cotard syndrome in neurological and psychiatric patients.

    Science.gov (United States)

    Ramirez-Bermudez, Jesus; Aguilar-Venegas, Luis C; Crail-Melendez, Daniel; Espinola-Nadurille, Mariana; Nente, Francisco; Mendez, Mario F

    2010-01-01

    The authors describe the frequency and characteristics of Cotard syndrome among neurological and psychiatric inpatients at a tertiary referral center. All inpatients from the National Institute of Neurology of Mexico (March 2007-May 2009) requiring neuropsychiatric consultation were reviewed. Among 1,321 inpatient consultations, 63.7% had neurological disease and one (0.11%) had viral encephalitis and Cotard syndrome. Of inpatients, 36.2% had pure psychiatric disorders and three (0.62%) had Cotard syndrome, associated with psychotic depression, depersonalization, and penile retraction (koro syndrome). This review discusses potential mechanisms for Cotard syndrome, including the role of a perceptual-emotional dissociation in self-misattribution in the deliré des negations.

  1. Psychiatric Prescribers' Experiences With Doctor Shoppers.

    Science.gov (United States)

    Worley, Julie; Johnson, Mary; Karnik, Niranjan

    2015-01-01

    Doctor shopping is a primary method of prescription medication diversion. After opioids, benzodiazepines and stimulants are the next most common prescription medications used nonmedically. Studies have shown that patients who engage in doctor shopping find it fun, exciting, and easy to do. There is a lack of research on the prescriber's perspective on the phenomenon of doctor shopping. This study investigates the experiences of prescribers in psychiatry with patients who engage in doctor shopping. Fifteen prescribers including psychiatrists and psychiatric nurse practitioners working in outpatient psychiatry were interviewed to elicit detailed information about their experiences with patients who engage in doctor shopping. Themes found throughout the interview were that psychiatric prescribers' experience with patients who engage in doctor shopping includes (a) detecting red flags, (b) negative emotional responding, (c) addressing the patient and the problem, and (d) inconsistently implementing precautions. When red flags were detected when prescribing controlled drugs, prescribers in psychiatry experienced both their own negative emotional responses such as disappointment and resentment as well as the negative emotions of the patients such as anger and other extreme emotional responses. Psychiatric prescribers responded to patient's doctor shopping in a variety of ways such as changing their practice, discharging the patients or taking steps to not accept certain patients identified as being at risk for doctor shopping, as well as by talking to the patient and trying to offer them help. Despite experiencing doctor shopping, the prescribers inconsistently implemented precautionary measures such as checking prescription drug monitoring programs. © The Author(s) 2015.

  2. Zinc deficiency is common in several psychiatric disorders.

    Directory of Open Access Journals (Sweden)

    Ole Grønli

    Full Text Available BACKGROUND: Mounting evidence suggests a link between low zinc levels and depression. There is, however, little knowledge about zinc levels in older persons with other psychiatric diagnoses. Therefore, we explore the zinc status of elderly patients suffering from a wide range of psychiatric disorders. METHODS: Clinical data and blood samples for zinc analyzes were collected from 100 psychogeriatric patients over 64 of age. Psychiatric and cognitive symptoms were assessed using the Montgomery and Aasberg Depression Rating Scale, the Cornell Scale for Depression in Dementia, the Mini-Mental State Examination, the Clockdrawing Test, clinical interviews and a review of medical records. In addition, a diagnostic interview was conducted using the Mini International Neuropsychiatric Interview instrument. The prevalence of zinc deficiency in patients with depression was compared with the prevalence in patients without depression, and the prevalence in a control group of 882 older persons sampled from a population study. RESULTS: There was a significant difference in zinc deficiency prevalence between the control group (14.4% and the patient group (41.0% (χ(2 = 44.81, df = 1, p<0.001. In a logistic model with relevant predictors, zinc deficiency was positively associated with gender and with serum albumin level. The prevalence of zinc deficiency in the patient group was significantly higher in patients without depression (i.e. with other diagnoses than in patients with depression as a main diagnosis or comorbid depression (χ(2 = 4.36, df = 1, p = 0.037. CONCLUSIONS: Zinc deficiency is quite common among psychogeriatric patients and appears to be even more prominent in patients suffering from other psychiatric disorders than depression. LIMITATIONS: This study does not provide a clear answer as to whether the observed differences represent a causal relationship between zinc deficiency and psychiatric symptoms. The blood sample collection time points

  3. Psychiatric comorbidity in DSM-III-R hypochondriasis.

    Science.gov (United States)

    Barsky, A J; Wyshak, G; Klerman, G L

    1992-02-01

    Forty-two DSM-III-R hypochondriacs from a general medical clinic were compared with a random sample of 76 outpatients from the same setting. Patients completed a research battery that included a structured diagnostic interview (Diagnostic Interview Schedule) and self-report questionnaires to measure personality disorder caseness, functional impairment, and hypochondriacal symptoms. Psychiatric morbidity in the hypochondriacal sample significantly exceeded that of the comparison sample. Hypochondriacs had twice as many lifetime Axis I diagnoses, twice as many Diagnostic Interview Schedule symptoms, and three times the level of personality disorder caseness as the comparison group. Of the hypochondriacal sample, 88% had one or more additional Axis I disorders, the overlap being greatest with depressive and anxiety disorders. One fifth of the hypochondriacs had somatization disorder, but the two conditions appeared to be phenomenologically distinct. Hypochondriacal patients with coexisting anxiety and/or depressive disorder (secondary hypochondriasis) did not differ greatly from hypochondriacal patients without these comorbid conditions (primary hypochondriasis). Because the nature of hypochondriasis remains unclear and requires further study, we suggest that its nosologic status not be altered in DSM-IV.

  4. Differences between youth with a single suicide attempt and repeaters regarding their and their parents history of psychiatric illness

    DEFF Research Database (Denmark)

    Jakobsen, Ida Skytte; Christiansen, Erik; Juul Larsen, Kim

    2011-01-01

    , psychiatric diagnoses, and psychopharmacological medications prescribed to youth before and after the index attempt were risk factors for repeated suicide attempts. Parental diagnoses and drug prescriptions following a child's first suicide attempt moderated the risk of repeated attempts. Psychiatric illness......The objective of this study was to determine predictors of repeated suicide attempts in young people, focusing on psychiatric illness. A longitudinal population-based register study of all adolescents born in Denmark between 1984 and 2006 was conducted. Greater numbers of hospitalizations...... is a strong predictor of repeated suicide attempts in young people, and those with co-morbid diagnoses are at increased risk of repeated suicide attempts. Treatment of psychiatric illness in the parents after their child's first suicide attempt is a potential protective factor....

  5. Substance use disorders and comorbid Axis I and II psychiatric disorders among young psychiatric patients: findings from a large electronic health records database.

    Science.gov (United States)

    Wu, Li-Tzy; Gersing, Ken; Burchett, Bruce; Woody, George E; Blazer, Dan G

    2011-11-01

    This study examined the prevalence of substance use disorders (SUDs) among psychiatric patients aged 2-17 years in an electronic health records database (N=11,457) and determined patterns of comorbid diagnoses among patients with a SUD to inform emerging comparative effectiveness research (CER) efforts. DSM-IV diagnoses of all inpatients and outpatients at a large university-based hospital and its associated psychiatric clinics were systematically captured between 2000 and 2010: SUD, anxiety (AD), mood (MD), conduct (CD), attention deficit/hyperactivity (ADHD), personality (PD), adjustment, eating, impulse-control, psychotic, learning, mental retardation, and relational disorders. The prevalence of SUD in the 2-12-year age group (n=6210) was 1.6% and increased to 25% in the 13-17-year age group (n=5247). Cannabis diagnosis was the most prevalent SUD, accounting for more than 80% of all SUD cases. Among patients with a SUD (n=1423), children aged 2-12 years (95%) and females (75-100%) showed high rates of comorbidities; blacks were more likely than whites to be diagnosed with CD, impulse-control, and psychotic diagnoses, while whites had elevated odds of having AD, ADHD, MD, PD, relational, and eating diagnoses. Patients with a SUD used more inpatient treatment than patients without a SUD (43% vs. 21%); children, females, and blacks had elevated odds of inpatient psychiatric treatment. Collectively, results add clinical evidence on treatment needs and diagnostic patterns for understudied diagnoses. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. Molecular Pathways Bridging Frontotemporal Lobar Degeneration and Psychiatric Disorders

    Directory of Open Access Journals (Sweden)

    Roberta eZanardini

    2016-02-01

    Full Text Available The overlap of symptoms between neurodegenerative and psychiatric diseases has been reported. Neuropsychiatric alterations are commonly observed in dementia, especially in the behavioral variant of frontotemporal dementia (bvFTD, which is the most common clinical FTD subtype. At the same time, psychiatric disorders, like schizophrenia, can display symptoms of dementia, including features of frontal dysfunction with relative sparing of memory. In the present review we discuss common molecular features in these pathologies with a special focus on FTD. Molecules like Brain Derived Neurotrophic Factor (BDNF and progranulin are linked to the pathophysiology of both neurodegenerative and psychiatric diseases. In these brain-associated illnesses, the presence of disease-associated variants in BDNF and progranulin (GRN genes cause a reduction of circulating proteins levels, through alterations in proteins expression or secretion. For these reasons, we believe that prevention and therapy of psychiatric and neurological disorders could be achieved enhancing both BDNF and progranulin levels thanks to drug discovery efforts.

  7. The association between psychiatric disorders and work-related problems among subway drivers in Korea.

    Science.gov (United States)

    Kim, Se-Eun; Kim, Hyoung-Ryoul; Park, Jong-Ik; Lee, Hae Woo; Lee, Jongin; Byun, Junsu; Yim, Hyeon Woo

    2014-01-01

    This study aimed to find the prevalence and occupational risk factors for major psychiatric disorders among subway drivers in South Korea. Of all 998 current subway drivers, 995 participated in this study. The Korean version of the Composite International Diagnostic Interview (K-CIDI 2.1) was administered by trained interviewers to diagnose psychiatric disorders in all participants. The questions on socio-demographic characteristics and working conditions included some questions related to a person under train (PUT) experience and work-related problems. One-year prevalence and lifetime prevalence of major depressive disorder (MDD), post-traumatic stress disorder (PTSD), and panic disorder were diagnosed through the interview. The standardized prevalence ratios (SPRs) of these three disorders were calculated in the sample of subway drivers using the 2011 Korean National Epidemiologic Survey data as a basis. Multiple logistic regressions were performed to determine the association between work-related factors and the prevalence of the psychiatric disorders. The standardized prevalence ratios (SPRs) for a 1-year prevalence of MDD and PTSD among subway drivers were 1.1 (95% CI 0.7-1.7) and 5.6 (95% CI 3.1-8.8), respectively. Conflict with passengers was significantly associated with an increased risk for both MDD and PTSD in 1-year and in lifetime prevalence. Experiencing a sudden stop due to an emergency bell increased the risk of the lifetime prevalence of MDD (OR 2.61, 95% CI 1.14-6.97) and PTSD (OR 7.53, 95% CI 1.77-32.02). The risk of PTSD significantly increased among drivers who once experienced a near accident in terms of both the 1-year prevalence (OR 8.81, 95% CI 1.96-39.3) and the lifetime prevalence (OR 6.36, 95% CI 2.40-16.90). PTSD and panic disorder were more prevalent among subway drivers than in the general population. We found that having a conflict with passengers, a near accident, and a breakdown while driving can be risk factors for psychiatric

  8. [Applying Neuman's Systems Model to a neuroleptic malignant syndrome psychiatric patient and his caregiver].

    Science.gov (United States)

    Wang, Shu-Mi; Lai, Chien-Yu

    2010-04-01

    This article describes a nurse's experience using Neuman's Systems Model to care for a chronic psychiatric patient and his caregiver. The patient was diagnosed as suffering from neuroleptic malignant syndrome (NMS). Nursing care described in this article was administered from October 23 to December 4, 2007. The patient developed NMS in the third month of a three-month period of hospitalization, which endangered his life as well as the health of his caregiver. Nursing care was provided to the patient and his caregiver based on Neuman's Systems Model, which included assessments of intrapersonal, interpersonal, and extra-personal forces as well as of environmental factors affecting the health of the patient and his caregiver. The four nursing care issues identified included: existing self-care deficit, sensory/perceptual alteration, sleep pattern disturbance, and caregiver role strain. Following Neuman's systems model, primary, secondary, and tertiary prevention were used to strengthen the flexible lines of defense, internal lines of resistance, and supporting existing strengths of both patient and caregiver, as well as to conserve client system energy. Significant improvements in patient and caregiver abilities were apparent in nursing intervention outcomes. This experience shows the Neuman's systems model to be an efficient model in psychiatric nursing care.

  9. A novel 3q29 deletion associated with autism, intellectual disability, psychiatric disorders, and obesity.

    Science.gov (United States)

    Biamino, Elisa; Di Gregorio, Eleonora; Belligni, Elga Fabia; Keller, Roberto; Riberi, Evelise; Gandione, Marina; Calcia, Alessandro; Mancini, Cecilia; Giorgio, Elisa; Cavalieri, Simona; Pappi, Patrizia; Talarico, Flavia; Fea, Antonio M; De Rubeis, Silvia; Cirillo Silengo, Margherita; Ferrero, Giovanni Battista; Brusco, Alfredo

    2016-03-01

    Copy number variation (CNV) has been associated with a variety of neuropsychiatric disorders, including intellectual disability/developmental delay (ID/DD), autism spectrum disorder (ASD), and schizophrenia (SCZ). Often, individuals carrying the same pathogenic CNV display high clinical variability. By array-CGH analysis, we identified a novel familial 3q29 deletion (1.36 Mb), centromeric to the 3q29 deletion region, which manifests with variable expressivity. The deletion was identified in a 3-year-old girl diagnosed with ID/DD and autism and segregated in six family members, all affected by severe psychiatric disorders including schizophrenia, major depression, anxiety disorder, and personality disorder. All individuals carrying the deletion were overweight or obese, and anomalies compatible with optic atrophy were observed in three out of four cases examined. Amongst the 10 genes encompassed by the deletion, the haploinsufficiency of Optic Atrophy 1 (OPA1), associated with autosomal dominant optic atrophy, is likely responsible for the ophthalmological anomalies. We hypothesize that the haploinsufficiency of ATPase type 13A4 (ATP13A4) and/or Hairy/Enhancer of Split Drosophila homolog 1 (HES1) contribute to the neuropsychiatric phenotype, while HES1 deletion might underlie the overweight/obesity. In conclusion, we propose a novel contiguous gene syndrome due to a proximal 3q29 deletion variably associated with autism, ID/DD, psychiatric traits and overweight/obesity. © 2015 Wiley Periodicals, Inc.

  10. Assessing the evidence for shared genetic risks across psychiatric disorders and traits.

    Science.gov (United States)

    Martin, Joanna; Taylor, Mark J; Lichtenstein, Paul

    2017-12-04

    Genetic influences play a significant role in risk for psychiatric disorders, prompting numerous endeavors to further understand their underlying genetic architecture. In this paper, we summarize and review evidence from traditional twin studies and more recent genome-wide molecular genetic analyses regarding two important issues that have proven particularly informative for psychiatric genetic research. First, emerging results are beginning to suggest that genetic risk factors for some (but not all) clinically diagnosed psychiatric disorders or extreme manifestations of psychiatric traits in the population share genetic risks with quantitative variation in milder traits of the same disorder throughout the general population. Second, there is now evidence for substantial sharing of genetic risks across different psychiatric disorders. This extends to the level of characteristic traits throughout the population, with which some clinical disorders also share genetic risks. In this review, we summarize and evaluate the evidence for these two issues, for a range of psychiatric disorders. We then critically appraise putative interpretations regarding the potential meaning of genetic correlation across psychiatric phenotypes. We highlight several new methods and studies which are already using these insights into the genetic architecture of psychiatric disorders to gain additional understanding regarding the underlying biology of these disorders. We conclude by outlining opportunities for future research in this area.

  11. Schizoaffective Disorder in an acute psychiatric unit: Profile of users and agreement with Operational Criteria (OPCRIT

    Directory of Open Access Journals (Sweden)

    Ryola Singh

    2016-05-01

    Full Text Available Background: Schizoaffective Disorder is a controversial and poorly understood diagnosis. Experts disagree on whether it is a discrete disorder; whether it is on a spectrum between Bipolar Disorder and Schizophrenia or whether it even exists. Lack of individual research attention given to this disorder, changing diagnostic criteria and hence poor diagnostic stability have all contributed to the dearth of knowledge surrounding Schizoaffective Disorder. Objectives: To describe the profile of mental health care users (MHCUs diagnosed with Schizoaffective Disorder and determine the degree of agreement between the clinicians’ diagnosis and Operational Criteria (OPCRIT. Method: All MHCUs at Helen Joseph Hospital psychiatric unit with Schizoaffective Disorder between 01 January 2004 and 31 December 2010 were included. The demographic, clinical and treatment profiles as well as data required for OPCRIT were extracted from hospital records and discharge summaries. Results: Most MHCUs with Schizoaffective Disorder were female (68.89%, with a mean age of illness onset of 25 years (SD ± 7.11, had a family history of mood disorders (76.92% and displayed impaired functioning. Majority (80% were treated with at least one antipsychotic and one mood stabiliser. No agreement was found between the clinicians’ diagnosis and OPCRIT. Conclusion: While the profile of MHCUs with Schizoaffective Disorder in this study is similar to other studies, the lack of agreement between the clinicians’ and OPCRIT diagnoses calls for further research using larger population samples and a dimensional approach to diagnoses in order to improve understanding and management of Schizoaffective Disorder.

  12. Stress among employees in psychiatric nursing

    Directory of Open Access Journals (Sweden)

    Urška Nemec

    2017-03-01

    Full Text Available Introduction: Evidence suggests that stressful situations are frequent in the field of psychiatry and that professionals working in this speciality are more prone to stress. Stressful situations may be compounded by ignoring the principles and strategies of therapeutic communication in all interactions with patients. The purpose of the research was to determine the presence of stress among the nursing team members. Methods: The research is based on a quantitative methodology; the data were collected using a semi-structured questionnaire. The sample consisted of 73 nurses working in a special social welfare institution (n = 37 and in a psychiatric hospital (n = 36. The survey was conducted in the first half of the year 2016. Descriptive statistics and chi-square test were used. Results: The list of stress factors most frequently reported by the participants include low pay (n = 40, 55 %, poor interpersonal relationships in the workplace (n = 23, 32 %, and the sense of insecurity due to unpredictable behaviour of patients (n = 32, 44 %. One fifth of the respondents are regularly subjected to patient physical violence and psychological abuse in the workplace (n = 14, 19 % and a large majority (n = 53, 72.5 % are frequently exposed to dangerous situations. The respondents are not fully aware of the crucial importance of therapeutic communication with the patients (n = 38, 52 %. Discussion and conclusion: It is impossible to completely avoid stressful situations in psychiatric settings. Psychiatric nurses should possess good communication skills and the ability to develop good interpersonal relationships.

  13. Home treatment for acute psychiatric illness.

    Science.gov (United States)

    Dean, C; Gadd, E M

    1990-11-03

    To determine the factors influencing the successful outcome of community treatment for severe acute psychiatric illnesses that are traditionally treated in hospital. All patients from a single electoral ward who were either admitted to hospital or treated at home over a two year period (1 October 1987 to 30 September 1989) were included in the study and their case notes audited. The second year of the study is reported. Electoral ward of Sparkbrook, Birmingham. 99 Patients aged 16-65 with severe acute psychiatric illness. 65 Patients were managed by home treatment alone; 34 required admission to hospital. The location of treatment was significantly (all p less than 0.05) influenced by social characteristics of the patients (marital state, age (in men), ethnicity, and living alone) and by characteristics of the referral (occurring out of hours; assessment taking place at hospital or police station). DSM-III-R diagnosis was more weakly associated with outcome. Violence during the episode was significantly related to admission, although deliberate self harm was not. Home treatment is feasible for most patients with acute psychiatric illness. A 24 hour on call assessment service increases the likelihood of success because admission is determined more strongly by social characteristics of the patient and the referral than by illness factors. Admission will still be required for some patients. A locally based mental health resource centre, a 24 hour on call service, an open referral system, and an active follow up policy increase the effectiveness of a home treatment service.

  14. Psychiatric disorder associated with vacuum-assisted breast biopsy clip placement: a case report

    Directory of Open Access Journals (Sweden)

    Zografos George C

    2008-10-01

    Full Text Available Abstract Introduction Vacuum-assisted breast biopsy is a minimally invasive technique that has been used increasingly in the treatment of mammographically detected, non-palpable breast lesions. Clip placement at the biopsy site is standard practice after vacuum-assisted breast biopsy. Case presentation We present the case of a 62-year-old woman with suspicious microcalcifications in her left breast. The patient was informed about vacuum-assisted breast biopsy, including clip placement. During the course of taking the patient's history, she communicated excellently, her demeanor was normal, she disclosed no intake of psychiatric medication and had not been diagnosed with any psychiatric disorders. Subsequently, the patient underwent vacuum-assisted breast biopsy (11 G under local anesthesia. A clip was placed at the biopsy site. The pathological diagnosis was of sclerosing adenosis. At the 6-month mammographic follow-up, the radiologist mentioned the existence of the metallic clip in her breast. Subsequently, the woman presented complaining about "being spied [upon] by an implanted clip in [her] breast" and repeatedly requested the removal of the clip. The patient was referred to the specialized psychiatrist of our breast unit for evaluation. The Mental State Examination found that systematized paranoid ideas of persecutory type dominated her daily routines. At the time, she believed that the implanted clip was one of several pieces of equipment being used to keep her under surveillance, the other equipment being her telephone, cameras and television. Quite surprisingly, she had never had a consultation with a mental health professional. The patient appeared depressed and her insight into her condition was impaired. The prevalent diagnosis was schizotypal disorder, whereas the differential diagnosis comprised delusional disorder of persecutory type, affective disorder with psychotic features or comorbid delusional disorder with major depression

  15. Utility of the Brief Symptom Inventory (BSI) in psychiatric outpatients with intellectual disabilities.

    Science.gov (United States)

    Wieland, J; Wardenaar, K J; Fontein, E; Zitman, F G

    2012-09-01

    Diagnostics and care for people with intellectual disabilities (ID) and psychiatric disorders need to be improved. This can be done by using assessment instruments to routinely measure the nature and severity of psychiatric symptoms. Up until now, in the Netherlands, assessment measures are seldom used in the psychiatric care for this population. The objective of the present paper is to evaluate the use of the Brief Symptom Inventory (BSI), a widely used standardised questionnaire in general psychiatry, in a well-defined sample of people with borderline intellectual functioning or mild ID diagnosed with one or more psychiatric disorders. A total of 224 psychiatric outpatients with either borderline intellectual functioning or mild ID participated in this study. All participants were new patients of Kristal, Centre for Psychiatry and Intellectual Disability in the Netherlands, in the period between 1 April 2008 and 1 October 2009. All participants were assessed by a multidisciplinary team, including a certified psychiatrist. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) criteria were applied. The mean total intelligence quotient was measured with the Wechsler Adult Intelligence Scale (WAIS-III). The BSI was administered in an assisted fashion. Utility and psychometric properties of the BSI were investigated. Internal consistency coefficients (Cronbach's alphas) were computed. Bivariate correlations between the sub-scales were computed to assess differentiation between the scales. Mean sub-scale scores were compared between different DSM-IV-TR subgroups to investigate the discriminant abilities of the scales. A confirmatory factor analysis was conducted. The results suggest that the BSI is practically useful. Internal consistencies ranged from 0.70 to 0.96 and thus are considered good to adequate. Sub-scale inter-correlations showed there is a degree of differentiation between the sub-scales. Discriminant validity was shown for the sub

  16. Cutaneous factitia in elderly patients: alarm signal for psychiatric disorders

    Directory of Open Access Journals (Sweden)

    Chiriac A

    2014-03-01

    Full Text Available Anca Chiriac,1 Liliana Foia,2 Cristina Birsan,1 Ancuta Goriuc,2 Caius Solovan3 1Department of Dermatology, Nicolina Medical Center, Iaşi, Romania; 2Surgical Department, Grigore T Popa University of Medicine and Pharmacy, Iaşi, Romania; 3Department of Dermatology, Victor Babeş University of Medicine and Pharmacy, Timişoara, Romania Background: The factitious disorders, more commonly known in daily practice as pathomimia, are expressed in dermatology units by skin lesions induced voluntarily by the patient, in order to draw attention of the medical staff and/or the family members. The disorder is often challenging to diagnose and even more difficult to document in front of the patient or relatives. It represents a challenge for the physician, and any attempt at treatment may be followed by recurrence of the self-mutilation. This paper describes two cases of pathomimia diagnosed by dermatologists and treated in a psychiatry unit, highlighting the importance of collaboration in these situations. Patients and methods: Two case reports, describing old female patients with pathomimia, hospitalized in a department of dermatology for bizarre skin lesions. Results: The first case was a 77-year-old female with unknown psychiatric problems and atrophic skin lesions on the face, self-induced for many months, with multiple hospitalizations in dermatology units, with no response to different therapeutic patterns, and full recovery after psychiatric treatment for a major depressive syndrome. The second case was a 61-year-old female patient with disseminated atrophic scars on the face, trunk, and limbs. She raised our interest because of possible psychiatric issues, as she had attempted to commit suicide. The prescription of antidepressants led to a significant clinical improvement. Conclusion: These cases indicate that a real psychiatric disease may be recorded in patients suffering from pathomimia. Therefore, complete psychiatric evaluation in order to

  17. Individual and parental psychiatric history and risk for suicide among adolescents and young adults in Denmark : A population-based study

    DEFF Research Database (Denmark)

    Stenager, Kirstina; Qin, Ping

    2008-01-01

    BACKGROUND: Both individual and familial histories of mental illness are substantial risk factors for suicide in young people. AIM: To explore suicide risk among adolescents and young adults according to detailed aspects of individual and parental psychiatric admission history. METHODS: A nested...... case-control study was undertaken using data from Danish population registers to include 4,142 suicide cases and 82,840 matched controls aged 9-35 years. Data were analyzed with conditional logistic regression. RESULTS: A history of hospitalized psychiatric illness was a strong risk factor for suicide...... in adolescents and young adults, and the effect of such a history was greater in females than males. The elevated risk peaked in the two periods immediately after admission and discharge for both sexes, and exceeded in females who had multiple admissions and in males who were diagnosed with schizophrenia...

  18. OCCUPATIONAL ROLE AFTER PSYCHIATRIC HOSPITALIZATION

    Directory of Open Access Journals (Sweden)

    GH.R GHASSEMI

    2003-03-01

    Full Text Available Introduction: Severe Psychiatricillness is accompanied by gross disturbances in patient's occupational role. This study presents a comparative picture of work performance before and after psychiatric hospitalization. Method: Subjects comprised 440 psychiatric admitters from Noor Medical center - Isfahan - Iran, who were followed from November 1999 to November 2000. Their work adjustment was measured by means of Weiss man's index. Data were computer analyzed using SPSS by running paired t- student and ANOVA. Results: Majority of the patients (53 % were without permanent sources of income before psychiatric hospitalization, about 12 percent of those who were working prior to hospitalization lost their job after being discharged from hospital. Better work adjustment before hospitalization was positively correlated with better work adjustment after discharge for working patients (r =0/66. Working ability of the patients after discharge was lesser than before the attack f9r patients with regular and irregular job (P < 001. Discussion: Job loss or poor working ability after psychiatric admission reported by several researchers and has bean confirmed in this study as well. These observatoins have been discussed in view of the current socio economic problems in the society and nature of psychiatric disturbances.

  19. Sexual harassment of psychiatric trainees: experiences and attitudes

    Science.gov (United States)

    Morgan, J.; Porter, S.

    1999-01-01

    A survey was carried out of psychiatric trainees' work-related experiences of unwanted sexual contact. A structured postal questionnaire was administered to 100 psychiatric trainees from senior house officer to specialist registrar level in a large psychiatric rotation. There was an 85% response rate; 86% (73) of the sample had experienced unwanted sexual contact, with 47% (40) experiencing deliberate touching, leaning over or cornering, and 18% (15) receiving letters, telephone calls or material of a sexual nature. Three-quarters (64) of respondents had experienced unwanted sexual contact from patients and 64% (54) from staff. Experiences and attitudes did not generally differ by gender, grade or training experience. Four out of 48 female respondents described stalking by patients. Of the 39 respondents who had reported harassment by patients, 31 felt supported by colleagues, while of the 13 who had reported harassment by colleagues, eight felt supported. Two-thirds of the respondents considered sexual harassment `sometimes' or `frequently' a problem for the profession. Diagnoses of confusional states, mania or schizophrenia made subjects less likely to consider unwanted sexual behaviour to be `sexual harassment' (86%, 80%, and 67%, respectively), but not for other diagnoses. Levels of threatening and intrusive sexual harassment are unacceptably high in this study group. Health trusts should adopt policies of `zero tolerance' and all incidents should be reported. Psychological impact on victims should be acknowledged even when the behaviour of the perpetrator can be explained by diagnosis.
 PMID:10474725

  20. Sexual harassment of psychiatric trainees: experiences and attitudes.

    Science.gov (United States)

    Morgan, J F; Porter, S

    1999-07-01

    A survey was carried out of psychiatric trainees' work-related experiences of unwanted sexual contact. A structured postal questionnaire was administered to 100 psychiatric trainees from senior house officer to specialist registrar level in a large psychiatric rotation. There was an 85% response rate; 86% (73) of the sample had experienced unwanted sexual contact, with 47% (40) experiencing deliberate touching, leaning over or cornering, and 18% (15) receiving letters, telephone calls or material of a sexual nature. Three-quarters (64) of respondents had experienced unwanted sexual contact from patients and 64% (54) from staff. Experiences and attitudes did not generally differ by gender, grade or training experience. Four out of 48 female respondents described stalking by patients. Of the 39 respondents who had reported harassment by patients, 31 felt supported by colleagues, while of the 13 who had reported harassment by colleagues, eight felt supported. Two-thirds of the respondents considered sexual harassment 'some-times' or 'frequently' a problem for the profession. Diagnoses of confusional states, mania or schizophrenia made subjects less likely to consider unwanted sexual behaviour to be 'sexual harassment' (86%, 80%, and 67%, respectively), but not for other diagnoses. Levels of threatening and intrusive sexual harassment are unacceptably high in this study group. Health trusts should adopt policies of 'zero tolerance' and all incidents should be reported. Psychological impact on victims should be acknowledged even when the behaviour of the perpetrator can be explained by diagnosis.

  1. Addiction and suicidal behavior in acute psychiatric inpatients.

    Science.gov (United States)

    Ries, Richard K; Yuodelis-Flores, Christine; Roy-Byrne, Peter P; Nilssen, Odd; Russo, Joan

    2009-01-01

    This study aims to evaluate the relationship of alcohol/drug use and effect severities to the degree of suicidality in acutely admitted psychiatric patients. Both degree of substance dependency and degree of substance-induced syndrome were analyzed. In addition, length of stay, involuntary status, and against medical advice discharge status were determined as they related to these variables. Structured clinical admissions and discharge ratings were gathered from 10,667 consecutive, single-case individual records, from an urban acute care county psychiatric hospital. Data indicate that of the most severely suicidal group, 56% had substance abuse or dependence, 40% were rated as having half or more of their admission syndrome substance induced, and most had nonpsychotic diagnoses. There was an inverse relationship between degree of substance problem and length of stay. Although these patients more commonly left against medical advice, and were readmitted more frequently, they were less likely to be involuntarily committed. A large, potentially lethal, and highly expensive subgroup of patients has been characterized, which might be called the "New Revolving Door acute psychiatric inpatient." This group, which uses the most expensive level of care in the mental health system but is substantially addiction related, poses special challenges for inpatient psychiatric units, addiction treatment providers, and health care planners.

  2. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

    Full Text Available ... for Women Diagnosed with Cancer Fertility Preservation for Men Diagnosed with Cancer Fertility Preservation for Children Diagnosed ... for Women Diagnosed with Cancer Fertility Preservation for Men Diagnosed with Cancer Fertility Preservation for Children Diagnosed ...

  3. Diagnoser som styringshybrider

    DEFF Research Database (Denmark)

    Bossen, Claus; Danholt, Peter; Ubbesen, Morten Bonde

    2016-01-01

    - Relaterede Grupper (DRG). DRG er et internationalt udbredt system til at knytte patienter og deres behandlingsomkostninger sammen i faste kategorier med henblik på at måle hospitalers produktivitet. Med afsæt i Science-Technology-Studies (STS)-feltet analyserer artiklen, hvorledes diagnoser overskrider deres......, hvordan DRG-systemet alternativt kan anskues som en samfundsudviklende infrastruktur, idet det forsamler og skaber gensidigt involverende interaktioner imellem politiske, administrative og sundhedsprofessionelle domæner. En sådan indsigt bidrager til en udvidet forståelse af infrastrukturers roller som...

  4. A Psychiatric Formulary for Long-Duration Spaceflight.

    Science.gov (United States)

    Friedman, Eric; Bui, Brian

    2017-11-01

    Behavioral health is essential for the safety, well-being, and performance of crewmembers in both human spaceflight and Antarctic exploration. Over the past five decades, psychiatric issues have been documented in orbital spaceflight. In Antarctica, literature suggests up to 5% of wintering crewmembers could meet criteria for a psychiatric illness, including mood disorders, stressor-related disorders, sleep-wake disorders, and substance-related disorders. Experience from these settings indicates that psychiatric disorders on deep space missions must be anticipated. An important part of planning for the psychological health of crewmembers is the onboard provision of psychotropic drugs. These medications have been available on orbital missions. A greater variety and supply of these drugs exist at Antarctic facilities. The size and diversity of a deep space psychiatric formulary will be greater than that provided on orbital missions. Drugs to be provisioned include anxiolytics, antidepressants, mood stabilizers, antipsychotics, and hypnotics. Each drug category should include different medications, providing diverse pharmacokinetic, pharmacodynamic, and side effect profiles. The formulary itself should be rigorously controlled, given the abuse potential of some medications. In-flight treatment strategies could include psychological monitoring of well-being and early intervention for significant symptoms. Psychiatric emergencies would be treated aggressively with behavioral and pharmacological interventions to de-escalate potentially hazardous situations. On long-duration space missions, a robust psychiatric formulary could provide crewmembers autonomy and flexibility in treating a range of behavioral issues from depression to acute psychosis. This will contribute to the safety, health, and performance of crewmembers, and to mission success.Friedman E, Bui B. A psychiatric formulary for long-duration spaceflight. Aerosp Med Hum Perform. 2017; 88(11):1024-1033.

  5. The Co-evolution of Neuroimaging and Psychiatric Neurosurgery.

    Science.gov (United States)

    Dyster, Timothy G; Mikell, Charles B; Sheth, Sameer A

    2016-01-01

    The role of neuroimaging in psychiatric neurosurgery has evolved significantly throughout the field's history. Psychiatric neurosurgery initially developed without the benefit of information provided by modern imaging modalities, and thus lesion targets were selected based on contemporary theories of frontal lobe dysfunction in psychiatric disease. However, by the end of the 20th century, the availability of structural and functional magnetic resonance imaging (fMRI) allowed for the development of mechanistic theories attempting to explain the anatamofunctional basis of these disorders, as well as the efficacy of stereotactic neuromodulatory treatments. Neuroimaging now plays a central and ever-expanding role in the neurosurgical management of psychiatric disorders, by influencing the determination of surgical candidates, allowing individualized surgical targeting and planning, and identifying network-level changes in the brain following surgery. In this review, we aim to describe the coevolution of psychiatric neurosurgery and neuroimaging, including ways in which neuroimaging has proved useful in elucidating the therapeutic mechanisms of neuromodulatory procedures. We focus on ablative over stimulation-based procedures given their historical precedence and the greater opportunity they afford for post-operative re-imaging, but also discuss important contributions from the deep brain stimulation (DBS) literature. We conclude with a discussion of how neuroimaging will transition the field of psychiatric neurosurgery into the era of precision medicine.

  6. Functional neuroimaging and presenting psychiatric features in frontotemporal dementia

    Science.gov (United States)

    Mendez, M F; McMurtray, A; Chen, A K; Shapira, J S; Mishkin, F; Miller, B L

    2006-01-01

    Background Frontotemporal dementia (FTD) is a behavioural syndrome caused by degeneration of the frontal and anterior temporal lobes. Behavioural disturbances include psychiatric features. Whether patients with FTD present with psychiatric features varies with the initial neuroanatomical variability of FTD. Objective To identify presenting psychiatric changes not part of diagnostic criteria of FTD and contrast them with the degree of hemispheric asymmetry and frontal and temporal hypoperfusion on single photon emission computed tomography (SPECT) imaging. Methods 74 patients who met consensus criteria for FTD were evaluated at a two year follow up. All had brain SPECT on initial presentation. Results of an FTD psychiatric checklist were contrasted with ratings of regional hypoperfusion. Results The regions of predominant hypoperfusion did not correlate with differences on FTD demographic variables but were associated with presenting psychiatric features. Dysthymia and anxiety were associated with right temporal hypoperfusion. “Moria” or frivolous behaviour also occurred with temporal lobe changes, especially on the right. The only significant frontal lobe feature was the presence of a peculiar physical bearing in association with right frontal hypoperfusion. Conclusions Patients with FTD may present with psychiatric changes distinct from the behavioural diagnostic criteria for this disorder. Early temporal involvement is associated with frivolous behaviour and right temporal involvement is associated with emotional disturbances. In contrast, those with right frontal disease may present with alterations in non‐verbal behaviour. PMID:16043457

  7. The progression of coeliac disease: its neurological and psychiatric implications.

    Science.gov (United States)

    Campagna, Giovanna; Pesce, Mirko; Tatangelo, Raffaella; Rizzuto, Alessia; La Fratta, Irene; Grilli, Alfredo

    2017-06-01

    The aim of the paper is to show the various neurological and psychiatric symptoms in coeliac disease (CD). CD is a T cell-mediated, tissue-specific autoimmune disease which affects genetically susceptible individuals after dietary exposure to proline- and glutamine-rich proteins contained in certain cereal grains. Genetics, environmental factors and different immune systems, together with the presence of auto-antigens, are taken into account when identifying the pathogenesis of CD. CD pathogenesis is related to immune dysregulation, which involves the gastrointestinal system, and the extra-intestinal systems such as the nervous system, whose neurological symptoms are evidenced in CD patients. A gluten-free diet (GFD) could avoid cerebellar ataxia, epilepsy, neuropathies, migraine and mild cognitive impairment. Furthermore, untreated CD patients have more symptoms and psychiatric co-morbidities than those treated with a GFD. Common psychiatric symptoms in untreated CD adult patients include depression, apathy, anxiety, and irritability and schizophrenia is also common in untreated CD. Several studies show improvement in psychiatric symptoms after the start of a GFD. The present review discusses the state of the art regarding neurological and psychiatric complications in CD and highlights the evidence supporting a role for GFD in reducing neurological and psychiatric complications.

  8. Forensic psychiatric nursing: skills and competencies: II clinical aspects.

    Science.gov (United States)

    Mason, T; Coyle, D; Lovell, A

    2008-03-01

    This study reports on research undertaken to identify the skills and competencies of forensic psychiatric nurses working in secure psychiatric services in the UK. The rationale for this research is the lack of clarity in the role definition of nurses working in these environments and the specific content that may underscore the curriculum for training forensic nurses. Over 3300 questionnaires were distributed to forensic psychiatric nurses, non-forensic psychiatric nurses and other disciplines and information obtained on (1) the perceived clinical problems that give forensic nurses the most difficulty; (2) the skills best suited to overcome those problems; and (3) the priority aspects of clinical nursing care that needs to be developed. A 35% response rate was obtained with 1019 forensic psychiatric nurses, 110 non-forensic psychiatric nurses and 43 other disciplines. The results highlighted a 'top ten' list of main problems with possible solutions and main areas for development. The conclusions drawn include a focus on skills and competencies regarding the management of personality disorders and the management of violence and aggression.

  9. Selective cognitive and psychiatric manifestations in Wolfram Syndrome.

    Science.gov (United States)

    Bischoff, Allison N; Reiersen, Angela M; Buttlaire, Anna; Al-Lozi, Amal; Doty, Tasha; Marshall, Bess A; Hershey, Tamara

    2015-05-30

    retrospective reports indicating significant cognitive and psychiatric impairment in WFS. While many of these patients were diagnosed with anxiety and hypersomnolence, self-reported measures of psychiatric symptoms indicated that the symptoms were not of grave concern to the patients. It may be that cognitive and psychiatric issues become more prominent later in life and/or in later stages of the disease, but this requires standardized assessment and larger samples to determine. In the relatively early stages of WFS, smell and sleep-related symptoms may be useful biomarkers of disease and should be monitored longitudinally to determine if they are good markers of progression as well. Current Clinicaltrials.gov Trial NCT02455414 .

  10. Psychiatric Adverse Effects of Dermatological Drugs

    Directory of Open Access Journals (Sweden)

    Mine Özmen

    2010-07-01

    Full Text Available Dermatological drugs, mostly corticosteroids and isotretinoin, cause different psychiatric adverse effects. During steroid therapy, a wide range of psychiatric conditions, from minor clinical symptoms like insomnia and anxiety to serious psychiatric syndromes like psychosis and delirium might be seen. In medical literature, a causal connection is usually suggested between “isotretinoin”, which is used for treatment of acne vulgaris and depression and suicide attempts. However, there are no statistically significant double-blind randomized studies that support this connection. Clinicians must know patient’s psychiatric history before using any dermatological treatment known as causing psychiatric adverse effects, and psychiatric consultation should be established whenever necessary.

  11. Effects of Music Therapy on Drug Therapy of Adult Psychiatric Outpatients: A Pilot Randomized Controlled Study

    Science.gov (United States)

    Degli Stefani, Mario; Biasutti, Michele

    2016-01-01

    Objective: Framed in the patients’ engagement perspective, the current study aims to determine the effects of group music therapy in addition to drug care in comparison with drug care in addition to other non-expressive group activities in the treatment of psychiatric outpatients. Method: Participants (n = 27) with ICD-10 diagnoses of F20 (schizophrenia), F25 (schizoaffective disorders), F31 (bipolar affective disorder), F32 (depressive episode), and F60 (specific personality disorders) were randomized to receive group music therapy plus standard care (48 weekly sessions of 2 h) or standard care only. The clinical measures included dosages of neuroleptics, benzodiazepines, mood stabilizers, and antidepressants. Results: The participants who received group music therapy demonstrated greater improvement in drug dosage with respect to neuroleptics than those who did not receive group music therapy. Antidepressants had an increment for both groups that was significant only for the control group. Benzodiazepines and mood stabilizers did not show any significant change in either group. Conclusion: Group music therapy combined with standard drug care was effective for controlling neuroleptic drug dosages in adult psychiatric outpatients who received group music therapy. We discussed the likely applications of group music therapy in psychiatry and the possible contribution of music therapy in improving the psychopathological condition of adult outpatients. In addition, the implications for the patient-centered perspective were also discussed. PMID:27774073

  12. Effects of music therapy on drug therapy of adult psychiatric outpatients: A pilot randomised controlled study

    Directory of Open Access Journals (Sweden)

    Mario Degli Stefani

    2016-10-01

    Full Text Available Objective: Framed in the patients’ engagement perspective, the current study aims to determine the effects of group music therapy in addition to drug care in comparison with drug care in the treatment of psychiatric outpatients. Method: Participants (n = 27 with ICD-10 diagnoses of F20 (schizophrenia, F25 (schizoaffective disorders, F31 (bipolar affective disorder, F32 (depressive episode and F60 (specific personality disorders were randomised to receive group music therapy plus standard care (48 weekly sessions of two hours or standard care only. The clinical measures included dosages of neuroleptics, benzodiazepines, mood stabilisers and antidepressants. Results: The participants who received group music therapy demonstrated greater improvement in drug dosage relative to neuroleptics than those who did not receive group music therapy. Antidepressants had an increment for both groups that was significant only for the control group. Benzodiazepines and mood stabilisers did not show any significant change in either group. Conclusions: Group music therapy combined with standard drug care is effective for controlling neuroleptic drug dosages in adult psychiatric outpatients who received group music therapy. We discuss the likely applications of group music therapy in psychiatry and the possible contribution of music therapy in improving the psychopathological condition of adult outpatients. In addition, the implications for the patient-centred perspective were also discussed.

  13. Psychiatric Disorders, Sociodemographic Features and Risk Factors in Children Driving to Committing Crime (Turkish

    Directory of Open Access Journals (Sweden)

    Murat Eyüboğlu

    2018-03-01

    Full Text Available Object: The aim of this study was to examine children driving to committing crime who were brought to psychiatry clinic for forensic evaluation because of the crimes they committed to. Additionally, evaluation of these children's psychiaytric disorders, crime characteristics, sociodemographic data, factors driving to committing crime and forensic reports arranged by the physician were other aims. Methods: In this study 204 children, who were brought to the clinic in order to be evaluated whether they perceive the legal meaning and consequences of that action or possess sufficient ability to channel their behaviors, were included. In order to diagnose any psychiatric disorder, a structured interrogation schedule for affective disorders and schizophrenia for present and lifetime was applied all children and families and sociodemographic data form was completed. Results: At least one psychiatric disorder was present in 47% (n =96 of children driving to committing crime. The most common disorders were Attention Deficit and Hyperactivity Disorder and Conduct Disorder. Almost none of them have been treated before. 45% of them dropped out their school, and 40% were smoking. Additionally, most of their parents who had low socioeconomical level also had very low education level. Discussion: It was determined that being male, living in a low socioeconomic family environment, living in large families, using drugs, smoking, not attending school and having parents with low education level were significant related factors for juvenile delinquency.

  14. Pathological Laughter and Crying and Psychiatric Comorbidity After Traumatic Brain Injury.

    Science.gov (United States)

    Roy, Durga; McCann, Una; Han, Dingfen; Rao, Vani

    2015-01-01

    There are limited data regarding the incidence of pathological laughter and crying (PLC) after traumatic brain injury (TBI). This study aimed to identify the occurrence of PLC in the first year after TBI and to determine whether there is a relationship between PLC and other clinical features or demographics. Subjects who sustained a first-time TBI were recruited from acute trauma units and were assessed at 3, 6, and 12 months after TBI. Rates of PLC at 3, 6, and 12 months after TBI were 21.4%, 17.5%, and 15.5%, respectively. Patients with PLC had higher percentages of psychiatric diagnoses, including personality changes, depressive disorders, and mood disorders secondary to a general medical condition, as well as higher rates of posttraumatic stress disorder. Univariate logistic and linear regression analyses indicated a significant association between PLC and scores on the Clinical Anxiety Scale 3 months after TBI and on the Hamilton Depression Rating Scale 12 months after TBI. Individuals who have PLC during the first year after TBI are more likely to have any psychiatric diagnosis as well as higher rates of mood and anxiety symptoms. In addition, PLC in the early TBI period may serve as a predictor of depression and anxiety symptoms at 12 months after TBI.

  15. Non-alcoholic Korsakoff syndrome in psychiatric patients with a history of undiagnosed Wernicke's encephalopathy.

    Science.gov (United States)

    Nikolakaros, Georgios; Ilonen, Tuula; Kurki, Timo; Paju, Janina; Papageorgiou, Sokratis G; Vataja, Risto

    2016-11-15

    Wernicke's encephalopathy is often undiagnosed, particularly in non-alcoholics. There are very few reports of non-alcoholic patients diagnosed with Korsakoff syndrome in the absence of a prior diagnosis of Wernicke's encephalopathy and no studies of diffusion tensor imaging in non-alcoholic Korsakoff syndrome. We report on three non-alcoholic psychiatric patients (all women) with long-term non-progressive memory impairment that developed after malnutrition accompanied by at least one of the three Wernicke's encephalopathy manifestations: ocular abnormalities, ataxia or unsteadiness, and an altered mental state or mild memory impairment. In neuropsychological examination, all patients had memory impairment, including intrusions. One patient had mild cerebellar vermis atrophy in MRI taken after the second episode of Wernicke's encephalopathy. The same patient had mild hypometabolism in the lateral cortex of the temporal lobes. Another patient had mild symmetrical atrophy and hypometabolism of the superior frontal lobes. Two patients were examined with diffusion tensor imaging. Reduced fractional anisotropy values were found in the corona radiata in two patients, and the uncinate fasciculus and the inferior longitudinal fasciculus in one patient. Our results suggest that non-alcoholic Korsakoff syndrome is underdiagnosed. Psychiatric patients with long-term memory impairment may have Korsakoff syndrome and, therefore, they should be evaluated for a history of previously undiagnosed Wernicke's encephalopathy. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. The prevalence and burden of psychiatric disorders in primary health care visits in Qatar: Too little time?

    Directory of Open Access Journals (Sweden)

    Abdulbari Bener

    2015-01-01

    Full Text Available Background: Psychiatric disorders including anxiety, depression, somatization, obsessive compulsive, and bipolar disorders are recognized as causing the biggest burden of disease worldwide. Aim: In this study, we aimed to assess the prevalence and burden of common mental disorders at Primary Health Care Centers (PHCC using the World Health Organization Composite International Diagnostic Interview (WHO-CIDI in the Qatari population, aged 18-65 who attended Primary Health Care (PHC settings. Design: A prospective cross-sectional study conducted during November 2011 to October 2012. Setting: Primary Health Care Centers of the Supreme Council of Health, Qatar. Subjects: A total of 2,000 Qatari subjects aged 18-65 years were approached; 1475 (73.3% agreed to participate. Methods: Prevalence and severity of International Classification of Disease-10 disorders were assessed with the WHO-CIDI (Version 3.0. Results: Of the 1475 participants, 830 (56.3% were females and 645 (43.7% was males. One-third were aged 35-49 years 558 (37.8%. The three most common disorders were major depression disorders (18.31%, any anxiety disorders (17.3%, any mood disorders (16.95%, followed by separation anxiety disorders (15.25%, personality disorder (14.1%. In the present study, prevalence in women was significantly higher than men for the most common psychiatric disorders, specifically generalized anxiety disorder, panic disorder, social phobia, specific phobias, obsessive compulsive disorders, posttraumatic disorder, somatization, major depressive disorder, bipolar disorder, dysthymia, and oppositional defiant disorder. Of the total 20% had only one psychiatric diagnosis and 12% had two disorders, 9.7% respondents with three diagnoses, and finally 4.3% of respondents had four or more diagnoses. Conclusion: One-fifth of all adults who attended the PHCC (20% had at least one psychiatric diagnosis. The CIDI is a useful instrument for psychiatric diagnosis in community

  17. The role of comorbid psychiatric conditions in health status in epilepsy.

    Science.gov (United States)

    Zeber, John E; Copeland, Laurel A; Amuan, Megan; Cramer, Joyce A; Pugh, Mary Jo V

    2007-06-01

    Comorbid psychiatric conditions are highly prevalent in patients with epilepsy, yet the long-term implications across multiple mental health conditions are poorly understood. We examined the association between psychiatric diagnoses and self-reported health status in veterans with epilepsy. ANCOVA models were used to derive adjusted SF-36V scores for individuals with epilepsy alone (N=7379) or with additional psychiatric conditions (N=6320): depression, schizophrenia, bipolar disorder, anxiety disorder, substance abuse, and posttraumatic stress disorder (PTSD). Compared with patients with epilepsy alone, scores of veterans with comorbid psychiatric diagnoses averaged 21% lower across all domains. Role Limitation scales exhibited the greatest decrement across domains. A PTSD diagnosis consistently corresponded to lower scores, followed by depression. Schizophrenia contributed the least detriment to perceived health status. Comorbid psychiatric conditions impart significant emotional and physical burdens, requiring timely recognition and treatment of these disorders. Patients with epilepsy are uniquely at risk for high physical-psychiatric comorbidity profiles, with concomitant losses in perceived health status.

  18. The copycat phenomenon after two Finnish school shootings: an adolescent psychiatric perspective

    Directory of Open Access Journals (Sweden)

    Lindberg Nina

    2012-07-01

    Full Text Available Abstract Background Two school shootings with altogether 18 victims took place in Finland in November 2007 and September 2008. Homicides and suicides are both associated with the copycat phenomenon. The aim of the present study was to characterize adolescent copycats who had threatened to carry out a school massacre. Methods The nation-wide study evaluated 77 13- to 18-year-old adolescents who were sent for adolescent psychiatric evaluations between 8.11.2007 and 30.6.2009, one of the reasons for evaluation being a threat of massacre at school. The medical files of the copycats were retrospectively analysed using a special data collection form. Data on demographics, family- and school-related issues, previous psychiatric treatment and previous delinquency, current symptoms, family adversities and psychiatric diagnoses were collected. The severity of the threat expressed and the risk posed by the adolescent in question were evaluated. The Psychopathy Checklist Youth Version was used to assess psychopathic traits. Results All of the copycats were native Finns with a mean age of 15.0 years. Almost two thirds of them had a history of previous mental health treatment before the index threat. Almost two thirds of the copycats suffered from anxiety and depressive symptoms, and almost half of the sample expressed either suicidal ideation or suicidal plans. Behavioural problems including impulse control problems, aggressive outbursts, the destruction of property as well as non-physical and physical violence against other persons were common. The diagnosis groups highlighted were behavioural and emotional disorders, mood disorders as well as schizophrenia-related disorders. The prevalence of pervasive developmental disorders was high. Only one of the copycats was assessed as expressing high traits of psychopathy. Conclusion The copycats with school massacre threats were characterized with a high prevalence of mental and behavioural disorders. Like

  19. [Prevalence of psychiatric disorders, psychopathology, and the need for treatment in female and male prisoners].

    Science.gov (United States)

    von Schönfeld, C-E; Schneider, F; Schröder, T; Widmann, B; Botthof, U; Driessen, M

    2006-07-01

    While the international literature documents a high prevalence of psychiatric disorders in prisoners, German studies in this field are rare. The base of knowledge is even worse with regard to female prisoners. The purpose of this study was to investigate DSM-IV axis I and II psychiatric disorders and current psychopathology and to estimate treatment needs in prisoners. On the 1st of May 2002, all female prisoners in Brackwede I Prison in Bielefeld, Germany, were included; and a sample of incarcerated men was matched according to age, nationality, and length of stay. Sixty-three women and 76 men participated. Criminal history and current living conditions were investigated using a questionnaire and prison documents. Psychopathology and psychiatric disorders were investigated using structured clinical interviews. In 88.2% of the sample, at least one current axis I (83.5%) and/or axis II personality disorder (53.2%) was found. Comorbidity rates were high, with 3.5+/-2.7 diagnoses per case. Mean SCL scores revealed a substantial psychopathologic burden. In female prisoners, opiate-related and polysubstance use disorders and affective and post-traumatic stress disorders were more frequent than in the male subsample, which in turn showed higher rates of alcohol-related disorders. Specific treatment needs were indicated in 83.4% of the sample. These results indicate that the proportion of mentally ill persons in prisons is substantially higher than in specialized hospitals for mentally ill criminals. More treatment options are urgently needed than has been realized up to now.

  20. Olfactory Disorder Pattern In Patients With Neurological Diseases Excluding Psychiatric And Traumatic Aetiologies.

    Science.gov (United States)

    de Haro-Licer, Josep; González-Fernández, Adela; Planas-Comes, Albert; González-Ares, Josep Antón

    2018-03-23

    The most common cause of olfactory ENT disorders are colds and flu, chronic sinusitis, allergies and traumatic brain injury. Rarer aetiologies include certain neurological, psychiatric and metabolic injuries. The aim of this paper was to check the sort of olfactory disorders found in people who have suffered a brain injury, excluding: cranial traumas, psychiatric diseases, epilepsy, Parkinson's and Alzheimer's disease, and synaesthesia. A descriptive study based on 61 patients with diagnoses of various neurological injuries, which were tested by BAST-24 olfactometer. The results were compared with those of a control group (n= 120). The results show major impairment in these patients' olfactory sense. The neurological injury patients were able to detect from 60-77% of the odours, while the control group were able to detect between 98-100%. The neurological patients were able, at best, to identify, 11-32% of the odours correctly, while the control group were able to correctly detect between 59 -75%. The differences between odour detection and correct identification were statistically significant (p<.05). We concluded: a) Neurological injury, not caused by traumatic brain injury, psychiatric disorders or ENT diseases, ranged from 68-89% of the olfactory failures. b) We must bear in mind that these sorts of injuries can cause olfactory disorders. c) ENT and Neurologists should collaborate in the treatment of these disorders. Copyright © 2018 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. The copycat phenomenon after two Finnish school shootings: an adolescent psychiatric perspective.

    Science.gov (United States)

    Lindberg, Nina; Sailas, Eila; Kaltiala-Heino, Riittakerttu

    2012-07-28

    Two school shootings with altogether 18 victims took place in Finland in November 2007 and September 2008. Homicides and suicides are both associated with the copycat phenomenon. The aim of the present study was to characterize adolescent copycats who had threatened to carry out a school massacre. The nation-wide study evaluated 77 13- to 18-year-old adolescents who were sent for adolescent psychiatric evaluations between 8.11.2007 and 30.6.2009, one of the reasons for evaluation being a threat of massacre at school. The medical files of the copycats were retrospectively analysed using a special data collection form. Data on demographics, family- and school-related issues, previous psychiatric treatment and previous delinquency, current symptoms, family adversities and psychiatric diagnoses were collected. The severity of the threat expressed and the risk posed by the adolescent in question were evaluated. The Psychopathy Checklist Youth Version was used to assess psychopathic traits. All of the copycats were native Finns with a mean age of 15.0 years. Almost two thirds of them had a history of previous mental health treatment before the index threat. Almost two thirds of the copycats suffered from anxiety and depressive symptoms, and almost half of the sample expressed either suicidal ideation or suicidal plans. Behavioural problems including impulse control problems, aggressive outbursts, the destruction of property as well as non-physical and physical violence against other persons were common. The diagnosis groups highlighted were behavioural and emotional disorders, mood disorders as well as schizophrenia-related disorders. The prevalence of pervasive developmental disorders was high. Only one of the copycats was assessed as expressing high traits of psychopathy. The copycats with school massacre threats were characterized with a high prevalence of mental and behavioural disorders. Like actual school shooters, they showed psychotic symptoms and traumatic

  2. Gender-related differences in the associations between sexual impulsivity and psychiatric disorders.

    Science.gov (United States)

    Erez, Galit; Pilver, Corey E; Potenza, Marc N

    2014-08-01

    Sexual impulsivity (SI) has been associated with conditions that have substantial public health costs, such as sexually transmitted infections and unintended pregnancies. However, SI has not been examined systematically with respect to its relationships to psychopathology. We aimed to investigate associations between SI and psychopathology, including gender-related differences. We performed a secondary data analysis of Wave-2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a national sample of 34,653 adults in the United States. DSM-IV-based diagnoses of mood, anxiety, drug and personality disorders were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Scheduled DSM-IV Version. The prevalence of SI was considerable (14.7%), with greater acknowledgment by men than women (18.9% versus 10.9%; p women and men, SI was positively associated with most Axis-I and Axis-II psychiatric disorders (OR range: Women, Axis-I:1.89-6.14, Axis-II:2.10-10.02; Men, Axis-I:1.92-6.21, Axis-II:1.63-6.05). Significant gender-related differences were observed. Among women as compared to men, SI was more strongly associated with social phobia, alcohol abuse/dependence, and paranoid, schizotypal, antisocial, borderline, narcissistic, avoidant and obsessive-compulsive personality disorders. The robust associations between SI and psychopathology across genders suggest the need for screening and interventions related to SI for individuals with psychiatric concerns. The stronger associations between SI and psychopathology among women as compared to men emphasize the importance of a gender-oriented perspective in targeting SI. Longitudinal studies are needed to determine the extent to SI predates, postdates or co-occurs with specific psychiatric conditions. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Opening of Psychiatric Observation Unit Eases Boarding Crisis.

    Science.gov (United States)

    Parwani, Vivek; Tinloy, Bradford; Ulrich, Andrew; D'Onofrio, Gail; Goldenberg, Matthew; Rothenberg, Craig; Patel, Amitkumar; Venkatesh, Arjun K

    2018-04-01

    The objective of this study was to evaluate the effect of a psychiatric observation unit in reducing emergency department (ED) boarding and length of stay (LOS) for patients presenting with primary psychiatric chief complaints. A secondary outcome was to determine the effect of a psychiatric observation unit on inpatient psychiatric bed utilization. This study was a before-and-after analysis conducted in a 1,541-bed tertiary care academic medical center including an adult ED with annual census over 90,000 between February 2013 and July 2014. All adult patients (age > 17 years) requiring evaluation by the acute psychiatry service in the crisis intervention unit (CIU) within the ED were included. Patients who left without being seen, left against medical advice, or were dispositioned to the pediatric hospital, hospice, or court/law enforcement were excluded. In December 2013, a 12-bed locked psychiatric observation unit was opened that included dedicated behavioral health staff and was intended for psychiatric patients requiring up to 48 hours of care. The primary outcomes were ED LOS, CIU LOS, and total LOS. Secondary outcomes included the hold rate defined as the proportion of acute psychiatry patients requiring subsequent observation or inpatient admission and the inpatient psychiatric admission rate. For the primary analysis we constructed ARIMA regression models that account for secular changes in the primary outcomes. We conducted two sensitivity analyses, first replicating the primary analysis after excluding patients with concurrent acute intoxication and second by comparing the 3-month period postintervention to the identical 3-month period of the prior year to account for seasonality. A total of 3,501 patients were included before intervention and 3,798 after intervention. The median ED LOS for the preintervention period was 155 minutes (interquartile range [IQR] = 19-346 minutes), lower than the median ED LOS for the postintervention period of 35

  4. The Consistency Between Clinical and Electrophysiological Diagnoses

    Directory of Open Access Journals (Sweden)

    Esra E. Okuyucu

    2009-09-01

    Full Text Available OBJECTIVE: The aim of this study was to provide information concerning the impact of electrophysiological tests in the clinical management and diagnosis of patients, and to evaluate the consistency between referring clinical diagnoses and electrophysiological diagnoses. METHODS: The study included 957 patients referred to the electroneuromyography (ENMG laboratory from different clinics with different clinical diagnoses in 2008. Demographic data, referring clinical diagnoses, the clinics where the requests wanted, and diagnoses after ENMG testing were recorded and statistically evaluated. RESULTS: In all, 957 patients [644 (67.3% female and 313 (32.7% male] were included in the study. Mean age of the patients was 45.40 ± 14.54 years. ENMG requests were made by different specialists; 578 (60.4% patients were referred by neurologists, 122 (12.8% by orthopedics, 140 (14.6% by neurosurgeons, and 117 (12.2% by physical treatment and rehabilitation departments. According to the results of ENMG testing, 513 (53.6% patients’ referrals were related to their referral diagnosis, whereas 397 (41.5% patients had normal ENMG test results, and 47 (4.9% patients had a diagnosis that differed from the referring diagnosis. Among the relation between the referral diagnosis and electrophysiological diagnosis according to the clinics where the requests were made, there was no statistical difference (p= 0.794, but there were statistically significant differences between the support of different clinical diagnoses, such as carpal tunnel syndrome, polyneuropathy, radiculopathy-plexopathy, entrapment neuropathy, and myopathy based on ENMG test results (p< 0.001. CONCLUSION: ENMG is a frequently used neurological examination. As such, referrals for ENMG can be made to either support the referring diagnosis or to exclude other diagnoses. This may explain the inconsistency between clinical referring diagnoses and diagnoses following ENMG

  5. Impact of marbling art therapy activities on the anxiety levels of psychiatric patients

    OpenAIRE

    Utaş Akhan, Latife; Atasoy, Nuray

    2017-01-01

    Purpose: Study was conducted to explore the impact of marbling art therapy on the anxiety levels of patients with schizophrenia and bipolar disorder.Methods: Data for the study were at a university hospital and in the psychiatric service,polyclinic of a State Hospital with 34 patients diagnosed with schizophrenia and 34 patients diagnosed with bipolar disorder. Investigations were carried out with study groups and a control group.Findings:Following marbling, it was found that there were signi...

  6. Psychiatric morbidity and quality of life in vitiligo patients.

    Science.gov (United States)

    Ramakrishna, Podaralla; Rajni, Tenali

    2014-07-01

    Vitiligo has underlying mental illness but mostly not diagnosed and never used psychiatric medication. Hence, the problem persists affecting mostly the individual's quality of life. Assessing the quality of life, level of depression, and self-esteem of patients with vitiligo and give psychiatric medication for underlying mental illness. The study conducted at Owaisi Hospital Research Centre, Hyderabad. The patients registered for dermatologist consultation were also registered for consultation with psychiatrist to rule out any mental illness after detailed evaluation using standardized scales. Patients suffering with vitiligo had depression and low self-esteem; their quality of life was disturbed. The findings provide the role of Mental Health Professionals involved in the field of dermatology for the patients suffering with vitiligo.

  7. Psychiatric/ psychological forensic report writing.

    Science.gov (United States)

    Young, Gerald

    Approaches to forensic report writing in psychiatry, psychology, and related mental health disciplines have moved from an organization, content, and stylistic framework to considering ethical and other codes, evidentiary standards, and practice considerations. The first part of the article surveys different approaches to forensic report writing, including that of forensic mental health assessment and psychiatric ethics. The second part deals especially with psychological ethical approaches. The American Psychological Association's Ethical Principles and Code of Conduct (2002) provide one set of principles on which to base forensic report writing. The U.S. Federal Rules of Evidence (2014) and related state rules provide another basis. The American Psychological Association's Specialty Guidelines for Forensic Psychology (2013) provide a third source. Some work has expanded the principles in ethics codes; and, in the third part of this article, these additions are applied to forensic report writing. Other work that could help with the question of forensic report writing concerns the 4 Ds in psychological injury assessments (e.g., conduct oneself with Dignity, avoid the adversary Divide, get the needed reliable Data, Determine interpretations and conclusions judiciously). One overarching ethical principle that is especially applicable in forensic report writing is to be comprehensive, scientific, and impartial. As applied to forensic report writing, the overall principle that applies is that the work process and product should reflect integrity in its ethics, law, and science. Four principles that derive from this meta-principle concern: Competency and Communication; Procedure and Protection; Dignity and Distance; and Data Collection and Determination. The standards or rules associated with each of these principles are reviewed. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  8. Genetic neuropathology of obsessive psychiatric syndromes.

    Science.gov (United States)

    Jaffe, A E; Deep-Soboslay, A; Tao, R; Hauptman, D T; Kaye, W H; Arango, V; Weinberger, D R; Hyde, T M; Kleinman, J E

    2014-09-02

    Anorexia nervosa (AN), bulimia nervosa (BN) and obsessive-compulsive disorder (OCD) are complex psychiatric disorders with shared obsessive features, thought to arise from the interaction of multiple genes of small effect with environmental factors. Potential candidate genes for AN, BN and OCD have been identified through clinical association and neuroimaging studies; however, recent genome-wide association studies of eating disorders (ED) so far have failed to report significant findings. In addition, few, if any, studies have interrogated postmortem brain tissue for evidence of expression quantitative trait loci (eQTLs) associated with candidate genes, which has particular promise as an approach to elucidating molecular mechanisms of association. We therefore selected single-nucleotide polymorphisms (SNPs) based on candidate gene studies for AN, BN and OCD from the literature, and examined the association of these SNPs with gene expression across the lifespan in prefrontal cortex of a nonpsychiatric control cohort (N=268). Several risk-predisposing SNPs were significantly associated with gene expression among control subjects. We then measured gene expression in the prefrontal cortex of cases previously diagnosed with obsessive psychiatric disorders, for example, ED (N=15) and OCD/obsessive-compulsive personality disorder or tics (OCD/OCPD/Tic; N=16), and nonpsychiatric controls (N=102) and identified 6 and 286 genes that were differentially expressed between ED compared with controls and OCD cases compared with controls, respectively (false discovery rate (FDR) <5%). However, none of the clinical risk SNPs were among the eQTLs and none were significantly associated with gene expression within the broad obsessive cohort, suggesting larger sample sizes or other brain regions may be required to identify candidate molecular mechanisms of clinical association in postmortem brain data sets.

  9. Research Domain Criteria as Psychiatric Nosology.

    Science.gov (United States)

    Akram, Faisal; Giordano, James

    2017-10-01

    Diagnostic classification systems in psychiatry have continued to rely on clinical phenomenology, despite limitations inherent in that approach. In view of these limitations and recent progress in neuroscience, the National Institute of Mental Health (NIMH) has initiated the Research Domain Criteria (RDoC) project to develop a more neuroscientifically based system of characterizing and classifying psychiatric disorders. The RDoC initiative aims to transform psychiatry into an integrative science of psychopathology in which mental illnesses will be defined as involving putative dysfunctions in neural nodes and networks. However, conceptual, methodological, neuroethical, and social issues inherent in and/or derived from the use of RDoC need to be addressed before any attempt is made to implement their use in clinical psychiatry. This article describes current progress in RDoC; defines key technical, neuroethical, and social issues generated by RDoC adoption and use; and posits key questions that must be addressed and resolved if RDoC are to be employed for psychiatric diagnoses and therapeutics. Specifically, we posit that objectivization of complex mental phenomena may raise ethical questions about autonomy, the value of subjective experience, what constitutes normality, what constitutes a disorder, and what represents a treatment, enablement, and/or enhancement. Ethical issues may also arise from the (mis)use of biomarkers and phenotypes in predicting and treating mental disorders, and what such definitions, predictions, and interventions portend for concepts and views of sickness, criminality, professional competency, and social functioning. Given these issues, we offer that a preparatory neuroethical framework is required to define and guide the ways in which RDoC-oriented research can-and arguably should-be utilized in clinical psychiatry, and perhaps more broadly, in the social sphere.

  10. Beyond the DSM: trends in psychiatry diagnoses

    Directory of Open Access Journals (Sweden)

    Andre Russowsky Brunoni

    Full Text Available Abstract Background: Although widely used in clinical practice and research, Diagnostic and Statistical Manual of Mental Disorders (DSM diagnoses have low validity: patients with different mental disorders can share similar symptoms, while those with the same diagnosis might have different symptoms. In fact, the DSM diagnostic system has been considered one of the main obstacles for further development of psychiatric research. Recently, it has been proposed that psychiatry nosology should be reframed according to a biologically-based etiology. Objectives: To review present and past endeavors of establishing an etiology-based nosology. Methods: Comprehensive review of articles on the topic. Results: From Hippocrates onwards, multiple attempts have been undertaken aiming to move etiology and nosology closer. The most recent efforts are represented by Developmental Psychopathology (DP and the Research Domain Criteria (RDoC, which presents an operational matrix recommended to be used in clinical research instead of the DSM diagnoses. Discussion: The DSM-based nosology is faulty. RDoC and DP might be interesting alternatives for an etiology-based nosology. However, while DP has already brought promising results, RDoC is a novel proposal, whose advantages and disadvantages should gradually be identified in the upcoming years.

  11. [Psychiatric disorders in patients with Cushing's disease before and after neurosurgery].

    Science.gov (United States)

    Gnjidiae, Zivko; Karloviae, Dalibor; Buljan, Danijel; Malencia, Masa; Kovak-Mufiae, Ana; Kostanjsak, Lidija

    2011-01-01

    Cushing's disease which is a consequence of ACTH-secreting pituitary adenoma leads to hypercortisolism. Cushing's disease is associated with several psychiatric disturbances. The aim of the present study was to identify which psychiatric disorders were present in patients with Cushing's disease over a 2-year period and to monitor their general psychiatric condition. Additionally, the study aimed to examine the relationship between the duration of Cushing's disease, and the severity of psychiatric conditions based on psychiatric rating scales. The study included 39 patients with Cushing's disease that underwent neurosurgery for ACTH-secreting pituitary adenomas. The transsphenoidal approach (the standard microsurgery technique) was performed in all patients. ACTH-secreting pituitary adenomas were confirmed based on immunohistochemistry in all patients. Psychiatric conditions in the patients were identified using the Clinical Global Impression Scale (CGI) and ICD 10 diagnostic criteria at 3 time points: prior to surgery, and 6 and 48 months post surgery. The Cushing's disease patients exhibited statistically significant improvement in their psychiatric condition, according to the CGI, 6 and 48 months post surgery. There wasn't any significant correlation between the duration of Cushing's disease and psychiatric status, as measured by the CGI prior to surgery, 6 months post surgery, or 48 months post surgery. Patients with Cushing's disease had a significant level psychiatric disturbance that remitted after surgery. There wasn't a significant correlation between the duration of Cushing's disease and psychiatric status.

  12. Experiences of psychiatric nurses exposed to hostility from patients in a forensic ward.

    Science.gov (United States)

    Tema, T R; Poggenpoel, M; Myburgh, C P H

    2011-10-01

    Hostile behaviour is becoming a way of life in South Africa. Hostility prevails at all settings, including in the health sector. In a forensic ward psychiatric nurses are subjected to hostile behaviour by the patients. The aim of the present study was to explore and describe the psychiatric nurses' experiences of hostile behaviour by patients in a forensic ward and make recommendations for nurse managers to empower these psychiatric nurses to cope with the patients' aggression. Qualitative, in-depth, phenomenological interviews were conducted with nine psychiatric nurses exposed to hostility from patients in a forensic ward. Recommendations were derived from the results from nurse managers to assist psychiatric nurses. It became apparent from the findings that psychiatric nurses in a forensic ward work in a stressful environment. Hostile behaviour in the forensic ward is consistently experienced by the psychiatric nurses as hindering therapeutic relationships. The psychiatric nurses experienced being disempowered. Psychiatric nurses experience hostile behaviour by patients in a forensic ward as disempowering. IMPLICATIONS FOR NURSE MANAGEMENT: Nurse managers can facilitate psychiatric nurses' empowerment by providing them access to: information, support, resources, opportunity and growth. © 2011 Blackwell Publishing Ltd.

  13. Diagnosable structured logic array

    Science.gov (United States)

    Whitaker, Sterling (Inventor); Miles, Lowell (Inventor); Gambles, Jody (Inventor); Maki, Gary K. (Inventor)

    2009-01-01

    A diagnosable structured logic array and associated process is provided. A base cell structure is provided comprising a logic unit comprising a plurality of input nodes, a plurality of selection nodes, and an output node, a plurality of switches coupled to the selection nodes, where the switches comprises a plurality of input lines, a selection line and an output line, a memory cell coupled to the output node, and a test address bus and a program control bus coupled to the plurality of input lines and the selection line of the plurality of switches. A state on each of the plurality of input nodes is verifiably loaded and read from the memory cell. A trusted memory block is provided. The associated process is provided for testing and verifying a plurality of truth table inputs of the logic unit.

  14. Clinical Profile and Sex Differences in Brazilian Children and Adolescents Receiving Psychiatric Services in the Emergency Department.

    Science.gov (United States)

    Tonezer, Jordana; Muller, Thomaz; Rocha, Gibsi Possapp; Recondo, Rogéria; Nogueira, Eduardo Lopes; Spanemberg, Lucas

    2015-06-27

    We present a survey of sex differences and socio-demographic and clinical variables in children and adolescents receiving a psychiatric consultation service in an emergency department (ED). This observational, retrospective, and cross-sectional study included all records of patients (age, services in an ED in a 4-year period (January 2010 to December 2013). Two hundred fifty-nine records of children and adolescents were located. The mean age of the participants was 14.19 years, and most subjects were female (59.5%) and had private health insurance (83.7%). Most participants (87.4%) were accompanied by their parents. The main complaints were suicide attempts (21.8%) and psychomotor agitation/aggressiveness (21.8%). Unipolar depression (37.8%) and adjustment, reactive, and anxiety disorders (13.7%) were the most prevalent diagnoses. Most patients received an indication of psychiatric hospitalization (51.7%). Females had more suicide attempts than males (28.3% vs 12.4%) and less psychomotor agitation/aggressiveness than males (15.5% vs 31.4%). Females also exhibited more unipolar depression (47.6% vs 23.5%), fewer psychotic disorders (4.2% vs 16.3%), and substance use/misuse (1.4% vs 13.3%) than males. Males needed more psychiatric medication during evaluation (37.9% vs 19.2%). This survey of the profile of pediatric patients evaluated by a psychiatric service in an ED in Brazil was the first of its kind. The large percentage of patients referred for hospitalization highlights the importance of specialized psychiatry care for this age group in this facility, which is a common entry point for mental health care.

  15. Diagnosing Dementia—Positive Signs

    Science.gov (United States)

    ... Navigation Bar Home Current Issue Past Issues Diagnosing Dementia—Positive Signs Past Issues / Fall 2007 Table of ... easy, affordable blood test that could accurately diagnose Alzheimer's disease (AD)—even before symptoms began to show? Researchers ...

  16. Psychiatric Co-Morbidities in Pregnant Women with Opioid Use Disorders: Prevalence, Impact, and Implications for Treatment.

    Science.gov (United States)

    Arnaudo, Camila L; Andraka-Christou, Barbara; Allgood, Kacy

    2017-01-01

    This review seeks to investigate three questions: What is the prevalence of comorbid psychiatric diagnoses among pregnant women with opioid use disorder (OUD)? How do comorbid psychiatric illnesses impact pregnant women with OUD? And how do comorbid psychiatric illnesses affect the ability of pregnant women with OUD to adhere to and complete OUD treatment? Based on this literature review, 25-33% of pregnant women with OUD have a psychiatric comorbidity, with depression and anxiety being especially common. However, of the 17 studies reviewed only 5 have prevalence rates of dual diagnosis in pregnant women with OUD as their primary outcome measures, their N's were typically small, methods for determining psychiatric diagnosis were variable, and many of the studies were undertaken with women presenting for treatment which carries with its implicit selection bias. Of the women enrolled in treatment programs for SUD, those with psychiatric comorbidity were more likely to have impaired psychological and family/social functioning than those without psychiatric comorbidity. Greater severity of comorbid psychiatric illness appears to predict poorer adherence to treatment, but more research is needed to clarify this relationship with the psychiatric illness is less severe. While cooccurrence of psychiatric disorders in pregnant women with opioid use disorder appears to be common, large population-based studies with validated diagnostic tools and longitudinal assessments are needed to obtain definitive rates and characteristics of cooccurring illnesses. Integrated prenatal, addiction, and psychiatric treatment in a setting that provides social support to pregnant patients with OUD is most effective in maintaining women in treatment. More research is still needed to identify optimal treatment settings, therapy modalities, and medication management for dually diagnosed pregnant women with OUD.

  17. Use of Modafinil in Psychiatric Disorders

    Directory of Open Access Journals (Sweden)

    Mehmet Hanifi Kokacya

    2016-03-01

    Full Text Available Modafinil, is a psychostimulant drug with neurochemical and behavourial effects, distinct from those of amphetamine. It is used to treat patients with narcolepsy and other excessive sleepiness. Modafinil has dopaminergic, noradrenergic, histaminergic, glutamergic, serotonergic and GABAergic interactions. It is also shown that modafinil has neuroprotective effects via antioxidative mechanisms. Besides modafinil shows initial promise for a variety of off-label indications in psychiatry, including bipolar disorder, attention-deficit/hyperactivity disorder, and schizophrenia . The aim of this article is to review the literature on clinical use of modafinil in psychiatric disorders. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(1: 42-51

  18. Psychiatric Services • In Matabeleland

    African Journals Online (AJOL)

    1974-05-04

    May 4, 1974 ... To provide some basis for planning psychiatric services in Matabeleland, a ... medicine. and at the same time up-grade mental health services.' Tn the .... We present a survey of some of the changes in a population of African ...

  19. [Insomnia associated with psychiatric disorders].

    Science.gov (United States)

    Suzuki, Masahiro; Konno, Chisato; Furihata, Ryuji; Osaki, Koichi; Uchiyama, Makoto

    2009-08-01

    Most psychiatric disorders, such as schizophrenia, mood disorders, or neurotic disorders are associated with sleep disorders of various kinds, among which insomnia is most prevalent and important in psychiatric practice. Almost all patients suffering from major depression complain of insomnia. Pharmacological treatment of insomnia associated with major depression shortens the duration to achieve remission of depression. Insomnia has been recently reported to be a risk factor for depression. In patients with schizophrenia, insomnia is often an early indicator of the aggravation of psychotic symptoms. Electroencephalographic sleep studies have also revealed sleep abnormalities characteristic to mood disorders, schizophrenia and anxiety disorders. A shortened REM sleep latency has been regarded as a biological marker of depression. Reduced amount of deep non-REM sleep has been reported to be correlated with negative symptoms of schizophrenia. Recently, REM sleep abnormalities were found in teenagers having post-traumatic stress disorder after a boat accident. Although these facts indicate that insomnia plays an important role in the development of psychiatric disorders, there are few hypotheses explaining the cause and effect of insomnia in these disorders. Here, we reviewed recent articles on insomnia associated with psychiatric disorders together with their clinical managements.

  20. Management of Current Psychiatric Disorders

    Science.gov (United States)

    Carbonnel, François; David, Michel; Norton, Joanna; Bourrel, Gérard; Boulenger, Jean-Philippe; Capdevielle, Delphine

    2016-01-01

    Objective: Describe and analyse the experience of family physicians in managing current psychiatric disorders to obtain a better understanding of the underlying reasons of under-detection and inadequate prescribing identified in studies. Methods: A qualitative study using in-depth interviews. Sample of 15 practicing family physicians, recruited by telephone from a precedent cohort (Sesame1) with a maximum variation: sex, age, single or group practice, urban or rural. Qualitative method is inspired by the completed grounded theory of a verbatim semiopragmatic analysis from 2 experts in this approach. Results: Family physicians found that current psychiatric disorders were related to psychological symptoms in reaction to life events. Their role was to make patients aware of a psychiatric symptom rather than establish a diagnosis. Their management responsibility was considered in contrasting ways: it was claimed or endured. They defined their position as facilitating compliance to psychiatrist consultations, while assuring a complementary psychotherapeutic approach. Prescribing medication was not a priority for them. Conclusions: The identified under-detection is essentially due to inherent frontline conditions and complexity of clinical forms. The family physician role, facilitating compliance to psychiatrist consultations while assuring a support psychotherapy is the main result of this study. More studies should be conducted to define more accurately the clinical reality, management and course of current psychiatric disorders in primary care.

  1. Incidence of eating disorders in Danish psychiatric secondary healthcare 1970-2008

    DEFF Research Database (Denmark)

    Gammelmark, Carina; Jensen, Signe Ow; Plessen, Kerstin J

    2015-01-01

    OBJECTIVE: Is an increased focus on eating disorders during the past few decades reflected by increasing occurrence in the psychiatric health service system. METHOD: All first-time diagnoses of eating disorders identified in the Danish Central Psychiatric Research Register 1970-2008 constitute...... the present research database. Age-standardized rates per 100,000 inhabitants were calculated and autoregressive models were fitted for males and females separately as well as for in- and outpatients. RESULTS: The incidence of eating disorders diagnosed in Danish psychiatric secondary healthcare has increased...... considerably during a nearly 40-year period of observation both within the general category of eating disorders and also specifically for anorexia nervosa. The steepest increase is seen within females aged 15-19 years, where the highest incidences are also found. Anorexia nervosa constitutes the vast majority...

  2. Attitudes of college students toward mental illness stigma and the misuse of psychiatric medications.

    Science.gov (United States)

    Stone, Amanda M; Merlo, Lisa J

    2011-02-01

    Mental illness stigma remains a significant barrier to treatment. However, the recent increase in the medical and nonmedical use of prescription psychiatric medications among college students seems to contradict this phenomenon. This study explored students' attitudes and experiences related to psychiatric medications, as well as correlates of psychiatric medication misuse (ie, attitudes toward mental illness and beliefs about the efficacy of psychiatric medications). Data were collected anonymously via self-report questionnaires from April 2008 to February 2009. Measures included the Michigan Alcoholism Screening Test, the Drug Abuse Screening Test, Day's Mental Illness Stigma Scale, the Attitudes Toward Psychiatric Medication scale, and the Psychiatric Medication Attitudes Scale. Participants included 383 university students (59.2% female), recruited on the campus of a large state university or through online classes offered through the same university. High rates of psychiatric medication misuse were shown (13.8%) when compared to rates of medical use (6.8%), and students with prescriptions for psychiatric drugs were also more likely to be misusers (χ(2) = 20.60, P mental illness, including lower anxiety around the mentally ill (t = 3.26, P mental illness (t = -2.11, P mental illness, the appropriate use of psychiatric medications, and the potential consequences associated with abuse of these potent drugs. © Copyright 2011 Physicians Postgraduate Press, Inc.

  3. Phenomenology and psychiatric origin of psychogenic nonepileptic seizures

    Directory of Open Access Journals (Sweden)

    Ristić Aleksandar J.

    2004-01-01

    Full Text Available INTRODUCTION Psychogenic nonepileptic seizure (PNES is a sudden change in a person's behavior, perception, thinking, or feeling that is usually time limited and resembles, or is mistaken for, epilepsy but does not have the characteristic electroencephalographic (EEG changes that accompanies a true epileptic seizure [1]. It is considered that PNES is a somatic manifestation of mental distress, in response to a psychological conflict or other Stressors [2]. A wide spectrum of clinical presentation includes syncope, generalized tonic-clonic seizure, simple and complex partial seizure, myoclonic seizure, frontal lobe seizures and status epilepticus [3]. Coexistence of epilepsy and PNES is seen in approximately 9% of cases [5]. Between 25-30% of patients referred to tertiary centers and initially diagnosed as refractory epilepsy were on further examination diagnosed as PNES [6,7]. In DSM-IV [12] PNES are usually categorized under conversion disorder with seizures or convulsions. However, psychiatric basis of PNES may be anxiousness (panic attack, somatization or factitious disorder, simulation, dissociative disorders and psychosis [1]. AIM The aim of the study was to establish clinical phenomenology and EEG characteristics as well as basic psychiatric disorder in patients with PNES. METHOD In a retrospective study covering the period from January 1st 1999 till April 31 st 2003, 24 patients (22 female, 2 male treated at the Institute of Neurology in Belgrade were analyzed. PNES were defined as sudden change in behavior incoherent with epileptiform activity registered on EEG. Possible PNES were determined on the basis of history data and clinical examination during the attack but definitive confirmation was established only by the finding of no ictal EEG changes during typical seizure of each patient. Patients with coexisting epilepsy were included in the study, too. At least two standard EEG (range 2-6, median 4 were performed at the beginning of

  4. Psychiatric Morbidity Among Suicide Attempters Who Needed ICU Intervention

    Directory of Open Access Journals (Sweden)

    MMA Shalahuddin Qusar

    2010-04-01

    Full Text Available Background: Suicide is a tragic and serious but preventable public health problem all over the world including Bangladesh. Committing suicide has become a burning issue and mortality rate increases especially in young females. Psychiatric evaluation is needed in suicide attempted patients for better management plan to reduce such unnatural mortality, as well as the impairment related to suicidal thought and psychiatric disorders. Objectives: To assess the psychiatric disorders and conditions that needed sufficient clinical attention among the suicide attempters who needed ICU intervention. Methods: This cross-sectional study was carried out in an Intensive Care Unit (ICU of a private hospital of Dhaka City from July 2008 to December 2008. Total forty four subjects of attempted suicide were included in the study and psychiatric diagnosis was made by using Diagnostic and Statistical Manual of Mental Disorders (DSM-IV by psychiatrists after initial physical problems subsided. Results: The most common psychiatric diagnosis was Major Depressive Disorder. Female suffered more and among them attention-seeking behaviors were frequent. Thirty-four patients (77.3% had previous history of psychiatric disorder. Chemicals (like; organophosphorous, kerosene, harpic and other medicine overdose ingestion was the most frequently used method by the suicide attempters. Conclusion: This study may be helpful for further research regarding suicide attempters and its' association with mental problems. In primary health care setting, the physicians may get a clue to design a system for preventing, early recognition and managing suicidal ideas, thoughts and attempts. Psychiatric consultation should be made mandatory for all patients admitted following attempted suicide. DOI: 10.3329/bsmmuj.v2i2.4761 BSMMU J 2009; 2(2: 73-77

  5. Towards Developmental Models of Psychiatric Disorders in Zebrafish

    Directory of Open Access Journals (Sweden)

    William Howard James Norton

    2013-04-01

    Full Text Available Psychiatric disorders are a diverse set of diseases that affect all aspects of mental function including social interaction, thinking, feeling and mood. Although psychiatric disorders place a large economic burden on society, the drugs available to treat them are often palliative with variable efficacy and intolerable side-effects. The development of novel drugs has been hindered by a lack of knowledge about the etiology of these diseases. It is thus necessary to further investigate psychiatric disorders using a combination of human molecular genetics, gene-by-environment studies, in vitro pharmacological and biochemistry experiments, animal models and investigation of the non-biological basis of these diseases, such as environmental effects.Many psychiatric disorders, including autism spectrum disorder, attention-deficit/hyperactivity disorder, mental retardation and schizophrenia can be triggered by alterations to neural development. The zebrafish is a popular model for developmental biology that is increasingly used to study human disease. Recent work has extended this approach to examine psychiatric disorders as well. However, since psychiatric disorders affect complex mental functions that might be human specific, it is not possible to fully model them in fish. In this review, I will propose that the suitability of zebrafish for developmental studies, and the genetic tools available to manipulate them, provide a powerful model to study the roles of genes that are linked to psychiatric disorders during neural development. The relative speed and ease of conducting experiments in zebrafish can be used to address two areas of future research: the contribution of environmental factors to disease onset, and screening for novel therapeutic compounds.

  6. PSYCHIATRIC MORBIDITY IN A NIGERIAN NEUROLOGY CLINIC

    African Journals Online (AJOL)

    2013-05-28

    May 28, 2013 ... in Psychiatrry, Department of Behavioural Sciences,University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria,. M. K. Jimba ... Psychiatric diagnosis was based .... The second stage: Clinical psychiatric interview was.

  7. Skin disorders in chronic psychiatric illness.

    NARCIS (Netherlands)

    Mookhoek, E.J.; Kerkhof, P.C.M. van de; Hovens, J.E.; Brouwers, J.R.B.J.; Loonen, A.J.M.

    2010-01-01

    BACKGROUND: Chronic psychiatric patients are prone to develop skin diseases. However, epidemiological data are scarce. OBJECTIVE: To describe the prevalence of skin complaints and dermatological disorders in residential psychiatric patients. METHODS: Ninety-one randomly chosen patients of the

  8. Skin disorders in chronic psychiatric illness

    NARCIS (Netherlands)

    Mookhoek, E. J.; van de Kerkhof, P. C. M.; Hovens, J. E. J. M.; Brouwers, J. R. B. J.; Loonen, A. J. M.

    2010-01-01

    Background Chronic psychiatric patients are prone to develop skin diseases. However, epidemiological data are scarce. Objective To describe the prevalence of skin complaints and dermatological disorders in residential psychiatric patients. Methods Ninety-one randomly chosen patients of the

  9. Biofeedback for psychiatric disorders: a systematic review

    NARCIS (Netherlands)

    Schoenberg, P.L.; David, A.S.

    2014-01-01

    Biofeedback potentially provides non-invasive, effective psychophysiological interventions for psychiatric disorders. The encompassing purpose of this review was to establish how biofeedback interventions have been used to treat select psychiatric disorders [anxiety, autistic spectrum disorders,

  10. Regionalised tertiary psychiatric residential facilities.

    Science.gov (United States)

    Lesage, Alain; Groden, David; Goldner, Elliot M; Gelinas, Daniel; Arnold, Leslie M

    2008-01-01

    Psychiatric hospitals remain the main venue for long-term mental health care and, despite widespread closures and downsizing, no country that built asylums in the last century has done away with them entirely--with the recent exception of Italy. Differentiated community-based residential alternatives have been developed over the past decades, with staffing levels that range from full-time professional, to daytime only, to part-time/on-call. This paper reviews the characteristics of community-based psychiatric residential care facilities as an alternative to long-term care in psychiatric hospitals. It describes five factors decision makers should consider: 1. number of residential places needed; 2. staffing levels; 3. physical setting; 4. programming; and 5. governance and financing. In Italy, facilities with full-time professional staff have been developed since the mid-1990s to accommodate the last cohorts of patients discharged from psychiatric hospitals. In the United Kingdom, experiments with hostel wards since the 1980s have shown that home-like, small-scale facilities with intensive treatment and rehabilitation programming can be effective for the most difficult-to-place patients. More recently in Australia, Community Care Units (CCUs) have been applying this concept. In the Canadian province of British Columbia (BC), Tertiary Psychiatric Residential Facilities (TPRFs) have been developed as part of an effort to regionalise health and social services and downsize and ultimately close its only psychiatric hospital. This type of service must be further developed in addition to the need for forensic, acute-care and intermediate-level beds, as well as for community-based care such as assertive community treatment and intensive case management. All these types of services, together with long-term community-based residential care, constitute the elements of a balanced mental health care system. As part of a region's balanced mental health care plan, these Tertiary

  11. Work and Psychiatric Illness in Aotearoa/New Zealand: Implications for Career Practice

    Science.gov (United States)

    Southern, Annie; Miller, Judi

    2012-01-01

    This paper aims to examine the influence of Maori culture upon psychiatric service provision in Aotearoa/New Zealand and the implications of this for career counselling of people with experience of mental illness in Aotearoa/New Zealand. The research explored the experiences of a group of women in Aotearoa/New Zealand who have been diagnosed with…

  12. The impact of the 2008 economic crisis on the increasing number of young psychiatric inpatients.

    Science.gov (United States)

    Medel-Herrero, Alvaro; Gomez-Beneyto, Manuel

    2017-11-21

    Little is published about the impact of the 2008 economic crisis on mental health services in Spain. An interrupted time series analysis was conducted to investigate a potential short-term association between the 2008 economic crisis and the number of psychiatric hospital admissions. The timing of the intervention (April 2008) was based on observed changes in Gross Domestic Product (GDP). Data on 1,152,880 psychiatric inpatients from the national Hospital Morbidity Survey, 69 months before and after the onset of the economic crisis (April 2008), were analyzed. Age-adjusted psychiatric (ICD9 290-319) hospital discharge rates significantly increased from April 2008, matching the onset of the crisis, especially for inpatients aged 15-24 years old and to a less extend for inpatients aged 25-34 years old. Other age groups were not affected. There was a significant increase in diagnoses for disturbance of conduct and emotions, depression, neurotic and personality disorders and alcohol and drug disorders; however, diagnoses for mental retardation and organic psychosis for 15-34 years old inpatients were unaffected. Psychiatric hospital admissions abruptly increased in April 2008, coinciding with the onset of the economic crisis. We identified age groups and diagnoses affected. Increased hospitalizations were found only at the age-ranges most affected by the rise in unemployment. The diagnoses affected were those most sensitive to environmental changes. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Ten-year mortality review in a pioneer psychiatric hospital in West ...

    African Journals Online (AJOL)

    Conclusion: It is concluded that the major psychotic disorders, schizophrenia and depression continue to constitute the highest psychopathologies diagnosed psychiatric mortality study. Finally, infections/infestations still continue to play leading role as major causes of death in the West African sub-region. East African ...

  14. HIV sero-positivity in recently admitted and long-term psychiatric in ...

    African Journals Online (AJOL)

    HIV rapid testing, HIV ELISA, syphilis-RPR and TPHA testing were performed. Results: The HIV prevalence of 11% in the sample was significantly associated with 'gender-and-duration-of-admission' categories (p=0.003). No significant association between HIV infection and psychiatric diagnoses or intravenous drug use ...

  15. EMTALA and patients with psychiatric emergencies: a review of relevant case law.

    Science.gov (United States)

    Lindor, Rachel A; Campbell, Ronna L; Pines, Jesse M; Melin, Gabrielle J; Schipper, Agnes M; Goyal, Deepi G; Sadosty, Annie T

    2014-11-01

    Emergency department (ED) care for patients with psychiatric complaints has become increasingly challenging given recent nationwide declines in available inpatient psychiatric beds. This creates pressure to manage psychiatric patients in the ED or as outpatients and may place providers and institutions at risk for liability under the Emergency Medical Treatment and Labor Act (EMTALA). We describe the patient characteristics, disposition, and legal outcomes of EMTALA cases involving patients with psychiatric complaints. Jury verdicts, settlements, and other litigation involving alleged EMTALA violations related to psychiatric patients between the law's enactment in 1986 and the end of 2012 were collected from 3 legal databases (Westlaw, Lexis, and Bloomberg Law). Details about the patient characteristics, disposition, and reasons for litigation were independently abstracted by 2 trained reviewers onto a standardized data form. Thirty-three relevant cases were identified. Two cases were decided in favor of the plaintiffs, 4 cases were settled, 10 cases had an unknown outcome, and 17 were decided in favor of the defendant institutions. Most patients in these 33 cases were men, had past psychiatric diagnoses, were not evaluated by a psychiatrist, and eventually committed or attempted suicide. The most frequently successful defense used by institutions was to demonstrate that their providers used a standard screening examination and did not detect an emergency medical condition that required stabilization. Lawsuits involving alleged EMTALA violations in the care of ED patients with psychiatric complaints are uncommon and rarely successful. Copyright © 2014 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  16. Organisational merger and psychiatric morbidity: a prospective study in a changing work organisation.

    Science.gov (United States)

    Väänänen, Ari; Ahola, Kirsi; Koskinen, Aki; Pahkin, Krista; Kouvonen, Anne

    2011-08-01

    Prospective studies on the relationship between organisational merger and mental health have been conducted using subjective health indicators. The objective of this prospective occupational cohort study was to examine whether a negative change during an organisational merger is an independent predictive factor of psychiatric morbidity. Survey data on organisational characteristics, health and other factors were collected prior to (1996) and after the merger (2000); register data on psychiatric morbidity were collected at baseline (1/1/1994-30/9/2000) and during the follow-up (1/10/2000-31/12/2005). Participants were 6511 (77% men) industrial employees aged 21-65 years with no register-based diagnosed psychiatric events prior to the follow-up (the Still Working Study). During the follow-up, 252 participants were admitted to the hospital due to psychiatric disorders, were prescribed a psychotropic drug or attempted or committed suicide. A negative self-reported change in the work organisation during the merger was associated with increased risk of postmerger psychiatric event (HR 1.60, 95% CI 1.19 to 2.14). This association was independent of mental health-related factors measured before the merger announcement, such as demographic characteristics, occupational status, personal orientation to life, self-rated health, self-reported psychiatric morbidity or chronic disease. A negative change in work organisation during an organisational merger may elevate the risk for postmerger psychiatric morbidity.

  17. Psychiatric disorders after radiation exposure

    Energy Technology Data Exchange (ETDEWEB)

    Kokai, Masahiro [Hyogo Coll. of Medicine, Nishinomiya (Japan); Soejima, Toshinori; Wang, Shangdong; Shinfuku, Naotaka

    2001-04-01

    This review focuses on the mental and psychological effects of medical radiation exposure, the nuclear accident at Three Mile Island, the Chernobyl disaster, atomic bomb explosions at Nagasaki and Hiroshima, and accidents at nuclear power plants and nuclear waste plants. Studies have shown that anxiety about the adverse effects of radiation in medicine (such as infertility, carcinogenicity, and genotoxicity) and fear for exposure has caused psychiatric disorders. Several studies on the mental health effects of the nuclear accident at Three Mile Island were conducted, and the results indicated that psychiatric distress persisted for a certain period of time, particularly in pregnant women and women who have children, even when no evidence of substantial of radiation exposure is seen clinically. The psychological consequences of the Chernobyl disaster have been investigated continuously, and various problems, e.g., acute stress reaction, neurosis, and psychosis, have been identified, although no physical damage due to the radiation or PTSD have been reported. By contrast, PTSD has been seen in survivors of the Nagasaki and Hiroshima nuclear explosions. A study in Ohio, (United States), which has a nuclear waste plant, investigated PTSD in people living near the plant and found that the symptom level was mild. In general, the most common symptoms among people with mental and psychological disorders due to radiation exposure are depression and anxiety, with many people having associated somatoform disorders, and some people complain of PTSD. Vague anxiety and fear of sequelae, regardless of the exposure dose, appears to cause such psychiatric disorders. Although it is rare for psychiatrists to see such cases of psychiatric disorders due to radiation exposure, their number may increase as psychiatric services become more widely available. (K.H.)

  18. Psychiatric disorders after radiation exposure

    International Nuclear Information System (INIS)

    Kokai, Masahiro; Soejima, Toshinori; Wang, Shangdong; Shinfuku, Naotaka

    2001-01-01

    This review focuses on the mental and psychological effects of medical radiation exposure, the nuclear accident at Three Mile Island, the Chernobyl disaster, atomic bomb explosions at Nagasaki and Hiroshima, and accidents at nuclear power plants and nuclear waste plants. Studies have shown that anxiety about the adverse effects of radiation in medicine (such as infertility, carcinogenicity, and genotoxicity) and fear for exposure has caused psychiatric disorders. Several studies on the mental health effects of the nuclear accident at Three Mile Island were conducted, and the results indicated that psychiatric distress persisted for a certain period of time, particularly in pregnant women and women who have children, even when no evidence of substantial of radiation exposure is seen clinically. The psychological consequences of the Chernobyl disaster have been investigated continuously, and various problems, e.g., acute stress reaction, neurosis, and psychosis, have been identified, although no physical damage due to the radiation or PTSD have been reported. By contrast, PTSD has been seen in survivors of the Nagasaki and Hiroshima nuclear explosions. A study in Ohio, (United States), which has a nuclear waste plant, investigated PTSD in people living near the plant and found that the symptom level was mild. In general, the most common symptoms among people with mental and psychological disorders due to radiation exposure are depression and anxiety, with many people having associated somatoform disorders, and some people complain of PTSD. Vague anxiety and fear of sequelae, regardless of the exposure dose, appears to cause such psychiatric disorders. Although it is rare for psychiatrists to see such cases of psychiatric disorders due to radiation exposure, their number may increase as psychiatric services become more widely available. (K.H.)

  19. Psychiatric comorbidity in adult eczema.

    Science.gov (United States)

    Schmitt, J; Romanos, M; Pfennig, A; Leopold, K; Meurer, M

    2009-10-01

    Atopic eczema (AE) is a common dermatological condition that causes significant problems in everyday life and high levels of illness-related stress in substantial proportions of patients. The extent to which adult AE is associated with clinically relevant psychiatric morbidity is unclear. To investigate the association between adult AE and major psychiatric/psychosomatic disorders. Case-control study utilizing the GKV database Saxony, an interdisciplinary administrative outpatient database from Germany. All patients documented as having AE at least twice within the study period (2003-2004) (n = 3769, mean age 44 years) were individually matched by age and sex to 3769 controls without AE. Logistic regression models were fitted to investigate the relationship of AE with affective, stress-related, behaviour and schizophrenic disorders, considering sociodemographic characteristics, consulting behaviour and allergic comorbidities as potential confounding factors. Eczema was independently associated with affective [adjusted odds ratio (OR) 1.42, 95% confidence interval (CI) 1.13-1.79], stress-related (OR 1.55, 95% CI 1.35-1.77), behaviour (OR 1.52, 95% CI 1.03-2.23) and schizophrenic disorders (OR 2.12, 95% CI 1.22-3.71). For each psychiatric condition the likelihood of being affected significantly increased with each physician visit due to AE, suggesting that the risk of psychiatric comorbidity increases with the severity of AE. This study indicates psychiatric comorbidity of adults with AE. Collaboration between dermatologists and mental health specialists may optimize medical care for a significant subgroup of patients with AE.

  20. Prevalence of psychiatric morbidity among medical practitioners in ...

    African Journals Online (AJOL)

    Background: Mental health problems can affect anybody including Doctors. It can be related to nature of our work and personal factors. Mental ill health includes a range of conditions like depression, bipolar disorder, anxiety and psychosis. Objective: To determine the prevalence of psychiatric morbidity among Medical ...

  1. Abnormal regional cerebral blood flow in systemic lupus erythematosus patients with psychiatric symptoms.

    Science.gov (United States)

    Oda, Kenji; Matsushima, Eisuke; Okubo, Yoshiro; Ohta, Katsuya; Murata, Yuji; Koike, Ryuji; Miyasaka, Nobuyuki; Kato, Motoichiro

    2005-07-01

    Single-photon emission computed tomography (SPECT) studies have demonstrated decreased regional cerebral blood flow (rCBF) in systemic lupus erythematosus (SLE) patients. However, no study has done voxel-based analysis using statistical parametric mapping (SPM) that can evaluate rCBF objectively, and the relationship between rCBF and psychiatric symptoms has not been well investigated. Using L,L-ethyl cysteinate dimer (99mTc ECD) SPECT and SPM, we aimed to clarify the association of rCBF changes with psychiatric symptoms in SLE patients whose magnetic resonance imaging (MRI) showed no morphological abnormalities. Twenty SLE patients and 19 healthy volunteers underwent 99mTc ECD SPECT. Data were collected from August 2000 to March 2003. SLE was diagnosed according to American College of Rheumatology criteria, and psychiatric symptoms were diagnosed according to ICD-10 criteria. On the basis of the modified Carbotte, Denburg, and Denburg method, the patients were classified into 3 groups: a group with major psychiatric symptoms (hallucinosis, delusional disorder, and mood disorder), a group with minor psychiatric symptoms (anxiety disorder, dissociative disorder, and emotionally labile disorder), and a group without psychiatric symptoms. Gross organic lesions were ruled out by brain MRI. Group comparisons of rCBF were performed with analysis using SPM99. SLE patients without MRI lesions showed decreased rCBF in the posterior cingulate gyrus and thalamus. The reduction in rCBF was overt in patients with major psychiatric symptoms. Our study indicated that SLE patients may have dysfunction in the posterior cingulate gyrus and thalamus and that this may be associated with the severity of psychiatric symptoms.

  2. Association of the World War II Finnish Evacuation of Children With Psychiatric Hospitalization in the Next Generation.

    Science.gov (United States)

    Santavirta, Torsten; Santavirta, Nina; Gilman, Stephen E

    2018-01-01

    Although there is evidence that adverse childhood experiences are associated with worse mental health in adulthood, scarce evidence is available regarding an emerging concern that the next generation might also be affected. To compare the risk of psychiatric hospitalization in cousins whose parents were vs were not exposed to the Finnish evacuation policy that involved a mean 2-year stay with a Swedish foster family. This multigenerational, population-based cohort study of Finnish individuals and their siblings born between January 1, 1933, and December 31, 1944, analyzed the association of evacuee status as a child during World War II in the first generation with the risk of psychiatric hospitalization among offspring in the second generation. Evacuee status during World War II was determined using the Finnish National Archive's registry of participants in the Finnish evacuation. Data on evacuee status were linked to the psychiatric diagnoses in the Finnish Hospital Discharge Register from January 1, 1971, through December 31, 2012, for offspring (n = 93 391) born between January 1, 1950, and December 31, 2010. Sex-specific Cox proportional hazards regression models were used to estimate hazard ratios for risk of psychiatric hospitalization during the follow-up period. Because offspring of evacuees and their nonevacuated siblings are cousins, the Cox proportional hazards regression models included fixed effects to adjust for confounding factors in families. Data analysis was performed from June 15, 2016, to August 26, 2017. Parental participation in the evacuation during World War II (coded 1 for parents who were evacuated and placed in foster care and 0 for those not evacuated). Offspring's initial admission to the hospital for a psychiatric disorder, obtained from the Finnish Hospital Discharge Register from January 1, 1971, through December 31, 2012. Of the 93 391 study persons, 45 955 (49.2%) were women and 47 436 (50.8) were men; mean (SD) age in

  3. Continuity of pharmaceutical care for psychiatric patients

    NARCIS (Netherlands)

    Abdullah-Koolmees, Heshu

    2015-01-01

    Psychiatric diseases are common. The effective treatment of a psychiatric disease, its (somatic) side effects and any concurrent somatic diseases is important for the patient’s overall health and wellbeing. The studies conducted in psychiatric patients generally focus on the continuation of

  4. 42 CFR 415.184 - Psychiatric services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Psychiatric services. 415.184 Section 415.184 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Psychiatric services. To qualify for physician fee schedule payment for psychiatric services furnished under...

  5. An observational study in psychiatric acute patients admitted to General Hospital Psychiatric Wards in Italy

    Directory of Open Access Journals (Sweden)

    Margari Francesco

    2007-01-01

    Full Text Available Abstract Objectives this Italian observational study was aimed at collecting data of psychiatric patients with acute episodes entering General Hospital Psychiatric Wards (GHPWs. Information was focused on diagnosis (DSM-IV, reasons of hospitalisation, prescribed treatment, outcome of aggressive episodes, evolution of the acute episode. Methods assessments were performed at admission and discharge. Used psychometric scales were the Brief Psychiatric Rating Scale (BPRS, the Modified Overt Aggression Scale (MOAS and the Nurses' Observation Scale for Inpatient Evaluation (NOSIE-30. Results 864 adult patients were enrolled in 15 GHPWs: 728 (320 M; mean age 43.6 yrs completed both admission and discharge visits. A severe psychotic episode with (19.1% or without (47.7% aggressive behaviour was the main reason of admission. Schizophrenia (42.8% at admission and 40.1% at discharge and depression (12.9% at admission and 14.7% at discharge were the predominant diagnoses. The mean hospital stay was 12 days. The mean (± SD total score of MOAS at admission, day 7 and discharge was, respectively, 2.53 ± 5.1, 0.38 ± 2.2, and 0.21 ± 1.5. Forty-four (6.0% patients had episodes of aggressiveness at admission and 8 (1.7% at day 7. A progressive improvement in each domain/item vs. admission was observed for MOAS and BPRS, while NOSIE-30 did not change from day 4 onwards. The number of patients with al least one psychotic drug taken at admission, in the first 7 days of hospitalisation, and prescribed at discharge, was, respectively: 472 (64.8%, 686 (94.2% and 676 (92.9%. The respective most frequently psychotic drugs were: BDZs (60.6%, 85.7%, 69.5%, typical anti-psychotics (48.3%, 57.0%, 49.6%, atypical anti-psychotics (35.6%, 41.8%, 39.8% and antidepressants (40.9%, 48.8%, 43.2%. Rates of patients with one, two or > 2 psychotic drugs taken at admission and day 7, and prescribed at discharge, were, respectively: 24.8%, 8.2% and 13.5% in mono-therapy; 22.0%, 20

  6. Improvement of psychiatric symptoms in youth following resolution of sinusitis.

    Science.gov (United States)

    Mahony, Talia; Sidell, Douglas; Gans, Hayley; Brown, Kayla; Farhadian, Bahare; Gustafson, Melissa; Sherr, Janell; Thienemann, Margo; Frankovich, Jennifer

    2017-01-01

    Accumulating evidence supports a role for inflammation in psychiatric illness, and the onset or exacerbation of psychiatric symptoms may follow non-CNS infections. Here, we provide the first detailed description of obsessive-compulsive and related psychiatric symptoms arising concurrently with sinusitis. We reviewed the charts of 150 consecutive patients evaluated in our Pediatric Acute-onset Neuropsychiatric Syndromes clinic for documented sinusitis as defined by the American Academy of Pediatrics guidelines. Sinusitis treatments, sinonasal imaging, and neuropsychiatric symptoms before, during, and after sinusitis onset were noted. Patients were included in the final review if they had a clear diagnosis of isolated sinusitis (without concurrent illness and/or immunodeficiency), and were evaluated during an episode of sinusitis. 10/150 (6.6%) patients had isolated sinusitis at the time of their neuropsychiatric deterioration. Eight patients received antibiotics to treat sinusitis, three of whom also received sinus surgery. Neuropsychiatric symptoms improved in all eight patients concurrent with resolution of sinusitis per parent report and clinician assessment. One patient did not follow through with recommended sinus surgery or antibiotics and her psychiatric symptoms persisted. One patient was lost to follow-up. Improvement of psychiatric symptoms correlated with resolution of sinus disease in this retrospective study. Identification, treatment, and resolution of underlying infections, including sinusitis, may have the potential to change the trajectory of some neuropsychiatric illnesses. Randomized clinical trials are needed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Psychiatric Morbidity in HIV-infected Male Prisoners

    Science.gov (United States)

    Peng, Eugene Yu-Chang; Lee, Ming-Been; Morisky, Donald Edward; Yeh, Ching-Ying; Farabee, David; Lan, Yu-Ching; Chen, Yi-Ming Arthur; Lyu, Shu-Yu

    2011-01-01

    Background/Purpose The seroincidence of human immunodeficiency virus (HIV) in Taiwan has drastically increased since 2004, particularly among injection drug users and prisoners. The major purpose of this study was to explore the prevalence and correlates of psychiatric morbidity among HIV-infected male prisoners. Methods In 2006, data were collected from all of HIV-infected male prisoners (n = 535) in seven prisons in Taiwan. This collection was performed using a self-administered, anonymous questionnaire in group settings directed by our interviewers. Psychiatric morbidity was measured using the five-item Brief Symptom Rating Scale in 535 participants, which represented an 85% response rate. After excluding incomplete data, 479 participants were included in the analysis. Results Psychiatric morbidity was present in 46% of participants. Multivariate logistic regression revealed that correlates of the five-item Brief Symptom Rating Scale defined cases included the following: being a recidivist, having poor self-rated health status, and having experienced psychiatric symptoms in one’s lifetime (e.g. significant physical pain or discomfort, depression for 2 weeks or longer, serious anxiety or tension, trouble understanding, concentrating, or remembering, and serious thoughts of suicide), with a Nagelkerke R2 equal to 0.365. Conclusion Psychiatric morbidity is prevalent among HIV-infected male prisoners. Tailored HIV/AIDS education related to mental health is therefore suggested for inclusion as part of a comprehensive HIV/AIDS training program among incarcerated populations. PMID:20434025

  8. Patterns of psychotropic medication use in inpatient and outpatient psychiatric settings in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Alosaimi FD

    2016-04-01

    Full Text Available Fahad D Alosaimi,1 Abdulhadi Alhabbad,2 Mohammed F Abalhassan,3 Ebtihaj O Fallata,4 Nasser M Alzain,5 Mohammad Zayed Alassiry,6 Bander Abdullah Haddad71Department of Psychiatry, King Saud University, Riyadh, 2Department of Psychiatry, Prince Mohammed Medical City, Aljouf, 3Department of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, 4Department of Psychiatry, Mental Health Hospital, Jeddah, 5Department of Psychiatry, Al-Amal Complex for Mental Health, Dammam, 6Medical Services Department, Abha Psychiatric Hospital, Abha, 7Department of Medicine, King Abdulaziz Medical City, Ministry of National Guard, Riyadh, Saudi ArabiaObjective: To study the pattern of psychotropic medication use and compare this pattern between inpatient and outpatient psychiatric settings in Saudi Arabia.Method: This cross-sectional observational study was conducted between July 2012 and June 2014 on patients seeking psychiatric advice at major hospitals in five main regions of Saudi Arabia. Male (n=651 and female (n=594 patients who signed the informed consent form and were currently or had been previously using psychotropic medications, irrespective of the patient’s type of psychiatric diagnosis and duration of the disease, were included. A total of 1,246 patients were found to be suitable in the inclusion criteria of whom 464 were inpatients while 782 were outpatients.Results: Several studied demographic factors have shown that compared with outpatients, inpatients were more likely to be male (P=0.004, unmarried (P<0.001, have less number of children (1–3; P=0.002, unemployed (P=0.001, have a lower family income (<3,000 SR; P<0.001, live in rural communities (P<0.001, have a lower body mass index (P=0.001, and are smokers (P<0.001; however, there were no differences with regard to age or educational levels. The current frequency of use of psychotropic medications in overall patients was antipsychotics (76.6%, antidepressants (41.4%, mood stabilizers

  9. Psychiatric morbidity among inmates of center for destitutes: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Raghavendra B Nayak

    2015-01-01

    Full Text Available Context: One percent of the population in India is homeless (destitutes which include beggars, commercial sex workers, homeless mentally ill, elderly women with dependent children, street children, and persons with disability. Psychiatric disorders are generally seen to be common among homeless individuals. The data are limited regarding psychiatric morbidity and its prevalence in this populace in Indian context. Aim: The aim was to study the prevalence of psychiatric morbidity among the inmates of a center for destitutes. Settings and Design: Cross-sectional study. Materials and Methods: The study included all the residents (n = 50 of a center of destitutes. Psychiatric evaluation was done by qualified practicing psychiatrist. Brief Psychiatric Rating Scale and Global Assessment of Functioning instruments were used to assess the severity of psychiatric symptoms and general functioning of the individuals with mental disorders. Statistical Analysis Used: SPSS version 13 was used for statistical analysis. Results: All residents (n = 50 of center of destitutes were evaluated for psychiatric co-morbidity. 42 (84% inmates were suffering from psychiatric disorders. Most common psychiatric disorder among them was psychotic disorders in 19 (38%, followed by affective disorders, mainly depression in 16 (32%, somatoform disorders in 5 (10%, and anxiety disorders in 2 (4%. No significant gender differences were noted (P = 0.335. Substance abuse was present in 22 (44% of the inmates. A significant negative correlation between psychiatric symptoms and functioning of the subject was seen, (P < 0.001. Conclusion: Psychiatric disorders and in particular substance abuse, are common among the homeless people who stay in the center of destitutes. Psychiatric disorders are likely to be the cause significant functional impairment.

  10. Gender Differences in the Prevalence of Fibromyalgia and in Concomitant Medical and Psychiatric Disorders: A National Veterans Health Administration Study.

    Science.gov (United States)

    Arout, Caroline A; Sofuoglu, Mehmet; Bastian, Lori A; Rosenheck, Robert A

    2018-04-02

    Fibromyalgia is a poorly understood, chronically disabling pain syndrome. While research has focused on its clinical presentation and treatment, less is known about fibromyalgia's clinical epidemiology in real-world healthcare systems. Gender differences have been difficult to study because relatively few males are diagnosed with fibromyalgia. Veterans Health Administration (VHA) patients diagnosed with fibromyalgia nationwide in FY 2012 were compared to Veterans with other pain diagnoses on sociodemographic characteristics, medical and psychiatric diagnoses, health service use, and opioid and psychotropic prescription fills. Additional analyses compared characteristics of men and women diagnosed with fibromyalgia. Risk ratios and Cohen's d were used for bivariate comparisons, followed by logistic regression analyses to identify independent factors associated with a diagnosis of fibromyalgia in the VHA. Altogether, 77,087 of 2,216,621 Veterans with pain diagnoses (3.48%) were diagnosed with fibromyalgia. They were more likely to be female, younger than patients with other pain conditions, more likely to have multiple psychiatric comorbidities and other types of pain, and used more medical outpatient services. Women diagnosed with fibromyalgia were younger and more likely to have headaches, connective tissue diseases (CTD), and psychiatric comorbidities, while men had more comorbid medical conditions. In this large, predominantly older male sample of Veterans with pain diagnoses, those with fibromyalgia were far more likely to be women. Gender comparisons showed women with fibromyalgia were more likely to be diagnosed with psychiatric disorders and CTD, while males were more likely to be diagnosed with medical conditions. Fibromyalgia shows a striking, gender-dependent picture of multimorbidity, which should be considered in treatment.

  11. Predicting psychiatric readmission: sex-specific models to predict 30-day readmission following acute psychiatric hospitalization.

    Science.gov (United States)

    Barker, Lucy Church; Gruneir, Andrea; Fung, Kinwah; Herrmann, Nathan; Kurdyak, Paul; Lin, Elizabeth; Rochon, Paula A; Seitz, Dallas; Taylor, Valerie H; Vigod, Simone N

    2018-02-01

    Psychiatric readmission is a common negative outcome. Predictors of readmission may differ by sex. This study aimed to derive and internally validate sex-specific models to predict 30-day psychiatric readmission. We used population-level health administrative data to identify predictors of 30-day psychiatric readmission among women (n = 33,353) and men (n = 32,436) discharged from all psychiatric units in Ontario, Canada (2008-2011). Predictor variables included sociodemographics, health service utilization, and clinical characteristics. Using derivation data sets, multivariable logistic regression models were fit to determine optimal predictive models for each sex separately. Results were presented as adjusted odds ratios (aORs) and 95% confidence intervals (CI). The multivariable models were then applied in the internal validation data sets. The 30-day readmission rates were 9.3% (women) and 9.1% (men). Many predictors were consistent between women and men. For women only, personality disorder (aOR 1.21, 95% CI 1.03-1.42) and positive symptom score (aOR 1.41, 95% CI 1.09-1.82 for score of 1 vs. 0; aOR 1.44, 95% CI 1.26-1.64 for ≥ 2 vs. 0) increased odds of readmission. For men only, self-care problems at admission (aOR 1.20, 95% CI 1.06-1.36) and discharge (aOR 1.44, 95% CI 1.26-1.64 for score of 1 vs. 0; aOR 1.79, 95% CI 1.17-2.74 for 2 vs. 0), and mild anxiety rating (score of 1 vs. 0: aOR 1.30, 95% CI 1.02-1.64, derivation model only) increased odds of readmission. Models had moderate discriminative ability in derivation and internal validation samples for both sexes (c-statistics 0.64-0.65). Certain key predictors of psychiatric readmission differ by sex. This knowledge may help to reduce psychiatric hospital readmission rates by focusing interventions.

  12. Risk of Psychiatric and Neurodevelopmental Disorders Among Siblings of Probands With Autism Spectrum Disorders.

    Science.gov (United States)

    Jokiranta-Olkoniemi, Elina; Cheslack-Postava, Keely; Sucksdorff, Dan; Suominen, Auli; Gyllenberg, David; Chudal, Roshan; Leivonen, Susanna; Gissler, Mika; Brown, Alan S; Sourander, Andre

    2016-06-01

    Previous research has focused on examining the familial clustering of schizophrenia, bipolar disorder, and autism spectrum disorders (ASD). Little is known about the clustering of other psychiatric and neurodevelopmental disorders among siblings of persons with ASD. To examine the risk for psychiatric and neurodevelopmental disorders among full siblings of probands with ASD. The Finnish Prenatal Study of Autism and Autism Spectrum Disorders used a population-based cohort that included children born from January 1, 1987, to December 31, 2005, who received a diagnosis of ASD by December 31, 2007. Each case was individually matched to 4 control participants by sex and date and place of birth. The siblings of the cases and controls were born from January 1, 1977, to December 31, 2005, and received a diagnosis from January 1, 1987, to December 31, 2009. This nested case-control study included 3578 cases with ASD with 6022 full siblings and 11 775 controls with 22 127 siblings from Finnish national registers. Data were analyzed from March 6, 2014, to February 12, 2016. The adjusted risk ratio (RR) for psychiatric and neurodevelopmental disorders among siblings of probands with ASD vs siblings of matched controls. Additional analyses were conducted separately for ASD subgroups, including childhood autism, Asperger syndrome, and pervasive developmental disorders not otherwise specified. Analyses were further stratified by sex and intellectual disability among the probands. Among the 3578 cases with ASD (2841 boys [79.4%]) and 11 775 controls (9345 boys [79.4%]), 1319 cases (36.9%) and 2052 controls (17.4%) had at least 1 sibling diagnosed with any psychiatric or neurodevelopmental disorder (adjusted RR, 2.5; 95% CI, 2.3-2.6). The largest associations were observed for childhood-onset disorders (1061 cases [29.7%] vs 1362 controls [11.6%]; adjusted RR, 3.0; 95% CI, 2.8-3.3), including ASD (374 cases [10.5%] vs 125 controls [1.1%]; adjusted RR, 11.8; 95% CI, 9

  13. Benzodiazepines still play a role in modern psychiatric therapy

    DEFF Research Database (Denmark)

    Jørgensen, Martin Balslev; Videbech, Poul; Osler, Merete

    2017-01-01

    Benzodiazepines (BZ) are widely used for anxiety across psychiatric diagnoses, but for the last decades regulation has been increasingly tight due to problems with tolerance, addiction, withdrawal symptoms and cognitive side effects. Some guidelines claim that BZ only work for a few weeks......, and that BZ cause traffic accidents, increased mortality and dementia. In Denmark, the use of BZ has been substantially reduced. In this article it is argued, that not all patients habituate, that most of the epidemiological findings are hampered by confounding, and that there still is a role for long...

  14. DEPRESSED-PATIENTS PARENTAL REPRESENTATIONS - STABILITY ACROSS CHANGES IN DEPRESSED MOOD AND SPECIFICITY ACROSS DIAGNOSES

    NARCIS (Netherlands)

    GERLSMA, C; DAS, J; EMMELKAMP, PMG

    Parental representations of a Dutch sample of psychiatric patients with diagnoses of dysthymia and unipolar depression were compared with those of a matched sample of non-depressed patients and a matched sample of healthy controls. No differences in recalled parental rearing styles were found

  15. Diagnosing suffering: a perspective.

    Science.gov (United States)

    Cassell, E J

    1999-10-05

    The alleviation of suffering is crucial in all of medicine, especially in the care of the dying. Suffering cannot be treated unless it is recognized and diagnosed. Suffering involves some symptom or process that threatens the patient because of fear, the meaning of the symptom, and concerns about the future. The meanings and the fear are personal and individual, so that even if two patients have the same symptoms, their suffering would be different. The complex techniques and methods that physicians usually use to make a diagnosis, however, are aimed at the body rather than the person. The diagnosis of suffering is therefore often missed, even in severe illness and even when it stares physicians in the face. A high index of suspicion must be maintained in the presence of serious disease, and patients must be directly questioned. Concerns over the discomfort of listening to patients' severe distress are usually more than offset by the gratification that follows the intervention. Often, questioning and attentive listening, which take little time, are in themselves ameliorative. The information on which the assessment of suffering is based is subjective; this may pose difficulties for physicians, who tend to value objective findings more highly and see a conflict between the two kinds of information. Recent advances in understanding how physicians increase the utility of information and make inferences allow one to reliably use the subjective information on which the diagnosis and treatment of suffering depend. Knowing patients as individual persons well enough to understand the origin of their suffering and ultimately its best treatment requires methods of empathic attentiveness and nondiscursive thinking that can be learned and taught. The relief of suffering depends on physicians acquiring these skills.

  16. Depression diagnoses following the identification of bipolar disorder: costly incongruent diagnoses

    Directory of Open Access Journals (Sweden)

    Schultz Jennifer F

    2010-06-01

    Full Text Available Abstract Background Previous research has documented that the symptoms of bipolar disorder are often mistaken for unipolar depression prior to a patient's first bipolar diagnosis. The assumption has been that once a patient receives a bipolar diagnosis they will no longer be given a misdiagnosis of depression. The objectives of this study were 1 to assess the rate of subsequent unipolar depression diagnosis in individuals with a history of bipolar disorder and 2 to assess the increased cost associated with this potential misdiagnosis. Methods This study utilized a retrospective cohort design using administrative claims data from 2002 and 2003. Patient inclusion criteria for the study were 1 at least 2 bipolar diagnoses in 2002, 2 continuous enrollment during 2002 and 2003, 3 a pharmacy benefit, and 4 age 18 to 64. Patients with at least 2 unipolar depression diagnoses in 2003 were categorized as having an incongruent diagnosis of unipolar depression. We used propensity scoring to control for selection bias. Utilization was evaluated using negative binomial models. We evaluated cost differences between patient cohorts using generalized linear models. Results Of the 7981 patients who met all inclusion criteria for the analysis, 17.5% (1400 had an incongruent depression diagnosis (IDD. After controlling for background differences, individuals who received an IDD had higher rates of inpatient and outpatient psychiatric utilization and cost, on average, an additional $1641 per year compared to individuals without an IDD. Conclusions A strikingly high proportion of bipolar patients are given the differential diagnosis of unipolar depression after being identified as having bipolar disorder. Individuals with an IDD had increased acute psychiatric care services, suggesting higher levels of relapses, and were at risk for inappropriate treatment, as antidepressant therapy without a concomitant mood-stabilizing medication is contraindicated in bipolar

  17. Views of practitioners of alternative medicine toward psychiatric illness and psychiatric care: a study from Solapur, India.

    Science.gov (United States)

    Holikatti, Prabhakar C; Kar, Nilamadhab

    2015-01-01

    It is common knowledge that patients seek treatment for psychiatric illnesses from various sources including the alternative medicine. Views and attitudes of clinicians often influence the provision of appropriate mental health care for these patients. In this context, it was intended to study the views of the practitioners of alternative medicine toward psychiatric disorders, patients and interventions. The study was conducted as a questionnaire-based survey among a sample of practitioners of alternative medicine specifically Ayurveda and Homeopathy, who were practicing in Solapur and adjoining areas of Maharashtra and Karnataka states in India. A semi-structured Attitudinal Inventory for Psychiatry questionnaire was used. Demographic and professional data were collected. Out of 62 practitioners approached, 50 responded (80.6%). There were no significant differences in the views of practitioners toward psychiatry and psychiatrists based on respondents' gender, place of residence, location of practice, type of alternative medicine, exposure to psychiatric patients, or if they knew someone with psychiatric illness. Attitudes were generally positive, but variable. Among negative observations were that approximately 60% of respondents felt that a patient can be disadvantaged by being given a psychiatric label and 58% believed that emotions are difficult to handle. A considerable proportion (40%) of the respondents felt doctors other than psychiatrists were unable to identify psychiatric disorders. This study's findings suggest that practitioners of alternative medicine have mixed views about mental illness, patients and treatment. Some of their negative views and perceived inability to identify psychiatric disorders may be addressed through further training, information sharing and collaborative work.

  18. Psychiatric effects of cannabis use.

    Science.gov (United States)

    Tunving, K

    1985-09-01

    That cannabis use may provoke mental disturbances is well known to Scandinavian psychiatrists today. A review of the psychiatric aspects of cannabis use is given, and the clinical signs of 70 cases of cannabis psychoses collected in Sweden are described. The bluntness and "amotivation" following chronic cannabis use are discussed. Anxiety reactions, flashbacks, dysphoric reactions and an abstinence syndrome are all sequels of cannabis use. Three risk groups begin to emerge: a) Young teenage cannabis users who lose some of their capacity to learn complex functions and who flee from reality to a world of dreams. With its sedative effect, cannabis could modify such emotions as anger and anxiety and slow down the liberation process of adolescence. b) Heavy daily users, often persons who cannot cope with depression or their life circumstances. c) Psychiatric patients whose resistance to relapses into psychotic reactions might be diminished according to the psychotropic effects of cannabis.

  19. Advances in Tourette syndrome: diagnoses and treatment.

    Science.gov (United States)

    Serajee, Fatema J; Mahbubul Huq, A H M

    2015-06-01

    Tourette syndrome (TS) is a childhood-onset neurodevelopmental disorder characterized by multiple motor tics and at least one vocal or phonic tic, and often one or more comorbid psychiatric disorders. Premonitory sensory urges before tic execution and desire for "just-right" perception are central features. The pathophysiology involves cortico-striato-thalamo-cortical circuits and possibly dopaminergic system. TS is considered a genetic disorder but the genetics is complex and likely involves rare mutations, common variants, and environmental and epigenetic factors. Treatment is multimodal and includes education and reassurance, behavioral interventions, pharmacologic, and rarely, surgical interventions. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Death of Dementia Patients in Psychiatric Hospitals and Regional Supply of Psychiatric Services: Study of the National Data from 1996 to 2014 in Japan.

    Science.gov (United States)

    Nakanishi, Miharu; Niimura, Junko; Yamasaki, Syudo; Nishida, Atsushi

    2017-01-01

    Japan designates psychiatric inpatient care for behavior management of individuals with dementia and for helping dementia patients discharge to home. However, there has been no examination of the effectiveness of this strategy. The present study investigated the association between dementia and the discharge destination of patients in psychiatric hospitals. Data from the National Patient Survey, which is a nationally representative cross-sectional survey of inpatient care, were used. The 96,420 patients with dementia or other mental illness who were discharged from psychiatric hospitals in September of every 3 years from 1996 to 2014 were included in analyses. Of the 96,420 discharged patients, 13,823 had dementia as the primary disease. Of the 13,823 dementia patients, 3,865 (28.0%) were discharged to home, 3,870 (28.0%) were admitted to a facility or other care settings, 3,574 (25.9%) were admitted to another hospital, and 2,514 (18.2%) died. Patients were more likely to die in psychiatric hospital if their primary disease was dementia, and they had resided in a region that provided fewer home visits for psychiatric nursing care or had available a larger number of psychiatric hospital beds per capita. Psychiatric inpatient care may be ineffective as a treatment for the challenging behaviors of dementia. A community mental health system for behavior management should be constructed in parallel with a reduction in the number of hospital beds allotted for psychiatric care.

  1. Continuity Between Interview-Rated Personality Disorders and Self-Reported DSM-5 Traits in a Danish Psychiatric Sample

    DEFF Research Database (Denmark)

    Bach, Bo; Anderson, Jaime; Simonsen, Erik

    2017-01-01

    The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) Section III offers an alternative model for the diagnosis of personality disorders (PDs), including 25 pathological personality trait facets organized into 5 trait domains. To maintain continuity with the categorical PD...... diagnoses found in DSM-5 Section II, specified sets of facets are configured into familiar PD types. The current study aimed to evaluate the continuity across the Section II and III models of PDs. A sample of 142 psychiatric outpatients were administered the Personality Inventory for DSM-5 and rated...... showed that, overall, the interview-rated DSM-5 Section II disorders were most strongly associated with expected self-reported Section III traits. Results also supported the addition of facets not included in the proposed Section III PD criteria. These findings partly underscore the continuity between...

  2. Virtual Reality, Telemedicine, Web and Data Processing Innovations in Medical and Psychiatric Education and Clinical Care

    Science.gov (United States)

    Hilty, Donald M.; Alverson, Dale C.; Alpert, Jonathan E.; Tong, Lowell; Sagduyu, Kemal; Boland, Robert J.; Mostaghimi, Arash; Leamon, Martin L.; Fidler, Don; Yellowlees, Peter M.

    2006-01-01

    Objective: This article highlights technology innovations in psychiatric and medical education, including applications from other fields. Method: The authors review the literature and poll educators and informatics faculty for novel programs relevant to psychiatric education. Results: The introduction of new technologies requires skill at…

  3. Late Preterm Birth, Maternal Depression, and Risk of Preschool Psychiatric Disorders

    Science.gov (United States)

    Rogers, Cynthia E.; Lenze, Shannon N.; Luby, Joan L.

    2013-01-01

    Objective: Preterm children are at greater risk for psychiatric disorders, including anxiety disorders and attention-deficit/hyperactivity disorder (ADHD), than their term-born peers. Prior research has focused primarily on children born at early gestational ages. Less is known about the rate of psychiatric disorders among late preterm or early…

  4. Parasitic Diseases and Psychiatric Illness

    OpenAIRE

    Weiss, Mitchell Gralnick

    1994-01-01

    Distinguishing parasitic diseases from other infections and tropical medical disorders based on microbiological classification is a matter of convenience. Organic brain syndromes are associated with both protozoan and helminthic infections; side-effects of drugs commonly used to treat parasitoses may impair mood and cause anxiety, agitation or psychosis. Emotional states may in turn affect the experience of medical illness. Psychiatrically significant features of medical illness are determine...

  5. Psychiatric Aspects of Childhood Epilepsy

    OpenAIRE

    Raman Deep PATTANAYAK; Rajesh SAGAR

    2012-01-01

    How to Cite this Article: Pattanayak RD, Sagar R. Psychiatric Aspects of Childhood Epilepsy. Iran J Child Neurol 2012;6(2):9-18.Childhood epilepsy is a chronic, recurrent disorder of unprovoked seizures. Theonset of epilepsy in childhood has significant implications for brain growth anddevelopment. Seizures may impair the ongoing neurodevelopmental processes and compromise the child’s intellectual and cognitive functioning, leading totremendous cognitive, behavioral and psychosocial consequen...

  6. The revolution in psychiatric diagnosis: problems at the foundations.

    Science.gov (United States)

    Galatzer-Levy, Isaac R; Galatzer-Levy, Robert M

    2007-01-01

    The third edition of the American Psychiatric Association's Diagnostic and Statistical Manual (DSM-III; 1974) not only revolutionized psychiatric diagnosis, it transformed and dominated American psychiatry. The nosology of psychiatry had been conceptually confusing, difficult to apply, and bound to widely questioned theories. Psychiatry and clinical psychology had been struggling with their scientific status. DSM attempted to solve psychiatry's problems by making psychiatry more like its authors' perception of general medicine. It tried to avoid theory, especially psychoanalytic theories, by discussing only observable manifestations of disorders. But DSM is actually highly theory-bound. It implicitly and powerfully includes an exclusively "medical" model of psychological disturbance, while excluding other psychiatric ideas. Its authors tried to meet what they saw as "scientific standards." To a surprising extent, DSM reflects its creators' personal distaste for psychoanalysis. The result is that DSM rests on a narrow philosophical perspective. The consequences of its adoption are widespread: it has profoundly affected drug development and other therapeutic studies, psychiatric education, attitudes toward patients, the public perception of psychiatry, and administrative and legal decisions. This article explores how DSM's most problematic features arise from its history in psychiatric controversies of the 1960s and its underlying positivistic philosophy.

  7. Associations between Polygenic Risk for Psychiatric Disorders and Substance Involvement.

    Science.gov (United States)

    Carey, Caitlin E; Agrawal, Arpana; Bucholz, Kathleen K; Hartz, Sarah M; Lynskey, Michael T; Nelson, Elliot C; Bierut, Laura J; Bogdan, Ryan

    2016-01-01

    Despite evidence of substantial comorbidity between psychiatric disorders and substance involvement, the extent to which common genetic factors contribute to their co-occurrence remains understudied. In the current study, we tested for associations between polygenic risk for psychiatric disorders and substance involvement (i.e., ranging from ever-use to severe dependence) among 2573 non-Hispanic European-American participants from the Study of Addiction: Genetics and Environment. Polygenic risk scores (PRS) for cross-disorder psychopathology (CROSS) were generated based on the Psychiatric Genomics Consortium's Cross-Disorder meta-analysis and then tested for associations with a factor representing general liability to alcohol, cannabis, cocaine, nicotine, and opioid involvement (GENSUB). Follow-up analyses evaluated specific associations between each of the five psychiatric disorders which comprised CROSS-attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (AUT), bipolar disorder (BIP), major depressive disorder (MDD), and schizophrenia (SCZ)-and involvement with each component substance included in GENSUB. CROSS PRS explained 1.10% of variance in GENSUB in our sample (p cannabis use, (B) MDD PRS and severe cocaine dependence, (C) SCZ PRS and non-problem cannabis use and severe cannabis dependence, and (D) SCZ PRS and severe cocaine dependence. These results suggest that shared covariance from common genetic variation contributes to psychiatric and substance involvement comorbidity.

  8. Cognitive Behavioral Therapy in Psychiatric Nursing in Japan

    Directory of Open Access Journals (Sweden)

    Naoki Yoshinaga

    2015-01-01

    Full Text Available Psychiatric nurses have played a significant role in disseminating cognitive behavioral therapy (CBT in Western countries; however, in Japan, the application, practice, efficiency, and quality control of CBT in the psychiatric nursing field are unclear. This study conducted a literature review to assess the current status of CBT practice and research in psychiatric nursing in Japan. Three English databases (MEDLINE, CINAHL, and PsycINFO and two Japanese databases (Ichushi-Web and CiNii were searched with predetermined keywords. Fifty-five articles met eligibility criteria: 46 case studies and 9 comparative studies. It was found that CBT took place primarily in inpatient settings and targeted schizophrenia and mood disorders. Although there were only a few comparative studies, each concluded that CBT was effective. However, CBT recipients and outcome measures were diverse, and nurses were not the only CBT practitioners in most reports. Only a few articles included the description of CBT training and supervision. This literature review clarified the current status of CBT in psychiatric nursing in Japan and identified important implications for future practice and research: performing CBT in a variety of settings and for a wide range of psychiatric disorders, conducting randomized controlled trials, and establishing pre- and postqualification training system.

  9. Psychiatric manifestations of Graves' hyperthyroidism: pathophysiology and treatment options.

    Science.gov (United States)

    Bunevicius, Robertas; Prange, Arthur J

    2006-01-01

    Graves' disease is an autoimmune disorder that is the most common cause of hyperthyroidism. Other symptoms associated with the disease are goitre, ophthalmopathy, and psychiatric manifestations such as mood and anxiety disorders and, sometimes, cognitive dysfunction. Graves' hyperthyroidism may result in these latter manifestations via the induction of hyperactivity of the adrenergic nervous system. This review addresses the psychiatric presentations, and their pathophysiology and treatment, in patients with hyperthyroidism, based on literature identified by a PubMed/MEDLINE database search. Although the focus is on mental symptoms associated with Graves' disease, it is not always clear from the literature whether patients had Graves' disease: in some studies, the patients were thought to have Graves' disease based on clinical findings such as diffuse goitre or ophthalmopathy or on measurements of thyroid antibodies in serum; however, in other studies, no distinction was made between Graves' hyperthyroidism and hyperthyroidism from other causes. Antithyroid drugs combined with beta-adrenoceptor antagonists are the treatments of choice for hyperthyroidism, as well as for the psychiatric disorders and mental symptoms caused by hyperthyroidism. A substantial proportion of patients have an altered mental state even after successful treatment of hyperthyroidism, suggesting that mechanisms other than hyperthyroidism, including the Graves' autoimmune process per se and ophthalmopathy, may also be involved. When psychiatric disorders remain after restoration of euthyroidism and after treatment with beta-adrenoceptor antagonists, specific treatment for the psychiatric symptoms, especially psychotropic drugs, may be needed.

  10. [Psychological and psychiatric problems in cancer patients: relationship to the localization of the disease].

    Science.gov (United States)

    Moussas, G I; Papadopoulou, A G; Christodoulaki, A G; Karkanias, A P

    2012-01-01

    Cancer may be localized in a variety of areas in the human body. This localization is associated with significant issues concerning not only therapy and prognosis but also psychological and psychiatric problems that the patient may be confronted with. The psychic impact on the patient is determined to a significant degree by the symbolism the affected organ carries. The symbolic significance of a sick body area triggers emotions and sets in motion self-defence mechanisms. In this way, patients deal with the new psychic reality that cancer creates. Therapeutic choices may include interventions, involving mutilation, which cause disfigurement and major consequences in the body image which result in narcissistic injuries. The phenomenology of anxiety and depressive disorders is connected to the affected body area. The appearance of cancer not only in sexual organs but also in other body areas, may disturb sexual function and therefore lead to sexual disorders. Especially, head and neck are connected with vital functions. This area of the body has had a major impact on psychic reality since early life. Complicated psychic functions have developed in relation to organs of the head and neck. Therefore, localization of cancer in this area leads to individual psychological and psychiatric problems, since eating and breathing are harmed, verbal communication becomes difficult and body image alters. Also, increased incidence of alcohol and nicotine abuse in these patients reflects special aspects of psychic structure and personality. Because of severe somatic symptoms and poor prognosis, lung cancer patients feel hopelessness and helplessness. Patients with gynaecological cancer are confronted with a disease that affects organs like breast and internal female sexual organs associated with femininity, attractiveness and fertility. Dietary habits are often a source of guilt for patients who suffer from cancer of the gastrointestinal tract. Additionally, stomas, as colostomy

  11. Psychiatric trainees in Finland 2001.

    Science.gov (United States)

    Putkonen, Hanna; Holi, Matti; Kaltiala-Heino, Riittakerttu; Korkeila, Jyrki; Eronen, Markku

    2005-01-01

    This study examined Finnish psychiatric trainees' views on their education. This was a survey study of nationwide data on Finnish psychiatric trainees in 2001. The quality of training was considered at least moderate by 84% of the respondents. Training on epidemiology, on taking history and status, and on psychopharmacology was considered the best. Quality was rated bad for training in leadership and administration, and educating the community. Research was done by 20%, and a personal clinical supervisor was appointed to 52% of the respondents. Offensive treatment had been experienced by 49% of the trainees in this study. Generally, studies of training also reflect strengths and weaknesses of the profession. Based on our results, it seems especially that training in leadership and in educating the community need to be improved; both of these are quintessential skills to survive in the struggle for economic and human resources. Furthermore, treatment of the trainees could still be better; attention should be paid to supervision of all trainees. Moreover, research must become more attractive. Psychiatry can be developed by the development of psychiatric training.

  12. Prevalence of psychiatric morbidity among cancer patients – hospital-based, cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Mohan Roy Gopalan

    2016-01-01

    Full Text Available Aim: To study the prevalence of Psychiatric disorders in cancer patients and to find out the factors associated with Psychiatric disorders in Cancer Patients. Settings and Design: Department of Radiotherapy, Medical College, Thiruvananthapuram, cross sectional survey design was used. Methods and Material: Adult patients (18 years of age and above, having a diagnosis of carcinoma were selected by consecutive sampling method.A questionnaire which included back ground data, socio economic variables, treatment variables like type of malignancy, exposure to radiation & chemotherapy prior to the evaluation and current treatment, co occurring medical illness & treatment and past & family history of psychiatric illness was used to collect data. Delirium rating scale and MINI International neuropsychiatric interview were used to assess Psychiatric disorders and delirium. Statistical Analysis Used: Chi square and logistics regression tests were used for analysis. Results: Of the 384 assessed, 160(41.7% had psychiatric disorders. Adjustment disorders were seen in 22.6%. 10.9% of subjects had major depressive disorder. Thus a total of 33.5% of patients had a diagnosis of either anxiety or depressive disorder. Proportion of patients having delirium was 6.5%. Hypomania was seen in small (1.6% of patients. Multivariate analysis for various parameters for psychiatric disorders showed that age, past history of chemotherapy, past history of radiotherapy, & surgical treatment of carcinomas are significant predictors of psychiatric disorders. Conclusions: Psychiatric disorders are seen in a significant proportion of Psychiatric patients.

  13. Prevalence of psychiatric morbidity among cancer patients – hospital-based, cross-sectional survey

    Science.gov (United States)

    Gopalan, Mohan Roy; Karunakaran, Vidhukumar; Prabhakaran, Anil; Jayakumar, Krishnannair Lalithamma

    2016-01-01

    Aim: To study the prevalence of Psychiatric disorders in cancer patients and to find out the factors associated with Psychiatric disorders in Cancer Patients. Settings and Design: Department of Radiotherapy, Medical College, Thiruvananthapuram, cross sectional survey design was used. Methods and Material: Adult patients (18 years of age and above), having a diagnosis of carcinoma were selected by consecutive sampling method.A questionnaire which included back ground data, socio economic variables, treatment variables like type of malignancy, exposure to radiation & chemotherapy prior to the evaluation and current treatment, co occurring medical illness & treatment and past & family history of psychiatric illness was used to collect data. Delirium rating scale and MINI International neuropsychiatric interview were used to assess Psychiatric disorders and delirium. Statistical Analysis Used: Chi square and logistics regression tests were used for analysis. Results: Of the 384 assessed, 160(41.7%) had psychiatric disorders. Adjustment disorders were seen in 22.6%. 10.9% of subjects had major depressive disorder. Thus a total of 33.5% of patients had a diagnosis of either anxiety or depressive disorder. Proportion of patients having delirium was 6.5%. Hypomania was seen in small (1.6%) of patients. Multivariate analysis for various parameters for psychiatric disorders showed that age, past history of chemotherapy, past history of radiotherapy, & surgical treatment of carcinomas are significant predictors of psychiatric disorders. Conclusions: Psychiatric disorders are seen in a significant proportion of Psychiatric patients. PMID:28066004

  14. Race and psychiatric services in post-apartheid South Africa: a preliminary study of psychiatrists' perceptions.

    Science.gov (United States)

    Kohn, Robert; Szabo, Christopher P; Gordon, Alan; Allwood, Clifford W

    2004-03-01

    The primary objective of this study was to examine the perception of the quality of psychiatric services five years after apartheid, and specifically whether care for black patients had improved. A survey was distributed to South African psychiatrists during a national congress and by mail. The questionnaire focused on the quality of psychiatric care in general, for black and white patients, the racial composition of each respondent's psychiatric practice currently, and the racial composition of the psychiatric practice during apartheid. Psychiatric services in South Africa were viewed as deteriorating. The end of apartheid has done little to improve the quality of psychiatric care for both black and white patients. Although less pronounced, racial inequality in psychiatric care continues to exist. Psychiatric practices continue to be overrepresented with white patients. There remains a differential in quality of psychiatric care and further monitoring should continue. Continued efforts to improve racial equality and the need for greater awareness of cultural issues need to be addressed. Limitations of this study included possible social desirability bias, use of subjective rather than objective measures, and a survey that was limited in scope.

  15. Diagnosing binge eating disorder in a primary care setting.

    Science.gov (United States)

    Montano, C Brendan; Rasgon, Natalie L; Herman, Barry K

    2016-01-01

    Binge eating disorder (BED), now recognized as a distinct eating disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, is the most prevalent eating disorder. Although nearly half of individuals with BED are obese, BED also occurs in nonobese individuals. Despite the relatively high percentage of weight loss treatment-seeking individuals meeting BED criteria, primary care physicians may not be familiar with or have ever diagnosed BED. Many providers may also have difficulty distinguishing BED as a contributory factor in obesity. This review differentiates BED from other causes of obesity by describing how obese individuals with BED differ from obese individuals without BED and from nonobese individuals with BED in areas including psychopathology, behavior, genetics, physiology, quality of life and productivity. The ways in which health-care providers can identify individuals who may have BED are also highlighted so the proper course of treatment is pursued. Overall, obese individuals with BED demonstrate a number of key characteristics that differentiate them from obese individuals without eating disorders, including increased impulsivity in response to food stimuli with loss of control over eating, resulting in the consumption of more calories. They also experience significant guilt and other negative emotions following a meal. In addition, individuals with BED patients have more psychiatric comorbidity, display more psychopathology, exhibit longer binge durations, consume more meals as snacks during the day and have less dietary restraint compared with individuals with BED who are not obese. However, the differences between individuals with BED who are obese versus not obese are not as prominent. Taken together, the evidence appears to support the conclusion that BED is a unique and treatable neurobehavioral disorder associated with distinct behavioral and psychological profiles and distinct medical and functional outcomes, and that

  16. [Being personal: the development of community psychiatric mental health nursing].

    Science.gov (United States)

    Shiau, Shu-Jen; Lee, Shu-Hong

    2009-08-01

    Community psychiatric mental health nursing care emphasizes humanistic values and focuses on serving patient and family needs. In Taiwan, such care is delivered largely as part of patient discharge care plans and hospital / community based service models. Issues involved underscore the importance of operating an effective and integrated transfer system, the role and function of nurses and training in relevant competencies (Shiau, Huang & Lin, 2005). This article again emphasizes the importance of 'being personal' in the development of community psychiatric mental health nursing in Taiwan. Critical issues to consider include humanization, empowerment, nursing competencies, regulations, relating on a personal level, and facilitating empowerment and enlightenment on the healing process.

  17. The incidence and prevalence of psychiatric disorders in multiple sclerosis

    DEFF Research Database (Denmark)

    Marrie, Ruth Ann; Reingold, Stephen; Cohen, Jeffrey

    2015-01-01

    -based studies, the prevalence of anxiety was 21.9% (95% CI: 8.76%-35.0%), while it was 14.8% for alcohol abuse, 5.83% for bipolar disorder, 23.7% (95% CI: 17.4%-30.0%) for depression, 2.5% for substance abuse, and 4.3% (95% CI: 0%-10.3%) for psychosis. CONCLUSION: This review confirms that psychiatric......BACKGROUND: Psychiatric comorbidity is associated with lower quality of life, more fatigue, and reduced adherence to disease-modifying therapy in multiple sclerosis (MS). OBJECTIVES: The objectives of this review are to estimate the incidence and prevalence of selected comorbid psychiatric...... disorders in MS and evaluate the quality of included studies. METHODS: We searched the PubMed, PsychInfo, SCOPUS, and Web of Knowledge databases and reference lists of retrieved articles. Abstracts were screened for relevance by two independent reviewers, followed by full-text review. Data were abstracted...

  18. Does intuition have a role in psychiatric diagnosis?

    Science.gov (United States)

    Srivastava, Anil; Grube, Michael

    2009-06-01

    Psychiatric diagnosis is invariably guided by self-report. When such self-report is questioned, reliance on formalized testing predominates. The situation is less certain, however, when such methods and clinical "feel", or intuition, conflict. While many argue for the supremacy of actuarial methods, fields such as Management have increasingly emphasized the importance of intuition; Psychiatry, although with few objective tests and reliance on the clinical encounter, offers surprisingly few answers. We explore here the use of intuition in decision-making through a case example and suggest that it is not inferior to other diagnostic methods: intuition should be used to suggest, guide, and modify psychiatric diagnosis. Mostly, there is a need for greater discussion among Psychiatrists including consideration to the clinical, legal, and ethical implications of the use of intuition in psychiatric decision-making.

  19. Shared genetic and environmental influences on early temperament and preschool psychiatric disorders in Hispanic twins.

    Science.gov (United States)

    Silberg, Judy L; Gillespie, Nathan; Moore, Ashlee A; Eaves, Lindon J; Bates, John; Aggen, Steven; Pfister, Elizabeth; Canino, Glorisa

    2015-04-01

    Despite an increasing recognition that psychiatric disorders can be diagnosed as early as preschool, little is known how early genetic and environmental risk factors contribute to the development of psychiatric disorders during this very early period of development. We assessed infant temperament at age 1, and attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and separation anxiety disorder (SAD) at ages 3 through 5 years in a sample of Hispanic twins. Genetic, shared, and non-shared environmental effects were estimated for each temperamental construct and psychiatric disorder using the statistical program MX. Multivariate genetic models were fitted to determine whether the same or different sets of genes and environments account for the co-occurrence between early temperament and preschool psychiatric disorders. Additive genetic factors accounted for 61% of the variance in ADHD, 21% in ODD, and 28% in SAD. Shared environmental factors accounted for 34% of the variance in ODD and 15% of SAD. The genetic influence on difficult temperament was significantly associated with preschool ADHD, SAD, and ODD. The association between ODD and SAD was due to both genetic and family environmental factors. The temperamental trait of resistance to control was entirely accounted for by the shared family environment. There are different genetic and family environmental pathways between infant temperament and psychiatric diagnoses in this sample of Puerto Rican preschool age children.

  20. Psychiatric disorders revealing multiple sclerosis after 20 years of evolvement

    Directory of Open Access Journals (Sweden)

    Aicha Slassi Sennou

    2014-01-01

    Full Text Available Previous research indicates that the onset of psychiatric disorders is sometimes associated with multiple sclerosis (MS evolving several years later. However, information on why this might occur, and on the outcomes of such patients, is still lacking. We aim to discuss these limitations with the current paper. We describe a 51-year-old female who demonstrated severe anxiety disorder and depression years before developing MS neurological symptoms. The patient was treated for these psychiatric disorders over 20 years. In the last 3 years of her treatment, the patient demonstrated a choreic-type of movement disorder in all her limbs. This disorder is consistent with relapsing-remitting MS. Clinical and magnetic resonance imaging (MRI examinations demonstrated aspects of MS, without MS being diagnosed conclusively. The visual evoked potential indicated a diagnosis of conduction abnormalities. The established diagnosis was slow relapsing MS. The patient underwent methylprednisolone bolus (1 g/day. This case-study suggests that health professionals should conduct a full neurological assessment when they find atypical psychiatric symptoms in a patient. This would make sure that patients receive a better standard of care, and thus experience a better quality of life.

  1. Suicide in a large population of former psychiatric inpatients.

    Science.gov (United States)

    Sani, Gabriele; Tondo, Leonardo; Koukopoulos, Athanasios; Reginaldi, Daniela; Kotzalidis, Giorgio D; Koukopoulos, Alexia E; Manfredi, Giovanni; Mazzarini, Lorenzo; Pacchiarotti, Isabella; Simonetti, Alessio; Ambrosi, Elisa; Angeletti, Gloria; Girardi, Paolo; Tatarelli, Roberto

    2011-04-01

    The aim of this study was to identify predictors of completed suicide in a wide sample of psychiatric inpatients receiving retrospective and prospective DSM-IV diagnoses. We followed up 4441 severe psychiatric patients who were hospitalized for some time during a 35-year period in a private hospital setting. We collected sociodemographic, clinical and temperamental data. Ninety-six patients from the sample committed suicide. There were no sex differences in suicide completion and no differences between major psychiatric disorders, but people who had been hospitalized for anxiety disorders did not commit suicide and people with bipolar disorders were more likely to commit suicide than people with unipolar major depression. Shorter-term treatment with lithium and anticonvulsants, longer-term treatment with antidepressants, history of suicide attempts, suicidal thinking, and single status positively predicted completed suicide. Suicide tended to occur after a mean period of about 14 years of duration of disease. Patients' symptoms during the period preceding suicide were assessed through interviewing patients' physicians or family members. Symptoms occurring in >10% of cases were, in decreasing order, inner tension, racing/crowded thoughts, aggressive behavior, guilt, psychomotor agitation, persecutory ideation, anxiety, and hallucinations. Surprisingly, cyclothymic temperament was less associated with completed suicide as compared to other temperaments. Suicide is likely to occur in a milieu of agitation, mixed anxiety and depression, and psychosis. Longer-term mood stabilizer treatment may reduce the rate of completed suicide. © 2011 The Authors. Psychiatry and Clinical Neurosciences © 2011 Japanese Society of Psychiatry and Neurology.

  2. [Nurturance of children during inpatient psychiatric treatment of their parents].

    Science.gov (United States)

    Kölch, Michael; Schmid, Marc

    2008-01-01

    About a third of all inpatients in psychiatric hospitals are parents of children aged below 18 years. The mental illness of a parent and especially the need of inpatient treatment burdens families. This study was contributed to assess parental stress, behavioural and emotional problems of the children and the needs of psychiatric inpatients for support. Barriers and hindrances as well as positive experience with support for their children were assessed. All psychiatric hospitals in a county with about 1.5 million inhabitants in South-West Germany participated in this study. From 643 inpatients after drop-out 83 (54 female, 29 male) patients with non full aged children were questioned with inventories as the SDQ, the PSS and further assessments. Diagnoses and biographic data were assessed by the documentation of the German Association of psychiatry and psychotherapy. Parents reported about an increased level of stress by parenthood (PSS mean 41.9, SD 9.4). Psychopathology of the children influenced the stress of the mentally ill parents. 40% of the patients are dissatisfied with the care of their children during their inpatient treatment, but 51% have strong resentments against the youth welfare custodies and do not ask for support. Our results prove the high negative attitude of mentally ill parents against youth welfare service which must be reduced by active information policy and offers in collaboration with the treating psychiatrist of the parents.

  3. Identification of nursing management diagnoses.

    Science.gov (United States)

    Morrison, R S

    1997-02-01

    Theories from nursing and management provide frameworks for enhancing effectiveness of nursing management practice. The concept nursing management diagnosis has been developed by integrating nursing diagnosis and organizational diagnosis as a basis for nurse manager decision-making. Method triangulation was used to identify problems of managing nursing units, to validate those problems for relevancy to practice, to generate nursing management diagnoses, and to validate the diagnoses. Diagnoses were validated according to a definition of nursing management diagnosis provided. Of the 72 nursing management diagnoses identified, 66 were validated at a 70% level of agreement by nurse managers participating in the study.

  4. [Who is rehospitalized in a psychiatric hospital? Psychiatric hospitalization rates and social indicators in the Zurich canton (Switzerland)].

    Science.gov (United States)

    Rüesch, P; Meyer, P C; Hell, D

    2000-03-01

    There are two approaches in the research on the relation between social conditions and mental disorder: The ecological approach is concerned with characteristics of the social composition of a certain geographical area and their relation to the frequency of disorders, whereas for the individualistic view variables of the psychosocial background of the individual are of interest. This study is on the risk for psychiatric admission (first and re-admission). While considering variables of the social context of the community as well as of the background of the individual, it tries to take into account both the ecological and the individualistic view of the relationship between social conditions and (treated) mental disorder. The sample of the study includes data of 4021 psychiatric inpatients treated in 1997 in one of the seven psychiatric hospitals of the Swiss canton of Zurich as well as data of social context of the 171 communities of the canton of Zurich. The psychiatric first and re-admission rates of the community can be predicted by the following variables of its social context: 1. pro portion of foreigners, 2. urban character of the living area, 3. population density. Two other variables are of relevance only for the prediction of first admissions: 4. proportion of one-person households and 5. local tax rate. However, further results of the study show that correlations between variables of the social context and psychiatric admission rate of the community cannot be interpreted as risks for the individual.

  5. Psychiatric comorbidity among patients with hypochondriasis.

    Science.gov (United States)

    Noyes, R; Kathol, R G; Fisher, M M; Phillips, B M; Suelzer, M T; Woodman, C L

    1994-03-01

    The purpose of this study was to determine the nature and extent of comorbidity among patients with DSM-III-R hypochondriasis and to examine the relationships between this disorder and coexisting psychiatric illness. For this purpose, patients seen in a general medicine clinic were screened using measures of hypochondriacal attitudes and somatic symptoms. Those scoring above an established cutoff were given a structured diagnostic interview. In this manner, 50 patients who met DSM-III-R criteria for hypochondriasis and 50 age- and sex-matched controls were identified. The presence of other psychiatric disorders (current and past) was determined by means of the same diagnostic interview. More hypochondriacal subjects (62.0%) had lifetime comorbidity than did controls (30.0%). Major depression, the most frequent comorbid disturbance, was usually current and most often had an onset after that of hypochondriasis. Panic disorder with agoraphobia, the most frequent anxiety disorder, was also current but often began before or at the same time as hypochondriasis. Few subjects met criteria for somatization disorder but a third qualified for a subsyndromal form of this disorder. The data show that, in medical outpatients with hypochondriasis, mood and anxiety disorders frequently coexist. This comorbidity is subject to varying interpretations including overlap of symptom criteria, treatment-seeking bias, and the possibility that hypochondriasis predisposes to or causes the comorbid disorder, as seems likely in the case of depression. In some instances hypochondriasis may be an associated feature of another illness.

  6. Bullying, psychiatric pathology and suicidal behavior.

    Science.gov (United States)

    Dobry, Yuriy; Braquehais, María Dolores; Sher, Leo

    2013-01-01

    Bullying is a highly prevalent behavior which carries a significant social, medical and financial cost for its victims and perpetrators, with powerful and long-lasting psychological and social impact. Bullying has been defined as a specific form of intentional, repeated aggression, that involves a disparity of power between the victim(s) and perpetrator(s). The aggression can take physical, verbal or gestural forms. The behavior of bullying crosses sociodemographic categories of age, gender, ethnicity, level of academic achievement and professional environment. It has been abundantly observed by teachers and parents in elementary schools, but has also shown its negative presence in corporate boardrooms. The direct outcome of bullying, for both victims and perpetrators, is an increased risk of psychiatric disorders including depression, post-traumatic stress disorder, anxiety disorders, substance abuse and suicidal behavior. Cruelty (and bullying, as one of its manifestations) breaks the basis of morality. Mental health professionals usually treat the victims of those actions unfortunately long after they have been exposed to the harm. The evidence does not support the idea that the majority of cruel actions are intrinsically "pathological", in the sense of being motivated by "mental disorders". Therefore, only moral rules and legal actions - but not psychiatric or psychological interventions - may dissuade humans from this form of cruelty.

  7. Biofeedback for psychiatric disorders: a systematic review.

    Science.gov (United States)

    Schoenberg, Poppy L A; David, Anthony S

    2014-06-01

    Biofeedback potentially provides non-invasive, effective psychophysiological interventions for psychiatric disorders. The encompassing purpose of this review was to establish how biofeedback interventions have been used to treat select psychiatric disorders [anxiety, autistic spectrum disorders, depression, dissociation, eating disorders, schizophrenia and psychoses] to date and provide a useful reference for consultation by clinicians and researchers planning to administer a biofeedback treatment. A systematic search of EMBASE, MEDLINE, PsycINFO, and WOK databases and hand searches in Applied Psychophysiology and Biofeedback, and Journal of Neurotherapy, identified 227 articles; 63 of which are included within this review. Electroencephalographic neurofeedback constituted the most investigated modality (31.7%). Anxiety disorders were the most commonly treated (68.3%). Multi-modal biofeedback appeared most effective in significantly ameliorating symptoms, suggesting that targeting more than one physiological modality for bio-regulation increases therapeutic efficacy. Overall, 80.9% of articles reported some level of clinical amelioration related to biofeedback exposure, 65.0% to a statistically significant (p biofeedback interventions within mainstream psychiatry.

  8. Cross-cultural psychiatric residency training: the Oregon experience.

    Science.gov (United States)

    Boehnlein, James K; Leung, Paul K; Kinzie, John David

    2008-01-01

    The purpose of this article is to describe the goals and structure of cross-cultural psychiatric training at Oregon Health and Science University (OHSU). This training in core knowledge, skills, and attitudes of cultural psychiatry over the past three decades has included medical students, residents, and fellows, along with allied mental health personnel. The curriculum includes both didactic sessions devoted to core topics in the field and varied clinical experiences in community settings and the Intercultural Psychiatric Program under the supervision of experienced academic faculty. The authors review the central elements of the training experiences and include a detailed description of the core clinical settings and experiences. At the conclusion of their clinical experiences, trainees have specialized cross-cultural psychiatric knowledge and skills, including treatment of refugees and immigrants, sociocultural variables that influence the assessment and treatment of a wide range of psychiatric conditions, and comfort with cultural dynamics that influence both the doctor/patient relationship and collaboration with a wide range of mental health professionals. Because of rapid demographic changes in the U.S. population, providing cross-cultural training for students, residents, and fellows is an essential foundation for the education of the next generation of clinicians and health care leaders. OHSU has provided a long-term model for this training in a busy clinical and academic setting that places an emphasis on multidisciplinary and multicultural collaboration.

  9. The correlates of stress, coping styles and psychiatric morbidity in ...

    African Journals Online (AJOL)

    The correlates of stress, coping styles and psychiatric morbidity in the first year of medical education at a Nigerian University. ... African Journal of Psychiatry ... used included socio demographic, sources of stress, the general health questionnaire-12 (GHQ-12), Maslachfs burnout inventory (MBI), and Brief COPE. Data were ...

  10. Concerns and Needs of University Students with Psychiatric Disabilities.

    Science.gov (United States)

    Weiner, Enid; Weiner, Judith

    1996-01-01

    A study using individual interviews with 24 university students with psychiatric disabilities identified five areas of concern: problems with focusing attention and organization, low self-esteem, problems with trust, stigma, and high stress levels. Findings point to need for comprehensive services, including peer support group, one-to-one…

  11. Quality of psychiatric referrals to secondary-level care | Struwig ...

    African Journals Online (AJOL)

    Less than 20% of the referral letters included information on previous psychiatric consultations, current psychotropic medication, the outcome of physical examinations, and results of special investigations. Only 17 (6%) referral letters indicated a preliminary diagnosis according to an officially recognised classification system ...

  12. Afghanistan and Iraq War Veterans: Mental Health Diagnoses are Associated with Respiratory Disease Diagnoses.

    Science.gov (United States)

    Slatore, Christopher G; Falvo, Michael J; Nugent, Shannon; Carlson, Kathleen

    2018-05-01

    Many veterans of the wars in Afghanistan and Iraq have concomitant respiratory conditions and mental health conditions. We wanted to evaluate the association of mental health diagnoses with respiratory disease diagnoses among post-deployment veterans. We conducted a retrospective cohort study of all Afghanistan and Iraq War veterans who were discharged from the military or otherwise became eligible to receive Veterans Health Administration services. The primary exposure was receipt of a mental health diagnosis and the primary outcome was receipt of a respiratory diagnosis as recorded in the electronic health record. We used multivariable adjusted logistic regression to measure the associations of mental health diagnoses with respiratory diagnoses and conducted several analyses exploring the timing of the diagnoses. Among 182,338 post-deployment veterans, 14% were diagnosed with a respiratory condition, 77% of whom had a concomitant mental health diagnosis. The incidence rates were 5,363/100,000 person-years (p-y), 587/100,000 p-y, 1,450/100,000 p-y, and 233/100,000 p-y for any respiratory disease diagnosis, bronchitis, asthma, and chronic obstructive lung disease diagnoses, respectively, after the date of first Veterans Health Administration utilization. Any mental health diagnosis was associated with increased odds for any respiratory diagnosis (adjusted odds ratio 1.41, 95% confidence interval 1.37-1.46). The association of mental health diagnoses and subsequent respiratory disease diagnoses was stronger and more consistent than the converse. Many Afghanistan and Iraq War veterans are diagnosed with both respiratory and mental illnesses. Comprehensive plans that include care coordination with mental health professionals and treatments for mental illnesses may be important for many veterans with respiratory diseases.

  13. Hyperthyroidism and psychiatric morbidity: evidence from a Danish nationwide register study.

    Science.gov (United States)

    Brandt, Frans; Thvilum, Marianne; Almind, Dorthe; Christensen, Kaare; Green, Anders; Hegedüs, Laszlo; Brix, Thomas Heiberg

    2014-02-01

    Thyroid hormones are essential for the normal development of the fetal brain, while hyperthyroidism in adults is associated with mood symptoms and reduced quality of life. In this study, we aimed to investigate the association and temporal relationship between hyperthyroidism and psychiatric morbidity. Register-based nationwide cohort study. Data on hyperthyroidism and psychiatric morbidity were obtained by record linkage of the Danish National Patient Registry and the Danish National Prescription Registry. A total of 2631 hyperthyroid individuals were identified and matched 1:4 with non-hyperthyroid controls and followed for a mean duration of 6 years (range 0-13). Logistic and Cox regression models were used to assess the risk of psychiatric morbidity before and after the diagnosis of hyperthyroidism respectively. BEFORE THE DIAGNOSIS OF HYPERTHYROIDISM, SUCH INDIVIDUALS HAD AN INCREASED RISK OF BEING HOSPITALIZED WITH PSYCHIATRIC DIAGNOSES (ODDS RATIO (OR): 1.33; 95% CI: 0.98-1.80) and an increased risk of being treated with antipsychotics (OR: 1.17; 95% CI: 1.00-1.38), antidepressants (OR: 1.13; 95% CI: 1.01-1.27), or anxiolytics (OR: 1.28; 95% CI: 1.16-1.42). After the diagnosis of hyperthyroidism, there was a higher risk of being hospitalized with psychiatric diagnoses (hazard ratio (HR): 1.51; 95% CI: 1.11-2.05) and an increased risk of being treated with antipsychotics (HR: 1.46; 95% CI: 1.20-1.79), antidepressants (HR: 1.54; 95% CI: 1.36-1.74), or anxiolytics (HR: 1.47; 95% CI: 1.27-1.69). Hyperthyroid individuals have an increased risk of being hospitalized with psychiatric diagnoses and being treated with antipsychotics, antidepressants, and anxiolytics, both before and after the diagnosis of hyperthyroidism.

  14. Increasing risk of psychiatric morbidity after childhood onset type 1 diabetes

    DEFF Research Database (Denmark)

    Dybdal, Daniel; Tolstrup, Janne S; Sildorf, Stine M

    2018-01-01

    AIMS/HYPOTHESIS: The aim of this study was to investigate psychiatric morbidity following childhood onset of type 1 diabetes. METHODS: In a matched, population-based cohort study based on Danish national registers, we identified children and adolescents who had been diagnosed as an in- or outpati......AIMS/HYPOTHESIS: The aim of this study was to investigate psychiatric morbidity following childhood onset of type 1 diabetes. METHODS: In a matched, population-based cohort study based on Danish national registers, we identified children and adolescents who had been diagnosed as an in...... of psychiatric disorders as well as the effects of age at onset and duration of type 1 diabetes on the risk of subsequently developing psychiatric morbidities. RESULTS: An increased risk of being diagnosed with mood disorders and anxiety, dissociative, eating, stress-related and somatoform disorders was observed....... CONCLUSIONS/INTERPRETATION: In the years following type 1 diabetes onset, an increased risk of eating disorders, anxiety and mood disorders, substance misuse, and personality disorders was found. These findings highlight a clinical need to monitor the mental health of children and adolescents in the years...

  15. A dance movement therapy group for depressed adult patients in psychiatric outpatient clinic: Effects of the treatment

    Directory of Open Access Journals (Sweden)

    Päivi Maria Pylvänäinen

    2015-07-01

    Full Text Available AbstractWe were interested in investigating the effects of dance movement therapy (DMT in a psychiatric outpatient clinic with patients diagnosed with depression. DMT aims to engage the patients in physical and verbal exploration of their experiences generated in movement based interaction. The assumption was that DMT, which includes both physical engagement as well as emotional and social exploration, would alleviate the mood and psychiatric symptoms.All adult patients (n = 33 included in the study received treatment as usual (TAU. 21 patients participated in a 12-session DMT group intervention, and the remaining 12 patients chose to take TAU only. The majority of the patients suffered from moderate or severe depression, recurrent and/or chronic type. The effects of the interventions were investigated after the intervention, and at 3-month follow-up. Compared to the TAU, adding DMT seemed to improve the effect of the treatment. The effect of the DMT was observable whether the patient was taking antidepressant medication or not. At follow-up, between group effect sizes (ES were medium in favor for the DMT group (d= 0.60-0.79. In the DMT group, the within ES at the 3 months follow-up varied from 0.62 to 0.82 as compared to TAU 0.15 – 0.37. The results indicated that DMT is beneficial in the treatment of depressed patients.

  16. Gender Differences in Compulsive Buying Disorder: Assessment of Demographic and Psychiatric Co-Morbidities.

    Science.gov (United States)

    Nicoli de Mattos, Cristiana; Kim, Hyoun S; Requião, Marinalva G; Marasaldi, Renata F; Filomensky, Tatiana Z; Hodgins, David C; Tavares, Hermano

    2016-01-01

    Compulsive buying is a common disorder found worldwide. Although recent research has shed light into the prevalence, etiology and clinical correlates of compulsive buying disorder, less is known about gender differences. To address this empirical gap, we assessed potential gender differences in demographic and psychiatric co-morbidities in a sample of 171 compulsive buyers (20 men and 151 women) voluntarily seeking treatment in São Paulo, Brazil. A structured clinical interview confirmed the diagnosis of compulsive buying. Of the 171 participants, 95.9% (n = 164) met criteria for at least one co-morbid psychiatric disorder. The results found that male and female compulsive buyers did not differ in problem severity as assessed by the Compulsive Buying Scale. However, several significant demographic and psychiatric differences were found in a multivariate binary logistic regression. Specifically, male compulsive buyers were more likely to report being non-heterosexual, and reported fewer years of formal education. In regards to psychiatric co-morbidities, male compulsive buyers were more likely to be diagnosed with sexual addiction, and intermittent explosive disorder. Conversely, men had lower scores on the shopping subscale of the Shorter PROMIS Questionnaire. The results suggest that male compulsive buyers are more likely to present with co-morbid psychiatric disorders. Treatment planning for compulsive buying disorder would do well to take gender into account to address for potential psychiatric co-morbidities.

  17. Psychiatric Comorbidity in Depressed HIV-infected Individuals: Common and Clinically Consequential

    Science.gov (United States)

    Gaynes, Bradley N.; O'Donnell, Julie; Nelson, Elise; Heine, Amy; Zinski, Anne; Edwards, Malaika; McGuinness, Teena; Riddhi, Modi A.; Montgomery, Charita; Pence, Brian W

    2015-01-01

    Objective To report on the prevalence of psychiatric comorbidity and its association with illness severity in depressed HIV patients. Methods As part of a multi-site randomized controlled trial of depression treatment for HIV patients, 304 participants meeting criteria for current Major Depressive Disorder (MDD) were assessed for other mood, anxiety and substance use disorders with the Mini-International Neuropsychiatric Interview, a structured psychiatric diagnostic interview. We also assessed baseline adherence, risk, and health measures. Results Complicated depressive illness was common. Only 18% of participants experienced MDD with no comorbid psychiatric diagnoses; 49% had comorbid dysthymia, 62% had ≥1 comorbid anxiety disorder, and 28% had a comorbid substance use disorder. Self-reported antiretroviral adherence did not differ by the presence of psychiatric comorbidity. However, psychiatric comorbidity was associated with worse physical health and functioning: compared to those with MDD alone, individuals with ≥1 comorbidity reported more HIV symptoms (5.1 vs. 4.1, p-value=0.01), and worse mental health-related quality of life on the SF-12 (29 vs. 35, p<0.01). Conclusion For HIV patients with MDD, chronic depression and psychiatric comorbidity are strikingly common, and this complexity is associated with greater HIV disease severity and worse quality of life. Appreciating this comorbidity can help clinicians better target those at risk of harder-to-treat HIV disease, and underscores the challenge of treating depression in this population. PMID:25892152

  18. Sleep problems in children and adolescents with epilepsy: Associations with psychiatric comorbidity.

    Science.gov (United States)

    Hansen, Berit Hjelde; Alfstad, Kristin Å; van Roy, Betty; Henning, Oliver; Lossius, Morten I

    2016-09-01

    Sleep problems are common in pediatric epilepsy and may influence seizure control, daytime functioning, and overall quality of life. Knowledge of factors contributing to sleep problems is likely to improve treatment. The aim of this study was to investigate associations between psychiatric comorbidity and parent-reported and self-reported sleep problems in a sample of children and adolescents with epilepsy. Participants were children and adolescents (N=94), aged 10-19years, with generalized or focal epilepsy who had been referred to a tertiary epilepsy treatment center in Norway. Participants underwent a thorough clinical assessment and 24h of EEG registration. Information on sleep problems was obtained from parents using the Children's Sleep Habit Questionnaire (CSHQ) and from self-reporting using the Sleep Self-Report (SSR) questionnaire. Psychiatric diagnoses were established using the semistructured psychiatric interview Schedule for Affective Disorders and Schizophrenia - Present and Lifetime Version (Kiddie-SADS-PL). Both the total and subdomain CSHQ and SSR scores were high in comparison with scores from population-based samples. Having one or more psychiatric disorder(s) was significantly associated with elevated scores on both the CSHQ and the SSR. With the exception of parent-reported parasomnias, associations between sleep problems and psychiatric disorders remained significant after adjusting for relevant epilepsy variables. Psychiatric comorbidity explained about one-third of the variance of the reported sleep problems in children and adolescents with epilepsy. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Psychiatric adult-onset of urea cycle disorders: A case-series

    Directory of Open Access Journals (Sweden)

    Adrien Bigot

    2017-09-01

    Full Text Available Adult onset urea cycle disorders (UCD may present with psychiatric symptoms, occasionally as the initial presentation. We aimed to describe the characteristics of patients presenting with a psychiatric adult-onset of UCDs, to discuss which signs could suggest this diagnosis in such a situation, and to determine which tests should be conducted. A survey of psychiatric symptoms occurring in teenagers or adults with UCD was conducted in 2010 among clinicians involved in the French society for the study of inborn errors of metabolism (SFEIM. Fourteen patients from 14 to 57 years old were reported. Agitation was reported in 10 cases, perseveration in 5, delirium in 4, and disinhibition in 3 cases. Three patients had pre-existing psychiatric symptoms. All patients had neurological symptoms associated with psychiatric symptoms, such as ataxia or dysmetria, psychomotor slowing, seizures, or hallucinations. Fluctuations of consciousness and coma were reported in 9 cases. Digestive symptoms were reported in 7 cases. 9 patients had a personal history suggestive of UCD. The differential diagnoses most frequently considered were exogenous intoxication, non-convulsive status epilepticus, and meningoencephalitis. Hyperammonemia (180–600 μmol/L was found in all patients. The outcome was severe: mechanical ventilation was required in 10 patients, 5 patients died, and only 4 patients survived without sequelae. Adult onset UCDs can present with predominant psychiatric symptoms, associated with neurological involvement. These patients, as well as patients presenting with a suspicion of intoxication, must have UCD considered and ammonia measured without delay.

  20. Comparison of psychiatric morbidity in patients with irritable bowel syndrome and non-ulcer dyspepsia

    Directory of Open Access Journals (Sweden)

    Susanta Kumar Padhy

    2016-01-01

    Full Text Available Background and Aims: The present study aimed to find psychiatric morbidity, stress, anxiety, and depression in patients with irritable bowel syndrome (IBS and compare it with patients having non-ulcer dyspepsia (NUD. Methods: This case NUD study compared 50 patients each with IBS and NUD. The two groups were compared on demographic data, psychiatric diagnosis using the Structured Clinical Interview for DSM-IV Axis 1 disorders, anxiety levels using the Hamilton Anxiety Rating Scale (HAM-A, and depression using the Hamilton Depression Rating Scale (HAM-D. The Presumptive Stressful Life Events Scale (PSLES was used to measure stress. Results: The cases of IBS were more likely to be of female gender (P = 0.012, married (P = 0.009, and employed (P < 0.001. Psychiatric diagnoses were more common in the cases of IBS than NUDs (88% vs. 30%, P< 0.001, the most common being major depression and somatization disorder. Symptoms of anxiety and depression were more common in patients with IBS (P < 0.001 for HAM-A and HAM-D. Logistic regression revealed that having IBS and increased age were independent predictors of having a psychiatric diagnosis. Conclusions: IBS is associated with the considerable degree of psychiatric morbidity. Adequate attention should be paid toward comorbid psychiatric illnesses, and prompt treatment should be instituted.

  1. Improving Psychiatric Hospital Care for Pediatric Patients with Autism Spectrum Disorders and Intellectual Disabilities

    Directory of Open Access Journals (Sweden)

    Robin L. Gabriels

    2012-01-01

    Full Text Available Pediatric patients with autism spectrum disorders (ASD and/or intellectual disabilities (ID are at greater risk for psychiatric hospitalization compared to children with other disorders. However, general psychiatric hospital environments are not adapted for the unique learning styles, needs, and abilities of this population, and there are few specialized hospital-based psychiatric care programs in the United States. This paper compares patient outcomes from a specialized psychiatric hospital program developed for pediatric patients with an ASD and/or ID to prior outcomes of this patient population in a general psychiatric program at a children’s hospital. Record review data indicate improved outcomes for patients in the specialized program of reduced recidivism rates (12% versus 33% and decreased average lengths of inpatient stay (as short as 26 days versus 45 days. Available data from a subset of patients (=43 in the specialized program showed a decrease in irritability and hyperactivity behaviors from admission to discharge and that 35 previously undetected ASD diagnoses were made. Results from this preliminary study support specialized psychiatric care practices with this population to positively impact their health care outcomes.

  2. Past trauma and present functioning of patients attending a women's psychiatric clinic.

    Science.gov (United States)

    Borins, E F; Forsythe, P J

    1985-04-01

    A women's psychiatric clinic, incorporated within a university teaching general hospital and staffed entirely by women, was opened in March of 1980. The authors studied a sample of 100 women who came to the clinic and characterized them by demographic variables, psychiatric diagnoses, health problems, chronic illness, death in the family, and traumatic incidents. Death in the family before she was 18 was found to predict a woman's subsequent request for or completion of sterilization. Physical or sexual abuse was significantly related to abortion, and abortion and trauma were significantly correlated.

  3. Review of two years of experiences with SPECT among psychiatric patients in a rural hospital setting.

    Science.gov (United States)

    Sheehan, William; Thurber, Steven

    2008-09-01

    We summarize single proton emission computed tomography (SPECT) findings from 63 psychiatric patients in a small rural hospital in western Minnesota. SPECT scans were ordered only for patients in whom documentation of hypoperfusion and functional deficits might be helpful in clarifying diagnoses and treatment planning. The patients referred for SPECT scans had histories of traumatic brain injuries, atypical psychiatric symptom presentations, or conditions that were refractory to standard treatments. In the context of strict referral guidelines and close psychiatrist-radiologist collaboration, a much higher yield of significant findings was obtained compared with those noted in other reports in the literature.

  4. Chest Radiographic Findings in Newly Diagnosed Pulmonary ...

    African Journals Online (AJOL)

    Five hundred newly diagnosed cases of Pulmonary Tuberculosis were treated with directly observed short-course treatment and 100 of them had chest radiographic examination done. The various chest radiographic patterns in the 100 subjects were studied and included: Fluffy exudative changes 80(80%), fibrosis 70(70%) ...

  5. Validation of nursing management diagnoses.

    Science.gov (United States)

    Morrison, R S

    1995-01-01

    Nursing management diagnosis based on nursing and management science, merges "nursing diagnosis" and "organizational diagnosis". Nursing management diagnosis is a judgment about nursing organizational problems. The diagnoses provide a basis for nurse manager interventions to achieve outcomes for which a nurse manager is accountable. A nursing organizational problem is a discrepancy between what should be happening and what is actually happening that prevents the goals of nursing from being accomplished. The purpose of this study was to validate 73 nursing management diagnoses identified previously in 1992: 71 of the 72 diagnoses were considered valid by at least 70% of 136 participants. Diagnoses considered to have high priority for future research and development were identified by summing the mean scores for perceived frequency of occurrence and level of disruption. Further development of nursing management diagnoses and testing of their effectiveness in enhancing decision making is recommended.

  6. [Community pneumonia - fundamentals of diagnosing and treatment].

    Science.gov (United States)

    Kolek, Vítězslav

    Pneumonia is the most serious respiratory disease which causes more than 3 000 deaths per year in the Czech Republic. Community-acquired pneumonia is contracted in the ordinary life environment outside of hospitals, its development is caused by known infectious agents which mostly exhibit satisfactory sensitivity to antibiotics. Diagnosing, prevention and treatment of the disease are described including considerations of individual evaluation of the risk of complications and possible death. The strategy of administering antibiotics is discussed.Key words: antibiotics - community-acquired pneumonias - diagnosing - treatment.

  7. A pilot study: pain, fatigue and stress in maternal relatives of adolescent female psychiatric inpatients assessed for juvenile primary fibromyalgia syndrome.

    Science.gov (United States)

    Lommel, Karen; Bamford, Jaime; Jhavari, Malhar; Martin, Catherine; Crofford, Leslie

    2011-01-01

    This study was designed to assess the presence of pain and impaired functioning in the maternal relatives of adolescent females in an inpatient adolescent psychiatric population. We compared the relatives of adolescents who met the criteria for juvenile primary fibromyalgia syndrome (JPFS) to relatives of adolescents who did not meet the criteria for JPFS. A total of 55 biological maternal relatives of adolescent females admitted to a psychiatric unit were recruited to participate in the study. Participants completed four self-administered questionnaires: Multidimensional Fatigue Inventory, Fibromyalgia Impact Questionnaire, Medical Outcomes Survey (SF36v2), and the EPIFUND Health Survey. The maternal relatives of adolescents who met the criteria for JPFS did not score higher than the maternal relatives of adolescents who did not meet the criteria for JPFS. However, all maternal relatives consistently scored higher on self-reported measures of pain, impaired functioning, fatigue, and fibromyalgia symptoms than the average patient diagnosed with fibromyalgia or a chronic pain syndrome. Mood disorders and pain disorders share genetic risk factors and vulnerability. Future research is needed to further delineate other factors impacting the maternal caregivers' functioning. These could include stress associated with an adolescent child with psychiatric issues severe enough to warrant hospitalization.

  8. Meanings of well-being from the perspectives of youth recently diagnosed with psychosis.

    Science.gov (United States)

    Lal, Shalini; Ungar, Michael; Malla, Ashok; Frankish, Jim; Suto, Melinda

    2014-02-01

    The phenomenon of well-being has attracted a surge of attention in mental health policy, clinical practice and research internationally. Yet, the definitions of well-being remain elusive, and there is limited understanding on its meanings from the perspectives of youth mental health service users. This study explored the meanings of well-being from the perspectives of youth mental health service users diagnosed with psychosis in the past 3 years. Using a qualitative approach, we conducted semi-structured interviews and participant-photography elicited focus groups with 17 youth recruited from an early intervention program for psychoses and a mental health program specializing in the delivery of psychiatric services to street youth. Analysis combined the methods of constructivist grounded theory and narrative inquiry. The findings illustrate five key themes in participants' conceptualizations of well-being: multidimensionality; active oriented states; social environment; identity; and normality. Dimensions of well-being identified in participants' accounts include: psychological, physical, emotional, moral/virtuous, financial/material, spiritual, and social aspects. Our heuristic framework for conceptualizing well-being, grounded in the narrative accounts of youth participants, can inform the future planning and design of interventions, research, and outcome measures pertaining to the well-being of youth recently diagnosed with psychosis.

  9. Behind the Mask: A Psychodynamic Exploration of the Experiences of Individuals Diagnosed with Social Anxiety Disorder.

    Science.gov (United States)

    McEvoy, Beth; O'Connor, John; McCarthy, Odhran

    2016-01-01

    The diagnostic category of social anxiety disorder (SAD) is one that is widely drawn upon in mental health settings; SAD is primarily characterized by a marked fear of social performance situations and possible scrutiny by other people (American Psychiatric Association [APA], 1994, 2013). The current study aims to explore the experiences of people diagnosed with SAD. Psychoanalytically informed research interviews, drawing on psychoanalytic ideas around the parameters of engagement and levels of engagement and analysis, were carried out with 4 male and 2 female participants with diagnoses of SAD. Four themes emerged strongly, reflecting the content and process of interviews: "A Critical Voice," "A Passive Presence," "Failure to Launch," and "Behind the Mask." These emerging themes and the overall findings are conceptualized through a Winnicottian lens, emphasising the role of the good-enough mother and facilitating environment in the struggle of participants to achieve an experience of individuation as well as authenticity with others. Theoretical, clinical, and research implications are discussed, including the need for clinicians to consider the role of early parent-child dynamics and the overall home environment and what these have left in the here and now for people presenting in this way, particularly in the way services are used and the therapeutic relationship develops. Further research into underlying dynamic issues in the origins and maintenance of social anxiety is proposed.

  10. Encopresis: a guide for psychiatric nurses.

    Science.gov (United States)

    Hardy, Lyons T

    2009-10-01

    Encopresis is an elimination disorder that involves symptoms of fecal incontinence in children. It affects an estimated 1.5% to 7.5% of children ages 6 to 12 and accounts for approximately 3% to 6% of psychiatric referrals. The etiology of encopresis is thought to be related to physiologic problems such as constipation; however, it is also a psychiatric diagnosis and anecdotally may have some association with psychiatric problems. Publications on this association and publications directed toward psychiatric nurses are limited. Encopresis is typically treated with nutritional and medical management along with behavioral modification. Psychiatric nurses working with patients who have encopresis in inpatient settings will have unique concerns and challenges. This article gives an overview of published literature from the past 10 years on the etiology and treatment of encopresis. Specific suggestions for inpatient psychiatric nurses based on published literature and the author's professional experience are provided.

  11. The association of cannabis use on inpatient psychiatric hospital outcomes.

    Science.gov (United States)

    Rylander, Melanie; Winston, Helena R; Medlin, Haley; Hull, Madelyne; Nussbaum, Abraham

    2018-01-01

    The associations between cannabis use and psychosis are well documented in numerous studies. There is a need to evaluate the impact of cannabis use on inpatient psychiatric utilization and outcomes. To evaluate the impact of cannabis use on psychiatric hospital outcomes. This study was conducted between April 20, 2015 and October 20, 2015. All patients (n = 120) admitted to Denver Health with psychotic symptoms were administered a urine toxicology screening testing for the presence of 11-nor-9-carboxy-Δ 9 -tetrahydrocannabinol (THC-COOH, the active metabolite of cannabis). Patients with positive tests were compared to those with negative tests on several measures, including length of stay, presence or lack of 30-day readmission, Brief Psychotic Rating Scale (BPRS) score, and use of antipsychotics and/or sedatives/anxiolytics. There were 120 patients. Twenty nine were women and 91 were men. Patients testing positive for THC-COOH had a shorter length of stay compared to patients testing negative for THC-COOH, after adjusting for age, prior psychiatric admissions, history of a psychotic-spectrum disorder, and comorbid additional substance use (p = 0.02). There were no differences in 30-day readmissions, 30-day post-discharge presentation to the Denver Health psychiatric emergency department, BPRS scores, and medication administration. Patients presenting with psychotic symptoms and cannabis use require shorter inpatient psychiatric hospitalizations. This study is the first to quantify this observation and highlights the need for future clinical decision-making tools that would ideally correlate cannabis use with the degree of potential need for expensive and scarce mental health resources, such as psychiatric hospitalization.

  12. [Gender aspects of psychiatric publications].

    Science.gov (United States)

    Freidl, Marion; Unger, Annemarie; Vyssoki, Benjamin; Wancata, Johannes

    2010-01-01

    Are authors of German language psychiatric journals more often male or female? Are there gender differences regarding scientific topics? Analysis of publications of two German-language journals (Neuropsychiatrie, Psychiatrische Praxis) for the period 2008-2009. We could not find any gender differences concerning the number of first authors, but the number of male co-authors was nearly double as high as of female co-authors. Qualitative research methods were used more often by female researchers, but there were no significant differences regarding scientific topics. Overall, we found fewer gender differences than expected concerning authorship.

  13. Cultural relativism and psychiatric illness.

    Science.gov (United States)

    Fabrega, H

    1989-07-01

    Psychiatry has had a long-standing association with sociology and, especially, cultural anthropology. These social sciences have been influential in developing the concept of cultural relativism and applying it to psychiatry, sometimes in a challenging way and with much detriment. The concept has been used by some antipsychiatrists in attempts to discredit psychiatric practice. Contemporary psychiatrists endorsing a form of biological determinism have tended to either disregard the concept or judge it as trivial if not nonsensical. This study describes the concept of cultural relativism, reviews its applications to illness, and analyzes its implications from a historical and theoretical point of view. Its varied aspects, power, and limitations are discussed.

  14. Psychiatric specialty training in Greece.

    Science.gov (United States)

    Margariti, M; Kontaxakis, V; Ploumpidis, D

    2017-01-01

    The reform and development of psychiatric services require, in addition to financial resources, reserves in specialized human resources. The role of psychiatrists in this process, and at reducing the consequences of mental morbidity is evident. Psychiatrists are required to play a multifaceted role as clinicians, as experts in multidisciplinary team environments and as advisors in the recognition of public needs in mental health issues, as teachers and mentors for students and other health professionals, as researchers in order to enrich our knowledge in the scientific field of psychiatry, and as public health specialists in the development of the mental health services system. This multifaceted role requires the continuous education of modern psychiatrists, but above all a broad, substantial and comprehensive training regime in the initial stage of their professional career, that is to say during specialization. Training in Psychiatry, as indeed has happened in all other medical specialties, has evolved considerably in recent decades, both in the content of education due to scientific advances in the fields of neurobiology, cognitive neuroscience, genetics, psychopharmacology, epidemiology and psychiatric nosology, and also because of advances in the educational process itself. Simple apprenticeship next to an experienced clinician, despite its importance in the clinical training of young psychiatrists, is no longer sufficient to meet the increased demands of the modern role of psychiatrists, resulting in the creation of educational programs defined by setting and pursuing minimum, though comprehensive educational objectives. This development has created the global need to develop organizations intended to supervise training programs. These organizations have various forms worldwide. In the European Union, the competent supervising body for medical specialties is the UEMS (European Union of Medical Specialities) and particularly in the case of the psychiatric

  15. A proposal for including nomophobia in the new DSM-V.

    Science.gov (United States)

    Bragazzi, Nicola Luigi; Del Puente, Giovanni

    2014-01-01

    The Diagnostic and Statistical Manual of Mental Disorders (DSM) is considered to be the gold standard manual for assessing the psychiatric diseases and is currently in its fourth version (DSM-IV), while a fifth (DSM-V) has just been released in May 2013. The DSM-V Anxiety Work Group has put forward recommendations to modify the criteria for diagnosing specific phobias. In this manuscript, we propose to consider the inclusion of nomophobia in the DSM-V, and we make a comprehensive overview of the existing literature, discussing the clinical relevance of this pathology, its epidemiological features, the available psychometric scales, and the proposed treatment. Even though nomophobia has not been included in the DSM-V, much more attention is paid to the psychopathological effects of the new media, and the interest in this topic will increase in the near future, together with the attention and caution not to hypercodify as pathological normal behaviors.

  16. Psychiatric medication use before and after the onset of type 1 diabetes in children and adolescents: A population-based cohort study.

    NARCIS (Netherlands)

    Abdullah, H; Fazeli Farsani, Sulmaz; Souverein, P.C.; de Boer, A.; Mantel-Teeuwisse, Aukje K.

    2017-01-01

    BACKGROUND: Several studies showed a bidirectional association between type 2 diabetes and psychiatric disorders in adults. Because there is limited information on the association between type 1 diabetes (T1D) and psychiatric disorders (including psychiatric medication use) in children and

  17. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

    Full Text Available ... Provider Pocket Guides Provider Guides Fertility Preservation for Women Diagnosed with Cancer Fertility Preservation for Men Diagnosed ... Patient Pocket Guides Patient Guides Fertility Preservation for Women Diagnosed with Cancer Fertility Preservation for Men Diagnosed ...

  18. Neuroblastoma in Children: Just Diagnosed Information

    Science.gov (United States)

    ... Financial Reports Watchdog Ratings Feedback Contact Select Page Neuroblastoma in Children – Just Diagnosed Home > Cancer Resources > Types ... Diagnosed Just Diagnosed In Treatment After Treatment Diagnosing Neuroblastoma Depending on the location of the tumor and ...

  19. Psychiatric disorders in Norwegian 8- to 10-year-olds: an epidemiological survey of prevalence, risk factors, and service use

    DEFF Research Database (Denmark)

    Heiervang, Einar; Stormark, Kjell M; Lundervold, Astri J

    2007-01-01

    OBJECTIVE: The Bergen Child Study is a longitudinal study of child mental health from the city of Bergen, Norway. We present methods and results from the first wave of the study, focusing on prevalence of disorders, associations with risk factors, and the use of services. METHOD: The target......% of children with attention-deficit/hyperactivity disorder had been in contact with specialist mental health services, this was true for only 13% of those with pure emotional disorders. CONCLUSIONS: The overall prevalence of psychiatric disorders in children is relatively low in this Norwegian sample, when...... population included all 9,430 children attending grades 2 to 4 in Bergen schools during the academic year 2002/2003. The main screening instrument was the Strengths and Difficulties Questionnaire, whereas diagnoses were based on the Development and Well-Being Assessment. Information about child and family...

  20. Pattern of psychiatric morbidity among theft offenders remanded or referred for psychiatric evaluation and factors associated with reoffence.

    Science.gov (United States)

    Chan, Lai Gwen; Bharat, Saluja; Dani, Dhaval Kirti

    2013-06-01

    In Singapore, theft and related crimes constitute more than 50% of all reported crime, and are the most common offences committed by accused persons remanded to the Institute of Mental Health (IMH), Singapore. There is a need for better understanding of the forensic psychiatric aspects of such offenders. This study aimed to determine the prevalence of psychiatric disorders among theft offenders remanded or referred for forensic assessment in 2010, compare the differences between first-time and repeat theft offenders, and identify the factors associated with reoffence. Forensic evaluations of inpatient and outpatient theft offenders that were conducted at IMH in the year 2010 were retrieved and reviewed. The sociodemographic and clinical data of first-time and repeat theft offenders were collected and compared using Student's t-test and chi-square test for continuous and categorical variables, respectively. Multivariate regression was used to identify the factors that were predictive of repeat offence. Overall, 10% of offenders had no mental illness. Substance use disorders, mood disorders and psychotic disorders were the most common diagnoses. Psychotic disorders were significantly less common in repeat offenders. Repeat offenders also tended to have a history of conduct problems in childhood. Noncompliance with psychiatric treatment was positively associated with repeat offence, while psychotic disorders were negatively associated. The pattern of psychiatric morbidity among theft offenders in Singapore has changed over the last ten years. Kleptomania remains rare. Significant differences between first-time and repeat offenders have implications on the treatment, follow-up and rehabilitation of theft offenders in Singapore.

  1. Psychiatric disorders among infertile men and women attending three infertility clinics in Riyadh, Saudi Arabia.

    Science.gov (United States)

    Alosaimi, Fahad Dakheel; Altuwirqi, Maram Hani; Bukhari, Mujahid; Abotalib, Zeinab; BinSaleh, Saleh

    2015-01-01

    No study has assessed psychiatric disorders among infertile men and women seeking fertility treatment in Saudi Arabia. Therefore, we sought to measure the rate of psychiatric disorders in this population. This was a cross-sectional observational study among patients attending infertility clinics at three referral hospitals in Riyadh, Saudi Arabia, between January 2013 and September 2014. 406 patients (206 women and 200 men) participated in the study. The approved Arabic version of the MINI tool was used to assess 18 common psychiatric illnesses. The response rate was 81%. Of the men surveyed, only 4.5% self-reported having a psychiatric disorder. Of the women surveyed, only 10.2% reported having a psychiatric disorder. However, using the MINI scale, psychiatric illness was documented in 30% of males and 36.9% of females. The most common diagnoses for both genders were depression (21.7%) and anxiety (21.2%). Significantly more females than males exhibited suicidality and depression. In contrast, significantly more males than females had bipolar disorders and substance-related disorders. A low monthly income among male and female participants and polygamy among female participants were significantly associated with psychiatric disorders. This study shows that a higher prevalence of psychiatric disorders, particularly depression and anxiety, among infertile men and women in Saudi Arabia is associated with lower income and polygamy. This study highlights the importance of integrated care for alleviating the psychological burden of this unfortunate population and improving outcomes and quality of life. This study also encourages follow-up studies that aim to further understand the complex relationship between fertility and psychological well-being.

  2. Influence of psychiatric diagnosis on treat