Assesment of psychiatric symptoms and co-morbidities in patients with irritable bowel syndrome.

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Sertbas, Y; Belli, H; Piskinpasa, N; Ural, C; Akbudak, M; Sertbas, M; Oncu, F

2012-08-01

To determine the psychiatric symptom assessment of patients seeking treatment for irritable bowel syndrome (IBS) and to demonstrate the presence of more complicated psychiatric disorders. The participants were recruited from patients who were attending internal medicine and gastroenterology clinics and who fullfilled the Rome III criteria for IBS. Fifty patients with IBS (IBS group) and 50 patients with complaints other than gastrointestinal symptoms (control group) were randomly selected. All participants were screened by the Structured Clinical Interview for DSM-IV (SCID-I), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Symptom Check list - 90 (Revised) [SCL-90-R]. Seventeen patients (34%) and three control subjects (6%) had at least one psychiatric diagnosis (p = 0.001). Global severity index (GSI) total scores and SCL-90-R items were significantly higher in the IBS group than the control group (0.92 +/- 0.46 vs 0.358 +/- 0.19, p IBS group than the control group (p disorders diagnosed with SCID-I were significantly higher in the IBS group (34% vs 6%) [p = 0.001]. Among the Axis-I disorders, somatoform and anxiety disorders were higher in the patient group than in the control subjects (p = 0.002 and p = 0.0057) whereas there was no difference for mood disorders (p = 0.204). Seven (14%) of the patients and two (4%) of the control subjects had at least one Axis-II psychiatric disorder diagnosed with SCID-II without any significance (p = 0.159). These findings suggest that except for mood and personality disorders, almost all psychiatric symptoms and disease co-morbities with IBS are higher than in the sample without IBS. We can easily use SCL-90-R, BAI and BDI in internal medicine and gastroenterology clinics to detect psychiatric symptom levels and then to refer patients to a psychiatrist for further evaluation and treatment.

Psychiatric symptoms in patients with sporadic Creutzfeldt-Jakob disease in Germany.

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Krasnianski, Anna; Bohling, Geeske T; Harden, Markus; Zerr, Inga

2015-09-01

Psychiatric symptoms in sporadic Creutzfeldt-Jakob disease (sCJD) are still not sufficiently evaluated. To describe psychiatric symptoms in sCJD with respect to molecular subtype. Patients in this retrospective study were classified according to established diagnostic criteria. 248 sCJD patients with known molecular subtype were recruited from January 1993 to December 2004 and investigated. Psychiatric symptoms were defined according to Möller and colleagues and the AMDP system (Study Group for Methods and Documentation in Psychiatry) and were collected by direct examination by study physicians or extracted from medical documentation. Our data were compared with published data on variant CJD (vCJD). Psychiatric symptoms were common in sCJD patients (90%) and mostly found already at the disease onset (agitation in 64% of the patients, hallucinations in 45%, anxiety in 50%, depression in 37%). All psychiatric symptoms but illusions were found early in the disease course. Psychiatric symptoms in sCJD were less frequent than in vCJD. We provide the first detailed analysis of psychiatric symptoms in a large group of patients with sCJD with respect to differences concerning frequency and time point of occurrence of psychiatric symptoms between molecular subtypes. These data suggest that psychiatric symptoms occurring early in the disease course are common not only in vCJD but also in other CJD types. © Copyright 2015 Physicians Postgraduate Press, Inc.

Effect of Rivastigmine on Behavioral and Psychiatric Symptoms of Parkinson’s Disease Dementia

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Yoon-Sang Oh

2015-05-01

Full Text Available Objective A recent study showed that rivastigmine and memantin improved behavioral and psychiatric symptoms of dementia (BPSD in Alzheimer’s dementia. Furthermore, according to recent guidelines presented by the Movement Disorder Society, rivastigmine is efficacious for the treatment of dementia in Parkinson’s disease (PD. We investigated the efficacy of rivastigmine for BPSD in patients with Parkinson’s disease dementia (PDD. Methods Twenty-three patients in whom cognitive impairment occurred at least one year after a diagnosis of PD participated in this open-label trial. Cognitive, psychiatric, and motor symptoms were assessed before and after 24 weeks of treatment with rivastigmine using unstructured clinical assessments and rating scales including the Unified Parkinson’s Disease Rating Scale, Mini-Mental State Examination (MMSE, and the Neuropsychiatric Inventory. Results Age (± standard deviation was 74.7 ± 5.9 years, average duration of PD was 3.5 ± 3.7 years, Hoehn and Yahr scores were 2.2 ± 0.8, and baseline MMSE scores were 19.1 ± 4.2. Improvements in global mental symptoms and neuropsychiatric symptoms were significant; among them, hallucination, depression and appetite changes improved. Caregiver distress significantly decreased, including distress resulting from hallucinations, depression, apathy, and appetite changes. Conclusions Although controlled trials are required, the findings suggest that rivastigmine is useful for control of several neuropsychiatric symptoms and beneficial for caregiver distress in patients with PDD.

The profile of psychiatric symptoms exacerbated by methamphetamine use.

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McKetin, Rebecca; Dawe, Sharon; Burns, Richard A; Hides, Leanne; Kavanagh, David J; Teesson, Maree; McD Young, Ross; Voce, Alexandra; Saunders, John B

2016-04-01

Methamphetamine use can produce symptoms almost indistinguishable from schizophrenia. Distinguishing between the two conditions has been hampered by the lack of a validated symptom profile for methamphetamine-induced psychiatric symptoms. We use data from a longitudinal cohort study to examine the profile of psychiatric symptoms that are acutely exacerbated by methamphetamine use. 164 methamphetamine users, who did not meet DSM-IV criteria for a lifetime primary psychotic disorder, were followed monthly for one year to assess the relationship between days of methamphetamine use and symptom severity on the 24-item Brief Psychiatric Rating Scale. Exacerbation of psychiatric symptoms with methamphetamine use was quantified using random coefficient models. The dimensions of symptom exacerbation were examined using principal axis factoring and a latent profile analysis. Symptoms exacerbated by methamphetamine loaded on three factors: positive psychotic symptoms (suspiciousness, unusual thought content, hallucinations, bizarre behavior); affective symptoms (depression, suicidality, guilt, hostility, somatic concern, self-neglect); and psychomotor symptoms (tension, excitement, distractibility, motor hyperactivity). Methamphetamine use did not significantly increase negative symptoms. Vulnerability to positive psychotic and affective symptom exacerbation was shared by 28% of participants, and this vulnerability aligned with a past year DSM-IV diagnosis of substance-induced psychosis (38% vs. 22%, χ(2)(df1)=3.66, p=0.056). Methamphetamine use produced a symptom profile comprised of positive psychotic and affective symptoms, which aligned with a diagnosis of substance-induced psychosis, with no evidence of a negative syndrome. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Psychiatric symptoms of patients with primary mitochondrial DNA disorders

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Inczedy-Farkas Gabriella

2012-02-01

Full Text Available Abstract Background The aim of our study was to assess psychiatric symptoms in patients with genetically proven primary mutation of the mitochondrial DNA. Methods 19 adults with known mitochondrial mutation (MT have been assessed with the Stanford Health Assessment Questionnaire 20-item Disability Index (HAQ-DI, the Symptom Check List-90-Revised (SCL-90-R, the Beck Depression Inventory-Short Form (BDI-SF, the Hamilton Depression Rating Scale (HDRS and the clinical version of the Structured Clinical Interview for the the DSM-IV (SCID-I and SCID-II As control, 10 patients with hereditary sensorimotor neuropathy (HN, harboring the peripheral myelin protein-22 (PMP22 mutation were examined with the same tools. Results The two groups did not differ significantly in gender, age or education. Mean HAQ-DI score was 0.82 in the MT (range: 0-1.625 and 0.71 in the HN group (range: 0-1.625. Level of disability between the two groups did not differ significantly (p = 0.6076. MT patients scored significantly higher on the BDI-SF and HDRS than HN patients (12.85 versus 4.40, p = 0.031, and 15.62 vs 7.30, p = 0.043, respectively. The Global Severity Index (GSI of SCL-90-R also showed significant difference (1.44 vs 0.46, p = 0.013 as well as the subscales except for somatization. SCID-I interview yielded a variety of mood disorders in both groups. Eight MT patient (42% had past, 6 (31% had current, 5 (26% had both past and current psychiatric diagnosis, yielding a lifetime prevalence of 9/19 (47% in the MT group. In the HN group, 3 patients had both past and current diagnosis showing a lifetime prevalence of 3/10 (30% in this group. SCID-II detected personality disorder in 8 MT cases (42%, yielding 3 avoidant, 2 obsessive-compulsive and 3 personality disorder not otherwise specified (NOS diagnosis. No personality disorder was identified in the HN group. Conclusions Clinicians should be aware of the high prevalence of psychiatric symptoms in patients with

Psychiatric Symptoms in Alpha-Mannosidosis

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Malm, D.; Pantel, J.; Linaker, O. M.

2005-01-01

Alpha-mannosidosis is characterized by mild to moderate intellectual disability (ID), moderate to severe neurosensory hearing loss, frequent infections, psychomotor disturbances and skeletal dysmorphism. For the first time, a panel of nine alpha-mannosidosis patients with psychiatric symptoms is presented. The clinical picture has several…

Effects of Psychiatric Symptoms on Attention in North Korean Refugees.

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Lee, Yu Jin; Jun, Jin Yong; Park, Juhyun; Kim, Soohyun; Gwak, Ah Reum; Lee, So Hee; Yoo, So Young; Kim, Seog Ju

2016-09-01

We investigated the performance of North Korean refugees on attention tasks, and the relationship between that performance and psychiatric symptoms. Sustained and divided attention was assessed using the computerized Comprehensive Attention Test in North Korean refugees and in South Koreans. All participants also completed the Beck Depression Inventory, the Beck Anxiety Inventory, the Impact of Event Scale-Revised and the Dissociative Experiences Scale-II (DES-II). The North Korean refugees showed slower reaction times (RTs) on the visual sustained attention task compared to the South Koreans after controlling for age and sex. North Korean refugees had a greater number of omission errors (OEs) on the divided attention task and a higher standard deviation (SD) of RT. Total DES-II scores of the North Korean refugees were associated with the number of OEs and the SD of RT on the sustained attention task, and with the number of OEs on the divided attention task. North Korean refugees showed poorer performance on computerized attention tasks. In addition, attention deficit among North Korean refugees was associated with their dissociative experiences. Our results suggest that refugees may have attention deficits, which may be related to their psychiatric symptoms, particularly dissociation.

Defense styles explain psychiatric symptoms: an empirical study.

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Holi, M M; Sammallahti, P R; Aalberg, V A

1999-11-01

To examine the relation between psychiatric symptoms and defense mechanisms, we administered two questionnaires, the Symptom Check-list 90 (SCL-90) and the Defense Style Questionnaire (DSQ) to 122 psychiatric out-patients and to a community sample of 337 subjects. Using regression analysis, we found that 51.8% of the variation in subject's Global Severity Index value could be explained by his defense style. Of the three defense styles, the immature style explained most of the variation in the symptoms. We found little overall evidence for specific connections between particular defenses and symptoms. Projection and dissociation were central in most of the symptom dimensions. We compared patients and controls with the same level of general symptom severity and found that patients used significantly more devaluation and splitting, and controls used significantly more altruism and idealization. Whether defenses predispose to certain symptomatology or are one of its aspects is discussed.

Occurrence of post traumatic stress symptoms and their relationship to professional quality of life (ProQoL) in nursing staff at a forensic psychiatric security unit: a cross-sectional study

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Lauvrud, Christian; Nonstad, Kåre; Palmstierna, Tom

2009-01-01

Background Violence is frequent towards nurses in forensic mental health hospitals. Implications of this high risk environment have not been systematically explored. This paper explores occurrence of symptoms on post traumatic stress and their relationship to professional quality of life. Methods Self report questionnaires assessing symptoms of post traumatic stress and professional quality of life were distributed among psychiatric nurses in a high security forensic psychiatric unit with high frequency of violent behaviour. Relationships between post traumatic stress symptoms, forensic nursing experience, type of ward and compassion satisfaction, burnout and compassion fatigue were explored. Results The prevalence of post traumatic stress symptoms was low. Low scores were found on compassion satisfaction. Length of psychiatric nursing experience and low scores on compassion satisfaction were correlated to increased post traumatic stress symptoms. Conclusion Although high violence frequency, low rate of post traumatic stress symptoms and low compassion satisfaction scores was found. High staff/patient ratio and emotional distance between staff and patients are discussed as protective factors. PMID:19371413

Improvement of psychiatric symptoms in youth following resolution of sinusitis.

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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.

Psychiatric disorders and symptoms severity in pre-school children with cow's milk allergy.

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

2016-01-01

Psychiatric disorders are seen frequently in atopic diseases. The present study aims to evaluate the frequency of psychiatric disorders and the severity of psychiatric symptoms in pre-school children with cow's milk allergy. The parents of the pre-school children with cow's milk allergy were interviewed in person and asked to fill out the Early Childhood Inventory-4 form. The cow's milk allergy group included 40 children (27 male, 13 female) with mean age, 44.5±14.7 months, and the control group included 41 children (25 male, 16 female) with mean age, 47.6±15.2 months. It was established that 65% of the group with cow's milk allergy received at least one psychiatric diagnosis, while 36.6% of the control group received at least one psychiatric diagnosis, with a statistically significant difference (p=0.02). Within the psychiatric disorders, attention deficit hyperactivity disorders (odds ratio: 4.9, 95% CI: 1.472-16.856, p=0.006), oppositional defiant disorder (odds ratio: 5.6, 95% CI: 1.139-28.128, p=0.026), and attachment disorder (odds ratio: 4.8, 95% CI: 1.747-13.506, p=0.004) were found significantly higher compared with the healthy control group. When the groups were compared in terms of psychiatric symptom severity scores, calculated by using the Early Childhood Inventory-4 form, attention deficit hyperactivity disorders severity (p=0.006) and oppositional defiant disorder severity (p=0.037) were found to be higher in the cow's milk allergy group. Psychiatric disorders are frequent and severe in pre-school children with cow's milk allergy. Copyright © 2016 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

Psychiatric Symptoms in Children with Gross Motor Problems

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Emck, Claudia; Bosscher, Ruud J.; van Wieringen, Piet C. W.; Doreleijers, Theo; Beek, Peter J.

2012-01-01

Children with psychiatric disorders often demonstrate gross motor problems. This study investigates if the reverse also holds true by assessing psychiatric symptoms present in children with gross motor problems. Emotional, behavioral, and autism spectrum disorders (ASD), as well as psychosocial problems, were assessed in a sample of 40 children…

Creutzfeldt-Jakob Disease and Psychiatric Symptoms

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Soner Cakmak

2013-08-01

Full Text Available Creutzfeldt-Jakob disease is a rapidly progressive, degenerative slow virus infection disease of central nervous system. Based on etiologic origins, four different Creutzfeldt-Jakob disease subtypes have been identified: sporadic, genetic, iatrogenic and variant. The clinical course generally begin with apathy, irritability, behavioral changes, speech problems, memory deterioration, rapidly progresses and concludes with death over a period of 3-12 months. Symptoms are observed secondary to brain cortex, cerebellum, corticospinal tracts, spinal anterior horn cells and basal ganglia damage. Unusual (%5-10 cases can survive up to 2 years. The initial symptoms of disease can be sudden which resultsin adjustment problems leading patients to seek psychiatric help. Patients could receive different diagnosis such as psychosis, depression with psychotic features, and treatments at this stages. Early diagnosis is crucial because of management of the disease and treatment approaches. In this article diagnosis and clinical features of Creutzfeldt-Jakob Disease and related psychiatric symptoms have been briefly reviewed. [Archives Medical Review Journal 2013; 22(4.000: 631-643

Psychiatric Symptoms in Adults with Down Syndrome and Alzheimer's Disease

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Urv, Tiina K.; Zigman, Warren B.; Silverman, Wayne

2010-01-01

Changes in psychiatric symptoms related to specific stages of dementia were investigated in 224 adults 45 years of age or older with Down syndrome. Findings indicate that psychiatric symptoms are a prevalent feature of dementia in the population with Down syndrome and that clinical presentation is qualitatively similar to that seen in Alzheimer's…

Abnormal regional cerebral blood flow in systemic lupus erythematosus patients with psychiatric symptoms.

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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.

Occurrence of post traumatic stress symptoms and their relationship to professional quality of life (ProQoL in nursing staff at a forensic psychiatric security unit: a cross-sectional study

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Nonstad Kåre

2009-04-01

Full Text Available Abstract Background Violence is frequent towards nurses in forensic mental health hospitals. Implications of this high risk environment have not been systematically explored. This paper explores occurrence of symptoms on post traumatic stress and their relationship to professional quality of life. Methods Self report questionnaires assessing symptoms of post traumatic stress and professional quality of life were distributed among psychiatric nurses in a high security forensic psychiatric unit with high frequency of violent behaviour. Relationships between post traumatic stress symptoms, forensic nursing experience, type of ward and compassion satisfaction, burnout and compassion fatigue were explored. Results The prevalence of post traumatic stress symptoms was low. Low scores were found on compassion satisfaction. Length of psychiatric nursing experience and low scores on compassion satisfaction were correlated to increased post traumatic stress symptoms. Conclusion Although high violence frequency, low rate of post traumatic stress symptoms and low compassion satisfaction scores was found. High staff/patient ratio and emotional distance between staff and patients are discussed as protective factors.

Automatic mining of symptom severity from psychiatric evaluation notes.

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Karystianis, George; Nevado, Alejo J; Kim, Chi-Hun; Dehghan, Azad; Keane, John A; Nenadic, Goran

2018-03-01

As electronic mental health records become more widely available, several approaches have been suggested to automatically extract information from free-text narrative aiming to support epidemiological research and clinical decision-making. In this paper, we explore extraction of explicit mentions of symptom severity from initial psychiatric evaluation records. We use the data provided by the 2016 CEGS N-GRID NLP shared task Track 2, which contains 541 records manually annotated for symptom severity according to the Research Domain Criteria. We designed and implemented 3 automatic methods: a knowledge-driven approach relying on local lexicalized rules based on common syntactic patterns in text suggesting positive valence symptoms; a machine learning method using a neural network; and a hybrid approach combining the first 2 methods with a neural network. The results on an unseen evaluation set of 216 psychiatric evaluation records showed a performance of 80.1% for the rule-based method, 73.3% for the machine-learning approach, and 72.0% for the hybrid one. Although more work is needed to improve the accuracy, the results are encouraging and indicate that automated text mining methods can be used to classify mental health symptom severity from free text psychiatric notes to support epidemiological and clinical research. © 2017 The Authors International Journal of Methods in Psychiatric Research Published by John Wiley & Sons Ltd.

Psychiatric and addictive symptoms of young adult female indoor tanners.

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Heckman, Carolyn J; Cohen-Filipic, Jessye; Darlow, Susan; Kloss, Jacqueline D; Manne, Sharon L; Munshi, Teja

2014-01-01

Indoor tanning (IT) increases risk for melanoma and is particularly common among young adult women. IT has also been linked with some psychiatric symptoms, and frequent tanning may indicate tanning dependence (addiction) associated with endorphin release during ultraviolet radiation exposure. The objective of the current study was to investigate associations between IT, tanning dependence, and psychiatric and substance use symptoms in young adult women. Cross-sectional survey and psychiatric interview. Online, except for the Mini International Neuropsychiatric Interview (MINI), which was completed over the telephone. Participants were 306 female university students aged 18 to 25 years. MINI, Seasonal Scale Index, tanning dependence scales, reporting ever having used a tanning bed or booth with tanning lamps (single item), reporting smoking a cigarette in the last 30 days (single item). Descriptive statistics, χ(2) analysis, multivariate logistic regression. Forty-six percent of the sample reported a history of IT, and 25% were classified as tanning dependent. Multivariate logistic regression analyses showed that IT was significantly associated with symptoms of alcohol use disorders, generalized anxiety, and not having social anxiety. Tanning dependence was associated with symptoms of alcohol use disorders. Tanning is of concern not only for its association with skin cancer but for its association with psychiatric and substance use symptoms. Young women with certain psychological problems may seek relief from their symptoms by IT. These findings suggest that indoor tanners may benefit from health behavior and other psychosocial interventions.

Mood changes after indoor tanning among college women: associations with psychiatric/addictive symptoms

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Carolyn Heckman

2016-06-01

Full Text Available Indoor tanning (IT has been linked with psychiatric and addictive symptoms, and frequent tanning may indicate tanning dependence (addiction. The current study evaluated the effects of an IT episode on mood states and the association of these effects with psychiatric and addictive symptoms among young adult female indoor tanners. One-hundred thirty-nine female university students aged 18-25 years who had indoor tanned completed an online survey including the Positive and Negative Affects Scales and a standardized psychiatric interview (the MINI International Neuropsychiatric Interview via telephone. Psychiatric and addictive symptoms were relatively common among these young adult female indoor tanners. Overall, participants reported significant decreases in both negative (upset, scared, irritable, nervous, jittery, afraid and positive (feeling interested mood states after their most recent tanning episode. Multivariable linear regression analyses showed that more frequent indoor tanning in the past month and symptoms of illicit drug use disorders were associated with decreases in negative mood, and symptoms of generalized anxiety disorder were associated with a decrease in feeling interested. In summary, indoor tanners report relatively high rates of psychiatric and substance use symptoms, including symptoms of tanning dependence, and indoor tanning appears to alter mood. Women with certain substance use and psychiatric characteristics may be more vulnerable to such mood changes after tanning indoors. Further research is needed to clarify the relationships among these variables.

Assessment of lower urinary tract symptoms in men by international prostate symptom score and core lower urinary tract symptom score.

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Fujimura, Tetsuya; Kume, Haruki; Nishimatsu, Hiroaki; Sugihara, Toru; Nomiya, Akira; Tsurumaki, Yuzuri; Miyazaki, Hideyo; Suzuki, Motofumi; Fukuhara, Hiroshi; Enomoto, Yutaka; Homma, Yukio

2012-05-01

Study Type - Therapy (symptom prevalence). Level of Evidence 2a. What's known on the subject? and What does the study add? The International Prostate Symptom Score (IPSS) has been most commonly used for the symptom assessment of men with lower urinary tract symptoms (LUTS). However, LUTS in men are so variable that they may not be fully captured by the IPSS questionnaire alone. This study has demonstrated that the Core Lower Urinary Tract Symptom Score (CLSS) questionnaire, which addresses 10 important symptoms, is an appropriate initial assessment tool for LUTS in men with various diseases/conditions. International Prostate Symptom Score (IPSS) has been commonly used to assess lower urinary tract symptoms (LUTS). We have recently developed Core Lower Urinary Tract Symptom Score (CLSS). The aim of this study is to compare IPSS and CLSS for assessing LUTS in men.  Consecutive 515 men fulfilled IPSS and CLSS questionnaires. IPSS QOL Index was used as the QOL surrogate. The clinical diagnoses were BPH (n = 116), BPH with OAB wet (n =80), prostate cancer (n = 128), prostatitis (n = 68), underactive bladder (n = 8), others (n = 72), and controls (e.g., occult blood) (n = 42). Simple statistics and predictability of poor QOL (QOL Index 4 or greater) were examined. All symptom scores were significantly increased in symptomatic men compared with controls. Scores of corresponding symptoms of two questionnaires were significantly correlated (r = 0.58-0.85, all P incontinence, slow stream, straining, incomplete emptying, bladder pain and urethral pain) as independent factors. The hazard ratios for bladder pain (2.2) and urgency incontinence (2.0) were among the highest. All the nine symptoms are addressed in CLSS, while three symptoms (urgency incontinence, bladder, and urethral pain) are dismissed in IPSS. CLSS questionnaire is more comprehensive than IPSS questionnaire for symptom assessment of men with various diseases/conditions, although both questionnaires can capture

Reducing severity of comorbid psychiatric symptoms in an epilepsy clinic using a colocation model: results of a pilot intervention.

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Chen, Jasper J; Caller, Tracie A; Mecchella, John N; Thakur, Devendra S; Homa, Karen; Finn, Christine T; Kobylarz, Erik J; Bujarski, Krzysztof A; Thadani, Vijay M; Jobst, Barbara C

2014-10-01

Patients with epilepsy (PWEs) and patients with nonepileptic seizures (PWNESs) constitute particularly vulnerable patient populations and have high rates of psychiatric comorbidities. This potentially decreases quality of life and increases health-care utilization and expenditures. However, lack of access to care or concern of stigma may preclude referral to outpatient psychiatric clinics. Furthermore, the optimal treatment for NESs includes longitudinal psychiatric management. No published literature has assessed the impact of colocated psychiatric services within outpatient epilepsy clinics. We, therefore, evaluated the colocation of psychiatric services within a level 4 epilepsy center. From July 2013 to June 2014, we piloted an intervention to colocate a psychiatrist in the Dartmouth-Hitchcock Epilepsy Center outpatient clinic one afternoon a week (0.1 FTE) to provide medication management and time-limited structural psychotherapeutic interventions to all patients who scored greater than 15 on the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) and who agreed to referral. Psychiatric symptom severity was assessed at baseline and follow-up visits using validated scales including NDDI-E, Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and cognitive subscale items from Quality of Life in Epilepsy-31 (QOLIE-31) scores. Forty-three patients (18 males; 25 females) were referred to the clinic over a one-year interval; 27 (64.3%) were seen in follow-up with a median of 3 follow-up visits (range: 1 to 7). Thirty-seven percent of the patients had NESs exclusive of epilepsy, and 11% of the patients had dual diagnosis of epilepsy and NESs. Psychiatric symptom severity decreased in 84% of the patients, with PHQ-9 and GAD-7 scores improving significantly from baseline (4.6±0.4 SD improvement in PHQ-9 and 4.0±0.4 SD improvement in GAD-7, p-valuesintegrated models of collaborative and colocated care are becoming more

Correlations between caregiver psychiatric symptoms and offspring psychopathology in a low-resource setting

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Camila T. Matsuzaka

2017-07-01

Full Text Available Objective: Associations between parental/caregiver depression and adverse child outcomes are well established and have been described through one or more mechanisms: child psychopathology following exposure to a depressed caregiver, child psychopathology exacerbating a caregiver’s depression, and caregiver and offspring depression sharing the same etiology. Data from low and middle-income countries is scarce. We examined correlations between common symptoms of mental disorders in caregivers and their offspring’s psychopathology in a Brazilian sample. Methods: In this cross-sectional study, adult caregivers were screened for depression during routine home visits by community health workers as part of the Brazilian Family Health Strategy. Caregivers with suspected depression were assessed using the Zung Self-Rating Depression Scale and the Self-Reporting Questionnaire (SRQ-20. Children’s symptoms were evaluated using the Strengths and Difficulties Questionnaire (SDQ. Results: The sample included 68 primary caregivers and 110 children aged 6 to 15 years. Higher caregiver scores on the SRQ-20 correlated significantly with psychiatric symptoms in offspring. Conclusion: These results substantiate our hypothesis that child psychopathology correlates with caregivers’ psychiatric symptoms. This paper adds to the growing literature on community mental health assessment and can help guide future strategies for reducing the burden of common mental disorders in caregivers and children alike in low and middle-income countries.

Development of a scale to measure symptoms of anxiety and depression in the general UK population: the psychiatric symptom frequency scale.

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Lindelow, M; Hardy, R; Rodgers, B

1997-01-01

OBJECTIVES: The psychiatric symptom frequency (PSF) scale was developed to assess symptoms of anxiety and depression (i.e. affective symptoms) experienced over the past year in the general population. This study aimed to examine the distribution of PSF scores, internal consistency, and factor structure and to investigate relationships between total scores for this scale and other indicators of poor mental health. PARTICIPANTS: The Medical Research Council national survey of health and development, a class stratified cohort study of men and women followed up from birth in 1946, with the most recent interview at age 43 when the PSF scale was administered. MAIN RESULTS: The PSF scale showed high internal consistency between the 18 items (Cronbach's alpha = 0.88). Ratings on items of the scale reflected one predominant factor, incorporating both depression and anxiety, and two additional factors of less statistical importance, one reflecting sleep problems and the other panic and situational anxiety. Total scores were calculated by adding 18 items of the scale, and high total scores were found to be strongly associated with reports of contact with a doctor or other health professional and use of prescribed medication for "nervous or emotional trouble or depression," and with suicidal ideas. CONCLUSIONS: The PSF is a useful and valid scale for evaluating affective symptoms in the general population. It is appropriate for administration by lay interviewers with minimal training, is relatively brief, and generates few missing data. The total score is a flexible measure which can be used in continuous or binary form to suit the purposes of individual investigations, and provides discrimination at lower as well as upper levels of symptom severity. PMID:9425466

The structure of common psychiatric symptoms: how many dimensions of neurosis?

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Ormel, J; Oldehinkel, A J; Goldberg, D P; Hodiamont, P P; Wilmink, F W; Bridges, K

1995-05-01

In order to replicate and elaborate the two-dimensional model of depression and anxiety underlying the structure of common psychiatric symptoms proposed by Goldberg et al. (1987), we carried out latent trait analyses on PSE symptom data of the original Manchester study and two recent Dutch studies. We used the same analytical strategy as Goldberg et al. to facilitate comparison with the earlier work. It was found that a more comprehensive set of common psychiatric symptoms caused an extra, third dimension to emerge, so that the earlier anxiety dimension became split between a specific anxiety axis characterized by situational and phobic anxiety and avoidance, and a non-specific anxiety axis characterized by free-floating anxiety, various symptoms relating to tension, irritability and restlessness. It is argued that three dimensions are sufficient to account for the covariance between common psychiatric symptoms. A fairly consistent correlation between the non-specific anxiety and the depression dimension was found across sites, as well as independence of the specific anxiety dimension from the other two dimensions. Furthermore, the depression dimension was robust with similar symptom profiles across samples, but there appeared to be local differences in the structure of anxiety symptoms.

Psychiatric symptoms and CAG expansion in Huntington`s disease

Energy Technology Data Exchange (ETDEWEB)

Weber, M.W.; Schmid, W.; Spiegel, R. [Univ. of Zuerich (Switzerland)

1996-02-16

The mutation responsible for Huntington`s disease (HD) is an elongated CAG repeat in the coding region of the IT15 gene. A PCR-based test with high sensitivity and accuracy is now available to identify asymptomatic gene carriers and patients. An inverse correlation between CAG copy number and age at disease onset has been found in a large number of affected individuals. The influence of the CAG repeat expansion on other phenotypic manifestations, especially specific psychiatric symptoms has not been studied intensively. In order to elucidate this situation we investigated the relation between CAG copy number and distinct psychiatric phenotypes found in 79 HD-patients. None of the four differentiated categories (personality change, psychosis, depression, and nonspecific alterations) showed significant differences in respect to size of the CAG expansion. In addition, no influence of individual sex on psychiatric presentation could be found. On the other hand in patients with personality changes maternal transmission was significantly more frequent compared with all other groups. Therefore we suggest that clinical severity of psychiatric features in HD is not directly dependent on the size of the dynamic mutation involved. The complex pathogenetic mechanisms leading to psychiatric alterations are still unknown and thus genotyping does not provide information about expected psychiatric symptoms in HD gene carriers. 40 refs., 1 fig., 2 tabs.

The Mediating Effect of Gaming Motivation Between Psychiatric Symptoms and Problematic Online Gaming: An Online Survey

Science.gov (United States)

Király, Orsolya; Urbán, Róbert; Griffiths, Mark D; Ágoston, Csilla; Nagygyörgy, Katalin; Kökönyei, Gyöngyi

2015-01-01

, Pescape scores (on a 5-point Likert scale: mean 2.28, SD 1.14) than men (mean 1.87, SD 0.97) and (2) a stronger association between the escape motive and problematic online gaming (standardized effect size=.64, Pescape and competition motives) negatively associated with POG. Therefore, the exploration of psychiatric symptoms and gaming motives of POG can be helpful in the preparation of prevention and treatment programs. PMID:25855558

[Adult attention deficit/hyperactivity disorder, associated symptoms and comorbid psychiatric disorders: diagnosis and pharmacological treatment].

Science.gov (United States)

Paslakis, G; Schredl, M; Alm, B; Sobanski, E

2013-08-01

Adult attention deficit/hyperactivity disorder (ADHD) is characterised by inattention and/or hyperactivity and impulsivity and is a frequent psychiatric disorder with childhood onset. In addition to core symptoms, patients often experience associated symptoms like emotional dysregulation or low self-esteem and suffer from comorbid disorders, particularly depressive episodes, substance abuse, anxiety or sleep disorders. It is recommended to include associated symptoms and comorbid psychiatric disorders in the diagnostic set-up and in the treatment plan. Comorbid psychiatric disorders should be addressed with disorder-specific therapies while associated symptoms also often improve with treatment of the ADHD core symptoms. The most impairing psychiatric disorder should be treated first. This review presents recommendations for differential diagnosis and treatment of adult ADHD with associated symptoms and comorbid psychiatric disorders with respect to internationally published guidelines, clinical trials and expert opinions. © Georg Thieme Verlag KG Stuttgart · New York.

What do bodily symptoms in African psychiatric patients mean ...

African Journals Online (AJOL)

Objective: To review the various bodily symptoms presented by African psychiatric patients and attempt to understand them. Method: The literature on bodily (somatic) symptoms is surveyed with special reference to Africans and examples are drawn from a focused group discussion in one African rural community.

Amelioration of psychiatric symptoms through exposure to music individually adapted to brain rhythm disorders - a randomised clinical trial on the basis of fundamental research.

Science.gov (United States)

Müller, Wolf; Haffelder, Günter; Schlotmann, Angelika; Schaefers, Andrea T U; Teuchert-Noodt, Gertraud

2014-01-01

This pilot study examined, whether long-term exposure of psychiatric patients to music that was individually adapted to brain rhythm disorders associated with psychoticism could act to ameliorate psychiatric symptoms. A total of 50 patients with various psychiatric diagnoses were randomised in a 1:1 ratio to listen to CDs containing either music adapted to brain rhythm anomalies associated with psychoticism - measured via a specific spectral analysis - or standard classical music. Participants were instructed to listen to the CDs over the next 18 months. Psychiatric symptoms in both groups were assessed at baseline and at 4, 8 and 18 months, using the Brief Symptom Inventory (BSI). At 18 months, patients in the experimental group showed significantly decreased BSI scores compared to control patients. Intriguingly, this effect was not only seen for symptoms of psychoticism and paranoia but also for anxiety, phobic anxiety and somatisation. Exposure to the adapted music was effective in ameliorating psychotic, anxiety and phobic anxiety symptoms. Based on the theories of neuroplasticity and brain rhythms, it can be hypothesised that this intervention may be enhancing brain-rhythm synchronisation and plasticity in prefrontal-hippocampal circuits that are implicated in both psychosis/paranoia and anxiety/phobic anxiety.

Associations between problematic gaming and psychiatric symptoms among adolescents in two samples.

Science.gov (United States)

Vadlin, Sofia; Åslund, Cecilia; Hellström, Charlotta; Nilsson, Kent W

2016-10-01

The aim of the present study was to investigate associations between problematic gaming and psychiatric symptoms among adolescents. Data from adolescents in the SALVe cohort, including adolescents in Västmanland who were born in 1997 and 1999 (N=1868; 1034 girls), and data from consecutive adolescent psychiatric outpatients in Västmanland (N=242; 169 girls) were analyzed. Adolescents self-rated on the Gaming Addiction Identification Test (GAIT), Adult ADHD Self-Report Scale Adolescent version (ASRS-A), Depression Self-Rating Scale Adolescent version (DSRS-A), Spence Children's Anxiety Scale (SCAS), and psychotic-like experiences (PLEs). Multivariable logistic regression analyses were performed, and adjusted for sex, age, study population, school bullying, family maltreatment, and interactions by sex, with two-way interactions between psychiatric measurements. Boys had higher self-rated problematic gaming in both samples, whereas girls self-rated higher in all psychiatric domains. Boys had more than eight times the probability, odds ratio (OR), of having problematic gaming. Symptoms of ADHD, depression and anxiety were associated with ORs of 2.43 (95% CI 1.44-4.11), 2.47 (95% CI 1.44-4.25), and 2.06 (95% CI 1.27-3.33), respectively, in relation to coexisting problematic gaming. Problematic gaming was associated with psychiatric symptoms in adolescents; when problematic gaming is considered, the probability of coexisting psychiatric symptoms should also be considered, and vice versa. Copyright © 2016 Elsevier Ltd. All rights reserved.

Estimation of Symptom Severity Scores for Patients with Schizophrenia Using ERP Source Activations during a Facial Affect Discrimination Task.

Science.gov (United States)

Kim, Do-Won; Lee, Seung-Hwan; Shim, Miseon; Im, Chang-Hwan

2017-01-01

Precise diagnosis of psychiatric diseases and a comprehensive assessment of a patient's symptom severity are important in order to establish a successful treatment strategy for each patient. Although great efforts have been devoted to searching for diagnostic biomarkers of schizophrenia over the past several decades, no study has yet investigated how accurately these biomarkers are able to estimate an individual patient's symptom severity. In this study, we applied electrophysiological biomarkers obtained from electroencephalography (EEG) analyses to an estimation of symptom severity scores of patients with schizophrenia. EEG signals were recorded from 23 patients while they performed a facial affect discrimination task. Based on the source current density analysis results, we extracted voxels that showed a strong correlation between source activity and symptom scores. We then built a prediction model to estimate the symptom severity scores of each patient using the source activations of the selected voxels. The symptom scores of the Positive and Negative Syndrome Scale (PANSS) were estimated using the linear prediction model. The results of leave-one-out cross validation (LOOCV) showed that the mean errors of the estimated symptom scores were 3.34 ± 2.40 and 3.90 ± 3.01 for the Positive and Negative PANSS scores, respectively. The current pilot study is the first attempt to estimate symptom severity scores in schizophrenia using quantitative EEG features. It is expected that the present method can be extended to other cognitive paradigms or other psychological illnesses.

Estimation of Symptom Severity Scores for Patients with Schizophrenia Using ERP Source Activations during a Facial Affect Discrimination Task

Directory of Open Access Journals (Sweden)

Do-Won Kim

2017-08-01

Full Text Available Precise diagnosis of psychiatric diseases and a comprehensive assessment of a patient's symptom severity are important in order to establish a successful treatment strategy for each patient. Although great efforts have been devoted to searching for diagnostic biomarkers of schizophrenia over the past several decades, no study has yet investigated how accurately these biomarkers are able to estimate an individual patient's symptom severity. In this study, we applied electrophysiological biomarkers obtained from electroencephalography (EEG analyses to an estimation of symptom severity scores of patients with schizophrenia. EEG signals were recorded from 23 patients while they performed a facial affect discrimination task. Based on the source current density analysis results, we extracted voxels that showed a strong correlation between source activity and symptom scores. We then built a prediction model to estimate the symptom severity scores of each patient using the source activations of the selected voxels. The symptom scores of the Positive and Negative Syndrome Scale (PANSS were estimated using the linear prediction model. The results of leave-one-out cross validation (LOOCV showed that the mean errors of the estimated symptom scores were 3.34 ± 2.40 and 3.90 ± 3.01 for the Positive and Negative PANSS scores, respectively. The current pilot study is the first attempt to estimate symptom severity scores in schizophrenia using quantitative EEG features. It is expected that the present method can be extended to other cognitive paradigms or other psychological illnesses.

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.

Pre-typhoon socioeconomic status factors predict post-typhoon psychiatric symptoms in a Vietnamese sample.

Science.gov (United States)

Brown, Ruth C; Trapp, Stephen K; Berenz, Erin C; Bigdeli, Tim Bernard; Acierno, Ron; Tran, Trinh Luong; Trung, Lam Tu; Tam, Nguyen Thanh; Tuan, Tran; Buoi, La Thi; Ha, Tran Thu; Thach, Tran Duc; Amstadter, Ananda B

2013-11-01

Exposure to natural disasters has been associated with increased risk for various forms of psychopathology. Evidence indicates that socioeconomic status (SES) may be important for understanding post-disaster psychiatric distress; however, studies of SES-relevant factors in non-Western, disaster-exposed samples are lacking. The primary aim of the current study was to examine the role of pre-typhoon SES-relevant factors in relation to post-typhoon psychiatric symptoms among Vietnamese individuals exposed to Typhoon Xangsane. In 2006, Typhoon Xangsane disrupted a mental health needs assessment in Vietnam in which the Self Reporting Questionnaire-20 (SRQ-20), and the Demographic and Health Surveys Wealth Index, a measure of SES created for use in low-income countries, were administered pre-typhoon. The SRQ-20 was re-administered post-typhoon. Results of a linear mixed model indicated that the covariates of older age, female sex, and higher levels of pre-typhoon psychiatric symptoms were associated with higher levels of post-typhoon psychiatric symptoms. Analysis of SES indicators revealed that owning fewer consumer goods, having lower quality of household services, and having attained less education were associated with higher levels of post-typhoon symptoms, above and beyond the covariates, whereas quality of the household build, employment status, and insurance status were not related to post-typhoon psychiatric symptoms. Even after controlling for demographic characteristics and pre-typhoon psychiatric symptoms, certain SES factors uniquely predicted post-typhoon psychiatric distress. These SES characteristics may be useful for identifying individuals in developing countries who are in need of early intervention following disaster exposure.

Subject-chosen activities in occupational therapy for the improvement of psychiatric symptoms of inpatients with chronic schizophrenia: a controlled trial.

Science.gov (United States)

Hoshii, Junko; Yotsumoto, Kayano; Tatsumi, Eri; Tanaka, Chito; Mori, Takashi; Hashimoto, Takeshi

2013-07-01

To compare the therapeutic effects of subject-chosen and therapist-chosen activities in occupational therapy for inpatients with chronic schizophrenia. Prospective comparative study. A psychiatric hospital in Japan. Fifty-nine patients with chronic schizophrenia who had been hospitalized for many years. The subjects received six-months occupational therapy, participating in either activities of their choice (subject-chosen activity group, n = 30) or activities chosen by occupational therapists based on treatment recommendations and patient consent (therapist-chosen activity group, n = 29). The Positive and Negative Syndrome Scale and the Global Assessment of Functioning (GAF) Scale were used to evaluate psychiatric symptoms and psychosocial function, respectively. After six-months occupational therapy, suspiciousness and hostility scores of the positive scale and preoccupation scores of the general psychopathology scale significantly improved in the subject-chosen activity group compared with the therapist-chosen activity group, with 2(2) (median (interquartile range)) and 3(1.25), 2(1) and 2.5(1), and 2(1) and 3(1), respectively. There were no significant differences in psychosocial functions between the two groups. In within-group comparisons before and after occupational therapy, suspiciousness scores of the positive scale, preoccupation scores of the general psychopathology scale, and psychosocial function significantly improved only in the subject-chosen activity group, with 3(1) to 2(2), 3(1) to 2(1), and 40(9) to 40(16) respectively, but not in the therapist-chosen activity group. The results suggested that the subject-chosen activities in occupational therapy could improve the psychiatric symptoms, suspiciousness, and preoccupation of the inpatients with chronic schizophrenia.

Treatment received, satisfaction with health care services, and psychiatric symptoms 3 months after hospitalization for self-poisoning

Directory of Open Access Journals (Sweden)

Grimholt Tine K

2012-04-01

Full Text Available Abstract Background Patients who self-poison have high repetition and high mortality rates. Therefore, appropriate follow-up is important. The aims of the present work were to study treatment received, satisfaction with health care services, and psychiatric symptoms after hospitalization for self-poisoning. Methods A cohort of patients who self-poisoned (n = 867 over a period of 1 year received a questionnaire 3 months after discharge. The Beck Depression Inventory (BDI, Beck Hopelessness Scale (BHS, and Generalized Self-Efficacy Scale (GSE were used. The participation rate was 28% (n = 242; mean age, 41 years; 66% females. Results Although only 14% of patients were registered without follow-up referrals at discharge, 41% reported no such measures. Overall, satisfaction with treatment was fairly good, although 29% of patients waited more than 3 weeks for their first appointment. A total of 22% reported repeated self-poisoning and 17% cutting. The mean BDI and BHS scores were 23.3 and 10.1, respectively (both moderate to severe. The GSE score was 25.2. BDI score was 25.6 among patients with suicide attempts, 24.9 for appeals, and 20.1 for substance-use-related poisonings. Conclusions Despite plans for follow-up, many patients reported that they did not receive any. The reported frequency of psychiatric symptoms and self-harm behavior indicate that a more active follow-up is needed.

Psychiatric Symptoms and Barriers to Care in HIV-Infected Individuals Who Are Lost to Care.

Science.gov (United States)

McLean, Carmen P; Gay, Natalie G; Metzger, David A; Foa, Edna B

Past studies of barriers to HIV care have not comprehensively assessed psychiatric symptoms, and few have assessed barriers to care among people living with HIV (PLWH) who are lost to care (LTC). We examined psychiatric symptoms, barriers to HIV care, and immune functioning in PLWH who were retained in care (RIC; n = 21) or LTC (n = 21). Participants completed diagnostic interviews for posttraumatic stress disorder (PTSD) and other psychiatric disorders, self-report measures of HIV risk behaviors and psychiatric symptoms, and a blood draw to assess viral load. Compared to RIC participants, LTC participants met criteria for a greater number of psychiatric disorders and reported greater depressive symptoms and more barriers to HIV care. There were no group differences in PTSD severity, risk behaviors, or viral load, suggesting that LTC individuals experience greater psychiatric problems and perceive more barriers to care than RIC participants, but are not less likely to have achieved viral suppression.

Efficacy of specialized group psychotherapy for survivors of childhood sexual abuse in reducing symptoms of PTSD and general psychiatric distress

DEFF Research Database (Denmark)

Elkjær, Henriette Kiilsholm; Kristensen, Ellids; Mortensen, Erik Lykke

-Revised (SCL-90-R). At the 5 year follow-up, the PTSD Checklist-Civilian (PCL-C) was also administered to confirm the findings from CR-PTSD and to determine whether the women met the DSM-IV symptom criteria of PTSD. ANOVA was performed using treatment group as a between factor and the four time points...... follow-up by the total symptom severity score on the PCL-C (r = 0.929). Of the women participating in the 5-years follow-up, 18 (28%) met the DSM-IV symptom criteria as measured by PCL-C (analytic: 36%, systemic: 21%, χ2 NS). Conclusion: Symptoms of PTSD and general psychiatric distress were reduced...... and general psychiatric distress (GSI from SCL-90-R) five years after discharge among adult women suffering from sequelae from childhood sexual abuse. Materials and method: This 5-year follow-up study of a randomized controlled trial included 106 women: 52 assigned to analytic group psychotherapy and 54...

Co-occurring eating and psychiatric symptoms in Taiwanese college students: effects of gender and parental factors.

Science.gov (United States)

Tseng, Mei-Chih Meg; Gau, Susan Shur-Fen; Tseng, Wan-Ling; Hwu, Hai-Gwo; Lee, Ming-Been

2014-03-01

To test whether gender and parental factors moderate the relationships between symptoms of eating disorder (ED) and other psychiatric symptoms. A total of 5,015 new entrants completed several questionnaires and 541 individuals with ED symptoms were identified by the Adult Self-Report Inventory-4 that assessed a wide range of Diagnostic and Statistical Manual of Mental Disorders Fourth Edition psychopathology. The participants also reported on their parents' attitude toward them before their ages of 16. ED symptoms, female gender, less parental care, and more parental protection were associated with more severe co-occurring psychiatric symptoms. Gender and parental factors also demonstrated differential moderating effects on the relationships between ED and co-occurring psychiatric symptoms. Parenting counseling may be individualized to young adults with ED symptoms and different co-occurring psychiatric symptoms. © 2013 Wiley Periodicals, Inc.

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

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.

Symptom scoring systems to diagnose distal polyneuropathy in diabetes : the Diabetic Neuropathy Symptom score

NARCIS (Netherlands)

Meijer, J.W.G.; Smit, A.J.; van Sonderen, E.; Groothoff, J.W.; Eisma, W.H.; Links, T.P.

2002-01-01

AIMS: To provide one of the diagnostic categories for distal diabetic polyneuro-pathy,several symptom scoring systems are available, which are often extensive andlack in validation. We validated a new four-item Diabetic Neuropathy Symptom (DNS) scorefor diagnosing distal diabetic polyneuropathy.

Psychiatric symptoms are present in most of the patients with idiopathic normal pressure hydrocephalus

Directory of Open Access Journals (Sweden)

Matheus F. Oliveira

2014-06-01

Full Text Available Normal pressure hydrocephalus (NPH is characterized by gait disturbance, dementia and/or urinary incontinence associated with dilation of ventricular system with normal opening cerebrospinal fluid pressure. Wide scientifical evidence confirms association between NPH and psychiatric symptoms. We selected 35 patients with idiopathic normal pressure hydrocephalus from January 2010 to January 2012 in a Brazilian tertiary hospital and performed a formal psychiatric evaluation to identify psychiatric disorders. Psychiatric disorders were present in 71% of these patients, especially anxiety, depression and psychotic syndromes. NPH patients may develop symptoms with frontal dominance, such as personality changes, anxiety, depression, psychotic syndromes, obsessive compulsive disorder, Othello syndrome; shoplifting and mania. Unusual appearances of NPH symptoms may hinder early diagnosis and consequently proper treatment.

Paths Leading to Teenage Psychiatric Symptoms and Substance Use: Developmental Epidemiological Studies in Woodlawn.

Science.gov (United States)

Kellam, Sheppard G.; And Others

Early predictors of two major areas of teenage outcome -- substance use and psychiatric symptoms -- were analyzed and specific developmental paths leading to each teenage outcome were identified in this long-term, follow-up study. Substance "use" rather than "abuse" and psychiatric "symptoms" rather than…

Pathological narcissism and depressive symptoms in psychiatric outpatients: mediating role of dysfunctional attitudes.

Science.gov (United States)

Marčinko, Darko; Jakšić, Nenad; Ivezić, Ena; Skočić, Milena; Surányi, Zsuzsanna; Lončar, Mladen; Franić, Tomislav; Jakovljević, Miro

2014-04-01

The aim of this study was to examine the relationships between pathological narcissism (narcissistic grandiosity and narcissistic vulnerability), dysfunctional attitudes (perfectionism and dependency on other people), and depressive symptoms in psychiatric outpatients. A sample of 234 adult psychiatric outpatients (57.3% male; mean age 44.39 years) completed the Pathological Narcissism Inventory, the Dysfunctional Attitudes Scale-Form A, and the Depression, Anxiety, Stress Scales-21. Narcissistic vulnerability exhibited unique positive correlations with depressive symptoms, whereas narcissistic grandiosity showed substantially weaker correlations with depressive symptoms. Perfectionism partially mediated the relationship between narcissistic vulnerability and depressive symptoms. The mediating role of dependency was not confirmed. Among adult psychiatric outpatients, narcissistic vulnerability is more strongly related to depressive symptoms than narcissistic grandiosity, and dysfunctional perfectionism represents one of the underlying mechanisms of this relationship. The implications of these findings are discussed in relation to the Diagnostic and Statistical Manual of Mental Disorders diagnostic criteria and the treatment of pathological narcissism. © 2013 Wiley Periodicals, Inc.

Athletic identity and psychiatric symptoms following retirement from varsity sports.

Science.gov (United States)

Giannone, Zarina A; Haney, Colleen J; Kealy, David; Ogrodniczuk, John S

2017-11-01

Despite evidence identifying adjustment difficulties among retiring athletes, research investigating factors that contribute to post-retirement complications is limited. Athletic identity may be an important determinant of adverse adaptation to sport retirement. The purpose of this study was to address the influence of athletic identity on post-retirement depression and anxiety symptoms among varsity athletes. An anonymous, online survey regarding athletic identity and psychiatric symptoms was completed by 72 self-identified varsity athletes during their final season of competition and 3 months after retiring from sport. After controlling for the effects of pre-retirement anxiety symptoms, endorsement of an athletic identity significantly predicted anxiety symptoms in the post-retirement period. A similar, but non-significant, pattern was observed for depressive symptoms. The findings of this study suggest that athletes' degree of athletic identity may be a risk factor for the emergence of psychiatric distress in the months following their retirement from sport. Identity-focused screening or intervention during athletes' sport careers could potentially mitigate some of the psychological difficulties associated with sport retirement.

The Effect of Traumatic Experiences and Psychiatric Symptoms on the Life Satisfaction of North Korean Refugees.

Science.gov (United States)

Choi, Yeonsun; Lim, Sun Young; Jun, Jin Yong; Lee, So Hee; Yoo, So Young; Kim, Soohyun; Gwak, Ah Reum; Kim, Ji-Chul; Lee, Yu Jin; Kim, Seog Ju

2017-01-01

Successful adaptation of refugees to a new society can be hindered by traumatic experiences and psychiatric symptoms. This study aims to examine the relationship between trauma, psychiatric symptoms and life satisfaction of North Korean refugees resettled in South Korea. A total of 211 North Korean refugees living in South Korea completed a series of questionnaires on the history of their previous traumatic experiences, life satisfaction in South Korea, depression, anxiety, somatization and post-traumatic stress disorder (PTSD) symptoms. North Korean refugees who had experienced more traumatic events were less satisfied with their economic status in South Korea. Severe depression, anxiety, somatization or PTSD symptoms negatively correlated with their overall satisfaction in South Korea. In the stepwise regression model including all psychiatric symptoms and the number of traumatic experiences as dependent variables, only anxiety, but not trauma, predicted lower life satisfaction in South Korea. Traumatic experiences of North Korean refugees negatively affected the life satisfaction, especially the economic satisfaction, in South Korea. Since the negative effect of trauma was mainly mediated by psychiatric symptoms, the strategy of relieving psychiatric symptoms of traumatized refugees may help the adaptation of refugees. © 2017 S. Karger AG, Basel.

Psychiatric symptoms among an HIV positive Urban Population in ...

African Journals Online (AJOL)

RICHY

frequently psychiatric symptoms in an HIV positive adult ... affect the outcome of HIV disease. Firstly ... ignoring the serious consequences and impact the have on ... separated. 10. 5.4 divorced. 19. 10.3 widowed. 48. 26.0. Educational level.

Anxiety symptoms in crack cocaine and inhalant users admitted to a psychiatric hospital in southern Brazil.

Science.gov (United States)

Zubaran, Carlos; Foresti, Katia; Thorell, Mariana Rossi; Franceschini, Paulo Roberto

2013-01-01

The occurrence of psychiatric comorbidity among individuals with crack or inhalant dependence is frequently observed. The objective of this study was to investigate anxiety symptoms among crack cocaine and inhalant users in southern Brazil. The study investigated two groups of volunteers of equal size (n=50): one group consisted of crack cocaine users, and the other group consisted of inhalant users. Research volunteers completed the Portuguese versions of the State-Trait Anxiety Inventory (STAI), Hamilton Anxiety Rating Scale (HAM-A), and Self-Report Questionnaire (SRQ). Both crack and inhalant users experience significant symptoms of anxiety. Inhalant users presented significantly more anxiety symptoms than crack users according to the HAM-A questionnaire only. In contrast to the results of the HAM-A, the STAI failed to demonstrate a significant difference between the two groups of substance users. SRQ scores revealed that crack and inhalants users had significant degrees of morbidity. A significant difference regarding anxiety symptomatology, especially state anxiety, was observed among inhalant and crack users. Anxiety and overall mental psychopathology were significantly correlated in this sample. The results indicate that screening initiatives to detect anxiety and additional psychiatric comorbidities among crack and inhalant users are feasible and relevant. Copyright © 2013 Elsevier Editora Ltda. All rights reserved.

11. Prevalence of psychiatric symptoms among patients with recurrent vasovagal and unexplained syncope

Directory of Open Access Journals (Sweden)

A.W. Al-Johar

2016-07-01

Full Text Available Syncope is defined as a transient loss of consciousness and absence of postural tone followed by spontaneous recovery. Neurally mediated syncope (vasovagal and idiopathic unexplained syncope (US are the most common causes of syncope. Syncope is a very limiting disease that, if recurrent, affects the patients’ physical and psychological health. Our objective from this study is to measure the prevalence of psychiatric symptoms among patients with US. All patients (>12 years with vasovagal or US who were evaluated in King Khalid University Hospital were identified. Echocardiography and table tilt test reports were reviewed and patients who had cardiac syncope (due to arrhythmia or structural heart disease were excluded (N = 18. Ninety-four patients were included for further psychiatric assessment. The patients were contacted to fill the Symptoms Checklist-90-Revised (SCL-90-R, which is a self-reporting questionnaire used to evaluate traits of depression, anxiety, somatization disorder and phobia. SCL-90-R scale has been translated to Arabic and validated in previous studies. Of the included cohort, 43 responded to fill the assessment scale, and 51 were excluded due to failure of communication (N = 41 or refusal to participate (N = 10. A control group was recruited with a case: control ratio of 1:3 matching for age, gender, and chronic illnesses.There were 43 patients and 129 control subjects, with predominance of females (67.4% and an average age of 33.8 (SD = 16. There was no difference in average scores of depression (13 vs. 14.53, P = 0.31, anxiety (11.3 vs. 10.4, P = 0.51, or phobia (5.4 vs. 5.2, P = 0.88. However, the syncope group had a higher average score for somatization disorder (18.53 vs. 13.66, P = 0.002. Binary logistic regression model was measured after grouping the cohort into above and below median scores. After adjusting for age, gender, and chronic illnesses, the association between syncope and somatization

Social class and gender patterning of insomnia symptoms and psychiatric distress: a 20-year prospective cohort study.

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Green, Michael J; Espie, Colin A; Benzeval, Michael

2014-05-25

Psychiatric distress and insomnia symptoms exhibit similar patterning by gender and socioeconomic position. Prospective evidence indicates a bi-directional relationship between psychiatric distress and insomnia symptoms so similarities in social patterning may not be coincidental. Treatment for insomnia can also improve distress outcomes. We investigate the extent to which the prospective patterning of distress over 20 years is associated with insomnia symptoms over that period. 999 respondents to the Twenty-07 Study had been followed for 20 years from approximately ages 36-57 (73.2% of the living baseline sample). Psychiatric distress was measured using the GHQ-12 at baseline and at 20-year follow-up. Gender and social class were ascertained at baseline. Insomnia symptoms were self-reported approximately every five years. Latent class analysis was used to classify patterns of insomnia symptoms over the 20 years. Structural Equation Models were used to assess how much of the social patterning of distress was associated with insomnia symptoms. Missing data was addressed with a combination of multiple-imputation and weighting. Patterns of insomnia symptoms over 20 years were classified as either healthy, episodic, developing or chronic. Respondents from a manual social class were more likely to experience episodic, developing or chronic patterns than those from non-manual occupations but this was mostly explained by baseline psychiatric distress. People in manual occupations experiencing psychiatric distress however were particularly likely to experience chronic patterns of insomnia symptoms. Women were more likely to experience a developing pattern than men, independent of baseline distress. Psychiatric distress was more persistent over the 20 years for those in manual social classes and this effect disappeared when adjusting for insomnia symptoms. Irrespective of baseline symptoms, women, and especially those in a manual social class, were more likely than men to

THE STRUCTURE OF COMMON PSYCHIATRIC-SYMPTOMS - HOW MANY DIMENSIONS OF NEUROSIS

NARCIS (Netherlands)

ORMEL, J; OLDEHINKEL, AJ; GOLDBERG, DP; HODIAMONT, PPG; WILMINK, FW; BRIDGES, K

In order to replicate and elaborate the two-dimensional model of depression and anxiety underlying the structure of common psychiatric symptoms proposed by Goldberg et al. (1987), we carried out latent trait analyses on PSE symptom data of the original Manchester study and two recent Dutch studies.

Internet Addiction and Psychiatric Symptoms among Korean Adolescents

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Jang, Keum Seong; Hwang, Seon Young; Choi, Ja Yun

2008-01-01

Background: The aims of this study were to identify the independent factors associated with intermittent addiction and addiction to the Internet and to examine the psychiatric symptoms in Korean adolescents when the demographic and Internet-related factors were controlled. Methods: Male and female students (N = 912) in the 7th-12th grades were…

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

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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

Prenatal Pregnancy Complications and Psychiatric Symptoms: Children with ASD versus Clinic Controls

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Tudor, Megan E.; DeVincent, Carla J.; Gadow, Kenneth D.

2012-01-01

The current study examined the association between prenatal pregnancy complications (PPC) and childhood psychiatric symptoms in children with an autism spectrum disorder (ASD) and non-ASD children who were referred to a psychiatric clinic (Controls). Parents completed a "DSM-IV"-referenced rating scale and developmental history questionnaire.…

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

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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…

Executive functions and psychiatric symptoms in drug-refractory juvenile myoclonic epilepsy.

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Walsh, Jordana; Thomas, Rhys H; Church, Carla; Rees, Mark I; Marson, Anthony G; Baker, Gus A

2014-06-01

The pattern of executive dysfunction reported in juvenile myoclonic epilepsy (JME) resembles that of patients with cluster B personality disorders. This study examined whether executive dysfunction and maladaptive behavior reported in patients with JME are related. Sixty patients with drug-refractory JME were administered tests of intellect, memory, and executive dysfunction. Anxiety, depression, personality traits, impact of epilepsy, and perceived cognitive effects of antiepileptic drugs were measured. Half of the cohort exhibited moderate to severe anxiety symptoms. The patients performed most poorly on naming ability and inhibition switching. Duration of epilepsy exacerbated poor performance on inhibition switching. Females presented with pathological scores for neurotic and introvert traits and males for introvert traits. Abnormal personality traits and psychiatric disorders were associated with worse intellectual and executive functioning. People with extreme Eysenck Personality Scale - Brief Version (EPQ-BV) scores demonstrated the greatest level of executive impairment. Furthermore, the same degree of dysfunction was not seen in any individual with unremarkable EPQ-BV scores. This study indicates that specific patterns of executive dysfunction are related to maladaptive behavior in JME. Distinct behavioral patterns may be used to identify functional and anatomical differences between people with JME and for stratification to enable gene discovery. Copyright © 2014. Published by Elsevier Inc.

Disability, psychiatric symptoms, and quality of life in infertile women: a cross-sectional study in Turkey.

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Sezgin, Hacer; Hocaoglu, Cicek; Guvendag-Guven, Emine Seda

2016-04-25

Infertility is a major life crisis which can lead to the development of psychiatric symptoms and negative effects on the quality of life of affected couples, but the magnitude of the effects may vary depending on cultural expectations. We compare the level of psychiatric symptoms, disability, and quality of life in fertile and infertile women in urban Turkey. This cross-sectional study enrolled 100 married women being treated for infertility at the outpatient department of the Obstetrics and Gynecology Department of the Rize Education and Research Hospital and a control group of 100 fertile married women. All study participants were evaluated with a socio-demographic data screening form, the Hospital Anxiety and Depression Scale (HADS), the Brief Disability Questionnaire (BDQ), and the Short Form Health Survey (SF-36). The mean anxiety subscale score and depression subscale score of HADS were slightly higher in the infertile group than in controls, but the differences were not statistically significant. The proportion of subjects with clinically significant anxiety (i.e., anxiety subscale score of HADS ≥11) was significantly higher in infertile women than in fertile women (31% v. 17%, χ (2)=5.37, p=0.020), but the proportion with clinically significant depressive symptoms (i.e., depression subscale score of HADS >8) was not significantly different (43% v. 33%, χ (2)=2.12, p=0.145). Self-reported disability over the prior month was significantly worse in the infertile group than in the controls, and 4 of the 8 subscales of the SF-36 - general health, vitality, social functioning, and mental health - were significantly worse in the infertile group. Compared to infertile women who were currently working, infertile women who were not currently working reported less severe depression and anxiety and better general health, vitality, and mental health. Married women from urban Turkey seeking treatment for infertility do not have significantly more severe depressive

Concomitant psychiatric symptoms and impaired quality of life in women with cervical cancer: a critical review

Directory of Open Access Journals (Sweden)

Klügel S

2017-10-01

Full Text Available Stephanie Klügel,1 Caroline Lücke,1 Aurora Meta,1 Meike Schild-Suhren,2 Eduard Malik,2 Alexandra Philipsen,1 Helge HO Müller1,3 1Department of Psychiatry and Psychotherapy, Carl von Ossietzky University Oldenburg, Bad Zwischenahn, 2Department of Gynecology and Obstetrics, Carl von Ossietzky University Oldenburg, Oldenburg, 3Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany Abstract: Our aim was to summarize the current relevant literature on concomitant psychiatric symptoms with a focus on anxiety/depression in a population with gynecologic cancer; to identify the predictors, associated factors, and prevention strategies of psychiatric disorders; to examine psychiatric disorders in a population with recurrent gynecologic cancer; and to describe the limitations of the literature and future research areas. Little is known about attending psychiatric disorders in patients with gynecologic and other malignant diseases like cervical or breast cancer. However, patients suffering from other types of gynecologic cancer (eg, genital/cervical cancer may also have an increased risk of psychiatric symptoms. In this review, we identify the potential information deficits in this field. A two-rater independent literature search was conducted using the PubMed/Google Scholar search engines to systematically evaluate the literature on the research objectives, followed by a critical reflection on the results. Of the 77 screened studies, 15 met the criteria for inclusion in this review. Patients with gynecologic malignancies, especially cervical cancer, had a very high prevalence of psychiatric symptoms including depression (33%–52%. Additionally, the risk groups facing higher rates of concomitant reduced quality of life and increased psychiatric symptoms such as depression were identified. Specifically, low socioeconomic status, sexual inactivity, absence of a partner, and physical symptoms were correlated with an increased risk. Patients

A six-month prospective evaluation of personality traits, psychiatric symptoms and quality of life in ayahuasca-naïve subjects.

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Barbosa, Paulo Cesar Ribeiro; Cazorla, Irene Maurício; Giglio, Joel Sales; Strassman, Rick

2009-09-01

The authors assessed 23 subjects immediately before and six months (27.5 weeks) after their first ayahuasca experience in an urban Brazilian religious setting, either Santo Daime (N = 15) or União do Vegetal (N = 8). Measures included scores on instruments assessing psychiatric symptoms, personality variables and quality of life. Independent variables were the frequency of ayahuasca use throughout the period and the length of ayahuasca wash-out after six months. Santo Daime subjects had a significant reduction of minor psychiatric symptoms, improvement of mental health, and a change in attitude towards more confidence and optimism. The União do Vegetal group had a significant decrease in physical pain, and attitude change towards more independence. Independence was positively correlated with the frequency of ayahuasca use and negatively correlated with the wash-out period. We discuss possible mechanisms by which these changes may occur and suggest areas for future research.

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.

Psychiatric Hospital Workers' Exposure to Disturbing Patient Behavior and Its Relation to Post-Traumatic Stress Disorder Symptoms.

Science.gov (United States)

Hilton, N Zoe; Ham, Elke; Dretzkat, Alecia

2017-09-01

Background About 10% of health-care workers experience post-traumatic stress disorder (PTSD); the rate is higher among workers exposed to aggression. Objective We extended this research by examining PTSD and exposure to violence and other disturbing patient behaviors, among nursing and other staff on inpatient psychiatric units (forensic and nonforensic). Method Surveys were completed online or in person by 219 respondents (30% response rate). Participants indicated which disturbing behaviors they had been exposed to and ranked the worst three behaviors in each of three categories: most unpleasant to work with, most disruptive to patient care, and most upsetting. Most ( n = 192) also completed the PTSD Checklist (PCL). Results All but two participants reported exposure to at least one disturbing behavior and ranked violence, feces smearing, and screaming constantly as the worst experiences overall. On the PCL, 24% scored above the cut off for probable PTSD. Nursing staff had the highest scores, with no difference between nursing staff on forensic versus nonforensic units. PCL score showed a small positive correlation with the number of disturbing behaviors experienced. Conclusion PTSD symptoms are common among psychiatric hospital workers, not only nursing staff. Future research using clinical assessment, longitudinal designs, and measurement of nonviolent disturbing behaviors is recommended.

Variables influencing presenting symptoms of patients with eating disorders at psychiatric outpatient clinics.

Science.gov (United States)

Tseng, Mei-Chih Meg; Chen, Kuan-Yu; Chang, Chin-Hao; Liao, Shih-Cheng; Chen, Hsi-Chung

2016-04-30

Eating disorders (EDs) have been underdiagnosed in many clinical settings. This study investigates the influence of clinical characteristics on presenting symptoms of patients with EDs. Psychiatric outpatients, aged 18-45, were enrolled sequentially and received a two-phase survey for EDs in August 2010-January 2013. Their primary reasons for seeking psychiatric help were obtained at their first encounter with outpatient psychiatrists. Patients' clinical and demographic characteristics were compared according to presenting symptoms with or without eating/weight problems. Of 2140 patients, 348 (16.3%) were diagnosed with an ED (22.6% of women and 6.3% of men). The three most common reasons for seeking psychiatric help were eating/weight problems (46.0%), emotional problems (41.3%), and sleep disturbances (19.3%). The multivariate analyses suggest that when patients with EDs presented symptoms that were less related to eating/weight problems, they were significantly more likely to be those having diagnoses other than anorexia nervosa or bulimia nervosa and less severe degree of binge-eating. Further, patients with EDs who demonstrated more impulsive behaviors and poorer functioning were less likely to report their eating problems when visiting psychiatric clinics. Thus, ED should be assessed routinely in patients with complex psychopathology to facilitate comprehensive treatment. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Dopaminergic dysfunction and psychiatric symptoms in movement disorders: a 123I-FP-CIT SPECT study

International Nuclear Information System (INIS)

Di Giuda, Daniela; Cocciolillo, Fabrizio; Bruno, Isabella; Giordano, Alessandro; Camardese, Giovanni; Pucci, Lorella; Janiri, Luigi; Bentivoglio, Anna Rita; Guidubaldi, Arianna; Fasano, Alfonso

2012-01-01

Psychiatric symptoms frequently occur in patients with movement disorders. They are not a mere reaction to chronic disability, but most likely due to a combination of psychosocial factors and biochemical dysfunction underlying the movement disorder. We assessed dopamine transporter (DAT) availability by means of 123 I-FP-CIT SPECT, and motor and psychiatric features in patients with Parkinson's disease, primary dystonia and essential tremor, exploring the association between SPECT findings and symptom severity. Enrolled in the study were 21 patients with Parkinson's disease, 14 patients with primary dystonia and 15 patients with essential tremor. The severity of depression symptoms was assessed using the Hamilton depression rating scale, anxiety levels using the Hamilton anxiety rating scale and hedonic tone impairment using the Snaith-Hamilton pleasure scale. Specific 123 I-FP-CIT binding in the caudate and putamen was calculated based on ROI analysis. The control group included 17 healthy subjects. As expected, DAT availability was significantly decreased in patients with Parkinson's disease, whereas in essential tremor and dystonia patients it did not differ from that observed in the control group. In Parkinson's disease patients, an inverse correlation between severity of depression symptoms and DAT availability in the left caudate was found (r = -0.63, p = 0.002). In essential tremor patients, levels of anxiety symptoms were inversely correlated with DAT availability in the left caudate (r = -0.69, p = 0.004). In dystonia patients, the severities of both anxiety and depression symptoms were inversely associated with DAT availability in the left putamen (r = -0.71, p = 0.004, and r = -0.75, p = 0.002, respectively). There were no correlations between psychometric scores and 123 I-FP-CIT uptake ratios in healthy subjects. We found association between presynaptic dopaminergic function and affective symptoms in different movement disorders. Interestingly, the

[Case report: kleptomania and other psychiatric symptoms after carbon monoxide intoxication].

Science.gov (United States)

Gürlek Yüksel, Ebru; Taşkin, E Oryal; Yilmaz Ovali, Gülgün; Karaçam, Melek; Esen Danaci, Ayşen

2007-01-01

Carbon monoxide (CO) intoxication is usually a serious condition, which can result in neurological disturbances or death. In some patients with CO intoxication, but not usually, a biphasic pattern can be seen. In this condition, after antitoxic treatment, patients may completely recover and after a short recovery period, neurological and/or psychiatric symptoms appear again. This condition is known as delayed encephalopathy and its occurrence rate is between 0.06% and 11.8%. Herein, we report a case with delayed encephalopathy after CO intoxication, which began with neurological symptoms and continued with obsessive-compulsive disorder, depression, kleptomania, and psychotic disorder. The 41-year-old female patient had no psychiatric or neurological symptoms or disorders prior to CO intoxication. Increased signal intensity changes in the basal region of the left temporal lobe (including the cortex and subcortical white matter), globus pallidus (bilateral), and cerebellar cortical and subcortical white matter (bilaterally symmetrical) was detected on axial T2-weighted magnetic resonance imaging (MRI). In addition, there were atrophic changes in both cerebellar hemispheres. To the best of our knowledge, this is the first case of kleptomania described after CO intoxication in the literature. We discuss the organic etiology of kleptomania and the other psychiatric symptoms of this patient in the light of recent research. We concluded that the kleptomania seen in this patient was related to concurrent lesions in the temporal lobe and globus pallidus; in other words, her kleptomania may have been related to dysfunction simultaneously seen in both the temporolimbic and frontal-subcortical circuits.

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.…

A naturalistic study on the relationship among resilient factors, psychiatric symptoms, and psychosocial functioning in a sample of residential patients with psychosis

Directory of Open Access Journals (Sweden)

Poloni N

2018-04-01

Full Text Available  Nicola Poloni, Daniele Zizolfi, Marta Ielmini, Roberto Pagani, Ivano Caselli, Marcello Diurni, Anna Milano, Camilla Callegari Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Varese, Italy Objective: Resilience is a multidimensional process of adaptation aimed to overcome stressful or traumatic life experiences; only in the last few years it has been considered as a personal resource in psychosis and schizophrenia. This study aimed to assess the relationship between intrapersonal and interpersonal resilience factors and schizophrenia, particularly whether and how resilience can improve the course of psychotic illness. Patients and methods: In this observational study, all patients recruited had to fulfill the following inclusion criteria: diagnosis of schizophrenia spectrum disorder (Diagnostic and Statistical Manual of Mental Disorders-5; aged between 18 and 65 years; provided written informed consent; to be clinically stable (Clinical Global Impression Scale <3; history of illness ≥5 years; to be compliant with antipsychotic therapy over the last year; and regular submission to periodic monthly psychiatric visits. Patients were evaluated through the following scales: Resilience Scale for Adults (RSA for resilience; Brief Psychiatric Rating Scale-Anchored version (BPRS-A, Scale for the Assessment of Negative Symptoms (SANS, and Scale for the Assessment of Positive Symptoms (SAPS for psychotic symptomatology; and Life Skills Profile (LSP for psychosocial functioning. ­Statistical analysis was performed by SPSS. Partial correlations were evaluated to assess the relationship between RSA total scores and subscores and BPRS-A, SANS, SAPS, and LSP total scores, removing the common variance among variables. Then, a series of hierarchical multiple linear regression models were used to examine the association between resilience, psychopathology, and psychosocial functioning. Results: A statistically significant

Exposure to non-ionizing electromagnetic radiation from mobile telephony and the association with psychiatric symptoms.

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Silva, Denize Francisca da; Barros, Warley Rocha; Almeida, Maria da Conceição Chagas de; Rêgo, Marco Antônio Vasconcelos

2015-10-01

The aim of this study was to investigate the association between exposure to non-ionizing electromagnetic radiation from mobile phone base stations and psychiatric symptoms. In a cross-sectional study in Salvador, Bahia State, Brazil, 440 individuals were interviewed. Psychiatric complaints and diagnoses were the dependent variables and distance from the individual's residence to the base station was considered the main independent variable. Hierarchical logistic regression analysis was conducted to assess confounding. An association was observed between psychiatric symptoms and residential proximity to the base station and different forms of mobile phone use (making calls with weak signal coverage, keeping the mobile phone close to the body, having two or more chips, and never turning off the phone while sleeping), and with the use of other electronic devices. The study concluded that exposure to electromagnetic radiation from mobile phone base stations and other electronic devices was associated with psychiatric symptoms, independently of gender, schooling, and smoking status. The adoption of precautionary measures to reduce such exposure is recommended.

[Parenting stress and the reliability of parental information in the diagnostics of children and adolescents with symptoms of psychiatric and behavioral disorders].

Science.gov (United States)

Irlbauer-Müller, Viktoria; Eichler, Anna; Stemmler, Mark; Moll, Gunther H; Kratz, Oliver

2017-07-01

Information from parents is regularly used in the diagnostic process of children and adolescents with psychiatric symptoms. But the reliability of this information is debatable, because the parents’ own stress can distort their perceptions of the child’s symptoms. For each of N = 68 children and adolescents (11–18 years) who were using mental health services for the first time, we evaluated the ratings of a parent and a professional clinician (internalizing, externalizing symptoms, total-problem score). In addition, parenting stress was scored on the Eltern-Belastungs-Inventars (EBI, Tröster, 2011), which measures both child-related stress and parent-related stress as well as total stress. Highly stressed parent ratings differed more from the clinicians’ ratings than the ratings of less stressed parents. Additionally, correlations showed that higher parenting stress resulted in larger differences between the parent’s and the clinician’s assessments. Multiple regressions proved the predictive value of child-caused parenting stress for these differences. These results apply for internalizing symptoms, externalizing symptoms, and total-problem score. Parenting stress should be evaluated systematically in order to carefully assess the value of the information from parents and to determine how it should be included in diagnostic and therapeutical decisions.

Psychiatric symptoms and disorders in HIV infected mine workers in ...

African Journals Online (AJOL)

Several other psychiatric symptoms and disorders, such as psychosis, secondary mania and depression, have also been associated ... contract, the workers returned home to their families in the rural areas ... 000 (23%) for HIV infection within the work force (Dr. Brian. Brink ..... Posttraumatic stress disorder (PTSD) was not.

High Baseline Postconcussion Symptom Scores and Concussion Outcomes in Athletes.

Science.gov (United States)

Custer, Aimee; Sufrinko, Alicia; Elbin, R J; Covassin, Tracey; Collins, Micky; Kontos, Anthony

2016-02-01

Some healthy athletes report high levels of baseline concussion symptoms, which may be attributable to several factors (eg, illness, personality, somaticizing). However, the role of baseline symptoms in outcomes after sport-related concussion (SRC) has not been empirically examined. To determine if athletes with high symptom scores at baseline performed worse than athletes without baseline symptoms on neurocognitive testing after SRC. Cohort study. High school and collegiate athletic programs. A total of 670 high school and collegiate athletes participated in the study. Participants were divided into groups with either no baseline symptoms (Postconcussion Symptom Scale [PCSS] score = 0, n = 247) or a high level of baseline symptoms (PCSS score > 18 [top 10% of sample], n = 68). Participants were evaluated at baseline and 2 to 7 days after SRC with the Immediate Post-concussion Assessment and Cognitive Test and PCSS. Outcome measures were Immediate Post-concussion Assessment and Cognitive Test composite scores (verbal memory, visual memory, visual motor processing speed, and reaction time) and total symptom score on the PCSS. The groups were compared using repeated-measures analyses of variance with Bonferroni correction to assess interactions between group and time for symptoms and neurocognitive impairment. The no-symptoms group represented 38% of the original sample, whereas the high-symptoms group represented 11% of the sample. The high-symptoms group experienced a larger decline from preinjury to postinjury than the no-symptoms group in verbal (P = .03) and visual memory (P = .05). However, total concussion-symptom scores increased from preinjury to postinjury for the no-symptoms group (P = .001) but remained stable for the high-symptoms group. Reported baseline symptoms may help identify athletes at risk for worse outcomes after SRC. Clinicians should examine baseline symptom levels to better identify patients for earlier referral and treatment for their

Effect of hopelessness on the links between psychiatric symptoms and suicidality in a vulnerable population at risk of suicide.

Science.gov (United States)

Gooding, Patricia; Tarrier, Nicholas; Dunn, Graham; Shaw, Jennifer; Awenat, Yvonne; Ulph, Fiona; Pratt, Daniel

2015-12-15

The aim of this study was to examine the impact of two risk factors working together on a measure of suicide probability in a highly vulnerable group who were male prisoners identified as being at risk of self harm. The first risk factor was psychiatric symptoms, including general psychiatric symptoms and symptoms of personality disorder. The second risk factor was psychological precursors of suicidal thoughts and behaviours which were defeat, entrapment, and hopelessness. Sixty-five male prisoners from a high secure prison in NW England, UK, were recruited, all of whom were considered at risk of suicide by prison staff. General psychiatric symptoms and symptoms of personality disorders predicted the probability of suicide. Hopelessness amplified the strength of the positive relationship between general psychiatric symptoms and suicide probability. These amplification effects acted most strongly on suicidal ideation as opposed to negative self evaluations or hostility. In contrast, defeat, entrapment and hopelessness did not affect the relationship between personality disorders and suicide probability. Clinical assessments of highly vulnerable individuals, as exemplified by prisoners, should include measures of a range of general psychiatric symptoms, together with measures of psychological components, in particular perceptions of hopelessness. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Dopaminergic dysfunction and psychiatric symptoms in movement disorders: a {sup 123}I-FP-CIT SPECT study

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Di Giuda, Daniela; Cocciolillo, Fabrizio; Bruno, Isabella; Giordano, Alessandro [Universita Cattolica del Sacro Cuore, Istituto di Medicina Nucleare, Rome (Italy); Camardese, Giovanni; Pucci, Lorella; Janiri, Luigi [Universita Cattolica del Sacro Cuore, Istituto di Psichiatria e Psicologia, Rome (Italy); Bentivoglio, Anna Rita; Guidubaldi, Arianna [Universita Cattolica del Sacro Cuore, Istituto di Neurologia, Rome (Italy); Fasano, Alfonso [Universita Cattolica del Sacro Cuore, Istituto di Neurologia, Rome (Italy); AFaR-Associazione Fatebenefratelli per la Ricerca, Rome (Italy)

2012-12-15

Psychiatric symptoms frequently occur in patients with movement disorders. They are not a mere reaction to chronic disability, but most likely due to a combination of psychosocial factors and biochemical dysfunction underlying the movement disorder. We assessed dopamine transporter (DAT) availability by means of {sup 123}I-FP-CIT SPECT, and motor and psychiatric features in patients with Parkinson's disease, primary dystonia and essential tremor, exploring the association between SPECT findings and symptom severity. Enrolled in the study were 21 patients with Parkinson's disease, 14 patients with primary dystonia and 15 patients with essential tremor. The severity of depression symptoms was assessed using the Hamilton depression rating scale, anxiety levels using the Hamilton anxiety rating scale and hedonic tone impairment using the Snaith-Hamilton pleasure scale. Specific {sup 123}I-FP-CIT binding in the caudate and putamen was calculated based on ROI analysis. The control group included 17 healthy subjects. As expected, DAT availability was significantly decreased in patients with Parkinson's disease, whereas in essential tremor and dystonia patients it did not differ from that observed in the control group. In Parkinson's disease patients, an inverse correlation between severity of depression symptoms and DAT availability in the left caudate was found (r = -0.63, p = 0.002). In essential tremor patients, levels of anxiety symptoms were inversely correlated with DAT availability in the left caudate (r = -0.69, p = 0.004). In dystonia patients, the severities of both anxiety and depression symptoms were inversely associated with DAT availability in the left putamen (r = -0.71, p = 0.004, and r = -0.75, p = 0.002, respectively). There were no correlations between psychometric scores and {sup 123}I-FP-CIT uptake ratios in healthy subjects. We found association between presynaptic dopaminergic function and affective symptoms in different movement

[Othello syndrome--jealousy and jealous delusions as symptoms of psychiatric disorders].

Science.gov (United States)

Soyka, M

1995-12-01

Jealousy as a psychopathological symptom has long been neglected by psychiatric research. Despite the obvious difficulty to prove or exclude the infidelity of a spouse, delusional jealousy can clearly be considered as pathological, but the evaluation and classification of non-psychotic jealousy remains a challenge. Typical psychopathological symptoms which usually accompany pathological jealousy and the prevalence of delusional jealousy in different psychiatric disorders are described. In delusional jealousy neuroleptic treatment is necessary. Positive results have been reported especially with pimozide. For non-psychotic jealousy various forms of psychotherapy have been advocated to improve self-esteem or to treat other psychological disorders. Other possible interventions are alcohol therapy or family counselling. Many studies show that jealousy is a frequent motive in homicide with the spouse being nearly exclusively the victim. Finally some forensic aspects of jealousy are discussed.

Personality disorder features as predictors of symptoms five years post-treatment.

Science.gov (United States)

Jansson, Irene; Hesse, Morten; Fridell, Mats

2008-01-01

Personality disorders are associated with dysfunction in a variety of areas. Recent longitudinal research has shown that personality disorders are also predictive of problems later in life, as well as of poor response to treatment of depression and anxiety. This study assessed whether personality disorder features were associated with psychiatric symptoms in a cohort of women treated for substance abuse in Sweden. Patients were diagnosed with personality disorders using the Structured Clinical Interview for DSM-IV (SCID-II) personality questionnaire and SCID-II interview, and were then administered a self-report questionnaire designed to measure symptoms of psychiatric illness, the Symptoms Checklist-90 (SCL-90), during and five years after treatment. Concurrently, features of all personality disorders, except histrionic, were associated with SCL-90 score. At five-year follow-up, most personality disorders remained associated with SCL-90 score, with the exception of paranoid and schizoid personality disorder. After controlling for baseline score on the SCL-90, conduct disorder, borderline personality disorder, and narcissistic personality disorder remained significantly associated with symptoms at follow-up. After controlling for abstinence and baseline score, only borderline personality disorder features remained associated with SCL-90 score at follow-up. Patients with personality disorders should be monitored after treatment for psychiatric symptoms.

Multi-informant reports of psychiatric symptoms among high-functioning adolescents with Asperger syndrome or autism.

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Hurtig, Tuula; Kuusikko, Sanna; Mattila, Marja-Leena; Haapsamo, Helena; Ebeling, Hanna; Jussila, Katja; Joskitt, Leena; Pauls, David; Moilanen, Irma

2009-11-01

The aim of the study was to examine psychiatric symptoms in high-functioning adolescents with autism spectrum disorders reported by multiple informants. Forty-three 11- to 17-year-old adolescents with Asperger syndrome (AS) or high-functioning autism (HFA) and 217 typically developed adolescents completed the Youth Self-Report (YSR), while their parents completed the Child Behavior Checklist (CBCL). Teachers of adolescents with AS/HFA completed the Teacher Report Form (TRF). The informants reported significantly more psychiatric symptoms, especially withdrawn, anxious/depressed, social and attention problems, in adolescents with AS/HFA than in controls. In contrast to findings in the general population, the psychiatric problems of adolescents with AS/HFA are well acknowledged by multiple informants, including self-reports. However, anxiety and depressive symptoms were more commonly reported by adolescents with AS/HFA and their teachers than their parents, indicating that some emotional distress may be hidden from their parents.

Effects of the cannabinoid-1 receptor antagonist rimonabant on psychiatric symptoms in overweight people with schizophrenia: a randomized, double-blind, pilot study.

Science.gov (United States)

Kelly, Deanna L; Gorelick, David A; Conley, Robert R; Boggs, Douglas L; Linthicum, Jared; Liu, Fang; Feldman, Stephanie; Ball, M Patricia; Wehring, Heidi J; McMahon, Robert P; Huestis, Marilyn A; Heishman, Stephen J; Warren, Kimberly R; Buchanan, Robert W

2011-02-01

Weight gain is a major adverse effect of several second-generation antipsychotic medications. Rimonabant is a cannabinoid-1 receptor antagonist that promotes weight loss in the general population. We conducted a 16-week, double-blind, placebo-controlled study of rimonabant (20 mg/d) in people with schizophrenia or schizoaffective disorder, based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria, who were clinically stable on second-generation antipsychotics. Participants had a body mass index of 27 kg/m or higher with hyperlipidemia or body mass index of 30 kg/m or higher, and no current substance abuse/dependence (except nicotine), more than weekly cannabis use, or recent depressive symptoms/suicidality. An exercise and dietary counseling group was offered weekly. Target enrollment was 60; the trial was terminated early because of withdrawal of rimonabant from the European market. Fifteen participants were randomized (7 rimonabant, 8 placebo); 5 completed in each group. Rimonabant was associated with a greater reduction in Brief Psychiatric Rating Scale total score versus placebo (mean ± SE difference, -1.9 ± 0.8, P = 0.02), driven by differences in the Brief Psychiatric Rating Scale anxiety/depression (-1.4 ± 0.35, P = 0.0004) and hostility (-0.7 ± 0.3, P = 0.02) factors. Group differences were not significant for the Calgary Depression Scale total score (P = 0.24), Scale for the Assessment of Negative Symptoms total score (P = 0.13), weight, blood pressure, or fasting lipids or glucose. Rimonabant was well tolerated with no significant adverse events. No significant weight loss, metabolic effects, or adverse psychiatric effects were associated with the cannabinoid-1 receptor antagonist rimonabant in this small sample of people with schizophrenia. The endocannabinoid system remains a promising target for pharmacotherapy of schizophrenia and obesity.

Genes, Parental Psychiatric Symptoms and Child Emotional Problems: Nurture versus Nature: There and Back Again

NARCIS (Netherlands)

F.P. Velders (Fleur)

2012-01-01

textabstractChildhood psychiatric disorders are common, show a high comorbidity and are associated with a long-term vulnerability for mental health problems, which underscores the importance of a better understanding of their etiology. Psychiatric symptoms of the parents place children at risk for

The effect of psychiatric symptoms on the internet addiction disorder in Isfahan′s University students

Directory of Open Access Journals (Sweden)

Seyyed Salman Alavi

2011-01-01

Full Text Available Background: Internet addiction disorder is an interdisciplinary phenomenon and it has been studied from different viewpoints in terms of various sciences such as medicine, computer, sociology, law, ethics, and psychology. The aim of this study was to determine the association of psychiatric symptoms with Internet addiction while controlling for the effects of age, gender, marital status, and educational levels. It is hypothesized, that high levels of Internet addiction are associated with psychiatric symptoms and are specially correlated with obsessive-compulsive disorder symptoms. Methods: In a cross-sectional study, a total number of 250 students from Isfahan′s universities were randomly selected. Subjects completed the demographic questionnaire, the Young Diagnostic Questionnaire (YDQ and the Symptom Checklist-90-Revision (SCL-90-R. Data was analyzed using the multiple logistic regression method. Results: There was an association between psychiatric symptoms such as somatization, sensitivity, depression, anxiety, aggression, phobias, and psychosis with exception of paranoia; and diagnosis of Internet addiction controlling for age, sex, education level, marital status, and type of universities. Conclusions: A great percentage of youths in the population suffer from the adverse effects of Internet addiction. It is necessary for psychiatrists and psychologists to be aware of the mental problems caused by Internet addiction.

Symptom characteristics and psychiatric comorbidity among males with muscle dysmorphia.

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Cafri, Guy; Olivardia, Roberto; Thompson, J Kevin

2008-01-01

Muscle dysmorphia has been described as a disorder in which individuals are pathologically preoccupied with their muscularity. This study was designed to further investigate the symptom characteristics and psychiatric conditions associated with the disorder. Weight lifting males meeting current criteria for muscle dysmorphia (n = 15), past muscle dysmorphia (n = 8), and no history of muscle dysmorphia (n = 28) responded to advertisements placed in gymnasium and nutrition stores. Structured and semistructured interviews were administered, as well as survey measures. Relative to controls, males with current muscle dysmorphia experienced more aversive symptoms related to the appearance of their bodies, including more often thinking about their muscularity, dissatisfaction with appearance, appearance checking, bodybuilding dependence, and functional impairment. Higher rates of mood and anxiety disorders were found among individuals with a history of muscle dysmorphia relative to individuals with no history of muscle dysmorphia. The findings suggest that muscle dysmorphia can be distinguished from normal weight lifting on a number of clinical dimensions. Muscle dysmorphia appears to be comorbid with other psychiatric conditions. Limitations of the current study and directions for future research are considered.

Distribution of Total Depressive Symptoms Scores and Each Depressive Symptom Item in a Sample of Japanese Employees.

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Tomitaka, Shinichiro; Kawasaki, Yohei; Ide, Kazuki; Yamada, Hiroshi; Miyake, Hirotsugu; Furukawa, Toshiaki A; Furukaw, Toshiaki A

2016-01-01

In a previous study, we reported that the distribution of total depressive symptoms scores according to the Center for Epidemiologic Studies Depression Scale (CES-D) in a general population is stable throughout middle adulthood and follows an exponential pattern except for at the lowest end of the symptom score. Furthermore, the individual distributions of 16 negative symptom items of the CES-D exhibit a common mathematical pattern. To confirm the reproducibility of these findings, we investigated the distribution of total depressive symptoms scores and 16 negative symptom items in a sample of Japanese employees. We analyzed 7624 employees aged 20-59 years who had participated in the Northern Japan Occupational Health Promotion Centers Collaboration Study for Mental Health. Depressive symptoms were assessed using the CES-D. The CES-D contains 20 items, each of which is scored in four grades: "rarely," "some," "much," and "most of the time." The descriptive statistics and frequency curves of the distributions were then compared according to age group. The distribution of total depressive symptoms scores appeared to be stable from 30-59 years. The right tail of the distribution for ages 30-59 years exhibited a linear pattern with a log-normal scale. The distributions of the 16 individual negative symptom items of the CES-D exhibited a common mathematical pattern which displayed different distributions with a boundary at "some." The distributions of the 16 negative symptom items from "some" to "most" followed a linear pattern with a log-normal scale. The distributions of the total depressive symptoms scores and individual negative symptom items in a Japanese occupational setting show the same patterns as those observed in a general population. These results show that the specific mathematical patterns of the distributions of total depressive symptoms scores and individual negative symptom items can be reproduced in an occupational population.

The effect of fecal microbiota transplantation on psychiatric symptoms among patients with irritable bowel syndrome, functional diarrhea and functional constipation: An open-label observational study.

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Kurokawa, Shunya; Kishimoto, Taishiro; Mizuno, Shinta; Masaoka, Tatsuhiro; Naganuma, Makoto; Liang, Kuo-Ching; Kitazawa, Momoko; Nakashima, Moeko; Shindo, Chie; Suda, Wataru; Hattori, Masahira; Kanai, Takanori; Mimura, Masaru

2018-08-01

The intestinal microbiota is considered as a potential common underpinning pathophysiology of Functional Gastrointestinal Disorders (FGIDs) and psychiatric disorders such as depression and anxiety. Fecal Microbiota Transplantation (FMT) has been reported to have therapeutic effects on diseases related to dysbiosis, but few studies have evaluated its effect on psychiatric symptoms. We followed 17 patients with either Irritable Bowel Syndrome (IBS), Functional Diarrhea (FDr) or Functional Constipation (FC) who underwent FMT for the treatment of gastrointestinal symptoms and observation of psychiatric symptoms. Changes in Hamilton Rating Scale for Depression (HAM-D) and subscale of sleep-related items, Hamilton Rating Scale for Anxiety (HAM-A) and Quick Inventory for Depressive Symptoms (QIDS) between baseline and 4 weeks after FMT, and relationship with the intestinal microbiota were measured. At baseline, 12 out of 17 patients were rated with HAM-D ≥ 8. Significant improvement in HAM-D total and sleep subscale score, HAM-A and QIDS were observed (p = 0.007, p = 0.007, p = 0.01, p = 0.007, respectively). Baseline Shannon index indicated that microbiota showed lower diversity in patients with HAM-D ≥ 8 compared to those of healthy donors and patients with HAM-D control group. Our results suggest that depression and anxiety symptoms may be improved by FMT regardless of gastrointestinal symptom change in patients with IBS, FDr and FC, and the increase of microbiota diversity may help to improve patient's mood. Copyright © 2018 Elsevier B.V. All rights reserved.

Adolescents’ internalizing problems following traumatic brain injury are related to parents’ psychiatric symptoms

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Peterson, Robin L.; Kirkwood, Michael W.; Taylor, H. Gerry; Stancin, Terry; Brown, Tanya M.; Wade, Shari L.

2013-01-01

Background A small body of previous research has demonstrated that pediatric traumatic brain injury increases risk for internalizing problems, but findings have varied regarding their predictors and correlates. Methods We examined the level and correlates of internalizing symptoms in 130 teens who had sustained a complicated mild to severe TBI within the past 1 to 6 months. Internalizing problems were measured via both maternal and paternal report Child Behavior Checklist. We also measured family functioning, parent psychiatric symptoms, and post-injury teen neurocognitive function. Results Mean parental ratings of internalizing problems were within the normal range. Depending on informant, 22–26% of the sample demonstrated clinically elevated internalizing problems. In multiple and binary logistic regression models, only parent psychiatric symptoms consistently provided unique prediction of teen internalizing symptoms. For maternal but not paternal report, female gender was associated with greater internalizing problems. Conclusion Parent and teen emotional problems are associated following adolescent TBI. Possible reasons for this relationship, including the effects of TBI on the family unit, are discussed. PMID:22935574

Correlation between International Prostate Symptom Score and ...

African Journals Online (AJOL)

2016-07-23

Jul 23, 2016 ... International Prostate Symptom Score (IPSS) and uroflowmetry in patients with lower urinary tract symptoms-benign prostatic ... cause of bladder outlet obstruction (BOO) in the male geriatric population.[1] ... age and results in LUTS in about 10% of elderly men.[1]. BPH causes morbidity through the urinary ...

Sleep, anxiety and psychiatric symptoms in children with Tourette syndrome and tic disorders.

Science.gov (United States)

Modafferi, Sergio; Stornelli, Maddalena; Chiarotti, Flavia; Cardona, Francesco; Bruni, Oliviero

2016-09-01

The current study evaluated the relationship between tic, sleep disorders and specific psychiatric symptoms (anxiety, depression, obsessive compulsive symptoms). Assessment of 36 consecutive children and adolescents with tic disorders included: the Yale Global Tic Severity Scale (YGTSS) to assess the severity of tic symptoms; the Self-administered scale for children and adolescents (SAFA) to evaluate the psychopathological profile; a specific sleep questionnaire consisting of 45 items to assess the presence of sleep disorders. An age and sex-matched control group was used for comparisons. Sleep was significantly more disturbed in patients with tic disorders than in controls. Difficulties in initiating sleep and increased motor activity during sleep were the most frequent sleep disturbances found in our sample. Patients showed also symptoms of anxiety (SAFA A), depressed mood (SAFA D) and doubt-indecision (SAFA O). Additionally, difficulties in initiating sleep resulted associated with other SAFA subscales relative to obsessive-compulsive symptoms and depression symptoms. Furthermore, anxiety symptoms (SAFA A) resulted associated with increased motor activity during sleep. Findings confirm literature studies reporting high frequency of sleep problems, anxiety and other psychopathological symptoms in patients with tic disorders, and support the hypothesis that intrusive thoughts and other emotional disturbances might disrupt the sleep onset of these patients. These results suggest the importance of a thorough assessment of sleep and psychiatric disturbances in patients with tic disorders. Copyright © 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Ceftriaxone treatment for two neurosyphilis cases presenting with cognitive and psychiatric symptoms

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Melek Kandemir

2011-06-01

Full Text Available Syphilis is a disease caused by the spirochetal bacterium Treponema Pallidum subspecies pallidum. The route of transmission of syphilis is almost always through sexual contact. The incidence of syphilis decreased significantly with the introduction of penicilin in the 1940s but rose sharply again with the advent of HIV infection in the 1980s. Tertiary or late syphilis develops years after the initial infection and can involve any organ system. Neurologic involvement occurs in up to 10 percent of patients with untreated syphilis. General paresis, the clinical form of neurosyphilis most associated with psychiatric symptoms, occurs with parenchymatous disease and involves neuronal loss as opposed to the vascular lesions or inflammatory changes characteristic of most other forms of neurosyphilis. In the classic description, after early psychiatric manifestations such as mood changes, psychosis, or cognitive changes, demantia becomes prominent. Penicillin is the only drug that has proved effective in the treatment of neurosyphilis. Ceftriaxone is used as an alternative treatment in patients with penicilin allergy. This article reports two cases of neurosyphilis one of whom is presented with dementia and the other with psychiatric symptoms. Both of them are treated with ceftriaxone. Our purpose is to reveal the fact that ceftriaxone is a succesful alternative treatment for the cases with penicilin allergy and to emphasize the importance of neurosyphilis in the differential diagnosis for the psychiatric cases that are resistant to treatment

The correlation between emotional distress and aging males’ symptoms at a psychiatric outpatient clinic: sexual dysfunction as a distinguishing characteristic between andropause and anxiety/depression in aging men

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Chen CY

2013-06-01

Full Text Available Ching-Yen Chen,1,4,5 Chin-Pang Lee,1,4 Yu Chen,2,4,5 Jun-Ran Jiang,3,4,5 Chun-Lin Chu,1,4,5 Chun-Liang Chen3,4,5 1Department of Psychiatry, 2Department of Urology, 3Department of Traditional Chinese Medicine, 4Men’s Health Center, Chang Gung Memorial Hospital at Linkou, Taiwan; 5School of Medicine, Chang Gung University, Taoyuan, Taiwan Background: Andropause and psychiatric disorders are associated with various symptoms in aging males and are part of the differential diagnosis of depression and anxiety. This study was designed to investigate the relationship between symptoms of aging, anxiety, and depression, and to determine if sexual dysfunction could be a differentiating characteristic in the psychiatric outpatient clinic. Methods: One hundred seventy-six male psychiatric outpatients participated in the study and completed self-reported measures assessing symptoms of aging, depression, and anxiety. Symptoms of aging were assessed by the Aging Males’ Symptoms scale. Anxiety and depression were measured by the Hospital Anxiety and Depression Scale. Erectile dysfunction was considered if a response to item 15 on the Aging Males’ Symptoms scale (impaired sexual potency was rated with 4 or 5 points. Affective disturbance was assessed by the total scores of the Hospital Anxiety and Depression Scale. Results: Age was correlated with less anxiety and more sexual symptoms. Anxiety and depression were associated with more severe symptoms of aging, and depression was associated with more sexual symptoms than was anxiety. Impaired sexual potency was the only sexual symptom not significantly associated with depression and anxiety. Depression was associated with an interspousal age gap of ≥6 years. The point prevalence of erectile dysfunction was 28.4%, and age and affective disturbance were associated with the risk of erectile dysfunction. Conclusion: Impaired sexual potency should raise the suspicion of androgen deficiency rather than depression

[Case report: taeniasis, is it a cause of psychiatric and neural symptoms?].

Science.gov (United States)

Inceboz, Tonay; Yalçin, Gülter; Aksoy, Umit

2006-01-01

The most frequent symptom of taeniasis is the discharge of proglottids (93.7%). Gravid proglottids which do not have uterine pores are damaged when they exit the anus by their movement. Because of this damage most of the eggs contaminate the perianal tract. The cellophane tape technique that is used for getting perineum material is also a convenient technique for diagnosis of taeniasis. A 36 year-old woman was admitted to our parasitology clinic complaining of a watering mouth for one year, of abdominal pain, and of loss of appetite for 6 months, and who had discharged proglottids from time to time. She had been eating raw meat since her childhood and had had treatment for taeniasis fifteen years ago. She has also been under treatment for obsessive and compulsive neurosis and depression for two years and complained of constipation that was the side effect of the drug clomipramine HCL. She was given treatment with niclosamide and purgative treatment. The result of the treatment was incomplete because the patient refused to use the purgative. She was called for follow up controls two weeks and six months after treatment and after six months did not have any evidence of infection in her stools. When she was asked, the patient said that she did not need to use the drugs for the treatment of obsessive and compulsive neurosis and depression any more since her symptoms had decreased. According to various authorities, taeniasis is thought to be the cause of psychiatric symptoms due to its neural and psychological effects. These claims have been confirmed in our case because of her psychiatric symptoms decreased after the taeniasis treatment. Thus, the view that there is a relationship between intestinal parasites and psychiatric disease has been strengthened.

Evolution of substance use, neurological and psychiatric symptoms in schizophrenia and substance use disorder patients: a 12-week, pilot, case-control trial with quetiapine

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Simon eZhornitsky

2011-05-01

Full Text Available Neurological and psychiatric symptoms are consequences of substance abuse in schizophrenia and non-schizophrenia patients. The present case-control study examined changes in substance abuse/dependence and neurological and psychiatric symptoms in substance abusers with (DD group, n=26 and without schizophrenia (SUD group, n=24 and in non-abusing schizophrenia patients (SCZ group, n=23 undergoing 12-week treatment with the atypical antipsychotic, quetiapine. Neurological and psychiatric symptoms were evaluated with the Positive and Negative Syndrome Scale, the Calgary Depression Scale for Schizophrenia, the Extrapyramidal Symptoms Rating Scale and the Barnes Akathisia Rating Scale. At endpoint, DD and SCZ patients were receiving significantly higher doses of quetiapine (mean = 554mg/d and 478mg/d, respectively, relative to SUD patients (mean = 150mg/d. We found that SUD patients showed greater improvement in weekly dollars spent on alcohol and drugs and SUD severity, compared to DD patients. At endpoint, there was no significant difference in dollars spent, but DD patients still had a higher mean SUD severity. Interestingly, DD patients had significantly higher Parkinsonism and depression than SCZ patients at baseline and endpoint. On the other hand, we found that SUD patients had significantly more akathisia at baseline, improved more than SCZ patients and this was related to cannabis abuse/dependence. Finally, SUD patients improved more in PANSS positive scores than DD and SCZ patients. Taken together, our results provide evidence for increased vulnerability to the adverse effects of alcohol and drugs in schizophrenia patients. They also suggest that substance abuse/withdrawal may mimic some symptoms of schizophrenia. Future studies will need to determine the role quetiapine played in these improvements.

Newly identified psychiatric illness in one general practice: 12-month outcome and the influence of patients' personality.

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Wright, A F; Anderson, A J

1995-01-01

BACKGROUND. Relatively little is known about the natural history and outcome of psychological problems in patients who present to general practitioners. Only a small proportion of such patients are seen by specialists. Clinical experience suggests that patient personality is one of the factors influencing outcome in patients diagnosed as having psychiatric illness. AIM. This study set out to examine prospectively the progress and 12-month outcome of patients with newly identified psychiatric illness, and the association of patients' personality with outcome. METHOD. One hundred and seventy one patients with clinically significant psychiatric illness attending one practice in a Scottish new town were followed up prospectively (96 presented with psychological symptoms and 75 with somatic symptoms), and were compared with a group of 127 patients with chronic physical illness. Patients were assessed in terms of psychiatric state, social problems and personality using both computer-based and pencil and paper tests in addition to clinical assessments at each consultation during the follow-up year and structured interview one year after recruitment. RESULTS. Most of the improvement in psychiatric state scores on the 28-item general health questionnaire occurred in the first six months of the illness. Of the 171 patients with psychiatric illness 34% improved quickly and remained well, 54% had an intermittent course but had improved at 12-month follow up while 12% pursued a chronic course without improvement. The mean number of consultations in the follow-up year was 8.4 for patients presenting with psychological symptoms, 7.2 for those presenting with somatic symptoms and 6.6 for patients with chronic physical illness. The Eysenck N score proved a strong predictor of the outcome of new psychiatric illness. CONCLUSION. Only one in three patients with newly identified psychiatric illness improved quickly and and remained well, reflecting the importance of continuing care of

Incremental predictive validity of the Addiction Severity Index psychiatric composite score in a consecutive cohort of patients in residential treatment for drug use disorders.

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Thylstrup, Birgitte; Bloomfield, Kim; Hesse, Morten

2018-01-01

The Addiction Severity Index (ASI) is a widely used assessment instrument for substance abuse treatment that includes scales reflecting current status in seven potential problem areas, including psychiatric severity. The aim of this study was to assess the ability of the psychiatric composite score to predict suicide and psychiatric care after residential treatment for drug use disorders after adjusting for history of psychiatric care. All patients treated for drug use disorders in residential treatment centers in Denmark during the years 2000-2010 with complete ASI data were followed through national registers of psychiatric care and causes of death (N=5825). Competing risks regression analyses were used to assess the incremental predictive validity of the psychiatric composite score, controlling for previous psychiatric care, length of intake, and other ASI composite scores, up to 12years after discharge. A total of 1769 patients received psychiatric care after being discharged from residential treatment (30.3%), and 27 (0.5%) committed suicide. After adjusting for all covariates, psychiatric composite score was associated with a higher risk of receiving psychiatric care after residential treatment (subhazard ratio [SHR]=3.44, psuicide (SHR=11.45, pdrug use disorders who could benefit from additional mental health treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

Data from frequency-volume charts versus symptom scores and quality of life score in men with lower urinary tract symptoms due to benign prostatic hyperplasia

NARCIS (Netherlands)

van Venrooij, GEPM; Eckhardt, MD; Gisolf, KWH; Boon, TA

Objective: The aim is to study the relations between reported data on frequency-volume charts and the American Urological Association (AUA) symptom scores and quality of life score. Methods: Males with lower urinary tract symptoms due to benign prostatic hyperplasia (BPH), were consecutively

Effects of Psychiatric Symptoms on Attention in North Korean Refugees

OpenAIRE

Lee, Yu Jin; Jun, Jin Yong; Park, Juhyun; Kim, Soohyun; Gwak, Ah Reum; Lee, So Hee; Yoo, So Young; Kim, Seog Ju

2016-01-01

Objective We investigated the performance of North Korean refugees on attention tasks, and the relationship between that performance and psychiatric symptoms. Methods Sustained and divided attention was assessed using the computerized Comprehensive Attention Test in North Korean refugees and in South Koreans. All participants also completed the Beck Depression Inventory, the Beck Anxiety Inventory, the Impact of Event Scale-Revised and the Dissociative Experiences Scale-II (DES-II). Results T...

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.

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.

[German validation of the Acute Cystitis Symptom Score].

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Alidjanov, J F; Pilatz, A; Abdufattaev, U A; Wiltink, J; Weidner, W; Naber, K G; Wagenlehner, F

2015-09-01

The Uzbek version of the Acute Cystitis Symptom Score (ACSS) was developed as a simple self-reporting questionnaire to improve diagnosis and therapy of women with acute cystitis (AC). The purpose of this work was to validate the ACSS in the German language. The ACSS consists of 18 questions in four subscales: (1) typical symptoms, (2) differential diagnosis, (3) quality of life, and (4) additional circumstances. Translation of the ACSS into German was performed according to international guidelines. For the validation process 36 German-speaking women (age: 18-90 years), with and without symptoms of AC, were included in the study. Classification of participants into two groups (patients or controls) was based on the presence or absence of typical symptoms and significant bacteriuria (≥ 10(3) CFU/ml). Statistical evaluations of reliability, validity, and predictive ability were performed. ROC curve analysis was performed to assess sensitivity and specificity of ACSS and its subscales. The Mann-Whitney's U test and t-test were used to compare the scores of the groups. Of the 36 German-speaking women (age: 40 ± 19 years), 19 were diagnosed with AC (patient group), while 17 women served as controls. Cronbach's α for the German ACSS total scale was 0.87. A threshold score of ≥ 6 points in category 1 (typical symptoms) significantly predicted AC (sensitivity 94.7%, specificity 82.4%). There were no significant differences in ACSS scores in patients and controls compared to the original Uzbek version of the ACSS. The German version of the ACSS showed a high reliability and validity. Therefore, the German version of the ACSS can be reliably used in clinical practice and research for diagnosis and therapeutic monitoring of patients suffering from AC.

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

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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.

Premenstrual Syndrome and Psychiatric Co-morbidities.

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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.

Predictors of violent behavior among acute psychiatric patients: clinical study.

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Amore, Mario; Menchetti, Marco; Tonti, Cristina; Scarlatti, Fabiano; Lundgren, Eva; Esposito, William; Berardi, Domenico

2008-06-01

Violence risk prediction is a priority issue for clinicians working with mentally disordered offenders. The aim of the present study was to determine violence risk factors in acute psychiatric inpatients. The study was conducted in a locked, short-term psychiatric inpatient unit and involved 374 patients consecutively admitted in a 1-year period. Sociodemographic and clinical data were obtained through a review of the medical records and patient interviews. Psychiatric symptoms at admission were assessed using the Brief Psychiatric Rating Scale (BPRS). Psychiatric diagnosis was formulated using the Structured Clinical Interview for DSM-IV. Past aggressive behavior was evaluated by interviewing patients, caregivers or other collateral informants. Aggressive behaviors in the ward were assessed using the Overt Aggression Scale. Patients who perpetrated verbal and against-object aggression or physical aggression in the month before admission were compared to non-aggressive patients, moreover, aggressive behavior during hospitalization and persistence of physical violence after admission were evaluated. Violent behavior in the month before admission was associated with male sex, substance abuse and positive symptoms. The most significant risk factor for physical violence was a past history of physically aggressive behavior. The persistent physical assaultiveness before and during hospitalization was related to higher BPRS total scores and to more severe thought disturbances. Higher levels of hostility-suspiciousness BPRS scores predicted a change for the worse in violent behavior, from verbal to physical. A comprehensive evaluation of the history of past aggressive behavior and psychopathological variables has important implications for the prediction of violence in psychiatric settings.

The association of cannabis use on inpatient psychiatric hospital outcomes.

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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.

Mindfulness and Coping Are Inversely Related to Psychiatric Symptoms in Patients and Informal Caregivers in the Neuroscience ICU: Implications for Clinical Care.

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Shaffer, Kelly M; Riklin, Eric; Jacobs, Jamie M; Rosand, Jonathan; Vranceanu, Ana-Maria

2016-11-01

To assess the correlation of psychosocial resiliency factors (mindfulness and coping) with symptoms of posttraumatic stress, anxiety, and depression in patients recently admitted to the neuroscience ICU and their primary informal caregivers. A descriptive, cross-sectional correlational study. Neuroscience ICU in a major medical center. A total of 78 dyads of patients (total n = 81) and their primary caregivers (total n = 92) from June to December 2015. Study enrollment occurred within the first 2 weeks of patient admission to the neuroscience ICU. None. Dyads completed self-report measures of mindfulness (Cognitive and Affective Mindfulness Scale-Revised), coping (Measure of Coping Status-A), posttraumatic stress (Posttraumatic Checklist-Specific Stressor), anxiety (Hospital Anxiety and Depression Scale-A), and depression (Hospital Anxiety and Depression Scale-D). Rates of clinically significant posttraumatic stress, anxiety, and depressive symptoms were high and comparable between patient and caregiver samples. Own psychological resilience factors and psychiatric symptoms were strongly correlated for both patients and caregivers. Depressive symptoms were interdependent between patients and their caregivers, and one's own mindfulness was independently related to one's partner's depressive symptoms. Rates of clinically significant psychiatric symptoms were high, equally prevalent in patients and caregivers, and interdependent between patients and their caregivers. For both patients and caregivers, psychological resiliency factors were associated with both self and partner psychiatric symptoms. Findings suggest that attending to the psychiatric health of both patients and caregivers in the neuroscience ICU is a priority and that patients and their caregivers must be considered together in a system to fully address either individual's psychiatric symptoms.

The mediating effect of gaming motivation between psychiatric symptoms and problematic online gaming: an online survey.

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Király, Orsolya; Urbán, Róbert; Griffiths, Mark D; Ágoston, Csilla; Nagygyörgy, Katalin; Kökönyei, Gyöngyi; Demetrovics, Zsolt

2015-04-07

The rapid expansion of online video gaming as a leisure time activity has led to the appearance of problematic online gaming (POG). According to the literature, POG is associated with different psychiatric symptoms (eg, depression, anxiety) and with specific gaming motives (ie, escape, achievement). Based on studies of alcohol use that suggest a mediator role of drinking motives between distal influences (eg, trauma symptoms) and drinking problems, this study examined the assumption that there is an indirect link between psychiatric distress and POG via the mediation of gaming motives. Furthermore, it was also assumed that there was a moderator effect of gender and game type preference based on the important role gender plays in POG and the structural differences between different game types. This study had two aims. The first aim was to test the mediating role of online gaming motives between psychiatric symptoms and problematic use of online games. The second aim was to test the moderator effect of gender and game type preference in this mediation model. An online survey was conducted on a sample of online gamers (N=3186; age: mean 21.1, SD 5.9 years; male: 2859/3186, 89.74%). The Brief Symptom Inventory (BSI), the Motives for Online Gaming Questionnaire (MOGQ), and the Problematic Online Gaming Questionnaire (POGQ) were administered to assess general psychiatric distress, online gaming motives, and problematic online game use, respectively. Structural regression analyses within structural equation modeling were used to test the proposed mediation models and multigroup analyses were used to test gender and game type differences to determine possible moderating effects. The mediation models fitted the data adequately. The Global Severity Index (GSI) of the BSI indicated that the level of psychiatric distress had a significant positive direct effect (standardized effect=.35, Pgaming motives: escape (standardized effect=.139, Pgaming (standardized effect size=.64

Effects of sports participation on psychiatric symptoms and brain activations during sports observation in schizophrenia

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Takahashi, H; Sassa, T; Shibuya, T; Kato, M; Koeda, M; Murai, T; Matsuura, M; Asai, K; Suhara, T; Okubo, Y

2012-01-01

Weight gain has been identified as being responsible for increased morbidity and mortality rates of schizophrenia patients. For the management of weight gain, exercise is one of the most acknowledged interventions. At the same time, exercise and sports have been recognized for their positive impact on psychiatric symptoms of schizophrenia. However, the neurobiological basis for this remains poorly understood. We aimed to examine the effect of sports participation on weight gain, psychiatric s...

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

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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.

SAFA: A new measure to evaluate psychiatric symptoms detected in a sample of children and adolescents affected by eating disorders. Correlations with risk factors

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Emilo Franzoni

2009-03-01

Full Text Available Emilo Franzoni1, Morena Monti1, Alessandro Pellicciari1, Carlo Muratore1, Alberto Verrotti3, et al1Child Neuropsychiatry Unit, Clinical Pediatrics; 2Protection and Enhancement Department, University of Bologna, Italy; 3Clinic of Paediatrics, University of Chieti, Chieti, ItalyAbstract: In order to evaluate the psychiatric symptoms associated with a diagnosis of eating disorders (ED we have administered a new psychometric instrument: the Self Administrated Psychiatric Scales for Children and Adolescents (SAFA test. SAFA was administered to a cohort of 97 patients, aged from 8.8 to 18, with an ED diagnosis. Age, body mass index (BMI and BMI standard deviation score were analyzed. Furthermore, while looking for linkable risk factors, we evaluated other data that took an influence over the SAFA profile, like parental separation and family components’ number. Compared to the range of statistical normality (based on Italian population, patients with bulimia nervosa or binge-eating disorder showed higher and pathologic values in specific subscales. When analyzing sex, males showed more pathologic values in most anxiety-related, obsessiveness–compulsiveness-related and insecurity subscales. A correlation among age, BMI and specific subscales (low self esteem, psychological aspects emerged in participants with anorexia nervosa. In order to plan more appropriate diagnostic and therapeutic approaches in children or adolescents suffering from ED, the SAFA test can be an important instrument to evaluate psychiatric symptoms. Therefore, we propose to include this useful, simple self-administered test as a new screening tool for ED diagnosis. Keywords: psychiatric comorbidity, anorexia nervosa, bulimia nervosa, binge-eating disorder, SAFA test

Psychiatric Co-Occurring Symptoms and Disorders in Young, Middle-Aged, and Older Adults with Autism Spectrum Disorder

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Lever, Anne G.; Geurts, Hilde M.

2016-01-01

Although psychiatric problems are less prevalent in old age within the general population, it is largely unknown whether this extends to individuals with autism spectrum disorders (ASD). We examined psychiatric symptoms and disorders in young, middle-aged, and older adults with and without ASD (N[subscript max] = 344, age 19-79 years, IQ > 80).…

Dopamine transporter gene polymorphism and psychiatric symptoms seen in schizophrenic patients at their first episode

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Inada, Toshiya; Sugita, Tetsuyoshi; Dobashi, Izumi [National Institute of Mental Health, Chiba (Japan)] [and others

1996-07-26

To investigate the possible role of the dopamine transporter (DAT) gene in determining the phenotype in human subjects, allele frequencies for the 40-bp variable number of tandem repeats (VNTR) polymorphism at this site were compared between 117 Japanese normal controls and 118 schizophrenic patients, including six subgroups: early-onset, those with a family history, and those suffering from one of the following psychiatric symptoms at their first episode: delusion and hallucination; disorganization; bizarre behavior; and negative symptoms. No significant differences were observed between the group as a whole or any subgroup of schizophrenic patients and controls. The results indicate that VNTR polymorphism in the DAT gene is unlikely to be a major contributor to any of the psychiatric parameters examined in the present population of schizophrenic subjects. 12 refs., 1 fig., 2 tabs.

Comorbid internet addiction in male clients of inpatient addiction rehabilitation centers: psychiatric symptoms and mental comorbidity.

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Wölfling, Klaus; Beutel, Manfred E; Koch, Andreas; Dickenhorst, Ulrike; Müller, Kai W

2013-11-01

Addictive Internet use has recently been proposed to be included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Still, little is known about its nosological features, including comorbidity with other mental disorders and disorder-specific psychopathological symptoms. To investigate whether Internet addiction (IA) is an issue in patients in addiction treatment, 1826 clients were surveyed in 15 inpatient rehabilitation centers. Male patients meeting criteria for comorbid IA (n = 71) were compared with a matched control group of male patients treated for alcohol addiction without addictive Internet use (n = 58). The SCL-90-R, the Patient Health Questionnaire, and the seven-item Generalized Anxiety Disorder were used to assess associated psychiatric symptoms and further comorbid disorders. Comorbid IA was associated with higher levels of psychosocial symptoms, especially depression, obsessive-compulsive symptoms, and interpersonal sensitivity. Moreover, the patients with IA more frequently met criteria for additional mental disorders. They display higher rates of psychiatric symptoms, especially depression, and might be in need of additional therapeutic treatment. In rehabilitation centers, a regular screening for IA is recommended to identify patients with this (non-substance-related) addiction and supply them with additional disorder-specific treatment.

Psychiatric and neurological symptoms in patients with Niemann-Pick disease type C (NP-C): Findings from the International NPC Registry.

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Bonnot, Olivier; Gama, Clarissa S; Mengel, Eugen; Pineda, Mercè; Vanier, Marie T; Watson, Louise; Watissée, Marie; Schwierin, Barbara; Patterson, Marc C

2017-10-09

Niemann-Pick disease type C (NP-C) is a rare inherited neurovisceral disease that should be recognised by psychiatrists as a possible underlying cause of psychiatric abnormalities. This study describes NP-C patients who had psychiatric manifestations at enrolment in the international NPC Registry, a unique multicentre, prospective, observational disease registry. Treating physicians' data entries describing psychiatric manifestations in NPC patients were coded and grouped by expert psychiatrists. Out of 386 NP-C patients included in the registry as of October 2015, psychiatric abnormalities were reported to be present in 34% (94/280) of those with available data. Forty-four patients were confirmed to have identifiable psychiatric manifestations, with text describing these psychiatric manifestations. In these 44 patients, the median (range) age at onset of psychiatric manifestations was 17.9 years (2.5-67.9; n = 15), while the median (range) age at NP-C diagnosis was 23.7 years (0.2-69.8; n = 34). Almost all patients (43/44; 98%) had an occurrence of ≥1 neurological manifestation at enrolment. These data show that substantial delays in diagnosis of NP-C are long among patients with psychiatric symptoms and, moreover, patients presenting with psychiatric features and at least one of cognitive impairment, neurological manifestations, and/or visceral symptoms should be screened for NP-C.

Evaluation of social disablement, psychiatric symptoms and autonomy in long-stay psychiatric patients Avaliação do comportamento social, sintomas psiquiátricos e autonomia em pacientes psiquiátricos de longa permanência

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Lúcia Abelha

2006-01-01

Full Text Available BACKGROUND: Data on prevalence of social disablement, psychiatric symptoms and independent living skills in long-stay psychiatric patients are scarce in Brazil. Therefore, a cross-sectional study was carried out on a population of 881 long-stay psychiatric patients. METHOD: Data were collected from all the patients living in the Municipal Mental Health Institute from Rio de Janeiro city, using 3 instruments: Social Behaviour Schedule (SBS-BR, Brief Psychiatric Rating Scale (BPRS, and Independent Living Skills Survey (ILSS-BR. RESULTS: 75% of total patients presented poor independent living skills, and high rates of social disablement, specially in the items: poor self care (50,9%, little spontaneous communication (46,2% and underactivity (37,5%. 15.1% of schizophrenic patients showed severe symptoms of hallucinations, delusions and conceptual disorganization.11.5% did not present psychiatric symptoms in the last month, and 16% showed no social disablement CONCLUSION: 50% of patients are older than 65 years and have been living in the institution for more than 38 years. They present high rates of problem behaviours and poor autonomy. Our data should suggest the adoption of treatment programs or interventions for those patients. Also, there is a group without psychiatric symptoms, good autonomy degree and no social disablement that could live in therapeutic residences in the community.INTRODUÇÃO: No Brasil ainda são escassos os dados sobre limitações no comportamento social, sintomas psiquiátricos e habilidades de vida independente. Nesse sentido foi realizado um estudo seccional em uma população de 881 pacientes psiquiátricos de longa permanência. METODOLOGIA: Foram coletados dados de todos os pacientes residentes no Instituto Municipal Juliano Moreira, utilizando três instrumentos: Avaliação das Limitações no Comportamento Social (SBS-BR, Brief Psychiatric Rating Scale (BPRS e o Inventário de Habilidades de Vida Independente para

Evaluation of the Quality of Life and Psychiatric Symptoms of Patients with Primary Coxarthrosis after Total Hip Arthroplasty.

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Balik, M S; Hocaoğlu, Ç; Erkut, A; Güvercin, Y; Keskin, D

2017-01-01

PURPOSE OF THE STUDY In this study, it was aimed to examine the preoperative and postoperative quality of life and psychiatric symptoms of the patients with primary coxarthrosis after total hip arthroplasty. MATERIAL AND METHODS 150 patients undergone total hip arthroplasty were involved in this study. The socio-demographical data form prepared by the researchers was utilized before and after the operation in order to demonstrate disease-related socio-demographical characteristics of the patient. The Quality of Life Scale Short Form (SF-36), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Harris Hip Score (HHS) and Visual Analog Scale (VSA) were implemented in the preoperative period and at 6th and 12th week after the operation. RESULTS Of the patients involved in study, 28.7% were male and 71.3% were female. Their mean age was 58.34±11.92 year. While statistically significant differences were found between the preoperative and postoperative periods in terms of physical function, physical role limitation, emotional role limitation, energy, social function, pain, and general health subscales of SF-36, no significant differences were found relating mental health subscale. In BAI, BDI, VAS, and HHS comparison, statistically significant differences were found between the preoperative and postoperative periods, except for BAI. CONCLUSIONS In this study, it was determined that primary coxarthrosis affects significantly the quality of the patients' lives in a negative way and can be accompanied by mental symptoms. After total hip arthroplasty, significant improvement was observed in quality of life, depression and pain scores. Key words: total hip prosthesis, quality of life, mental symptoms.

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

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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...

Posttraumatic growth, depressive symptoms, posttraumatic stress symptoms, post-migration stressors and quality of life in multi-traumatized psychiatric outpatients with a refugee background in Norway.

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Teodorescu, Dinu-Stefan; Siqveland, Johan; Heir, Trond; Hauff, Edvard; Wentzel-Larsen, Tore; Lien, Lars

2012-07-23

Psychiatric outpatients with a refugee background have often been exposed to a variety of potentially traumatizing events, with numerous negative consequences for their mental health and quality of life. However, some patients also report positive personal changes, posttraumatic growth, related to these potentially traumatic events. This study describes posttraumatic growth, posttraumatic stress symptoms, depressive symptoms, post-migration stressors, and their association with quality of life in an outpatient psychiatric population with a refugee background in Norway. Fifty five psychiatric outpatients with a refugee background participated in a cross-sectional study using clinical interviews to measure psychopathology (SCID-PTSD, MINI), and four self-report instruments measuring posttraumatic growth, posttraumatic stress symptoms, depressive symptoms, and quality of life (PTGI-SF, IES-R, HSCL-25-depression scale, and WHOQOL-Bref) as well as measures of social integration, social network and employment status. All patients reported some degree of posttraumatic growth, while only 31% reported greater amounts of growth. Eighty percent of the patients had posttraumatic stress symptoms above the cut-off point, and 93% reported clinical levels of depressive symptoms. Quality of life in the four domains of the WHOQOL-Bref levels were low, well below the threshold for the'life satisfaction' standard proposed by Cummins. A hierarchic regression model including depressive symptoms, posttraumatic stress symptoms, posttraumatic growth, and unemployment explained 56% of the total variance found in the psychological health domain of the WHOQOL-Bref scale. Posttraumatic growth made the strongest contribution to the model, greater than posttraumatic stress symptoms or depressive symptoms. Post-migration stressors like unemployment, weak social network and poor social integration were moderately negatively correlated with posttraumatic growth and quality of life, and positively

Posttraumatic growth, depressive symptoms, posttraumatic stress symptoms, post-migration stressors and quality of life in multi-traumatized psychiatric outpatients with a refugee background in Norway

Science.gov (United States)

2012-01-01

Background Psychiatric outpatients with a refugee background have often been exposed to a variety of potentially traumatizing events, with numerous negative consequences for their mental health and quality of life. However, some patients also report positive personal changes, posttraumatic growth, related to these potentially traumatic events. This study describes posttraumatic growth, posttraumatic stress symptoms, depressive symptoms, post-migration stressors, and their association with quality of life in an outpatient psychiatric population with a refugee background in Norway. Methods Fifty five psychiatric outpatients with a refugee background participated in a cross-sectional study using clinical interviews to measure psychopathology (SCID-PTSD, MINI), and four self-report instruments measuring posttraumatic growth, posttraumatic stress symptoms, depressive symptoms, and quality of life (PTGI-SF, IES-R, HSCL-25-depression scale, and WHOQOL-Bref) as well as measures of social integration, social network and employment status. Results All patients reported some degree of posttraumatic growth, while only 31% reported greater amounts of growth. Eighty percent of the patients had posttraumatic stress symptoms above the cut-off point, and 93% reported clinical levels of depressive symptoms. Quality of life in the four domains of the WHOQOL-Bref levels were low, well below the threshold for the’life satisfaction’ standard proposed by Cummins. A hierarchic regression model including depressive symptoms, posttraumatic stress symptoms, posttraumatic growth, and unemployment explained 56% of the total variance found in the psychological health domain of the WHOQOL-Bref scale. Posttraumatic growth made the strongest contribution to the model, greater than posttraumatic stress symptoms or depressive symptoms. Post-migration stressors like unemployment, weak social network and poor social integration were moderately negatively correlated with posttraumatic growth and

Wilson's disease: start with psychiatric symptoms. Brain magnetic resonance findings

International Nuclear Information System (INIS)

Nagel, Jorge; Miralles, Sabrina

2007-01-01

Wilson's disease - hepatolenticular degeneration - is an autosomal recessive genetic disorder, characterized by an excessive and toxic accumulation of cooper in different tissues. This accumulation is produced by an inherited defect in cooper's biliary excretion. This rare disorder affects approximately one on 30.000 individuals. Signs and symptoms of hepatic, neurologic and psychiatric disease are the most common clinical presentations of symptomatic Wilson's disease. The diagnosis can usually be made by laboratory tests that find a decreased cooper binding protein in blood called ceruloplasmin, an increase in the excretion of cooper in 24 hour urine and the appearance of corneal Kayser-Fleischer ring. We present a 28 years patient who began with depression and panic attacks, followed by neurologic symptoms. Brain MRI was performed and showed different alterations suggesting the diagnosis of this infrequent sickness. (author) [es

An examination of the symptoms of anxiety and parental attitude in children with hemophilia.

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Abali, Osman; Zülfikar, Osman Bülent; Karakoç Demirkaya, Sevcan; Ayaydin, Hamza; Kircelli, Fuat; Duman, Mehtap

2014-01-01

Hemophilia is an inherited disease with serious repercussions. Psychiatric symptoms are frequently seen in children and adolescents with hemophilia. The aim of this study was to assess symptoms of anxiety in children with hemophilia and parental attitude towards children with hemophilia. 42 boys were assessed according to child and adolescent psychiatry. Anxiety symptoms and parental attitude were obtained by the State-Trait Anxiety Scale, the Self-Report for Childhood Anxiety Related Disorders (SCARED) and the Parent Attitude Research Instrument (PARI). The mean age was 11.6 ± 2.5 (range; 7-16). State anxiety scores (44.02 ± 6.9) were higher than trait anxiety scores (32.7 + 7.5). The most interesting results were high scores related to overprotective mothering (47.9 ± 9.7) and the application of strict discipline (39.4 ± 9.1). The total SCARED scores obtained were (23.25 ± 11.3). Assuring a high quality of life is important for children and adolescents with chronic illness. Quality of life is negatively affected by psychiatric symptoms (e.g. anxiety symptoms, depression, intra-familial stress symptoms) in children with hemophilia. This study suggests that high anxiety scores and problems related to parental attitude can be seen in children and adolescents with hemophilia. These problems caused by parental attitude and anxiety symptoms should be considered in the treatment of hemophilia.

Comparison of the Effects of Haloperidol and Benzodiazepines Used for Postictal Psychiatric Symptoms on Seizure Recurrence: A Pilot Study

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Pınar Hanife Kara

2017-09-01

Full Text Available Aim: Patients with epilepsy may experience a number of psychiatric and cognitive symptoms or behavioral manifestations during the period of a seizure and the postictal period. The aim of this pilot study was to compare the effects medications commonly used in emergency departments for postictal psychiatric symptoms on seizure recurrence. Methods: Data of 32 epileptic patients, who presented to İzmir Katip Çelebi University Atatürk Research and Training Hospital Emergency Department with postictal psychiatric symptoms between January 2013 and December 2014, were retrospectively collected. Demographic and clinical data were obtained from the emergency department charts and neurology and psychiatry consultation records. Data regarding administered drugs were obtained from the hospital data processing system. The chi-square test, Mann-Whitney U test and the Kruskal-Wallis test were used as statistical methods. Bonferroni correction was performed for post-hoc analysis. Results: There were no differences in the seizure recurrence rate between benzodiazepine, haloperidol and without medication groups (p>0.05. Conclusion: Our results suggest that benzodiazepines and haloperidol do not affect the development of recurrent seizures when administered for postictal symptoms.

Impact of Deployment-Related Sexual Stressors on Psychiatric Symptoms After Accounting for Predeployment Stressors: Findings From a U.S. National Guard Cohort.

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McCallum, Ethan B; Murdoch, Maureen; Erbes, Christopher R; Arbisi, Paul; Polusny, Melissa A

2015-08-01

This study used a longitudinal research design to examine the impact of predeployment stressors and deployment-related sexual stressors on self-reported psychiatric symptoms of U.S. National Guard soldiers returning from deployments to Iraq or Afghanistan. Prior to deployment, participants completed measures of depression and posttraumatic stress symptoms, along with an inventory of predeployment stressor experiences. At 3-months postdeployment, participants (468 men, 60 women) again completed self-report measures of psychiatric symptoms, along with an inventory of sexual stressors experienced during deployment. We compared a cross-sectional model of sexual stressors' impact on psychiatric symptoms, in which only postdeployment reports were considered, to a longitudinal model in which we adjusted for participants' predeployment stressors and psychiatric symptoms. No participants reported sexual assault during deployment, though sexual harassment was common. The cross-sectional model suggested that deployment-related sexual stressors were significantly associated with postdeployment depression (R(2) = .11) and posttraumatic stress symptoms (R(2) = .10). Once predeployment factors were taken into consideration, however, sexual stressors were no longer significant. The results did not support the notion of lasting negative impact for low-level sexual stressors (e.g., sexual harassment) during deployment after predeployment stressors are accounted for. Future studies of sexual stressors should consider longitudinal designs. © 2015 International Society for Traumatic Stress Studies.

Severity of self-reported diseases and symptoms in Denmark

DEFF Research Database (Denmark)

Iburg, Kim Moesgaard; Rasmussen, Niels Kristian; Avlund, Kirsten

2006-01-01

, more frequently than males, reported on all symptoms and all disease groups except injuries. People with relatively low levels of education reported most diseases, especially musculoskeletal and cardiovascular diseases, more frequently than people with higher education. Age-adjusted mean SF-36 scores...... for all dimensions combined showed that the symptoms of melancholy/depression and breathing difficulties, psychiatric disorders and respiratory diseases scored lowest (i.e. were most often associated with worse health). Females had lower SF-36 combined scores (worse health) than males on all symptoms. We......OBJECTIVE: To estimate and rank the relative severity of self-reported diseases and symptoms in Denmark. METHOD: The 1994 Danish Health and Morbidity Survey collected data from 5,472 Danes older than 16 years of age. Interviews (response frequency: 79%) gave information on diseases and symptoms...

High prevalence of body dysmorphic disorder symptoms in patients seeking rhinoplasty.

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Picavet, Valerie A; Prokopakis, Emmanuel P; Gabriëls, Lutgardis; Jorissen, Mark; Hellings, Peter W

2011-08-01

Nasal aesthetic deformities may be associated with significant body image dissatisfaction. The only diagnostic category in the current list of psychiatric disorders that directly addresses these concerns is body dysmorphic disorder. This large-scale study determined the prevalence of body dysmorphic disorder and its symptoms in patients seeking rhinoplasty and evaluated the clinical profile of these patients. Two hundred twenty-six patients were given questionnaires including demographic characteristics, visual analogue scales for nasal shape, the Yale-Brown Obsessive Compulsive Scale modified for body dysmorphic disorder to assess severity of symptoms, a generic quality-of-life questionnaire, and the Derriford Appearance Scale 59, to assess appearance-related disruption of everyday living. Independent observers scored the nasal shape. Thirty-three percent of patients showed at least moderate symptoms of body dysmorphic disorder. Aesthetic goals (p dysmorphic disorder scores correlated inversely with the subjective nasal scoring (n = 210, p dysmorphic disorder symptoms significantly reduced the generic quality of life (n = 160, p dysmorphic disorder symptoms in an aesthetic rhinoplasty population is high. Patients undergoing revision rhinoplasty and with psychiatric history are particularly at risk. Body dysmorphic disorder symptoms significantly reduce the quality of life and cause significant appearance-related disruption of everyday living. Risk, III.

Work-related stress disorders: variability in clinical expression and pitfalls in psychiatric diagnosis.

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Buselli, Rodolfo; Veltri, Antonello; Baldanzi, Sigrid; Bozzi, Silvia; Marino, Riccardo; Chiumiento, Martina; Dell'Osso, Liliana; Cristaudo, Alfonso

2016-03-24

Putative occupational stress-related psychiatric disorders are Adjustment Disorders (AD) and Post-Traumatic Stress Disorder (PTSD). Mood Disorders (MD) are not excluded but are unlikely to be identified as occupational diseases. The differential diagnosis between AD and MD is not easy and is based on strict categorical criteria. The aim of this study  was to explore differences in personality and mood spectrum symptoms among workers investigated for occupational stress suffering from AD or MD. Sixty-two patients with AD and 43 with MD were recruited and evaluated by means of rating scales for psychosocial occupational risk and work-related stress (WHS, CDL, OSQ), for sleep disturbances (PSQI), for personality disorders (SCID-II) and for mood spectrum symptoms (MOODS-SR). The diagnostic groups did not differ for WHS, OSQ and PSQI scores. The duration of exposure to stressful/adversative work situations was significantly higher in the MD group (p=0.03). Positive family psychiatric history (p=0.005), personality disorders (p=0.009) and pathological personality traits (p<0.0001) were significantly more frequent in the MD group. The MOODS-SR questionnaire total score (p=0.019) and the manic component score (p=0.001) but not the depressive score were significantly higher in the MD group. The present study suggests that  positive family psychiatric history, pathological personality traits and  spectrum manic symptoms represent markers of vulnerability and low resilience for workers exposed to occupational stress. These characteristics could weaken the etiological relationship between work-related stress and an initial  major depressive episode when it is under investigation as a possible occupational disease.

Attenuated psychotic and basic symptom characteristics in adolescents with ultra-high risk criteria for psychosis, other non-psychotic psychiatric disorders and early-onset psychosis.

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Lo Cascio, Nella; Saba, Riccardo; Hauser, Marta; Vernal, Ditte Lammers; Al-Jadiri, Aseel; Borenstein, Yehonatan; Sheridan, Eva M; Kishimoto, Taishiro; Armando, Marco; Vicari, Stefano; Fiori Nastro, Paolo; Girardi, Paolo; Gebhardt, Eva; Kane, John M; Auther, Andrea; Carrión, Ricardo E; Cornblatt, Barbara A; Schimmelmann, Benno G; Schultze-Lutter, Frauke; Correll, Christoph U

2016-10-01

While attenuated psychotic symptoms (APS) and basic symptoms (BS) are the main current predictors of psychosis in adults, studies in adolescents are scarce. Thus, we (1) described the prevalence and severity of positive, negative, disorganization, general, and basic symptoms in adolescent patients at ultra-high risk for psychosis (UHR), with other non-psychotic psychiatric disorders (PC) and with early-onset psychosis (EOP); and (2) investigated BS criteria in relation to UHR criteria. Sixty-nine 12-18-year-old adolescents (15.3 ± 1.7 years, female = 58.0 %, UHR = 22, PC = 27, EOP = 20) were assessed with the structured interview for prodromal syndromes (SIPS) and the schizophrenia proneness instrument-child and youth version (SPI-CY). Despite similar current and past 12-month global functioning, both UHR and EOP had significantly higher SIPS total and subscale scores compared to PC, with moderate-large effect sizes. Expectedly, UHR had significantly lower SIPS positive symptom scores than EOP, but similar SIPS negative, disorganized, and general symptom scores. Compared to PC, both EOP and UHR had more severe basic thought and perception disturbances, and significantly more often met cognitive disturbances criteria (EOP = 50.0 %, UHR = 40.9 %, PC = 14.8 %). Compared to UHR, both EOP and PC significantly less often met cognitive-perceptive BS criteria (EOP = 35.0 %, UHR = 68.2 %, PC = 25.9 %). BS were significantly more prevalent in both EOP and UHR than PC, and UHR were similar to EOP in symptom domains. Given the uncertain outcome of adolescents at clinical high-risk of psychosis, future research is needed to determine whether the combined assessment of early subjective disturbances with observable APS can improve the accuracy of psychosis prediction.

Dissociation, childhood trauma, and ataque de nervios among Puerto Rican psychiatric outpatients.

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Lewis-Fernández, Roberto; Garrido-Castillo, Pedro; Bennasar, Mari Carmen; Parrilla, Elsie M; Laria, Amaro J; Ma, Guoguang; Petkova, Eva

2002-09-01

This study examined the relationships of dissociation and childhood trauma with ataque de nervios. Forty Puerto Rican psychiatric outpatients were evaluated for frequency of ataque de nervios, dissociative symptoms, exposure to trauma, and mood and anxiety psychopathology. Blind conditions were maintained across assessments. Data for 29 female patients were analyzed. Among these 29 patients, clinician-rated dissociative symptoms increased with frequency of ataque de nervios. Dissociative Experiences Scale scores and diagnoses of panic disorder and dissociative disorders were also associated with ataque frequency, before corrections were made for multiple comparisons. The rate of childhood trauma was uniformly high among the patients and showed no relationship to dissociative symptoms and disorder or number of ataques. Frequent ataques de nervios may, in part, be a marker for psychiatric disorders characterized by dissociative symptoms. Childhood trauma per se did not account for ataque status in this group of female outpatients.

Complex Psychiatric Comorbidity of Treatment-Seeking Youth with Autism Spectrum Disorder and Anxiety Symptoms

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Hepburn, Susan L.; Stern, Jessica A.; Blakeley-Smith, Audrey; Kimel, Lila K.; Reaven, Judith A.

2014-01-01

This descriptive study examines the complexity of psychiatric comorbidity in treatment-seeking youth with ASD and anxiety symptoms. Forty-two parents of youth with ASD and anxiety (ages 8-14) completed a structured diagnostic interview (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version). Youth…

Prevalence of elevated serum anti-N-methyl-D-aspartate receptor antibody titers in patients presenting exclusively with psychiatric symptoms: a comparative follow-up study.

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Ando, Yoshihito; Shimazaki, Haruo; Shiota, Katsutoshi; Tetsuka, Syuichi; Nakao, Koichi; Shimada, Tatsuhiro; Kurata, Kazumi; Kuroda, Jinichi; Yamashita, Akihiro; Sato, Hayato; Sato, Mamoru; Eto, Shinkichi; Onishi, Yasunori; Tanaka, Keiko; Kato, Satoshi

2016-07-08

Increasing numbers of patients with elevated anti-N-methyl-D-aspartate (NMDA) receptor antibody titers presenting exclusively with psychiatric symptoms have been reported. The aim of the present study was to clarify the prevalence of elevated serum anti-NMDA receptor antibody titers in patients with new-onset or acute exacerbations of psychiatric symptoms. In addition, the present study aimed to investigate the association between elevated anti-NMDA receptor titers and psychiatric symptoms. The present collaborative study included 59 inpatients (23 male, 36 female) presenting with new-onset or exacerbations of schizophrenia-like symptoms at involved institutions from June 2012 to March 2014. Patient information was collected using questionnaires. Anti-NMDA receptor antibody titers were measured using NMDAR NR1 and NR2B co-transfected human embryonic kidney (HEK) 293 cells as an antigen (cell-based assay). Statistical analyses were performed for each questionnaire item. The mean age of participants was 42.0 ± 13.7 years. Six cases had elevated serum anti-NMDA antibody titers (10.2 %), four cases were first onset, and two cases with disease duration >10 years presented with third and fifth recurrences. No statistically significant difference in vital signs or major symptoms was observed between antibody-positive and antibody-negative groups. However, a trend toward an increased frequency of schizophrenia-like symptoms was observed in the antibody-positive group. Serum anti-NMDA receptor antibody titers may be associated with psychiatric conditions. However, an association with specific psychiatric symptoms was not observed in the present study. Further studies are required to validate the utility of serum anti-NMDA receptor antibody titer measurements at the time of symptom onset.

Prospective comparison of a new visual prostate symptom score versus the international prostate symptom score in men with lower urinary tract symptoms.

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van der Walt, Chris L E; Heyns, Chris F; Groeneveld, Adam E; Edlin, Rachel S; van Vuuren, Stephan P J

2011-07-01

To evaluate the correlation between the International Prostate Symptom Score (IPSS) and a new Visual Prostate Symptom Score (VPSS) using pictures rather than words to assess lower urinary tract symptoms (LUTS). Four IPSS questions related to frequency, nocturia, weak stream, and quality of life (QoL) were represented by pictograms in the VPSS. Men with LUTS were given the IPSS and VPSS to complete. Peak (Qmax.) and average (Qave.) urinary flow rates were measured. Statistical analysis was performed using Student's t, Fisher's exact, and Spearman's correlation tests. The educational level of the 96 men (mean age 64, range 33-85 years) evaluated August 2009 to August 2010 was school grade 8-12 (62%), grade 1-7 (28%), university education (6%), and no schooling (4%). The IPSS was completed without assistance by 51 of 96 men (53%) and the VPSS by 79 of 96 men (82%) (Pvs grade>10 groups, the IPSS required assistance in 27 of 31 men (87%) vs 9 of 38 men (24%) (Pvs 3 of 38 men (8%) (P=.014). There were statistically significant correlations between total VPSS, Qmax. and Qave., total VPSS and IPSS, and individual VPSS parameters (frequency, nocturia, weak stream and QoL) vs their IPSS counterparts. The VPSS correlates significantly with the IPSS, Qmax. and Qave., and can be completed without assistance by a greater proportion of men with limited education, indicating that it may be more useful than the IPSS in patients who are illiterate or have limited education. Copyright © 2011 Elsevier Inc. All rights reserved.

Sintomas de conteúdo religioso em pacientes psiquiátricos Symptoms of religious content on psychiatric patients

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Clarissa de Rosalmeida Dantas

1999-09-01

Full Text Available INTRODUÇÃO: Vários trabalhos têm identificado a importância da religiosidade na vida pessoal, nas relações sociais, nas atitudes e representações relacionadas a saúde e doença, assim como na composição dos sintomas psiquiátricos. Poucos estudos empíricos em nosso meio têm investigado as relações entre religiosidade e perfil psicopatológico. OBJETIVO: O presente trabalho visa avaliar fatores socioculturais e sintomas psicopatológicos gerais associados à presença e intensidade de sintomas com conteúdos religiosos ou místicos. MÉTODO: Foram estudadas 200 internações consecutivas na unidade psiquiátrica da Unicamp (Universidade Estadual de Campinas. As escalas de avaliação de sintomas psicopatológicos foram: BPRS-forma expandida e o GAS, acrescentando-se um item referente a sintomas religiosos, o qual explicitamente solicitava ao avaliador que verificasse a presença e intensidade de sintomas de conteúdo religioso. O nível de significância estatística considerado foi pBACKGROUND: A number of studies have identified the role of religion in personal life, social relationships, attitudes and values related to health and mental illness. Moreover, religious personal experience has been proved to contribute to the genesis and configuration of psychiatric symptoms. Few empirical studies have investigated in Brazil the interaction of religiosity and psychopathology. OBJECTIVE: The study aims to evaluate the relationship between mental symptoms of religious content, social and cultural factors and general psychiatric symptoms. METHOD: A number of 200 consecutive admissions in a General Hospital psychiatric in-patient unit were reviewed. In order to identify symptoms of religious content, a specific item was added to the BPRS-extended form. Statistical significance was considered above the 0.01 level. RESULTS: Moderate to intense symptoms of religious content were present in 15.7% of all patients. No significant interactions

Applicability of the Chinese version of the Hypomania Symptom Checklist (HCL-32 scale for outpatients of psychiatric departments in general hospitals.

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Xiao Huang

Full Text Available OBJECTIVES: This study aimed to determine the suitability of the Chinese version of the Hypomania Symptom Checklist (HCL-32 scale for psychiatric department outpatients with mood disorders in Chinese general hospitals, and provide a theoretical basis for the application of the HCL-32 scale. METHODS: Outpatients with mood disorders receiving continuous treatment in the psychiatric medicine department of three top-ranking general hospitals in three cities completed scoring the HCL-32 scale. RESULTS: A total of 1010 patients were recruited. 417 were diagnosed with bipolar disorder (236 for type I and 181 for type II and 593 were depression. Four factors with eigenvalues >1 were considered. Factor 1 with an eigenvalue of 5.5 was labeled "active/cheerful". Factor 2 with an eigenvalue of 2.7 was labeled "adventurous/irritable." The coefficient of internal consistency reliability of the HCL-32 total scale was 0.84, and the coefficients for factors 1 and 2 were 0.84 and 0.88, respectively. With the total score of HCL-32≥14 as positive standard, the sensitivity of HCL-32 was calculated at 69.30% and the specificity was 97.81%. CONCLUSIONS: Results showed that HCL-32 had a preferable reliability and validity and was suitable as auxiliary means for bipolar disorder screening in general hospitals.

Effects of sports participation on psychiatric symptoms and brain activations during sports observation in schizophrenia.

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Takahashi, H; Sassa, T; Shibuya, T; Kato, M; Koeda, M; Murai, T; Matsuura, M; Asai, K; Suhara, T; Okubo, Y

2012-03-20

Weight gain has been identified as being responsible for increased morbidity and mortality rates of schizophrenia patients. For the management of weight gain, exercise is one of the most acknowledged interventions. At the same time, exercise and sports have been recognized for their positive impact on psychiatric symptoms of schizophrenia. However, the neurobiological basis for this remains poorly understood. We aimed to examine the effect of sports participation on weight gain, psychiatric symptoms and brain activation during sports observation in schizophrenia patients. Thirteen schizophrenia patients who participated in a 3-month program, including sports participation and 10 control schizophrenia patients were studied. In both groups, body mass index (BMI), Positive and Negative Syndrome Scale (PANSS), and brain activation during observation of sports-related actions measured by functional magnetic resonance imaging were accessed before and after a 3-month interval. BMI and general psychopathology scale of PANSS were significantly reduced in the program group but not in the control group after a 3-month interval. Compared with baseline, activation of the body-selective extrastriate body area (EBA) in the posterior temporal-occipital cortex during observation of sports-related actions was increased in the program group. In this group, increase in EBA activation was associated with improvement in the general psychopathology scale of PANSS. Sports participation had a positive effect not only on weight gain but also on psychiatric symptoms in schizophrenia. EBA might mediate these beneficial effects of sports participation. Our findings merit further investigation of neurobiological mechanisms underlying the therapeutic effect of sports for schizophrenia.

Predictive values of psychiatric symptoms for internet addiction in adolescents: a 2-year prospective study.

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Ko, Chih-Hung; Yen, Ju-Yu; Chen, Cheng-Sheng; Yeh, Yi-Chun; Yen, Cheng-Fang

2009-10-01

To evaluate the predictive values of psychiatric symptoms for the occurrence of Internet addiction and to determine the sex differences in the predictive value of psychiatric symptoms for the occurrence of Internet addiction in adolescents. Internet addiction, depression, attention-deficit/hyperactivity disorder, social phobia, and hostility were assessed by self-reported questionnaires. Participants were then invited to be assessed for Internet addiction 6, 12, and 24 months later (the second, third, and fourth assessments, respectively). Ten junior high schools in southern Taiwan. A total of 2293 (1179 boys and 1114 girls) adolescents participated in the initial investigation. The course of time. Internet addiction as assessed using the Chen Internet Addiction Scale. Depression, attention-deficit/hyperactivity disorder, social phobia, and hostility were found to predict the occurrence of Internet addiction in the 2-year follow-up, and hostility and attention-deficit/hyperactivity disorder were the most significant predictors of Internet addiction in male and female adolescents, respectively. These results suggest that attention-deficit/hyperactivity disorder, hostility, depression, and social phobia should be detected early on and intervention carried out to prevent Internet addiction in adolescents. Also, sex differences in psychiatric comorbidity should be taken into consideration when developing prevention and intervention strategies for Internet addiction.

Comorbidity of psychiatric disorders and symmetric distal polyneuropathy among type II diabetic outpatients.

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Moreira, R O; Papelbaum, M; Fontenelle, L F; Appolinario, J C; Ellinger, V C M; Coutinho, W F; Zagury, L

2007-02-01

The objective of the present study was to establish the frequency of psychiatric comorbidity in a sample of diabetic patients with symmetric distal polyneuropathy (SDPN). Sixty-five patients with type 2 diabetes mellitus were selected consecutively to participate in the study at Instituto Estadual de Diabetes e Endocrinologia. All patients were submitted to a complete clinical and psychiatric evaluation, including the Portuguese version of the structured clinical interview for DSM-IV, the Beck Depression Inventory, the Neuropathy Symptom Score, and Neuropathy Disability Score. SDPN was identified in 22 subjects (33.8%). Patients with and without SDPN did not differ significantly regarding sociodemographic characteristics. However, a trend toward a worse glycemic control was found in patients with SDPN in comparison to patients without SDPN (HbA1c = 8.43 +/- 1.97 vs 7.48 +/- 1.95; P = 0.08). Patients with SDPN exhibited axis I psychiatric disorders significantly more often than those without SDPN (especially anxiety disorders, in general (81.8 vs 60.0%; P = 0.01), and major depression--current episode, in particular (18.2 vs 7.7%; P = 0.04)). The severity of the depressive symptoms correlated positively with the severity of SDPN symptoms (r = 0.38; P = 0.006), but not with the severity of SDPN signs (r = 0.07; P = 0.56). In conclusion, the presence of SDPN seems to be associated with a trend toward glycemic control. The diagnosis of SDPN in diabetic subjects seems also to be associated with relevant psychiatric comorbidity, including anxiety and current mood disorders.

A network view on psychiatric disorders: network clusters of symptoms as elementary syndromes of psychopathology.

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Goekoop, Rutger; Goekoop, Jaap G

2014-01-01

The vast number of psychopathological syndromes that can be observed in clinical practice can be described in terms of a limited number of elementary syndromes that are differentially expressed. Previous attempts to identify elementary syndromes have shown limitations that have slowed progress in the taxonomy of psychiatric disorders. To examine the ability of network community detection (NCD) to identify elementary syndromes of psychopathology and move beyond the limitations of current classification methods in psychiatry. 192 patients with unselected mental disorders were tested on the Comprehensive Psychopathological Rating Scale (CPRS). Principal component analysis (PCA) was performed on the bootstrapped correlation matrix of symptom scores to extract the principal component structure (PCS). An undirected and weighted network graph was constructed from the same matrix. Network community structure (NCS) was optimized using a previously published technique. In the optimal network structure, network clusters showed a 89% match with principal components of psychopathology. Some 6 network clusters were found, including "Depression", "Mania", "Anxiety", "Psychosis", "Retardation", and "Behavioral Disorganization". Network metrics were used to quantify the continuities between the elementary syndromes. We present the first comprehensive network graph of psychopathology that is free from the biases of previous classifications: a 'Psychopathology Web'. Clusters within this network represent elementary syndromes that are connected via a limited number of bridge symptoms. Many problems of previous classifications can be overcome by using a network approach to psychopathology.

Brain tumors in patients primarly treated psychiatrically

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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.

Correlation between overactive bladder symptom score and neuropsychological parameters in Alzheimer’s disease patients with lower urinary tract symptom

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Jung, Ha Bum; Choi, Don Kyoung; Lee, Seong Ho; Cho, Sung Tae; Na, Hae Ri; Park, Moon Ho

2017-01-01

ABSTRACT Purpose To examine an association between the overactive bladder symptom score (OABSS) and neuropsychological parameters. Moreover, we investigate the factors that affect each item in the questionnaire. Materials and Methods A total of 376 patients (males: 184; females: 192) with probable Alzheimer’s disease (AD) were recruited. Cognitive testing was conducted using the Mini Mental Status Examination (MMSE), Clinical Dementia Rating (CDR) scale, Global Deterioration Scale (GDS), and Barthel Activities of Daily Living (ADL). Lower urinary tract symptom (LUTS) was assessed using OABSS and voiding diary. Results The prevalence of overactive bladder (OAB) (defined as OABSS ≥3 with an urgency score of ≥2) in patients with AD was 72.6%. Among the OAB subjects, the most common severity of symptom was moderate (72.6%), followed by mild (21.2%), and severe (5.8%). It was found that OABSS had a very high correlation with aging (r=0.75; p<0.001). When compared with neuropsychological parameters, it was found that OABSS was highly correlated with the CDR scores (r=0.446; p<0.001). However, no significant correlation was found between the changes in OABSS scores and those in other neuropsychological parameters. Based on the individual symptom scores, urgency incontinence was highly correlated with the CDR scores (r=0.43; p<0.001). Conclusions OABSS is a useful tool in assessing AD patients with LUTS. There was a consistent positive association between OABSS severity, including urgency incontinence, and CDR scores. PMID:27802001

Ayahuasca in adolescence: a preliminary psychiatric assessment.

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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.

Sedentary behavior and psychiatric symptoms in overweight and obese adults with schizophrenia and schizoaffective disorders (WAIST Study).

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Janney, Carol A; Ganguli, Rohan; Richardson, Caroline R; Holleman, Rob G; Tang, Gong; Cauley, Jane A; Kriska, Andrea M

2013-04-01

Examine the association between sedentary behavior and psychiatric symptoms among overweight and obese adults with schizophrenia or schizoaffective disorders (SZO/SA). Randomized clinical trial; Weight Assessment and Intervention in Schizophrenia Treatment (WAIST) Study: baseline data collected 2005-2008. University of Pittsburgh Medical Center, Pittsburgh, PA, USA. Community-dwelling adults diagnosed with SZO/SA, with mild symptom severity [Positive and Negative Syndrome Scale (PANSS)losing weight, age 18-70years, BMI>27kg/m(2). Objectively measured sedentary behavior by accelerometry, and psychopathology assessed by PANSS. Participants wore the actigraphs for 7 consecutive days during their waking hours. Sedentary behavior was defined as ≤100 counts per minute during wear-time and excluded sleep and non-wear time. On average, 81% of the participant's monitoring time or 756min/day was classified as sedentary behavior using accelerometry. No association was observed between sedentary behaviors and PANSS psychiatric symptoms [total (p≥0.75), positive (p≥0.81), negative (p≥0.59) and general psychopathology (p≥0.65) subscales]. No association was observed between sedentary behaviors and age, race, gender and BMI. From a clinical and public health perspective, the amount of time (approximately 13h) and percentage of time (81% excluding non-wear time associated with sleeping) engaged in sedentary behavior among overweight and obese adults in this population is alarming, and points to an urgent need for interventions to decrease sedentary behaviors. The lack of associations between sedentary behavior and psychiatric symptoms may be due to a ceiling effect for sedentary behavior. Copyright © 2013 Elsevier B.V. All rights reserved.

Sintomas psiquiátricos entre pacientes com demência atendidos em um serviço ambulatorial Psychiatric symptoms amongst outpatients with dementia in São Paulo, Brazil

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OSVALDO P. ALMEIDA

1999-12-01

of dementia (ICD-10 assessed at a Memory Clinic in São Paulo-Brazil between February 1997 and May 1998. The mental and cognitive state of patients were assessed with an extended version of the SRQ-20 and the MMSE respectively. Thirty-four (45.3% out of a total of 75 subjects scored 8 or more on the SRQ-20, indicating the presence of significant psychiatric morbidity. Depressive symptoms were reported by 69.3% of patients. Persecutory ideas and auditory hallucinations were observed in 20.0% and 16.0% of the sample respectively. Eight subjects (10.7% described suicidal ideation 3/4 they all displayed depressive symptoms. Patients with scores on the SRQ-20 3 8 or who described suicidal ideation were significantly younger than their counterparts. Auditory hallucinations were more frequent amongst subjects with lower MMSE scores. There were no sex differences in the distribution of the psychiatric symptoms under investigation. The assessment of patients with dementia should always include a detailed psychiatric examination, as the detection and treatment of such symptoms may contribute to decrease the stress of patients and the burden on carers.

Psychiatric disorders associated with Cushing's syndrome.

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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.

Psychiatric and subjective symptoms and cerebral blood flow in patients with chronic cerebral infarction after treatment with Ca antagonist (nilvadipine). Quantitative measurement of cerebral blood flow by the 123IMP-SPECT ARG method

International Nuclear Information System (INIS)

Sakayori, Osamu; Kitamura, Shin; Mishina, Masahiro; Yamazaki, Mineo; Terashi, Akirou

1997-01-01

Psychiatric and subjective symptoms such as headache, dizziness, lack of spontaneity, anxiety, and a depressive state are often found in patients with chronic cerebral infarction. Some Ca antagonists are reported to relieve such symptoms. The purpose of the present study was to investigate the relationship between psychiatric and subjective symptoms and cerebral blood flow (CBF) in cerebral infarction and to evaluate the clinical effects of Ca antagonists from the standpoint of the cerebral circulation. Nilvadipine was administered to is patients with chronic cerebral infarction and their CBF was measured by the 123 IMP-SPECT ARG method before and at 8 weeks after the nilvadipine treatment. The CBF in patients with hypertension was increased by 11% after giving nilvadipine. Patients without hypertension showed no tendency for elevation of their CBF. Patients who were relieved from some psychiatric symptoms revealed a 14% increase of CBF in all cortical regions, and a significant increase was noted in the frontal and temporal regions. In other patients without changes in psychiatric symptoms, the CBF did not increase in any of the cortical regions. No relationship between symptoms and CBF was observed in any of the patients with subjective symptoms. Our study demonstrated a close correlation between psychiatric symptoms and CBF. We speculate that psychiatric symptoms in chronic cerebral infarction may reflect diffuse brain dysfunctions. We also conclude that nilvadipine is more effective in relieving psychiatric symptoms in patients with hypertensive cerebral infarction. It is inferred that nilvadipine may be more effective in relieving psychiatric symptoms in patients with hypertension. (author)

Psychiatric and cognitive symptoms in Huntington's disease are modified by polymorphisms in catecholamine regulating enzyme genes

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Vinther-Jensen, T; Nielsen, Troels Tolstrup; Budtz-Jørgensen, E

2016-01-01

Huntington's disease (HD) is an autosomal dominantly inherited neurodegenerative disorder characterized by motor, psychiatric, and cognitive manifestations. HD is caused by a CAG repeat expansion in the Huntingtin (HTT) gene but the exact pathogenesis remains unknown. Dopamine imbalance has......-described cohort of Danish HD gene-expansion carriers. We show that cognitive impairment and psychiatric symptoms in HD are modified by polymorphisms in the monoamine oxidase A (MAOA) and catechol-O-methyltransferase (COMT) genes and by the 4p16.3 B haplotype. These results support the theory of dopamine imbalance...

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

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

2013-02-01

In this Part II psychiatric disorders coexisting with organic diseases are discussed. "Comorbidity phenomenon" defines the not univocal interrelation between medical illnesses and psychiatric disorders, each other negatively influencing morbidity and mortality. Most severe psychiatric disorders, such as schizophrenia, bipolar disorder and depression, show increased prevalence of cardiovascular disease, related to poverty, use of psychotropic medication, and higher rate of preventable risk factors such as smoking, addiction, poor diet and lack of exercise. Moreover, psychiatric and organic disorders can develop together in different conditions of toxic substance and prescription drug use or abuse, especially in the emergency setting population. Different combinations with mutual interaction of psychiatric disorders and substance use disorders are defined by the so called "dual diagnosis". The hypotheses that attempt to explain the psychiatric disorders and substance abuse relationship are examined: (1) common risk factors; (2) psychiatric disorders precipitated by substance use; (3) psychiatric disorders precipitating substance use (self-medication hypothesis); and (4) synergistic interaction. Diagnostic and therapeutic difficulty concerning the problem of dual diagnosis, and legal implications, are also discussed. Substance induced psychiatric and organic symptoms can occur both in the intoxication and withdrawal state. Since ancient history, humans selected indigene psychotropic plants for recreational, medicinal, doping or spiritual purpose. After the isolation of active principles or their chemical synthesis, higher blood concentrations reached predispose to substance use, abuse and dependence. Abuse substances have specific molecular targets and very different acute mechanisms of action, mainly involving dopaminergic and serotoninergic systems, but finally converging on the brain's reward pathways, increasing dopamine in nucleus accumbens. The most common

Assessment of the performance of the American Urological Association symptom score in 2 distinct patient populations.

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Johnson, Timothy V; Schoenberg, Evan D; Abbasi, Ammara; Ehrlich, Samantha S; Kleris, Renee; Owen-Smith, Ashli; Gunderson, Kristin; Master, Viraj A

2009-01-01

Recent research suggests that low education and illiteracy may drive misunderstanding of the American Urological Association Symptom Score, a key tool in the American Urological Association benign prostatic hyperplasia guidelines. It is unclear whether misunderstanding is confined to patients of low socioeconomic status. Therefore, we reevaluated the prevalence and impact of this misunderstanding in a county vs university hospital population. This prospective study involved 407 patients from a county hospital and a university hospital who completed the American Urological Association Symptom Score as self-administered and then as interviewer administered. Responses were compared by calculating correlation coefficients and weighted kappa statistics to assess patient understanding of the American Urological Association Symptom Score. Multivariate logistic regression analyses were used to examine the association between patient characteristics and poor understanding of the American Urological Association Symptom Score. Of the patients 72% understood all 7 American Urological Association Symptom Score questions. Of the measured demographic variables only education level significantly affected this understanding. Compared to patients with more than 12 years of education county hospital patients with less than 9 years of education were 57.06 times more likely to misunderstand the American Urological Association Symptom Score (95% CI 14.32-329.34) while university hospital patients with less than 9 years of education were 38.27 times more likely to misunderstand the American Urological Association Symptom Score (95% CI 1.69-867.83). Of county hospital patients 31% and of university hospital patients 21% significantly misrepresented their symptom severity according to current guidelines. Patients with low education regardless of location are more likely to misunderstand the American Urological Association Symptom Score, misrepresent their symptoms and, therefore, receive

A naturalistic study on the relationship among resilient factors, psychiatric symptoms, and psychosocial functioning in a sample of residential patients with psychosis.

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Poloni, Nicola; Zizolfi, Daniele; Ielmini, Marta; Pagani, Roberto; Caselli, Ivano; Diurni, Marcello; Milano, Anna; Callegari, Camilla

2018-01-01

Resilience is a multidimensional process of adaptation aimed to overcome stressful or traumatic life experiences; only in the last few years it has been considered as a personal resource in psychosis and schizophrenia. This study aimed to assess the relationship between intrapersonal and interpersonal resilience factors and schizophrenia, particularly whether and how resilience can improve the course of psychotic illness. In this observational study, all patients recruited had to fulfill the following inclusion criteria: diagnosis of schizophrenia spectrum disorder ( Diagnostic and Statistical Manual of Mental Disorders-5 ); aged between 18 and 65 years; provided written informed consent; to be clinically stable (Clinical Global Impression Scale SPSS. Partial correlations were evaluated to assess the relationship between RSA total scores and subscores and BPRS-A, SANS, SAPS, and LSP total scores, removing the common variance among variables. Then, a series of hierarchical multiple linear regression models were used to examine the association between resilience, psychopathology, and psychosocial functioning. A statistically significant negative correlation among intrapersonal resilience factors and BPRS-A total score emerged, predicting psychiatric symptoms severity and explaining approximately 31% of the BPRS-A variance; otherwise, only the interpersonal resilience factors associated with social support were statistically and positively correlated with LSP total score, predicting psychosocial functioning and explaining the 11% of LSP variance. The specific contribution that resilience factors may have in predicting the severity of symptoms and the extent of psychosocial functioning emphasizes the importance of personalizing treatment for patients affected by schizophrenia, promoting personal resources, and translating them into better outcomes.

Correlation between overactive bladder symptom score and neuropsychological parameters in Alzheimer's disease patients with lower urinary tract symptom.

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Jung, Ha Bum; Choi, Don Kyoung; Lee, Seong Ho; Cho, Sung Tae; Na, Hae Ri; Park, Moon Ho

2017-01-01

To examine an association between the overactive bladder symptom score (OABSS) and neuropsychological parameters. Moreover, we investigate the factors that affect each item in the questionnaire. A total of 376 patients (males: 184; females: 192) with probable Alzheimer's disease (AD) were recruited. Cognitive testing was conducted using the Mini Mental Status Examination (MMSE), Clinical Dementia Rating (CDR) scale, Global Deterioration Scale (GDS), and Barthel Activities of Daily Living (ADL). Lower urinary tract symptom (LUTS) was assessed using OABSS and voiding diary. The prevalence of overactive bladder (OAB) (defined as OABSS ≥3 with na urgency score of ≥2) in patients with AD was 72.6%. Among the OAB subjects, the most common severity of symptom was moderate (72.6%), followed by mild (21.2%), and severe (5.8%). It was found that OABSS had a very high correlation with aging (r=0.75; pincontinence was highly correlated with the CDR scores (r=0.43; pincontinence, and CDR scores. Copyright® by the International Brazilian Journal of Urology.

Housework, paid work and psychiatric symptoms Trabalho doméstico, trabalho assalariado e sintomas psiquiátricos

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Vilma S Santana

2001-02-01

Full Text Available OBJECTIVE: To evaluate the hypothesis that work burden, the simultaneous engagement in paid work and unpaid family housework, is a potential risk factor for psychiatric symptoms among women. METHODS: A cross-sectional study was carried out with 460 women randomly selected from a poor area of the city of Salvador, Brazil. Women between 18 to 70 years old, who reported having a paid occupation or were involved in unpaid domestic activities for their families, were eligible. Work burden-related variables were defined as: a double work shift, i.e., simultaneous engagement in a paid job plus unpaid housework; and b daily working time. Psychiatric symptoms were collected through a validated questionnaire, the QMPA. RESULTS: Positive, statistically significant associations between high (>7 symptoms QMPA scores and either double work shift (prevalence ratio -- PR=2.04, 95% confidence interval -- CI: 1.16, 2.29 or more than 10 hours of daily work time (PR=2.29, 95% CI: 1.96, 3.43 were found after adjustment for age, marital status and number of pre-school children. CONCLUSIONS: Major correlates of high QMPA scores are work burden variables. Being married or having pre-school children are also associated with high QMPA scores only when associated with work burden.OBJETIVO: Avaliar a hipótese de que a dupla carga de trabalho é um fator de risco potencial para sintomas psiquiátricos em mulheres. MÉTODOS: Estudo transversal realizado com 460 mulheres aleatoriamente selecionadas de uma área pobre da cidade de Salvador, BA, Brasil. Foram selecionadas mulheres entre 18 e 70 anos de idade, que referiram ter ocupação paga ou estar envolvidas com trabalho doméstico não remunerado para as suas famílias. A sobrecarga de trabalho foi analisada como: a dupla jornada de trabalho, i.e., envolvimento simultâneo em trabalho pago e trabalho não pago para a família; e b duração da jornada diária total de trabalho. Os sintomas psiquiátricos foram registrados

Influence of drugs of abuse and alcohol upon patients admitted to acute psychiatric wards: physician's assessment compared to blood drug concentrations.

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Mordal, Jon; Medhus, Sigrid; Holm, Bjørn; Mørland, Jørg; Bramness, Jørgen G

2013-06-01

In acute psychiatric services, rapid and accurate detection of psychoactive substance intake may be required for appropriate diagnosis and intervention. The aim of this study was to investigate the relationship between (a) drug influence as assessed by physicians and (b) blood drug concentrations among patients admitted to acute psychiatric wards. We also explored the possible effects of age, sex, and psychotic symptoms on physician's assessment of drug influence. In a cross-sectional study, the sample comprised 271 consecutive admissions from 2 acute psychiatric wards. At admission, the physician on call performed an overall judgment of drug influence. Psychotic symptoms were assessed with the positive subscale of the Positive and Negative Syndrome Scale. Blood samples were screened for a wide range of psychoactive substances, and quantitative results were used to calculate blood drug concentration scores. Patients were judged as being under the influence of drugs and/or alcohol in 28% of the 271 admissions. Psychoactive substances were detected in 56% of the blood samples. Altogether, 15 different substances were found; up to 8 substances were found in samples from 1 patient. Markedly elevated blood drug concentration scores were estimated for 15% of the patients. Physician's assessment was positively related to the blood drug concentration scores (r = 0.52; P < 0.001), to symptoms of excitement, and to the detection of alcohol, cannabis, and amphetamines. The study demonstrates the major impact of alcohol and drugs in acute psychiatric settings and illustrates the challenging nature of the initial clinical assessment.

Prescribing Patterns in a Psychiatrically Referred Sample of Youth With Autism Spectrum Disorder.

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Shekunov, Julia; Wozniak, Janet; Conroy, Kristina; Pinsky, Elizabeth; Fitzgerald, Maura; de Leon, Melissa F; Belser, Abigail; Biederman, Joseph; Joshi, Gagan

The aim of this study was to examine the pattern of psychopharmacologic interventions in a psychiatrically referred sample of youth with autism spectrum disorder (ASD). This retrospective chart review aimed at collecting demographic and clinical information, including data on DSM-IV-TR criteria-based psychiatric disorders and related current medication treatment and response. Data were collected in December 2011. Clinicians identified the target disorder for each medication and any adverse events. Level of psychopathology and therapeutic response was assessed by the clinician-rated Clinical Global Impressions scale (CGI). Psychiatrically referred youth with ASD (n = 54) suffered from multiple psychopathologies (mean = 2.3) and had a marked level of morbidity (range of baseline CGI-Severity of Illness mean scores, 4.3-5.6). The most prevalent psychopathology was ADHD (83%), anxiety disorders (67%), bipolar spectrum disorder (43%), and mood disorder not otherwise specified (44%). The majority (80%) of the subjects received combination therapy (mean ± SD number of psychotropic medications = 3 ± 1.5). Forty percent of the participants responded on all treatment target symptoms (CGI-Improvement scale score ≤ 2), and an additional 10% experienced response versus nonresponse on a relatively greater number of target symptoms. Half of the subjects reported an adverse event, most commonly weight gain (28%) and sedation (12%), both from antipsychotic medication use. Psychiatrically referred youth with ASD suffer from multiple highly impairing psychiatric disorders that require combination pharmacotherapy. These findings highlight the need for further research to guide clinical decision-making and treatment. © Copyright 2017 Physicians Postgraduate Press, Inc.

结节性硬化症所致精神障碍1例%Psychiatric symptoms in an individual with tuberous sclerosis

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Qiaojin LIU; Jinli GAO

2012-01-01

Tuberous sclerosis is a rare disorder with no specific treatment. In some cases psychological symptoms are the initial presenting symptoms, making the differential diagnosis difficult. We describe a patient with tuberous sclerosis who developed psychiatric symptoms and discuss the use of low-dose quetiapine to control her emotional and behavioral symptoms.

Feigned Symptoms among Defendants Claiming Psychiatric Problems: Survey of 45 Malingerers

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Seyed Mehdi Saberi

2013-03-01

Full Text Available Objective: In many jurisdictions, psychiatric problems are intended for commutation. Therefore, a forensic psychiatrist has an important role in detection of malingering. While several studies evaluate diagnostic tests, it is less known what symptoms are more likely to be imitated by malingerers.Method: In a prospective study [t1] 45 [t2] malingerers, who were diagnosed according to interviews by two forensic psychiatrists, from defendants [t3] with a judicial order for evaluation of mental status and criminal responsibility during a period of eighteen months were examined in legal medicine center of Tehran.[t4] [t5] Participants were assessed in another interview to determine symptoms. Dichotomous symptoms in felony and misdemeanor groups were analyzed using fisher’s exact test. The level of statistical significance was set at P<0.05. [t6] Results: Thirty-eight malingerers were charged with misdemeanors and seven with felonies. Behavioral symptoms were most frequently faked by 35 participants (77.8%. Participants charged with criminal accusation had a significantly lower mean age (P=0.032 and a higher level of education (P=0.008 than other non-criminal defendants. A statistically significant increase in memory function problems was demonstrated in the misdemeanor group (P=0.040. With regard to dual symptom imitation, statistically significant correlations were observed between thought content and perceptual symptoms (P=0.048 for felonies and mood & affect and thought process symptoms (P=0.034, mood & affect and behavioral symptoms (P=0.000 and cognitive function and behavioral symptoms (P=0.039 for misdemeanors. In general, many simulators attempted to mimic simple symptoms of behavioral disorders. Probably felony offenses need less accurate programming; therefore, their rates are higher in older, less educated participants.Conclusion: This study demonstrated that differences between presenting symptoms among different offenses may not be

Bidirectional Linkages between Psychological Symptoms and Sexual Activities among African American Adolescent Girls in Psychiatric Care

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Starr, Lisa R.; Donenberg, Geri R.; Emerson, Erin

2012-01-01

The current study examines longitudinal associations between light and heavy sexual experiences and psychiatric symptoms in African American adolescent girls receiving mental health care. Research supports bidirectional associations between adolescent romantic and sexual behaviors and depression and other mental health problems, but this finding…

The Effects of Mood Disorders and Dissociative Symptoms on Suicide Attempts

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Halil ÖZCAN

2014-03-01

Full Text Available Objective: The aim of this study is to examine patients with suicide attempts in respect of mood disorders and dissociative symptoms and to understand the impact of these symptoms on suicide attempts. Method: Seventy participants who were directed to psychiatry outpatient department from the Kastamonu State Hospital crisis intervention unit between January 2009 and January 2010 and who agreed to participate in the study were included. All of the patients were evaluated by psychiatric interview. A detailed sociodemographic and clinical data form was filled for all included patients and present or past history of psychiatric illness were explored. The Mood Disorders Questionnaire (MDQ, Beck Depression Inventory (BDI, Beck Suicide Intention Scale (BSIS, Dissociative Experiences Scale (DES were applied to all participants. Results: The mean score of DES was 39±21.3, of MDQ 7.5±2.5, of BDI 28±14 and of BSIS 15.3±5.8. Participants who scored higher than 7 in the MDQ had statistically more dissociative experiences than those who scored lower than 7 in MDQ. In addition, participants who scored higher than 5 points in the MDQ had more dissociative experiences than those who scored lower than 5 in the MDQ. Having higher scores on DES, MDQ and BDI was positively correlated with having higher scores on BSIS. Conclusion: The etiologies of suicides are complex. Suicide attempter might often have both mood symptoms and dissociative experiences.

Cultural differences in symptom representation for depression and somatization measured by the PHQ between Vietnamese and German psychiatric outpatients.

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Dreher, Annegret; Hahn, Eric; Diefenbacher, Albert; Nguyen, Main Huong; Böge, Kerem; Burian, Hannah; Dettling, Michael; Burian, Ronald; Ta, Thi Minh Tam

2017-11-01

Despite an extensive body of research on somatic symptom presentation among people of East- and Southeast-Asian descent, results are still inconclusive. Examining and comparing symptom presentation in clinically and ethnically well-characterized populations may constitute a step towards understanding symptom presentation between patients with a different cultural background. This study aims to compare Vietnamese and German patients regarding cultural dynamics of symptom presentation upon first admission to a psychiatric outpatient service. 110 Vietnamese and 109 German patients seeking psychiatric treatment at two outpatient clinics completed the Patient Health Questionnaire (PHQ). The somatic symptom subscale (PHQ-15), the depression subscale (PHQ-9) and PHQ-subscales examining anxiety and psychosocial stress levels were analyzed and compared for both groups using multivariate analysis of covariance. Regression analysis was utilized to examine the influences of sociodemographic and migration specific factors. Vietnamese and German patients showed comparable Cronbach's alpha for all subscales. Vietnamese patients endorsed significantly higher levels of somatic symptoms overall and on certain items (as pain-related items, dizziness, and fainting spells) despite similar levels of depression severity in comparison with German patients. Vietnamese patients with poor German language skills showed a significantly higher focus on somatic symptoms. Raising awareness for cultural dynamics of symptom presentation in patients with depression is indispensable. Cross-cultural symptom assessment using the PHQ seems feasible and expands our understanding of depressive and psychosomatic symptoms when assessed by clinicians. Copyright © 2017. Published by Elsevier Inc.

The Danish Prostatic Symptom Score (DAN-PSS-1) questionnaire is reliable in stroke patients

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Tibaek, Sigrid; Jensen, Rigmor; Klarskov, Peter

2006-01-01

. The questionnaire consists of 12 questions related to lower urinary tract symptoms (LUTS). The participants were asked to state the frequency and severity of their symptoms (symptom score) and its impact on their daily life (bother score). Seventy-one stroke patients were included and 59 (83%) answered...... the questionnaire twice. The reliability test was done in two aspects: (a) detecting the frequency of each symptom and its bother factor, the scores were reduced to a two-category scale (=0, >0) and simple kappa statistics was used; (b) detecting the severity of each symptom and its bother factor, the total scale...... (kappa(w) = 0.48) to good (kappa(w) = 0.68). CONCLUSIONS: The DAN-PSS-1 questionnaire had acceptable test-retest reliability and may be suitable for measuring the frequency and severity of LUTS and its bother factor in stroke patients....

Neural Reactivity to Emotional Stimuli Prospectively Predicts the Impact of a Natural Disaster on Psychiatric Symptoms in Children.

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Kujawa, Autumn; Hajcak, Greg; Danzig, Allison P; Black, Sarah R; Bromet, Evelyn J; Carlson, Gabrielle A; Kotov, Roman; Klein, Daniel N

2016-09-01

Natural disasters expose entire communities to stress and trauma, leading to increased risk for psychiatric symptoms. Yet, the majority of exposed individuals are resilient, highlighting the importance of identifying underlying factors that contribute to outcomes. The current study was part of a larger prospective study of children in Long Island, New York (n = 260). At age 9, children viewed unpleasant and pleasant images while the late positive potential (LPP), an event-related potential component that reflects sustained attention toward salient information, was measured. Following the event-related potential assessment, Hurricane Sandy, the second costliest hurricane in United States history, hit the region. Eight weeks after the hurricane, mothers reported on exposure to hurricane-related stress and children's internalizing and externalizing symptoms. Symptoms were reassessed 8 months after the hurricane. The LPP predicted both internalizing and externalizing symptoms after accounting for prehurricane symptomatology and interacted with stress to predict externalizing symptoms. Among children exposed to higher levels of hurricane-related stress, enhanced neural reactivity to unpleasant images predicted greater externalizing symptoms 8 weeks after the disaster, while greater neural reactivity to pleasant images predicted lower externalizing symptoms. Moreover, interactions between the LPP and stress continued to predict externalizing symptoms 8 months after the hurricane. Results indicate that heightened neural reactivity and attention toward unpleasant information, as measured by the LPP, predispose children to psychiatric symptoms when exposed to higher levels of stress related to natural disasters, while greater reactivity to and processing of pleasant information may be a protective factor. Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

A network view on psychiatric disorders: network clusters of symptoms as elementary syndromes of psychopathology.

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Rutger Goekoop

Full Text Available INTRODUCTION: The vast number of psychopathological syndromes that can be observed in clinical practice can be described in terms of a limited number of elementary syndromes that are differentially expressed. Previous attempts to identify elementary syndromes have shown limitations that have slowed progress in the taxonomy of psychiatric disorders. AIM: To examine the ability of network community detection (NCD to identify elementary syndromes of psychopathology and move beyond the limitations of current classification methods in psychiatry. METHODS: 192 patients with unselected mental disorders were tested on the Comprehensive Psychopathological Rating Scale (CPRS. Principal component analysis (PCA was performed on the bootstrapped correlation matrix of symptom scores to extract the principal component structure (PCS. An undirected and weighted network graph was constructed from the same matrix. Network community structure (NCS was optimized using a previously published technique. RESULTS: In the optimal network structure, network clusters showed a 89% match with principal components of psychopathology. Some 6 network clusters were found, including "Depression", "Mania", "Anxiety", "Psychosis", "Retardation", and "Behavioral Disorganization". Network metrics were used to quantify the continuities between the elementary syndromes. CONCLUSION: We present the first comprehensive network graph of psychopathology that is free from the biases of previous classifications: a 'Psychopathology Web'. Clusters within this network represent elementary syndromes that are connected via a limited number of bridge symptoms. Many problems of previous classifications can be overcome by using a network approach to psychopathology.

Burnout in psychiatric nursing: examining the interplay of autonomy, leadership style, and depressive symptoms.

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Madathil, Renee; Heck, Nicholas C; Schuldberg, David

2014-06-01

It is important to consider ways in which nurses can be protected from experiencing the effects of burnout. This study examined the relationships between leadership style of psychiatric nurse supervisors, work role autonomy, and psychological distress in relation to psychiatric nurse burnout. Eighty-nine psychiatric nurses from Montana and New York hospitals completed an online survey that assessed their work-related experiences. Overall, results of this study indicate that the participants were experiencing high levels of emotional exhaustion and depersonalization when compared to a normative sample of mental health workers. Results also showed that leadership style and work role autonomy are likely to be environmental factors that protect against burnout in nurses. Finally, it was shown that the relationship between depressive symptoms and the burnout component of personal accomplishment may be influenced by nurses' perceptions of the leadership style in their work environment. These findings are important because nurse supervisor leadership styles and amount of autonomy are characteristics of the work environment that may be amenable to change through training and intervention. Copyright © 2014 Elsevier Inc. All rights reserved.

The Roles of Socioeconomic Status, Occupational Health and Job Rank on the Epidemiology of Different Psychiatric Symptoms in a Sample of UK Workers.

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Lopes, B; Kamau, C; Jaspal, R

2018-03-06

There is a considerable gap in epidemiological literature about community mental health showing how psychiatric symptoms are associated with job rank, socioeconomic status, and occupational health. We examine data from 4596 employees collected in the United Kingdom's Psychiatric Morbidity among Adults Living in Private Households Survey. There were 939 workers in managerial jobs, 739 in supervisory jobs and 2918 employees in lower ranking jobs. Of the 4596 workers, 2463 had depressive symptoms and 2133 no depressive symptoms. Job rank, household gross income, social class, personal gross income and socio-economic group were significantly associated with general health, occupational health and depressive and avoidant symptoms. Job rank, occupational and physical health also explained the variance in paranoid and avoidant symptoms among the employees. This study shows that severe psychopathology is related to workers' job rank.

Mental illness and legal fitness (competence) to stand trial in New York State: expert opinion and criminal defendants' psychiatric symptoms.

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Lee, Eugene; Rosner, Richard; Harmon, Ronnie

2014-07-01

Fitness to Stand Trial is a critical concept in the adjudication of justice-involved persons. A retrospective study was conducted to examine criminal defendants' specific psychiatric symptoms and those symptoms' associations with expert opinions on Competence to Stand Trial. One hundred charts were reviewed: 50 Cases (opined as Not Fit) were compared against 50 Controls (opined as Fit) with respect to ratings on the Brief Psychiatric Rating Scale (BPRS). A significance level of 0.001 was selected a priori. Statistically significant differences were found in seven of the eighteen BPRS symptom constructs (with the highest differences in Conceptual Disorganization and Unusual Thought Content) and two of the four BPRS higher-order syndrome factors (Thinking Disorder and Hostile-Suspiciousness). Consistent with previous reports, psychotic symptoms are found in this study to be inversely associated with Fitness. Validity, reliability, and limitations of this study, as well as directions for future research, are discussed herein. © 2014 American Academy of Forensic Sciences.

Neural correlates of RDoC reward constructs in adolescents with diverse psychiatric symptoms: A Reward Flanker Task pilot study.

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Bradley, Kailyn A L; Case, Julia A C; Freed, Rachel D; Stern, Emily R; Gabbay, Vilma

2017-07-01

There has been growing interest under the Research Domain Criteria initiative to investigate behavioral constructs and their underlying neural circuitry. Abnormalities in reward processes are salient across psychiatric conditions and may precede future psychopathology in youth. However, the neural circuitry underlying such deficits has not been well defined. Therefore, in this pilot, we studied youth with diverse psychiatric symptoms and examined the neural underpinnings of reward anticipation, attainment, and positive prediction error (PPE, unexpected reward gain). Clinically, we focused on anhedonia, known to reflect deficits in reward function. Twenty-two psychotropic medication-free youth, 16 with psychiatric symptoms, exhibiting a full range of anhedonia, were scanned during the Reward Flanker Task. Anhedonia severity was quantified using the Snaith-Hamilton Pleasure Scale. Functional magnetic resonance imaging analyses were false discovery rate corrected for multiple comparisons. Anticipation activated a broad network, including the medial frontal cortex and ventral striatum, while attainment activated memory and emotion-related regions such as the hippocampus and parahippocampal gyrus, but not the ventral striatum. PPE activated a right-dominant fronto-temporo-parietal network. Anhedonia was only correlated with activation of the right angular gyrus during anticipation and the left precuneus during PPE at an uncorrected threshold. Findings are preliminary due to the small sample size. This pilot characterized the neural circuitry underlying different aspects of reward processing in youth with diverse psychiatric symptoms. These results highlight the complexity of the neural circuitry underlying reward anticipation, attainment, and PPE. Furthermore, this study underscores the importance of RDoC research in youth. Copyright © 2016 Elsevier B.V. All rights reserved.

Subtype differences in adults with attention-deficit/hyperactivity disorder (ADHD) with regard to ADHD-symptoms, psychiatric comorbidity and psychosocial adjustment.

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Sobanski, Esther; Brüggemann, Daniel; Alm, Barbara; Kern, Sebastian; Philipsen, Alexandra; Schmalzried, Hannah; Hesslinger, Bernd; Waschkowski, H; Rietschel, Marcella

2008-03-01

To date, nearly all research of subtype differences in ADHD has been performed in children and only two studies, with conflicting results, have covered this subject in adults with ADHD. This study examined subtype differences in the clinical presentation of ADHD-symptoms, related psychopathological features, psychosocial functioning and comorbid psychiatric disorders in adults with ADHD. One hundred and eighteen adults with ADHD, diagnosed according to DSM-IV criteria, and a population based control group underwent diagnostic evaluations with clinical interviews for ADHD, DSM-IV disorders and demographic features. Comparisons were made between ADHD combined type (n=64), predominantly inattentive type (n=30) and predominantly inattentive type, anamnestically combined type (n=24), relative to each other and to a community control group (n=70). The four groups did not differ in age and gender composition. All ADHD groups had significantly less education, were significantly more often unemployed and reported significantly more lifetime psychiatric comorbidity than controls. In comparison to each other, the three ADHD groups differed mainly in core symptoms and the pattern of comorbid psychiatric disorders, whereas no prominent differences in associated psychopathological features and most of the assessed psychosocial functions could be found. Patients with ADHD combined type and inattentive, anamnestically combined type both presented with significantly more hyperactive symptoms and also showed more impulsive symptoms than those with the predominantly inattentive type. With a similar overall lifetime psychiatric comorbidity in the three groups, patients with ADHD combined type and inattentive, anamnestically combined type suffered significantly more from lifetime substance use disorders than patients with predominantly inattentive type. Our results clearly show impaired psychosocial adjustment and elevated risk for additional psychiatric disorders in adults with all

Mirror neurons and the understanding of behavioural symptoms in psychiatric disorders.

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Buccino, Giovanni; Amore, Mario

2008-05-01

Recent findings show that we can understand other people's actions, intentions and emotions through a mirror mechanism as if we performed the same actions and felt the same intentions or emotions (embodied simulation). The present paper reviews experimental evidence that this mechanism may be broken in some psychiatric disorders. A mirror neuron system has been described in both monkeys and humans that allows one to map an observed action on a correspondent motor representation in the observer's brain. This mechanism has been involved in many higher motor functions ranging from action understanding to imitation and intention coding. A mirror mechanism has also been invoked in empathy, through an embodied simulation. A dysfunction of the mirror neuron system may be at the root of the inability to empathize in patients with autism and may play a role in some negative and positive symptoms found in patients with schizophrenia. This opens up new perspectives in the interpretation of psychotic symptoms and possibly in developing therapeutic strategies.

[Symptoms of depression in children and adolescents in relation to psychiatric comorbidities].

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Baji, Ildikó; Gádoros, Júlia; Kiss, Enikô; Mayer, László; Kovács, Eszter; Benák, István; Vetró, Agnes

2012-01-01

The lifetime prevalence of MDD before adolescence is 4-5%, while the symptoms concern 13-20% of the adolescents. In the development of suicidal behaviour the most important risk factors are the use of psychoactive drugs and smoking. Psychiatric comorbidities are aggravating significantly the major depression. The comorbidities are high among major depression, anxiety and disruptive disorders. We examined 649 children being in a depressive episode diagnosed by ISCA-D semi-structured interview, 45,9% of them were girls, and 54,1% were boys, the mean age was 11,7 years ( SD=2,00). The participants were enrolled into three groups according to their comorbidities: group with only depression without comorbidities, group with anxiety comorbidity, and group with disruptive comorbidity. We compared the three groups according to the frequency of their depressive symptoms. Anxiety comorbidities increase the incidence of depressive symptoms. Among the criteria symptoms irritability where the most frequent symptom independently from the comorbidities, the depressed mood is the most frequent within the anxiety group, while anhedonia occurred with a moderate frequency in each groups. In the anxiety group the vegetative symptoms, while in the disruptive group the psychomotor agitation and the feeling of worthlessness are the most frequent symptoms. Comorbidities are increasing the incidence of the suicide symptoms. The incidence of impaired decision making was high in each group, the comorbidities didn't influence it's frequency. Among depressed boys irritability and feelings of worthlessness (low self-esteem) increase the presence of externalisation comorbidity. Among depressed girls guilt was significantly more frequent in the anxiety comorbidity group, and concentration problems are the most typical symptoms in the clear MDD group, without comorbidities.

Web of Objects Based Ambient Assisted Living Framework for Emergency Psychiatric State Prediction

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Alam, Md Golam Rabiul; Abedin, Sarder Fakhrul; Al Ameen, Moshaddique; Hong, Choong Seon

2016-01-01

Ambient assisted living can facilitate optimum health and wellness by aiding physical, mental and social well-being. In this paper, patients’ psychiatric symptoms are collected through lightweight biosensors and web-based psychiatric screening scales in a smart home environment and then analyzed through machine learning algorithms to provide ambient intelligence in a psychiatric emergency. The psychiatric states are modeled through a Hidden Markov Model (HMM), and the model parameters are estimated using a Viterbi path counting and scalable Stochastic Variational Inference (SVI)-based training algorithm. The most likely psychiatric state sequence of the corresponding observation sequence is determined, and an emergency psychiatric state is predicted through the proposed algorithm. Moreover, to enable personalized psychiatric emergency care, a service a web of objects-based framework is proposed for a smart-home environment. In this framework, the biosensor observations and the psychiatric rating scales are objectified and virtualized in the web space. Then, the web of objects of sensor observations and psychiatric rating scores are used to assess the dweller’s mental health status and to predict an emergency psychiatric state. The proposed psychiatric state prediction algorithm reported 83.03 percent prediction accuracy in an empirical performance study. PMID:27608023

Translation and cultural adaptation of the Pediatric Eosinophilic Esophagitis Symptom Score (PEESS v2.0).

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Santos, Maria Fernanda Oliveira; Barros, Cristina Palmer; Silva, Carlos Henrique Martins da; Paro, Helena Borges Martins da Silva

2017-11-04

To translate and culturally adapt the Pediatric Eosinophilic Esophagitis Symptom Score (version 2.0), a tool used to assess pediatric eosinophilic esophagitis symptoms reported by patients and/or their parents/caregivers. The Pediatric Eosinophilic Esophagitis Symptom Score was translated through the following stages: initial translation, back-translation, and consensus of independent reviewers through the Delphi technique. The pre-final version of the Pediatric Eosinophilic Esophagitis Symptom Score was applied to five 8-to-18-year-old patients and to ten parents of two-to-18-year-old patients from an outpatient pediatric gastroenterology service (pre-test). During the translation process, no translations presenting with difficult consensus in the review process or grammar inconsistencies were observed. During the pre-test, difficulties in comprehension of some unconventional terms, e.g., "náusea", were observed. Adverbs of frequency, such as "quase nunca" were also identified as being of difficult understanding by patients and parents, and the substitution by the term "raramente" was suggested. Such difficulties may be inherent to the pediatric age group. Age 8 years or above should be considered adequate for the self-reporting of symptoms. The study presents the Brazilian version of the Pediatric Eosinophilic Esophagitis Symptom Score, which is adapted to the Brazilian culture. This version may be introduced as a clinical and research tool for the assessment of patients with esophagic disease symptoms. The Pediatric Eosinophilic Esophagitis Symptom Score is a breakthrough in the evaluation of symptoms of pediatric eosinophilic esophagitis, since it reinforces the importance of self-reporting by patients who experience this disease. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Hazardous alcohol users during pregnancy: psychiatric health and personality traits.

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Magnusson, Asa; Göransson, Mona; Heilig, Markus

2007-07-10

We examined alcohol use disorders, psychiatric symptoms and personality traits in women reporting alcohol use during pregnancy. In a pilot cohort (n=139), subjects were screened for alcohol use disorders, and assessed for psychopathology, personality traits, and alcohol use during the first trimester. Those reporting consumption exceeding a conservative threshold for harmful use were offered a diagnostic psychiatric interview. The main findings of the pilot study were replicated using a large sample of women in the third trimester (n=715), who were screened for alcohol use disorders, had their consumption during pregnancy assessed, and were assessed for personality traits. In the pilot cohort, only a minority of women who consumed significant amounts of alcohol during pregnancy fulfilled alcohol dependence criteria, or had scores on the Alcohol Use Disorder Identification Test typically associated with such a diagnosis. Psychiatric morbidity was also unremarkable as assessed by self-reported symptom intensity. The distinguishing feature was high novelty seeking. The results were robustly confirmed in the replication study. Most women with significant alcohol consumption during pregnancy do not seem to be alcohol dependent. Instead, use during pregnancy may reflect impulsive personality traits, and be correlated with additional risk behaviors.

The Utility of the Wisconsin Card Sorting Test in Differential Diagnosis of Cognitive Disorders in Iranian Psychiatric Patients and Healthy Subjects

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Razieh Hashemi, MA

2011-09-01

Full Text Available Objective: The Wisconsin Test Card Sorting Test (WCST is a neuropsychological test that has been suggested as a more specific test for frontal lobes dysfunctions. This study was designed to determine whether WCST is able to differentiate between Iranian psychiatric patients with cognitive disorders and normal subjects, and whether WCST scores are related to severity of symptoms in depressive and schizophrenic patients.Method: Participants were four groups: schizophrenics with positive symptoms (n=25; schizophrenics with negative symptoms (n=25; major depressives (n=25; and normal subjects (n=25. All subjects were tested individually using WCST. To analyze the data, various descriptive statistics, ANOVA, t-test and multiple regression analysis were used.Results: Regarding the number of categories (P<0.001 and the rate of perseverative errors (P<0.01, according to the results, the normal subjects performed significantly better than patient groups on WCST, although the differences between patient groups were not significant. Our results also showed that greater positive or depressive symptoms were not associated with poorer scores on WCST performance. Only the level of severity of negative symptoms predicted scores on perseverative errors.Conclusion: It is concluded that WCST can differentiate Iranian psychiatric patients with cognitive disorders from normal subjects, but it is not able to clearly differentiate schizophrenic patients with negative symptoms from those with positive symptoms and depressives. Only severity of negative symptoms affects WCST performance

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

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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

Differences in body mass index z-scores and weight status in a Dutch pediatric psychiatric population with and without use of second-generation antipsychotics.

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de Hoogd, Sjoerd; Overbeek, Wieske A; Heerdink, Eibert R; Correll, Christoph U; de Graeff, Elisabeth R; Staal, Wouter G

2012-04-01

Weight gain and metabolic adverse effects of second-generation antipsychotics (SGAs) have become a major concern, particularly in youth. However, the specific contribution of SGAs versus other medications or the underlying illness is unclear. In a chart review study of psychiatric outpatients aged ≤ 18 years treated with SGAs and psychiatric controls without lifetime SGA, use body mass index (BMI) z-scores between patients and controls were compared in the entire sample, patients without co-medications, diagnostic subgroups, and age subgroups. In patients with follow-up data, weight z-score change was calculated. Altogether, 592 Caucasian patients aged 4-18 (mean: 10.0) years with a psychiatric diagnosis were included. BMI z-scores in 96 youth treated with SGAs for 9.0 ± 6.1 months were significantly higher than in 496 patients without lifetime SGA use (0.81 ± 1.1 vs. 0.05 ± 1.2; pz-score differences remained significant in all age groups z-score increased significantly from -0.17 ± 1.5 to 0.25 ± 1.4 (p<0.0001) with 12.5% transitioning to overweight or obese status. These data show robust and significant differences in sex- and age-adjusted body weight and weight status in young pediatric Caucasian samples with and without use of SGAs independent of Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV-TR) (American Psychiatric Association 2000 ) diagnosis and nonantipsychotic medications. Weight status and metabolic effects of SGAs require careful attention, especially in youth.

Psychiatric Disorders in HTLV-1-Infected Individuals with Bladder Symptoms.

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Glória O Orge

Full Text Available Previous studies have reported high rates of depression and anxiety in HTLV-1 infected individuals with the neurological disease and in the asymptomatic phase. No study has investigated the rates in individuals that already show bladder symptoms without severe neurological changes; that is, during the oligosymptomatic phase. The present study investigated patients in this intermediate form on the spectrum of the infection.Participants answered a sociodemographic questionnaire, the Mini International Neuropsychiatric Interview Brazilian Version 5.0.0 (MINI PLUS and the Hospital Anxiety and Depression Scale (HADS. Data analysis was performed in STATA statistical software (version 12.0. Depressive disorder was the most frequent comorbidity. Current depressive disorder was higher in the group of overactive bladder subjects (11.9%, and lifelong depression was more frequent in the HAM/TSP group (35%. The three groups had similar frequencies of anxiety disorders. Increased frequency and severity of anxiety and depression symptoms were observed in the overactive bladder group.The results suggest that individuals with overactive bladders need a more thorough assessment from the mental health perspective. These patients remain an understudied group regarding psychiatric comorbidities.

Plasma HVA in psychiatric patients: longitudinal studies.

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Javaid, J I; Sharma, R P; Janicak, P G; Davis, J M

1990-01-01

Plasma homovanillic acid (pHVA) was measured in 40 inpatients (25 schizophrenic and 15 nonschizophrenic patients) who underwent up to 3 weeks of drug washout. Schizophrenic patients were then treated with trifluoperazine for 4 weeks, and weekly behavioral and pHVA measures were obtained. The baseline pHVA had no relationship to age, sex, washout period, diagnosis, or behavioral rating scores. In schizophrenic patients, the baseline pHVA did not differ significantly from any value obtained during 4 weeks of treatment. Although there was significant improvement in clinical symptoms, this was not related to changes in pHVA. Further, changes in any of the four Brief Psychiatric Rating Scale (BPRS) factors (i.e., positive symptoms, negative symptoms, hostility/suspicion, or anxiety/depression) were not correlated with changes in pHVA. Although other studies have reported a positive correlation between pHVA and psychotic symptoms, results of this study suggest that any observed relationship between pHVA and psychosis must be carefully interpreted.

Temporary work and depressive symptoms: a propensity score analysis.

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Quesnel-Vallée, Amélie; DeHaney, Suzanne; Ciampi, Antonio

2010-06-01

Recent decades have seen a tremendous increase in the complexity of work arrangements, through job sharing, flexible hours, career breaks, compressed work weeks, shift work, reduced job security, and part-time, contract and temporary work. In this study, we focus on one specific group of workers that arguably most embodies non-standard employment, namely temporary workers, and estimate the effect of this type of employment on depressive symptom severity. Accounting for the possibility of mental health selection into temporary work through propensity score analysis, we isolate the direct effects of temporary work on depressive symptoms with varying lags of time since exposure. We use prospective data from the U.S. National Longitudinal Survey of Youth 1979 (NLSY79), which has followed, longitudinally, from 1979 to the present, a nationally representative cohort of American men and women between 14 and 22 years of age in 1979. Three propensity score models were estimated, to capture the effect of different time lags (immediately following exposure, and 2 and 4 years post exposure) between the period of exposure to the outcome. The only significant effects were found among those who had been exposed to temporary work in the two years preceding the outcome measurement. These workers report 1.803 additional depressive symptoms from having experienced this work status (than if they had not been exposed). Moreover, this difference is both statistically and substantively significant, as it represents a 50% increase from the average level of depressive symptoms in this population. Copyright 2010 Elsevier Ltd. All rights reserved.

Polygenic Risk Score, Parental Socioeconomic Status, Family History of Psychiatric Disorders, and the Risk for Schizophrenia: A Danish Population-Based Study and Meta-analysis.

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Agerbo, Esben; Sullivan, Patrick F; Vilhjálmsson, Bjarni J; Pedersen, Carsten B; Mors, Ole; Børglum, Anders D; Hougaard, David M; Hollegaard, Mads V; Meier, Sandra; Mattheisen, Manuel; Ripke, Stephan; Wray, Naomi R; Mortensen, Preben B

2015-07-01

Schizophrenia has a complex etiology influenced both by genetic and nongenetic factors but disentangling these factors is difficult. To estimate (1) how strongly the risk for schizophrenia relates to the mutual effect of the polygenic risk score, parental socioeconomic status, and family history of psychiatric disorders; (2) the fraction of cases that could be prevented if no one was exposed to these factors; (3) whether family background interacts with an individual's genetic liability so that specific subgroups are particularly risk prone; and (4) to what extent a proband's genetic makeup mediates the risk associated with familial background. We conducted a nested case-control study based on Danish population-based registers. The study consisted of 866 patients diagnosed as having schizophrenia between January 1, 1994, and December 31, 2006, and 871 matched control individuals. Genome-wide data and family psychiatric and socioeconomic background information were obtained from neonatal biobanks and national registers. Results from a separate meta-analysis (34,600 cases and 45,968 control individuals) were applied to calculate polygenic risk scores. Polygenic risk scores, parental socioeconomic status, and family psychiatric history. Odds ratios (ORs), attributable risks, liability R2 values, and proportions mediated. Schizophrenia was associated with the polygenic risk score (OR, 8.01; 95% CI, 4.53-14.16 for highest vs lowest decile), socioeconomic status (OR, 8.10; 95% CI, 3.24-20.3 for 6 vs no exposures), and a history of schizophrenia/psychoses (OR, 4.18; 95% CI, 2.57-6.79). The R2 values were 3.4% (95% CI, 2.1-4.6) for the polygenic risk score, 3.1% (95% CI, 1.9-4.3) for parental socioeconomic status, and 3.4% (95% CI, 2.1-4.6) for family history. Socioeconomic status and psychiatric history accounted for 45.8% (95% CI, 36.1-55.5) and 25.8% (95% CI, 21.2-30.5) of cases, respectively. There was an interaction between the polygenic risk score and family history

Psychiatric aspects of Parkinson′s disease

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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.

The psychiatric interview

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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...

Psychiatric profiles of mothers who take Ecstasy/MDMA during pregnancy: reduced depression 1 year after giving birth and quitting Ecstasy.

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Turner, John J D; Parrott, Andrew C; Goodwin, Julia; Moore, Derek G; Fulton, Sarah; Min, Meeyoung O; Singer, Lynn T

2014-01-01

The recreational drug MDMA (3,4-methylenedioxymethamphetamine) or 'Ecstasy' is associated with heightened psychiatric distress and feelings of depression. The Drugs and Infancy Study (DAISY) monitored the psychiatric symptom profiles of mothers who used Ecstasy/MDMA while pregnant, and followed them over the first year post-partum. We compared 28 young women whom took MDMA during their pregnancy with a polydrug control group of 68 women who took other psychoactive drugs while pregnant. The Brief Symptom Inventory (BSI) was completed for several periods: The first trimester of pregnancy; and 1, 4 and 12 months after childbirth. Recreational drug use was monitored at each time point. During the first trimester of pregnancy, MDMA-using mothers reported higher depression scores than the polydrug controls. At 1 year after childbirth, their BSI depression scores were significantly lower, now closer to the control group values. At the same time point, their self-reported use of MDMA became nearly zero, in contrast to their continued use of Cannabis/marijuana, nicotine and alcohol. We found significant symptom reductions in those with BSI obsessive-compulsive and interpersonal sensitivity, following Ecstasy/MDMA cessation. The findings from this unique prospective study of young recreational drug-using mothers are consistent with previous reports of improved psychiatric health after quitting MDMA.

The effects of simultaneous exercise and psychotherapy on depressive symptoms in inpatient, psychiatric older adults.

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Jacquart, Son D; Marshak, Helen H; Dos Santos, Hildemar; Luu, Sen M; Berk, Lee S; McMahon, Paul T; Riggs, Matt

2014-01-01

Depression is the leading cause of early death, affecting 15% of Americans older than 65 y and costing $43 billion each year. The current mental health service system for seniors, particularly for the population hospitalized in acute inpatient psychiatric units, is fragmented because of poor funding and a shift to a transitory health care paradigm, leading to inadequate treatment modalities, questionable quality of care, and lack of research demonstrating the superiority of a particular treatment. These issues are likely to lead to a public health crisis in the coming years. To investigate the effectiveness of combining exercise and psychotherapy in improving acute depressive symptoms among older adults who were receiving treatment in an inpatient psychiatric unit. Based on rolling admissions, inpatients were randomly assigned to 1 of 3 treatment groups. The study was blinded and controlled. This study took place in inpatient psychiatric units at the Loma Linda University's Behavioral Medicine Center (LLUBMC) in Redlands, California. Participants were 78 inpatients, aged 50-89 y. Participants in the simultaneous exercise and psychotherapy (STEP) group (n = 26) took part in exercise and received psychotherapy for 30 min per session, whereas those in the TALK group (n = 26) received individual psychotherapy for 30 min per session. Participants in the control group (n = 26) served as a comparison group, receiving standard therapy. The effects of the interventions were determined by assessing differences from baseline to postintervention in the symptomatology of all 3 groups. The research team also administered the Behavioral and Symptom Identification Scale (BASIS-32) and the Geriatric Depression Scale (GDS) pre- and postintervention. At posttest, the STEP group (M = 4.24, SE = 0.62) had a better response than the TALK group (M = 11.34, SE = 0.62, P exercise program consisting of 30 min of walking in conjunction with individual psychotherapy was an effective

Psychiatric symptomatology and personality in a population of primary care patients

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Maja Biała

2014-06-01

Full Text Available introduction and objective. Psychiatric disorders (and their high rates of prevalence in primary care have been widely analyzed, but the problem of underdiagnosis remains unresolved. This becomes increasingly more important in rural health centres in the face of lack of epidemiological data from these centres. The aim of this study is focused on the relationship between general health, psychiatric symptomatology and personality characteristics in the context of an adequate diagnosis. materials and methods. 518 primary care patients in 6 Polish urban clinical centres were studied using (in order of administration: a sociodemographic questionnaire, the General Health Questionnaire (GHQ-28 and Eysenck Personality Questionnaire (EPQ-R. results. The investigated sample was representative for urban primary care patients. The findings confirmed a significant association between neuroticism and general health. The strongest relation with current functioning and mental distress of the patients (GHQ general score was observed in case of symptoms of anxiety and insomnia. The symptoms of depression may be the most difficult to identify (psychiatric symptoms assessed using GHQ sub-scales. conclusions. According to the GHQ assumptions and confirmed by the presented study, sub-threshold psychiatric symptomatology affects the functioning of primary care patients and their general health. This correlates with personality factors. Improving adequacy of diagnosis becomes extremely important, as it may often be the only chance for appropriate therapy of mental problems for people living in rural areas due to lower availability of specialistic mental services. Further epidemiological studies concerning rural primary care and prevalence of the spectrum of mental disorders need to be conducted.

Hyperthyroidism and psychiatric morbidity

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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....

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

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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.

Changes in Psychiatric behavior of adolescents due to absence one of the parents

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Ashry, K.; El-Maghraby, S.A.

2013-01-01

This study aimed at exploring psychiatric morbidity among adolescents of single parent families. Subjects were recruited from 15 randomly chosen schools distributed in 3 educational districts in Greater Cairo. They were candidates for socio-demographic data sheet, the General Health Questionnaire (GHQ), Children Anxiety Scale(CAS), Children Depression Inventory(CDI), Youth Self Report(YSR), and symptom check list(SCL). Single parenting was due to parental death in 55.67%, parental travel in 29.31% ,divorce in 7.88% and desertion in 7.14%. Stratistically Higher minimal psychiatric morbidity, higher anxiety and depression symptoms, and higher YSR behavioral problem scores were found in single-parent than two-parent adolescents. Single parenting was significantly associated with low scholastic achievement and with diagnosis depression, mixed anxiety depression, and mixed anxiety with somatization disorder and phobias (specially social phobia).Conduct disorder and psychoactive substance experimentation although it is overrepresented, it didn't show a significant correlation. Parent absence (particularly the father), through divorce or death has greater impact on boys than girls. Every type of single parenting has its own profile on adolescent's behavioral and psychiatric problems

PTSD symptom severity and psychiatric comorbidity in recent motor vehicle accident victims: a latent class analysis.

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Hruska, Bryce; Irish, Leah A; Pacella, Maria L; Sledjeski, Eve M; Delahanty, Douglas L

2014-10-01

We conducted a latent class analysis (LCA) on 249 recent motor vehicle accident (MVA) victims to examine subgroups that differed in posttraumatic stress disorder (PTSD) symptom severity, current major depressive disorder and alcohol/other drug use disorders (MDD/AoDs), gender, and interpersonal trauma history 6-weeks post-MVA. A 4-class model best fit the data with a resilient class displaying asymptomatic PTSD symptom levels/low levels of comorbid disorders; a mild psychopathology class displaying mild PTSD symptom severity and current MDD; a moderate psychopathology class displaying severe PTSD symptom severity and current MDD/AoDs; and a severe psychopathology class displaying extreme PTSD symptom severity and current MDD. Classes also differed with respect to gender composition and history of interpersonal trauma experience. These findings may aid in the development of targeted interventions for recent MVA victims through the identification of subgroups distinguished by different patterns of psychiatric problems experienced 6-weeks post-MVA. Copyright © 2014 Elsevier Ltd. All rights reserved.

Does varenicline worsen psychiatric symptoms in patients with schizophrenia or schizoaffective disorder? A review of published studies.

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Cerimele, Joseph M; Durango, Alejandra

2012-08-01

To review published cases and prospective studies describing the use of varenicline in patients with schizophrenia and schizoaffective disorder. PubMed, PsychINFO, and the Cochrane Database were searched in July 2011 using the key words schizophrenia, schizoaffective disorder, psychosis, positive symptoms, negative symptoms, aggression, hostility, suicidal ideation AND varenicline to identify reports published between January 2006 and July 2011 in English. Five case reports, 1 case series, 1 retrospective study, 10 prospective studies (17 publications), and 1 meeting abstract describing the use of varenicline in patients with schizophrenia or schizoaffective disorder were identified. Review articles and articles describing findings other than the use of varenicline in patients with schizophrenia or schizoaffective disorder were excluded. Thirteen reports were included in the final analysis. Information on each study's patient population, age, diagnosis, medication treatment, tobacco use history, adverse effects, and outcome was collected from the published reports. Of the 260 patients with schizophrenia or schizoaffective disorder who received varenicline in these published reports, 13 patients (5%) experienced the onset or worsening of any psychiatric symptom, although 3 of the 13 patients experienced a very brief negative effect after 1 dose. No patients experienced suicidal ideation or suicidal behaviors. Published reports suggest that, in most stable, closely monitored patients with schizophrenia or schizoaffective disorder, varenicline treatment is not associated with worsening of psychiatric symptoms. Current, prospective studies are assessing effectiveness and further assessing safety in this population. © Copyright 2012 Physicians Postgraduate Press, Inc.

Characteristics and Psychiatric Symptoms of Internet Gaming Disorder among Adults Using Self-Reported DSM-5 Criteria

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Kim, Na Ri; Hwang, Samuel Suk-Hyun; Choi, Jung-Seok; Kim, Dai-Jin; Demetrovics, Zsolt; Király, Orsolya; Nagygyörgy, Katalin; Griffiths, Mark. D.; Hyun, So Yeon; Youn, Hyun Chul

2016-01-01

Objective The Section III of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) proposed nine diagnostic criteria and five cut-point criteria for Internet Gaming Disorder (IGD). We aimed to examine the efficacy of such criteria. Methods Adults (n=3041, men: 1824, women: 1217) who engaged in internet gaming within last 6 months completed a self-report online survey using the suggested wordings of the criteria in DSM-5. Major characteristics, gaming behavior, and psychiatric symptoms of IGD were analyzed using ANOVA, chi-square, and correlation analyses. Results The sociodemographic variables were not statistically significant between the healthy controls and the risk group. Among the participants, 419 (13.8%) were identified and labeled as the IGD risk group. The IGD risk group scored significantly higher on all motivation subscales (psymptom dimensions, i.e., somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism (p<0.001). Conclusion The IGD risk group showed differential psychopathological manifestations according to DSM-5 IGD diagnostic criteria. Further studies are needed to evaluate the reliability and validity of the specific criteria, especially for developing screening instruments. PMID:26766947

Validity of the Danish Prostate Symptom Score questionnaire in stroke

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Tibaek, S.; Dehlendorff, Christian

2009-01-01

Objective – To determine the content and face validity of the Danish Prostate Symptom Score (DAN-PSS-1) questionnaire in stroke patients. Materials and methods – Content validity was judged among an expert panel in neuro-urology. The judgement was measured by the content validity index (CVI). Face...... validity was indicated in a clinical sample of 482 stroke patients in a hospital-based, cross-sectional survey. Results – I-CVI was rated >0.78 (range 0.94–1.00) for 75% of symptom and bother items corresponding to adequate content validity. The expert panel rated the entire DAN-PSS-1 questionnaire highly...... questionnaire appears to be content and face valid for measuring lower urinary tract symptoms after stroke....

STUDY ON PSYCHIATRIC CO - MORBIDITY IN PSORIASIS

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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

Correlation between uroflowmetry, prostate volume, postvoid residue, and lower urinary tract symptoms as measured by the International Prostate Symptom Score

NARCIS (Netherlands)

Ezz el Din, K.; Kiemeney, L. A.; de Wildt, M. J.; Debruyne, F. M.; de la Rosette, J. J.

1996-01-01

To evaluate the relation between lower urinary tract symptoms (LUTS) as measured by the International Prostate Symptom Score (IPSS) and noninvasive objective parameters of lower urinary tract dysfunction. Eight hundred three consecutive patients with LUTS and/or benign prostatic hyperplasia were

Novel Use of Natural Language Processing (NLP to Predict Suicidal Ideation and Psychiatric Symptoms in a Text-Based Mental Health Intervention in Madrid

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Benjamin L. Cook

2016-01-01

Full Text Available Natural language processing (NLP and machine learning were used to predict suicidal ideation and heightened psychiatric symptoms among adults recently discharged from psychiatric inpatient or emergency room settings in Madrid, Spain. Participants responded to structured mental and physical health instruments at multiple follow-up points. Outcome variables of interest were suicidal ideation and psychiatric symptoms (GHQ-12. Predictor variables included structured items (e.g., relating to sleep and well-being and responses to one unstructured question, “how do you feel today?” We compared NLP-based models using the unstructured question with logistic regression prediction models using structured data. The PPV, sensitivity, and specificity for NLP-based models of suicidal ideation were 0.61, 0.56, and 0.57, respectively, compared to 0.73, 0.76, and 0.62 of structured data-based models. The PPV, sensitivity, and specificity for NLP-based models of heightened psychiatric symptoms (GHQ-12 ≥ 4 were 0.56, 0.59, and 0.60, respectively, compared to 0.79, 0.79, and 0.85 in structured models. NLP-based models were able to generate relatively high predictive values based solely on responses to a simple general mood question. These models have promise for rapidly identifying persons at risk of suicide or psychological distress and could provide a low-cost screening alternative in settings where lengthy structured item surveys are not feasible.

Novel Use of Natural Language Processing (NLP) to Predict Suicidal Ideation and Psychiatric Symptoms in a Text-Based Mental Health Intervention in Madrid.

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Cook, Benjamin L; Progovac, Ana M; Chen, Pei; Mullin, Brian; Hou, Sherry; Baca-Garcia, Enrique

2016-01-01

Natural language processing (NLP) and machine learning were used to predict suicidal ideation and heightened psychiatric symptoms among adults recently discharged from psychiatric inpatient or emergency room settings in Madrid, Spain. Participants responded to structured mental and physical health instruments at multiple follow-up points. Outcome variables of interest were suicidal ideation and psychiatric symptoms (GHQ-12). Predictor variables included structured items (e.g., relating to sleep and well-being) and responses to one unstructured question, "how do you feel today?" We compared NLP-based models using the unstructured question with logistic regression prediction models using structured data. The PPV, sensitivity, and specificity for NLP-based models of suicidal ideation were 0.61, 0.56, and 0.57, respectively, compared to 0.73, 0.76, and 0.62 of structured data-based models. The PPV, sensitivity, and specificity for NLP-based models of heightened psychiatric symptoms (GHQ-12 ≥ 4) were 0.56, 0.59, and 0.60, respectively, compared to 0.79, 0.79, and 0.85 in structured models. NLP-based models were able to generate relatively high predictive values based solely on responses to a simple general mood question. These models have promise for rapidly identifying persons at risk of suicide or psychological distress and could provide a low-cost screening alternative in settings where lengthy structured item surveys are not feasible.

Admissions to acute adolescent psychiatric units: a prospective study of clinical severity and outcome

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Jensen Gunnar

2011-01-01

Full Text Available Abstract Background Several countries have established or are planning acute psychiatric in-patient services that accept around-the-clock emergency admission of adolescents. Our aim was to investigate the characteristics and clinical outcomes of a cohort of patients at four Norwegian units. Methods We used a prospective pre-post observational design. Four units implemented a clinician-rated outcome measure, the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA, which measures mental health problems and their severity. We collected also data about the diagnoses, suicidal problems, family situations, and the involvement of the Child Protection Service. Predictions of outcome (change in HoNOSCA total score were analysed with a regression model. Results The sample comprised 192 adolescents admitted during one year (response rate 87%. Mean age was 15.7 years (range 10-18 and 70% were girls. Fifty-eight per cent had suicidal problems at intake and the mean intake HoNOSCA total score was 18.5 (SD 6.4. The largest groups of main diagnostic conditions were affective (28% and externalizing (26% disorders. Diagnoses and other patient characteristics at intake did not differ between units. Clinical psychiatric disorders and developmental disorders were associated with severity (on HoNOSCA at intake but not with outcome. Of adolescents ≥ 16 years, 33% were compulsorily admitted. Median length of stay was 8.5 days and 75% of patients stayed less than a month. Compulsory admissions and length of stay varied between units. Mean change (improvement in the HoNOSCA total score was 5.1 (SD 6.2, with considerable variation between units. Mean discharge score was close to the often-reported outpatient level, and self-injury and emotional symptoms were the most reduced symptoms during the stay. In a regression model, unit, high HoNOSCA total score at intake, or involvement of the Child Protection Service predicted improvement during admission

A patient with Graves’ disease showing only psychiatric symptoms and negativity for both TSH receptor autoantibody and thyroid stimulating antibody

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Hamasaki Hidetaka

2012-12-01

Full Text Available Abstract Background Both thyroid stimulating hormone (TSH and thyroid stimulating antibody (TSAb negative Graves’s disease (GD is extremely rare. Here we present such a patient. Case presentation The patient was a 76-year-old woman who was diagnosed as having schizophrenia forty years ago. She did not show characteristic symptoms for hyperthyroidism, such as swelling of thyroid, exophthalmos, tachycardia and tremor, however, she showed only psychomotor agitation. Serum free triiodothyronine and free thyroxine levels were elevated and TSH level was suppressed, suggesting the existence of hyperthyroidism. However, both the first generation TSH receptor autoantibody (TRAb1 and the thyroid stimulating autoantibody (TSAb were negative. Slightly increased blood flow and swelling was detected by thyroid echography. Thyroid scintigraphy demonstrated diffuse and remarkably elevated uptake of 123I uptake. Finally, we diagnosed her as having GD. She was treated by using methimazole, and hyperthyroidism and her psychiatric symptoms were promptly ameliorated. Discussion We experienced a patient with GD who did not show characteristic symptoms except for psychiatric symptoms, and also showed negativity for both TRAb1 and TSAb. Thyroid autoantibody-negative GD is extremely rare. Thyroid scintigraphy was useful to diagnose such a patient.

The responsiveness of the International Prostate Symptom Score, Incontinence Impact Questionnaire-7 and Depression, Anxiety and Stress Scale-21 in patients with lower urinary tract symptoms.

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Choi, Edmond P H; Chin, Weng Yee; Lam, Cindy L K; Wan, Eric Y F

2015-08-01

To examine the responsiveness of a combined symptom severity and health-related quality of life measure, condition-specific health-related quality of life measure and mental health measure in patients with lower urinary tract symptoms. To establish the responsiveness of measures that accurately capture the change in health status of patients is crucial before any longitudinal studies can be appropriately planned and evaluated. Prospective longitudinal observational study. 402 patients were surveyed at baseline and 1-year using the International Prostate Symptom Score, the Incontinence Impact Questionnaire-7 and Depression, Anxiety and Stress Scales-21. The internal and external responsiveness were assessed. Surveys were conducted from March 2013-July 2014. In participants with improvements, the internal responsiveness for detecting positive changes was satisfactory in males and females for all scales, expect for the Depression subscale. The health-related quality of life question of the International Prostate Symptom Score was more externally responsive than the Incontinence Impact Questionnaire-7. The International Prostate Symptom Score and Anxiety and Stress subscales were more responsive in males than in females. The symptom questions of the International Prostate Symptom Score and Anxiety and Stress subscales were not externally responsive in females. The health-related quality of life question of the International Prostate Symptom Score outperformed the Incontinence Impact Questionnaire-7 in both males and females, in terms of external responsiveness. © 2015 John Wiley & Sons Ltd.

Predictors of self-esteem in adolescents with a psychiatric referral.

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Akdemir, Devrim; Çak, Tuna; Aslan, Cihan; Aydos, Büşra Sultan; Nalbant, Kevser; Çuhadaroğlu-Çetin, Füsun

2016-01-01

In the literature self-esteem is found to be lower in clinically referred adolescents compared to adolescents without any psychiatric disorder. The aim of this study is to examine self-esteem and associated socio-demographical and psychological factors in clinically referred adolescents in Turkey. Three hundred forty-nine adolescents aged between 12 and 18 years admitted to the Department of Child and Adolescent Psychiatry with a psychiatric complaint were enrolled. Rosenberg Self-Esteem Scale (RSES), Brief Symptom Inventory (BSI), Parenting Style Scale (PSS) and Sense of Identity Assessment Form (SIAF) were used for the evaluation. Self-esteem was lower in: girls, adolescents without siblings, living in non-nuclear families, with a past suicide attempt, and with history of a non-suicidal self-injurious behavior (NSSI). Self-esteem was negatively correlated with identity confusion on SIAF and positively correlated with acceptance/involvement on PSS. Significant predictors of self-esteem were gender, presence of a sibling, history of a NSSI and SIAF scores. Interactions between self-esteem and gender, psychiatric symptoms, parenting and identity development are complex in clinically referred adolescents. Further elucidation of the mechanisms through which these characteristics modify self-esteem will be necessary to guide families and clinicians to help adolescents to maintain high self-esteem levels.

Psilocybin-Assisted Therapy: A Review of a Novel Treatment for Psychiatric Disorders.

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Thomas, Kelan; Malcolm, Benjamin; Lastra, Dan

2017-01-01

Recent research suggests that functional connectivity changes may be involved in the pathophysiology of psychiatric disorders. Hyperconnectivity in the default mode network has been associated with psychopathology, but psychedelic serotonin agonists like psilocybin may profoundly disrupt these dysfunctional neural network circuits and provide a novel treatment for psychiatric disorders. We have reviewed the current literature to investigate the efficacy and safety of psilocybin-assisted therapy for the treatment of psychiatric disorders. There were seven clinical trials that investigated psilocybin-assisted therapy as a treatment for psychiatric disorders related to anxiety, depression, and substance use. All trials demonstrated reductions in psychiatric rating scale scores or increased response and remission rates. There were large effect sizes related to improved depression and anxiety symptoms. Psilocybin may also potentially reduce alcohol or tobacco use and increase abstinence rates in addiction, but the benefits of these two trials were less clear due to open-label study designs without statistical analysis. Psilocybin-assisted therapy efficacy and safety appear promising, but more robust clinical trials will be required to support FDA approval and identify the potential role in clinical psychiatry.

New possibility of traditional Chinese and Japanese medicine as treatment for behavioral and psychiatric symptoms in dementia

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Kung FC

2012-10-01

Full Text Available Fan-Chin Kung,1 Ryouhei Ishii,2 Hsing-Cheng Liu,3 Masatoshi Takeda21Yuli Hospital, DOH, Hualien, Taiwan; 2Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan; 3Department of General Psychiatry, Taipei City Psychiatric Center, Taipei, TaiwanAbstract: Yokukansan, one of the Kampo prescriptions, is composed of seven herbaceous plants and was developed in China in the 16th century as a cure for restlessness and agitation in children. Yokukansan has also become a popular drug combination in Japan, especially for the behavioral and psychiatric symptoms of dementia (BPSD. Recent studies have shown that yokukansan might also be quite effective against BPSD occurring in association with other types of dementia, such as Alzheimer's disease, Lewy body disease, Parkinson's disease with dementia, frontotemporal dementia, and vascular dementia. Researchers have intensively investigated yokukansan, focusing on the pharmacological mechanisms against glutamate-mediated excitotoxicity. This traditional Chinese and Japanese medicine holds potential promise for improving BPSD in elderly patients suffering from dementia.Keywords: yokukansan, dementia, Alzheimer's disease, behavioral and psychological symptoms of dementia, Kampo, glutamate

Depressive symptoms and symptoms of post-traumatic stress disorder in women after childbirth.

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Zaers, Stefanie; Waschke, Melanie; Ehlert, Ulrike

2008-03-01

This study examined the course of psychological problems in women from late pregnancy to six months postpartum, the rates of psychiatric, especially depressive and post-traumatic stress symptoms and possible related antecedent variables. During late pregnancy, one to three days postpartum, six weeks and six months postpartum, 47 of the 60 participating women completed a battery of questionnaires including the General Health Questionnaire, the State-Trait Anxiety Inventory, the Edinburgh Postnatal Depression Scale, and the PTSD Symptom Scale. In general, most women recovered from psychiatric and somatic problems over the period of investigation. However, depressive and post-traumatic stress symptoms in particular were not found to decline significantly. Six weeks postpartum, 22% of the women had depressive symptoms, with this figure remaining at 21.3% six months postpartum. In addition, 6% of the women studied reported clinically significant PTSD symptoms at six weeks postpartum with 14.9% reporting such symptoms at six months postpartum. The most important predictor for depressive and post-traumatic stress symptoms was the block variable "anxiety in late pregnancy". Other predictors were the variables "psychiatric symptoms in late pregnancy", "critical life events" and the "experience of delivery". The results of our study show a high prevalence rate of psychiatric symptoms in women after childbirth and suggest, besides the experience of the delivery itself, a vulnerability or predisposing history that makes the development of psychiatric symptoms after childbirth more probable.

Neurovisceral phenotypes in the expression of psychiatric symptoms

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Jessica Anne Eccles

2015-02-01

Full Text Available This review explores the proposal that vulnerability to psychological symptoms, particularly anxiety, originates in constitutional differences in the control of bodily state, exemplified by a set of conditions that include Joint Hypermobility, Postural Tachycardia Syndrome and Vasovagal Syncope. Research is revealing how brain-body mechanisms underlie individual differences in psychophysiological reactivity that can be important s for predicting, stratifying and treating individuals with anxiety disorders and related conditions. One common constitutional difference is Joint Hypermobility, in which there is an increased range of joint movement as a result of a variant of collagen. Joint hypermobility is over-represented in people with anxiety, mood and neurodevelopmental disorders. It is also linked to stress-sensitive medical conditions such as irritable bowel syndrome, chronic fatigue syndrome and fibromyalgia. Structural differences in ‘emotional’ brain regions are reported in hypermobile individuals, and many people with joint hypermobility manifest autonomic abnormalities, typically Postural Tachycardia Syndrome. Enhanced heart rate reactivity is characteristic of Postural Tachycardia Syndrome, and there is a phenomenological overlap with anxiety disorders, which may be partially accounted for by exaggerated neural reactivity within ventromedial prefrontal cortex. People who experience Vasovagal Syncope, a heritable tendency to fainting induced by emotional challenges (and needle/ blood phobia, are also more vulnerable to anxiety disorders. Neuroimaging implicates brainstem differences in vulnerability to faints, yet the structural integrity of the caudate nucleus appears important for the control of fainting frequency in relation to parasympathetic tone and anxiety. Together there is clinical and neuroanatomical evidence to show that common constitutional differences affecting autonomic responsivity are linked to psychiatric symptoms

Obstructive sleep apnea: management considerations in psychiatric patients

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Heck T

2015-10-01

Full Text Available Taryn Heck,1 Monica Zolezzi21Pharmacy Department, University of Alberta Hospital, Alberta Health Services, Edmonton, AB, Canada; 2Clinical Pharmacy and Practice, College of Pharmacy, Qatar University, Doha, QatarAbstract: Psychiatric disorders and obstructive sleep apnea (OSA are often comorbid. However, there is limited information on the impact of psychotropic medications on OSA symptoms, on how to manage psychiatric pharmacotherapy in patients presenting with OSA, or on the effectiveness and challenges of OSA treatments in patients with comorbid mental illness. As such, the objective of this article is to provide an overview of some epidemiological aspects of OSA and treatment considerations in the management of OSA in individuals with comorbid psychiatric disorders. Predefined keywords were used to search for relevant literature in electronic databases. Data show that OSA is particularly prevalent in patients with psychiatric disorders. The medical care that patients with these comorbidities require can be challenging, as some of the psychiatric medications used by these patients may exacerbate OSA symptoms. As such, continuous positive airway pressure continues to be the first-line treatment, even in patients with psychiatric comorbidity. However, more controlled studies are required, particularly to determine continuous positive airway pressure compliance in patients with mental illness, the impact of treating OSA on psychiatric symptoms, and the impact of the use of psychotropic medications on OSA symptoms.Keywords: obstructive sleep apnea, psychiatric disorders, comorbidity, psychotropic medications

The Role of Parenting Styles in the Relation Between Functions of Aggression and Internalizing Symptoms in a Child Psychiatric Inpatient Population.

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Pederson, Casey A; Rathert, Jamie L; Fite, Paula J; Stoppelbein, Laura; Greening, Leilani

2016-10-01

Psychiatric inpatient hospitalization is a costly intervention for youth. With rates of hospitalization rising, efforts to refine prevention and intervention are necessary. Aggression often precedes severe internalizing behaviors, and proactive and reactive functions of aggression are differentially associated with internalizing symptomatology. Thus, further understanding of the links between functions of aggression and internalizing symptomatology could aid in the improvement of interventions for hospitalized youth. The current study examined parenting styles, gender, and age as potential moderators of the relations between proactive and reactive aggression and internalizing symptoms. Participants included 392 children, 6-12 years of age admitted consecutively to a psychiatric inpatient unit. Reactive aggression was uniquely associated with anxiety symptoms. However, proactive aggression was associated with internalizing problems only when specific parenting styles and demographic factors were present. Although both proactive and reactive subtypes of aggression were associated with internalizing symptoms, differential associations were evident. Implications of findings are discussed.

Violent and disruptive behavior among drug-involved prisoners: relationship with psychiatric symptoms.

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Friedmann, Peter D; Melnick, Gerald; Jiang, Lan; Hamilton, Zachary

2008-01-01

This study examines the relationship between psychiatric symptoms and violent/disruptive behavior among 192 inmates who participated in prison-based substance abuse treatment. Participants came from two sites able to provide narrative reports of disciplinary actions in the Criminal Justice Drug Abuse Treatment Studies' Co-Occurring Disorders Screening Instrument study. In multivariate logistic models, a lifetime history of thought insertion/control ideation (OR, 11.6; 95% CI, 1.8-75.2), antisocial personality disorder (OR, 3.3; 95% CI, 1.2-8.9), and disciplinary action related to possession of controlled substances or contraband (OR, 4.9; 95% CI, 1.9-12.3) were associated with increased risk for violent or disruptive behavior while in prison, whereas lifetime phobic symptoms (OR, 0.2; 95% CI, 0.1-0.54) and high school graduation (OR, 0.4; 95% CI, 0.2-1.0) were associated with a decreased risk of violence and disruptive behavior in general. We conclude that, among inmates in substance abuse treatment, symptoms that increase risk for violence or disruptive behavior include thought control/insertion ideation and disciplinary infractions related to controlled substances, contraband, or failure to participate in assigned programs, as well a history of antisocial personality disorder.

[Does routine outcome monitoring have a promising future? An investigation into the use of shared decision-making combined with ROM for patients with a combination of physical and psychiatric symptoms].

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van der Feltz-Cornelis, C M; Andrea, H; Kessels, E; Duivenvoorden, H J; Biemans, H; Metz, M

2014-01-01

Although routine outcome monitoring (ROM) has been developed and widely used in the course of patient centered outcome research in the Netherlands, so far the technique has hardly ever been used to improve the treatment of individual patients. To describe how a rom technique based on the principles of shared decision-making (SDM) was developed and evaluated at the Center for Body, Mind and Health at GGz Breburg, a specialised mental health institution in the Netherlands. We have developed a conceptual model for SDM that involves patient participation and the use of evidence-based decision-aids with cut-off scores. According to the conceptual model for SDM that we developed, the patient and the health professional involved took 'shared' decisions in three phases; the decisions related to triage, the drawing-up of a treatment plan and a follow-up treatment course. At the end of the 6 month intake-phase 7 of the 67 patients who were deemed eligible for ROM/SDM were dropped from the study because they were incapable of performing ROM assessments. Due to diagnostic advice and referral at the end of the intake-phase, 25 patients did not require further treatment. Of the remaining 35 patients, 33 delivered at least one follow-up ROM assessment during the subsequent treatment phases. In these patients somatic and psychiatric symptoms were found to be significantly reduced. ROM combined with sdm can be used successfully with patients who have a combination of physical and psychiatric symptoms and the technique can be applied by the professional in charge. Very few patients dropped out of the follow-up measurements and somatic as well as depressive or psychiatric symptoms diminished significantly. These findings indicate that a Randomised Clinical Trial is warranted in order to test the effectiveness of sdm combined with ROM as a decision-making instrument.

Motivational and Behavioral Activation as an Adjunct to Psychiatric Rehabilitation for Mild to Moderate Negative Symptoms in Individuals with Schizophrenia: A Proof-of-Concept Pilot Study

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Kee-Hong Choi

2016-11-01

Full Text Available Few psychosocial approaches address the negative symptoms of schizophrenia, which shares common features with depression and anxiety. Behavioral activation (BA is effective for addressing depression and anxiety in adults with various mental disorders. Motivational Interviewing (MI has been successfully applied to address ambivalence or lack of motivation towards treatment. Motivational and behavioral activation (mBA has been developed by incorporating the core principles from BA and MI with recent findings on the negative symptoms of schizophrenia. In this study, we aimed to examine the feasibility and preliminary efficacy of mBA in a non-randomized controlled pilot study that included individuals with schizophrenia with mild to moderate negative symptoms receiving psychiatric rehabilitation. A total of 73 individuals with schizophrenia were recruited. Forty-seven of the participants who met the study inclusion and exclusion criteria were assigned to either an mBA + usual psychiatric rehabilitation group (mBA or a usual psychiatric rehabilitation only group (treatment as usual, TAU. Administering mBA to individuals with schizophrenia with mild to moderate negative symptoms was feasible in a community mental health setting. Relative to TAU, mBA was associated with large effects in reducing negative symptoms measured using the Positive and Negative Syndrome Scale (PANSS and the Brief Negative Symptom Scale (BNSS. However, after considering PANSS cognitive deficits and marital status as covariates due to significant differences in their baseline levels, the treatment effects on the BNSS were partially observed. In addition, participants in the mBA group showed improved verbal learning and memory compared with those in the TAU group. In individuals with schizophrenia receiving the usual forms of psychiatric rehabilitation in a community mental health setting, mBA appears to offer a promising adjunctive approach for addressing mild to moderate

Word Memory Test Performance Across Cognitive Domains, Psychiatric Presentations, and Mild Traumatic Brain Injury.

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Rowland, Jared A; Miskey, Holly M; Brearly, Timothy W; Martindale, Sarah L; Shura, Robert D

2017-05-01

The current study addressed two aims: (i) determine how Word Memory Test (WMT) performance relates to test performance across numerous cognitive domains and (ii) evaluate how current psychiatric disorders or mild traumatic brain injury (mTBI) history affects performance on the WMT after excluding participants with poor symptom validity. Participants were 235 Iraq and Afghanistan-era veterans (Mage = 35.5) who completed a comprehensive neuropsychological battery. Participants were divided into two groups based on WMT performance (Pass = 193, Fail = 42). Tests were grouped into cognitive domains and an average z-score was calculated for each domain. Significant differences were found between those who passed and those who failed the WMT on the memory, attention, executive function, and motor output domain z-scores. WMT failure was associated with a larger performance decrement in the memory domain than the sensation or visuospatial-construction domains. Participants with a current psychiatric diagnosis or mTBI history were significantly more likely to fail the WMT, even after removing participants with poor symptom validity. Results suggest that the WMT is most appropriate for assessing validity in the domains of attention, executive function, motor output and memory, with little relationship to performance in domains of sensation or visuospatial-construction. Comprehensive cognitive batteries would benefit from inclusion of additional performance validity tests in these domains. Additionally, symptom validity did not explain higher rates of WMT failure in individuals with a current psychiatric diagnosis or mTBI history. Further research is needed to better understand how these conditions may affect WMT performance. Published by Oxford University Press 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Evidence that COMT genotype and proline interact on negative-symptom outcomes in schizophrenia and bipolar disorder.

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Clelland, C L; Drouet, V; Rilett, K C; Smeed, J A; Nadrich, R H; Rajparia, A; Read, L L; Clelland, J D

2016-09-13

Elevated peripheral proline is associated with psychiatric disorders, and there is evidence that proline is a neuromodulator. The proline dehydrogenase (PRODH) gene, which encodes the enzyme that catalyzes proline catabolism, maps to human chromosome 22q11.2, a region conferring risk of schizophrenia. In the Prodh-null mouse, an interaction between elevated peripheral proline and another 22q11.2 gene, catechol-O-methyltransferase (COMT), on neurotransmission and behavior has been reported. We explored the relationship between fasting plasma proline levels and COMT Val(158)Met genotype on symptoms (positive, negative and total) in schizophrenia patients. In an exploratory study we also examined symptom change in patients with bipolar disorder. There was a significant interaction between peripheral proline and COMT on negative symptoms in schizophrenia (PScale for the Assessment of Negative Symptom (SANS) scores. In contrast, high proline was associated with high SANS scores in patients carrying a Met allele. The relationship between proline and COMT also appears to modify negative symptoms across psychiatric illness. In bipolar disorder, a significant interaction was also observed on negative-symptom change (P=0.007, n=43). Negative symptoms are intractable and largely unaddressed by current medications. These data indicate a significant interaction between peripheral proline and COMT genotype, influencing negative symptoms in schizophrenia and bipolar disorder. That high proline has converse effects on symptoms by COMT genotype, may have implications for therapeutic decisions.

Worsening psychosis induced by varenicline in a hospitalized psychiatric patient.

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DiPaula, Bethany A; Thomas, Michele D

2009-07-01

Varenicline is a novel treatment for smoking cessation; however, the agent has not been well studied in a population with severe mental illness. Varenicline can reportedly cause neuropsychiatric adverse effects, some resulting in hospitalizations and/or suicides. We describe a case of clinician-observed, worsening psychotic symptoms in a patient with chronic mental illness who was receiving varenicline. A 45-year-old woman with bipolar disorder, mixed type with psychotic features, was admitted to a psychiatric hospital due to acute decompensation after she discontinued her drug therapy. Because of the facility's smoke-free policy, the patient was not permitted to smoke cigarettes during her hospitalization. Over the next several weeks, her condition was stabilized with psychotropic drugs. Her symptoms improved, and plans were made for her discharge. Varenicline was prescribed to manage her nicotine cravings. After 2 days of treatment, staff members noted worsening of the patient's psychotic symptoms and agitation. Varenicline was discontinued, the patient's mental status returned to baseline, and she was subsequently discharged. Use of the Naranjo adverse drug reaction probability scale indicated a probable relationship (score of 7) between the patient's worsening psychosis and her varenicline therapy. This case report provides valuable support of previously published cases that demonstrate the risk of exacerbation of psychotic symptoms with varenicline use in patients with severe mental illness. With proper assessment and management of varenicline-induced neuropsychiatric effects, health care professionals can provide an important role in helping to prevent and manage worsening psychiatric symptoms.

Narcissism in patients admitted to psychiatric acute wards: its relation to violence, suicidality and other psychopathology

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Svindseth, Marit F; Nøttestad, Jim Aage; Wallin, Juliska; Roaldset, John Olav; Dahl, Alv A

2008-01-01

Background The objective was to examine various aspects of narcissism in patients admitted to acute psychiatric wards and to compare their level of narcissism to that of an age- and gender-matched sample from the general population (NORM). Methods This cross-sectional study interviewed 186 eligible acute psychiatric patients with the Brief Psychiatric Rating Scale (BPRS) and the Global Assessment of Functioning (GAF). The patients filled in the Narcissistic Personality Inventory-21 item version (NPI-21), The Hospital Anxiety and Depression Scale (HADS) and the Rosenberg Self-Esteem Scale. High and low narcissism was defined by the median of the total NPI-21 score. An age- and gender-matched control sample from the general population also scored the NPI-21 (NORM). Results Being male, involuntary admitted, having diagnosis of schizophrenia, higher self-esteem, and severe violence were significantly associated with high narcissism, and so were also low levels of suicidality, depression, anxiety and GAF scores. Severe violence and high self-esteem were significantly associated with high narcissism in multivariable analyses. The NPI-21 and its subscales showed test-retest correlations ≥0.83, while the BPRS and the HADS showed lower correlations, confirming the trait character of the NPI-21. Depression and suicidality were negatively associated with the NPI-21 total score and all its subscales, while positive association was observed with grandiosity. No significant differences were observed between patients and NORM on the NPI-21 total score or any of the NPI subscales. Conclusion Narcissism in the psychiatric patients was significantly associated with violence, suicidality and other symptoms relevant for management and treatment planning. Due to its trait character, use of the NPI-21 in acute psychiatric patients can give important clinical information. The similar level of narcissism found in patients and NORM is in need of further examination. PMID:18304339

Narcissism in patients admitted to psychiatric acute wards: its relation to violence, suicidality and other psychopathology

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Wallin Juliska

2008-02-01

Full Text Available Abstract Background The objective was to examine various aspects of narcissism in patients admitted to acute psychiatric wards and to compare their level of narcissism to that of an age- and gender-matched sample from the general population (NORM. Methods This cross-sectional study interviewed 186 eligible acute psychiatric patients with the Brief Psychiatric Rating Scale (BPRS and the Global Assessment of Functioning (GAF. The patients filled in the Narcissistic Personality Inventory-21 item version (NPI-21, The Hospital Anxiety and Depression Scale (HADS and the Rosenberg Self-Esteem Scale. High and low narcissism was defined by the median of the total NPI-21 score. An age- and gender-matched control sample from the general population also scored the NPI-21 (NORM. Results Being male, involuntary admitted, having diagnosis of schizophrenia, higher self-esteem, and severe violence were significantly associated with high narcissism, and so were also low levels of suicidality, depression, anxiety and GAF scores. Severe violence and high self-esteem were significantly associated with high narcissism in multivariable analyses. The NPI-21 and its subscales showed test-retest correlations ≥0.83, while the BPRS and the HADS showed lower correlations, confirming the trait character of the NPI-21. Depression and suicidality were negatively associated with the NPI-21 total score and all its subscales, while positive association was observed with grandiosity. No significant differences were observed between patients and NORM on the NPI-21 total score or any of the NPI subscales. Conclusion Narcissism in the psychiatric patients was significantly associated with violence, suicidality and other symptoms relevant for management and treatment planning. Due to its trait character, use of the NPI-21 in acute psychiatric patients can give important clinical information. The similar level of narcissism found in patients and NORM is in need of further examination.

Changes in psychiatric symptoms among persons with methamphetamine dependence predicts changes in severity of drug problems but not frequency of use.

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Polcin, Douglas L; Korcha, Rachael; Bond, Jason; Galloway, Gantt; Nayak, Madhabika

2016-01-01

Few studies have examined how changes in psychiatric symptoms over time are associated with changes in drug use and severity of drug problems. No studies have examined these relationships among methamphetamine (MA)-dependent persons receiving motivational interviewing within the context of standard outpatient treatment. Two hundred seventeen individuals with MA dependence were randomly assigned to a standard single session of motivational interviewing (MI) or an intensive 9-session model of MI. Both groups received standard outpatient group treatment. The Addiction Severity Index (ASI) and timeline follow-back (TLFB) for MA use were administered at treatment entry and 2-, 4-, and 6-month follow-ups. Changes in ASI psychiatric severity between baseline and 2 months predicted changes in ASI drug severity during the same time period, but not changes on measures of MA use. Item analysis of the ASI drug scale showed that psychiatric severity predicted how troubled or bothered participants were by their drug us, how important they felt it was for them to get treatment, and the number of days they experienced drug problems. However, it did not predict the number days they used drugs in the past 30 days. These associations did not differ between study conditions, and they persisted when psychiatric severity and outcomes were compared across 4- and 6-month time periods. Results are among the first to track how changes in psychiatric severity over time are associated with changes in MA use and severity of drug problems. Treatment efforts targeting reduction of psychiatric symptoms among MA-dependent persons might be helpful in reducing the level of distress and problems associated with MA use but not how often it is used. There is a need for additional research describing the circumstances under which the experiences and perceptions of drug-related problems diverge from frequency of consumption.

[Network clusters of symptoms as elementary syndromes of psychopathology: implications for clinical practice].

Science.gov (United States)

Goekoop, R; Goekoop, J G

2016-01-01

In a recent publication we reported the existence of around 11 (to 15) 'elementary syndromes' that may combine in various ways, rather like 'building blocks', to explain the wide range of psychiatric symptoms. 'Bridge symptoms' seem to be responsible both for combining large sets of symptoms into elementary syndromes and for combining the various elementary syndromes to form one globally connected network structure. To discuss the implication of these findings for clinical practice. We performed a network analysis of symptom scores. Elementary syndromes provide a massive simplification of the description of psychiatric disease. Instead of the more than 300 categories in DSM-5, we now need to consider only a handful of elementary syndromes and personality domains. This modular representation of psychiatric illnesses allows us to make a complete, systematic and efficient assessment of patients and a systematic review of treatment options. Clinicians, patients, managerial staff and insurance companies can verify whether symptom reduction is taking place in the most important domains of psychopathology. Unlike classic multidimensional methods of disease description, network models of psychopathology can be used to explain comorbidity patterns, predict the clinical course of psychopathology and to designate primary targets for therapeutic interventions. A network view on psychopathology could significantly improve everyday clinical practice.

Convergence Insufficiency Symptom Survey Scores for Reading Versus Other Near Visual Activities in School-Age Children.

Science.gov (United States)

Clark, Tiana Y; Clark, Robert A

2015-11-01

To measure the difference in Convergence Insufficiency Symptom Survey scores for reading vs favorite near visual activities. Comparative validity analysis of diagnostic tools. At a single clinical private practice, 100 children aged 9-18 with normal binocular vision were recruited to receive either the original survey emphasizing reading or a modified survey replacing "reading" with their favorite near activity. Average survey scores and subscores for questions emphasizing fatigue, discomfort, impaired vision, and cognitive performance were compared using t tests, while responses to individual questions were compared using Mann-Whitney U tests. The average reading survey score was significantly greater than the favorite near activity survey score (14.1 ± 11.5 vs 6.7 ± 5.8, P = .0001). The largest difference resulted from questions emphasizing cognitive performance (subscore 5.8 ± 4.3 vs 2.0 ± 2.1, P = .0000002), although significant differences were also found for fatigue (5.4 ± 3.8 vs 3.0 ± 2.7, P = .0003), discomfort (3.9 ± 4.6 vs 1.8 ± 2.2, P = .004), and impaired vision (3.2 ± 3.9 vs 1.8 ± 2.2, P = .02). Significant differences were found for 7 survey questions, with higher symptom scores for the reading survey in every case. Using survey scores ≥16 to diagnose convergence insufficiency, significantly more children taking the reading survey would have been diagnosed with convergence insufficiency than children taking the favorite near activity survey (19 of 50 [38%] vs 5 of 50 [10%], P = .001). By emphasizing reading, the Convergence Insufficiency Symptom Survey score significantly overestimates near visual symptoms in children with normal binocular vision compared with symptoms caused by preferred near activities that require similar amplitudes of accommodation and convergence. Copyright © 2015 Elsevier Inc. All rights reserved.

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.

Next-generation negative symptom assessment for clinical trials: validation of the Brief Negative Symptom Scale.

Science.gov (United States)

Strauss, Gregory P; Keller, William R; Buchanan, Robert W; Gold, James M; Fischer, Bernard A; McMahon, Robert P; Catalano, Lauren T; Culbreth, Adam J; Carpenter, William T; Kirkpatrick, Brian

2012-12-01

The current study examined the psychometric properties of the Brief Negative Symptom Scale (BNSS), a next-generation rating instrument developed in response to the NIMH sponsored consensus development conference on negative symptoms. Participants included 100 individuals with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder who completed a clinical interview designed to assess negative, positive, disorganized, and general psychiatric symptoms, as well as functional outcome. A battery of anhedonia questionnaires and neuropsychological tests were also administered. Results indicated that the BNSS has excellent internal consistency and temporal stability, as well as good convergent and discriminant validity in its relationships with other symptom rating scales, functional outcome, self-reported anhedonia, and neuropsychological test scores. Given its brevity (13-items, 15-minute interview) and good psychometric characteristics, the BNSS can be considered a promising new instrument for use in clinical trials. Copyright © 2012 Elsevier B.V. All rights reserved.

Boundary curves of individual items in the distribution of total depressive symptom scores approximate an exponential pattern in a general population.

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Tomitaka, Shinichiro; Kawasaki, Yohei; Ide, Kazuki; Akutagawa, Maiko; Yamada, Hiroshi; Furukawa, Toshiaki A; Ono, Yutaka

2016-01-01

Previously, we proposed a model for ordinal scale scoring in which individual thresholds for each item constitute a distribution by each item. This lead us to hypothesize that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores follow a common mathematical model, which is expressed as the product of the frequency of the total depressive symptom scores and the probability of the cumulative distribution function of each item threshold. To verify this hypothesis, we investigated the boundary curves of the distribution of total depressive symptom scores in a general population. Data collected from 21,040 subjects who had completed the Center for Epidemiologic Studies Depression Scale (CES-D) questionnaire as part of a national Japanese survey were analyzed. The CES-D consists of 20 items (16 negative items and four positive items). The boundary curves of adjacent item scores in the distribution of total depressive symptom scores for the 16 negative items were analyzed using log-normal scales and curve fitting. The boundary curves of adjacent item scores for a given symptom approximated a common linear pattern on a log normal scale. Curve fitting showed that an exponential fit had a markedly higher coefficient of determination than either linear or quadratic fits. With negative affect items, the gap between the total score curve and boundary curve continuously increased with increasing total depressive symptom scores on a log-normal scale, whereas the boundary curves of positive affect items, which are not considered manifest variables of the latent trait, did not exhibit such increases in this gap. The results of the present study support the hypothesis that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores commonly follow the predicted mathematical model, which was verified to approximate an exponential mathematical pattern.

Boundary curves of individual items in the distribution of total depressive symptom scores approximate an exponential pattern in a general population

Directory of Open Access Journals (Sweden)

Shinichiro Tomitaka

2016-10-01

Full Text Available Background Previously, we proposed a model for ordinal scale scoring in which individual thresholds for each item constitute a distribution by each item. This lead us to hypothesize that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores follow a common mathematical model, which is expressed as the product of the frequency of the total depressive symptom scores and the probability of the cumulative distribution function of each item threshold. To verify this hypothesis, we investigated the boundary curves of the distribution of total depressive symptom scores in a general population. Methods Data collected from 21,040 subjects who had completed the Center for Epidemiologic Studies Depression Scale (CES-D questionnaire as part of a national Japanese survey were analyzed. The CES-D consists of 20 items (16 negative items and four positive items. The boundary curves of adjacent item scores in the distribution of total depressive symptom scores for the 16 negative items were analyzed using log-normal scales and curve fitting. Results The boundary curves of adjacent item scores for a given symptom approximated a common linear pattern on a log normal scale. Curve fitting showed that an exponential fit had a markedly higher coefficient of determination than either linear or quadratic fits. With negative affect items, the gap between the total score curve and boundary curve continuously increased with increasing total depressive symptom scores on a log-normal scale, whereas the boundary curves of positive affect items, which are not considered manifest variables of the latent trait, did not exhibit such increases in this gap. Discussion The results of the present study support the hypothesis that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores commonly follow the predicted mathematical model, which was verified to approximate an

Parental psychological symptoms and familial risk factors of children and adolescents who exhibit school refusal.

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Bahali, K; Tahiroglu, A Y; Avci, A; Seydaoglu, G

2011-12-01

To assess the levels of psychological symptoms in the parents of children with school refusal and determine the familial risk factors in its development. This study was performed on 55 pairs of parents who had children exhibiting school refusal and were compared with a control group. A socio-demographic data form, the Beck Depression Inventory, the State-Trait Anxiety Inventory, and the Symptom Checklist-90 revised were applied to these parents. Parents of the school refusal group had higher anxiety and depression scores than the controls. Among the risk factors for school refusal, physical punishment by the parents, a history of organic disease in the parents or children, and a history of psychiatric disorders in the parents or other relatives were found to be significant. Depending on genetic and environmental factors, parents with psychiatric disorders appeared to be associated with development of psychiatric disorders in their children. Moreover, psychiatric disorders in parents negatively affected the treatment of their children and adolescents who exhibited school refusal. It is therefore vital to treat psychiatric disorders of parents with the children having psychiatric disorders, and thus increase parent participation in their children's therapeutic process.

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 ...

Psychiatric comorbidity in children and youth with epilepsy: An association with executive dysfunction?

Science.gov (United States)

Alfstad, Kristin Å; Torgersen, Halvor; Van Roy, Betty; Hessen, Erik; Hansen, Berit Hjelde; Henning, Oliver; Clench-Aas, Jocelyne; Mowinckel, Petter; Gjerstad, Leif; Lossius, Morten I

2016-03-01

Psychopathology in children and youth with epilepsy has previously been related to executive dysfunction, but the nature of the association is uncertain. We sought to explore risk factors for psychiatric disorders in children and youth with epilepsy, with emphasis on executive dysfunction, along with seizure-related and psychosocial factors. The cohort consisted of one hundred and one consecutive patients aged 10-19 years with focal (n=52) or genetic generalized (n=49) epilepsy. All were screened for psychiatric symptoms, using part of an extensive questionnaire, the Strengths and Difficulties Questionnaire (SDQ) for both patients and their parents. Participants scoring in the borderline or abnormal range on the SDQ received a psychiatric interview (Kiddie-SADS-PL). All participants underwent a neuropsychological examination, and those with general cognitive abilities (IQ)epilepsy-related or psychosocial factors were not significantly associated with psychiatric disorders. Multiple factors are associated with psychiatric problems in children and youth with epilepsy. In this study, executive dysfunction, male gender, and early epilepsy onset were independent risk factors for having a psychiatric disorder. An evaluation of psychiatric and cognitive problems is important to enable a positive long-term outcome in childhood epilepsy. Copyright © 2016 Elsevier Inc. All rights reserved.

Patient Smartphone Ownership and Interest in Mobile Apps to Monitor Symptoms of Mental Health Conditions: A Survey in Four Geographically Distinct Psychiatric Clinics

OpenAIRE

Torous, John; Chan, Steven Richard; Yee-Marie Tan, Shih; Behrens, Jacob; Mathew, Ian; Conrad, Erich J; Hinton, Ladson; Yellowlees, Peter; Keshavan, Matcheri

2014-01-01

Background: Despite growing interest in mobile mental health and utilization of smartphone technology to monitor psychiatric symptoms, there remains a lack of knowledge both regarding patient ownership of smartphones and their interest in using such to monitor their mental health. Objective: To provide data on psychiatric outpatients’ prevalence of smartphone ownership and interest in using their smartphones to run applications to monitor their mental health. Methods: We surveyed 320 psychiat...

The emotional impact of psychiatric symptoms in dementia on partner caregivers: do caregiver, patient, and situation characteristics make a difference?

NARCIS (Netherlands)

Meiland, F.J.M.; Kat, M.G.; van Tilburg, W.; Jonker, C.; Dr�es, R.M.

2005-01-01

This study aims to investigate the emotional impact of psychiatric symptoms of patients with dementia on their caregiving partners, and to explore if caregiver, patient, and situation factors predict this emotional impact on caregivers. A cross-sectional design was used. Partners of patients with

The comorbid psychiatric symptoms of Internet addiction: attention deficit and hyperactivity disorder (ADHD), depression, social phobia, and hostility.

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Yen, Ju-Yu; Ko, Chih-Hung; Yen, Cheng-Fang; Wu, Hsiu-Yueh; Yang, Ming-Jen

2007-07-01

To: (1) determine the association between Internet addiction and depression, self-reported symptoms of attention deficit and hyperactivity disorder (ADHD), social phobia, and hostility for adolescents; and (2) evaluate the sex differences of association between Internet addiction and the above-mentioned psychiatric symptoms among adolescents. A total of 2114 students (1204 male and 910 female) were recruited for the study. Internet addiction, symptoms of ADHD, depression, social phobia, and hostility were evaluated by the self-report questionnaire. The results demonstrated that adolescents with Internet addiction had higher ADHD symptoms, depression, social phobia, and hostility. Higher ADHD symptoms, depression, and hostility are associated with Internet addiction in male adolescents, and only higher ADHD symptoms and depression are associated with Internet addiction in female students. These results suggest that Internet addiction is associated with symptoms of ADHD and depressive disorders. However, hostility was associated with Internet addiction only in males. Effective evaluation of, and treatment for ADHD and depressive disorders are required for adolescents with Internet addiction. More attention should be paid to male adolescents with high hostility in intervention of Internet addiction.

[Internet dependency as a symptom of depressive mood disorders].

Science.gov (United States)

te Wildt, Bert T; Putzig, Inken; Zedler, Markus; Ohlmeier, Martin D

2007-09-01

In psychiatric contexts, the quick distribution of virtual techniques in private and professional everyday life gives rise to the question, if these can evoke a psychological addiction. Yet, the diagnostic assessment of internet or computer game dependency remains problematic. Within a study with 23 internet-dependent patients with significant psychological strain, 18 (77.8%) were diagnosed with a depressive mood disorder by thorough clinical examination and structured interviews. The presented work compares psychometric test results of the depressed subpopulation with healthy controls matched for age, sex and school education. In the Barrat Impulsiveness Scale patients with internet dependency scored significantly higher than the control group (p Internet Addiction Scale. Becks Depression Inventory and the Symptom-Checklist subscale for depression revealed significantly higher scores within the patient group as compared to controls (p internet dependent subjects showed significantly more pathological scores than the healthy subjects (p internet dependency can be understood as a novel psychopathology of well known psychiatric conditions, every psychiatrist should be able to detect and treat it adequately, as long as there is a willingness to deal with the contents and impacts of cyberspace. Especially with depressed patients, it seems to be crucial to include questions about media usage in psychiatric examination taking.

Change in Psychiatric Symptomatology after Benfotiamine Treatment in Males is a Function of Lifetime Alcoholism Severity

Science.gov (United States)

Manzardo, Ann M.; Pendleton, Tiffany; Poje, Albert; Penick, Elizabeth C.; Butler, Merlin G.

2015-01-01

Background Severe alcoholism can be associated with significant nutritional and vitamin deficiency, especially vitamin B1 (thiamine) which is associated with serious illness and neurological deficits that influence mood and cognition. We previously reported reduced alcohol consumption among female but not male alcoholics after supplementation with the high potency thiamine analog benfotiamine (BF). As a follow-up, we have examined the relationship between lifetime alcoholism severity and psychiatric symptoms among the alcohol dependent men from this cohort and their response to BF treatment. Methods Eighty-five adult men (mean age = 48 ± 8 yrs) meeting DSM-IV-TR criteria for current alcohol dependence participated in a randomized, double-blind, placebo-controlled trial of 600 mg BF vs placebo (PL) for 6 months. Psychometric testing included a derived Lifetime Alcoholism Severity Score (AS), Symptom Checklist 90R (SCL-90R), and the Barratt Impulsivity Scale (BIS) at baseline and at 6 months with data analyzed using ANOVA and MANOVA modeling. Results Baseline SCL-90-R scale scores for men with high alcoholism severity (AS ≥ 24; N=46 HAS) were significantly greater than for men with low alcoholism severity (AS < 24; N=39 LAS), but BIS scores did not differ. MANOVA modeling identified a significant treatment effect (F=2.5, df=10, p<0.03) and treatment x alcoholism severity level interaction (F=2.5, dfnum=10, dfden=30, p<0.03) with SCL-90-R scores showing a reduction in symptoms among BF treated, high severity males. Conclustion BF appears to reduce psychiatric distress and may facilitate recovery in severely affected males with lifetime alcohol dependence and should be considered for adjuvant therapy in alcohol rehabilitation. PMID:25908323

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.

The BDNF-Val66Met polymorphism modulates parental rearing effects on adult psychiatric symptoms: a community twin-based study.

Science.gov (United States)

Ibarra, P; Alemany, S; Fatjó-Vilas, M; Córdova-Palomera, A; Goldberg, X; Arias, B; González-Ortega, I; González-Pinto, A; Nenadic, I; Fañanás, L

2014-06-01

To test whether firstly, different parental rearing components were associated with different dimensions of psychiatric symptoms in adulthood, secondly BDNF-Val66Met polymorphism moderated this association and thirdly, this association was due to genetic confounding. Perceived parental rearing according to Parental Bonding Instrument (PBI), psychiatric symptoms evaluated with the Brief Symptom Inventory (BSI) and the BDNF-Val66Met polymorphism were analyzed in a sample of 232 adult twins from the general population. In the whole sample, paternal care was negatively associated with depression. Maternal overprotection was positively associated with paranoid ideation, obsession-compulsion and somatization. Gene-environment interaction effects were detected between the BDNF-Val66Met polymorphism and maternal care on phobic anxiety, paternal care on hostility, maternal overprotection on somatization and paternal overprotection also in somatization. In the subsample of MZ twins, intrapair differences in maternal care were associated with anxiety, paranoid ideation and somatization. Met carriers were, in general, more sensitive to the effects of parental rearing compared to Val/Val carriers in relation to anxiety and somatization. Contra-intuitively, our findings suggest that high rates of maternal care might be of risk for Met carriers regarding anxiety. Results from analyses controlling for genetic confounding were in line with this finding. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Anxiety and depression symptoms and migraine: a symptom-based approach research.

Science.gov (United States)

Peres, Mario Fernando Prieto; Mercante, Juliane P P; Tobo, Patricia R; Kamei, Helder; Bigal, Marcelo Eduardo

2017-12-01

Anxiety and mood disorders have been shown to be the most relevant psychiatric comorbidities associated with migraine, influencing its clinical course, treatment response, and clinical outcomes. Limited information is available on how specific anxiety and depression symptoms are related to migraine. Symptoms-based approach, a current trend in mental health research, may improve our understanding in migraine comorbidity. The purpose of this study was to analyze how anxiety and depression aspects are related to migraine through a symptom-based approach. We studied 782 patients from the general population who completed a self-administered questionnaire assessing demographics, headache features, anxiety and depression symptoms. A binary logistic regression analyses were conducted to test the association between all four ratings in GAD-7 (anxiety) and PHQ-9 (depression) scales subitems as covariates, and migraine vs no headache as the outcome. The leading Odd Ratios (OR) observed in individuals with migraine relative to those without migraine were anxiety related, "Not being able to stop or control worrying" on a daily basis [OR (CI 95%)] 49.2 (13.6-178.2), "trouble relaxing" 25.7 (7.1-92.6), "Feeling nervous, anxious or on edge" on a daily basis 25.4 (6.9-93.8), and "worrying too much about different things" 24.4 (7.7-77.6). Although the hallmark symptoms of depression are emotional (hopelessness and sadness), the highest scores found were physical: apetite, fatigue, and poor sleep. Irritability had a significant increase in migraine risk [OR 3.8 (1.9-7.8) if experienced some days, 7.5 (2.7-20.7) more than half the days, and 22.0 (5.7-84.9) when experienced nearly every day]. Anxiety was more robustly associated with increase in migraine risk than depression. Lack of ability to properly control worrying and to relax are the most prominent issues in migraine psychiatric comorbidity. Physical symptoms in depression are more linked to migraine than emotional symptoms. A

Patient Smartphone Ownership and Interest in Mobile Apps to Monitor Symptoms of Mental Health Conditions: A Survey in Four Geographically Distinct Psychiatric Clinics.

Science.gov (United States)

Torous, John; Chan, Steven Richard; Yee-Marie Tan, Shih; Behrens, Jacob; Mathew, Ian; Conrad, Erich J; Hinton, Ladson; Yellowlees, Peter; Keshavan, Matcheri

2014-01-01

Despite growing interest in mobile mental health and utilization of smartphone technology to monitor psychiatric symptoms, there remains a lack of knowledge both regarding patient ownership of smartphones and their interest in using such to monitor their mental health. To provide data on psychiatric outpatients' prevalence of smartphone ownership and interest in using their smartphones to run applications to monitor their mental health. We surveyed 320 psychiatric outpatients from four clinics around the United States in order to capture a geographically and socioeconomically diverse patient population. These comprised a state clinic in Massachusetts (n=108), a county clinic in California (n=56), a hybrid public and private clinic in Louisiana (n=50), and a private/university clinic in Wisconsin (n=106). Smartphone ownership and interest in utilizing such to monitor mental health varied by both clinic type and age with overall ownership of 62.5% (200/320), which is slightly higher than the average United States' rate of ownership of 58% in January 2014. Overall patient interest in utilizing smartphones to monitor symptoms was 70.6% (226/320). These results suggest that psychiatric outpatients are interested in using their smartphones to monitor their mental health and own the smartphones capable of running mental healthcare related mobile applications.

The Associations Between Pre- and Postnatal Maternal Symptoms of Distress and Preschooler's Symptoms of ADHD, Oppositional Defiant Disorder, Conduct Disorder, and Anxiety

DEFF Research Database (Denmark)

Bendiksen, Bothild; Aase, Heidi; Diep, Lien My

2015-01-01

,195), recruited from the Norwegian Mother and Child Cohort Study, were assessed with a semistructured parental psychiatric interview. Perinatal maternal symptoms of distress were assessed by Symptom Checklist (SCL-5); Poisson regression was used to examine the associations. RESULTS: Mid-gestational maternal......OBJECTIVE: The objective of this article is to examine the associations between pre- and postnatal maternal distress and preschooler's symptoms of ADHD, Oppositional Defiant Disorder (ODD), Conduct Disorder (CD), and anxiety, by timing and gender. METHOD: Children, aged 3.5 years (N = 1...... distress significantly increased the average number of child symptoms, ranging between 3.8% for ADHD hyperactive-impulsive (ADHD-HI) and 8.7% for anxiety. The combination of high maternal scores of distress both pre- and postnatally were associated with increased risk of child symptoms of anxiety (relative...

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.

Military Chronic Musculoskeletal Pain and Psychiatric Comorbidity: Is Better Pain Management the Answer?

Directory of Open Access Journals (Sweden)

Cindy A. McGeary

2016-06-01

Full Text Available Chronic musculoskeletal pain, such as low back pain, often appears in the presence of psychiatric comorbidities (e.g., depression, posttraumatic stress disorder (PTSD, especially among U.S. military service members serving in the post-9/11 combat era. Although there has been much speculation about how to best address pain/trauma psychiatric symptom comorbidities, there are little available data to guide practice. The present study sought to examine how pre-treatment depression and PTSD influence outcomes in a functional restoration pain management program using secondary analysis of data from the Department of Defense-funded Functional and Orthopedic Rehabilitation Treatment (FORT trial. Twenty-eight FORT completers were analyzed using a general linear model exploring how well depression and PTSD symptoms predict post-treatment pain (Visual Analog Scale (VAS pain rating, disability (Oswestry Disability Index; Million Visual Analog Scale, and functional capacity (Floor-to-Waist and Waist-to-Eye Level progressive isoinertial lifting evaluation scores in a sample of active duty military members with chronic musculoskeletal pain and comorbid depression or PTSD symptoms. Analysis revealed that pre-treatment depression and PTSD symptoms did not significantly predict rehabilitation outcomes from program completers. Implications of these findings for future research on trauma-related pain comorbidities are discussed.

Effect of silodosin on specific urinary symptoms associated with benign prostatic hyperplasia: analysis of international prostate symptom scores in 2 phase III clinical studies.

Science.gov (United States)

Gittelman, Marc C; Marks, Leonard S; Hill, Lawrence A; Volinn, Weining; Hoel, Gary

2010-01-01

Pooled results from 2 randomized, placebo-controlled, US phase III studies (NCT00224107, NCT00224120) showed that silodosin, a uroselective α-blocker, significantly improved International Prostate Symptom Scores (IPSS) in men with symptomatic benign prostatic hyperplasia (BPH). This analysis evaluated the effect of silodosin on each symptom assessed by IPSS questionnaire. Study participants (N = 923) were men aged ≥50 years with IPSS ≥13 and Qmax 4-15 mL/s. They received silodosin 8 mg or placebo once daily for 12 weeks. Patient responses to 7 IPSS questions were collected at weeks 0 (baseline), 0.5, 1, 2, 4, and 12 and scored on a 6-point scale. Efficacy of silodosin versus placebo was assessed by analysis of covariance. For each symptom, the 2 treatment groups had similar mean baseline scores. Decrease in score from baseline (mean ± standard deviation) to last observation was significantly greater with silodosin than with placebo for all symptoms (P silodosin (versus placebo) was greatest for weak stream (silodosin, -1.1 ± 1.4 versus placebo, -0.5 ± 1.2; P nocturia (silodosin, -0.6 ± 1.1 versus placebo, -0.4 ± 1.2; P = 0.0037). Compared with placebo, silodosin significantly improved nocturia within 1 week (silodosin, -0.5 ± 1.07 versus placebo, -0.3 ± 1.05; P = 0.009) and all other symptoms within 3 to 4 days (P Silodosin significantly improved all BPH-associated symptoms assessed by IPSS questionnaire within the first week of treatment. All improvements were maintained over the 12-week study period.

Psychiatric morbidity in patients with chronic whiplash-associated disorder.

Science.gov (United States)

Kivioja, Jouko; Själin, Mikael; Lindgren, Urban

2004-06-01

Prospective cohort with age- and gender-matched controls. To compare psychiatric morbidity between two groups: patients having chronic symptoms after a whiplash injury and patients who recovered completely. Psychiatric morbidity may influence the outcome of somatic diseases, and it has been suggested that psychological factors are often involved in the development of chronic symptoms after whiplash injuries, but there is no study assessing psychiatric morbidity in whiplash-associated disorder (WAD) using the Structured Clinical Interview for DSM-IV. We studied a consecutive sample of 278 patients with a whiplash injury. Eighty-five had persisting neck pain after 1 year, and 38 of these participated in this study. For each patient with chronic neck pain at the 1 year follow-up, a gender- and age-matched recovered patient was selected from the study cohort of 278 cases. Psychiatric morbidity was determined using the Structured Clinical Interview for DSM-IV (SCID). The interview was conducted at 1 year after the accident (360 days, SD 2 days). The chronic WAD group had a significantly (P factor for chronic symptoms after a whiplash injury. The development of chronic symptoms after awhiplash injury seems to be associated with psychiatric vulnerability.

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.

Low levels of posttraumatic stress symptoms and psychiatric symptomatology among third-generation Holocaust survivors whose fathers were war veterans.

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Zerach, Gadi; Solomon, Zahava

2016-02-01

There is an ongoing debate regarding the intergenerational transmission of Holocaust trauma to the third generation (TGH). However, due to the rareness of this population, there are no studies that have examined TGH individuals whose fathers were also victims of war-related trauma and captivity. This prospective study aimed to assess the role of parents' Holocaust background, fathers' posttraumatic stress symptoms (PTSS), and adult offspring's anxiety sensitivity (AS) in adult offspring's PTSS and psychiatric symptomatology. A sample of 123 Israeli father-child dyads (42 TGH and 71 non-TGH), that included 80 former prisoners of war (ex-POWs) dyads and a comparison group of 44 veteran dyads, completed AS, PTSS and psychiatric symptomatology self-report measures. Fathers were assessed 17 years following the Yom Kippur War (T1: 2008) while offspring took part in T2 (2013-2014). Surprisingly, results show that TGH participants reported lower levels of PTSS and psychiatric symptomatology than non-TGH participants, regardless of their fathers' captivity status. Interestingly, a moderated mediation analysis indicated that offspring's AS mediated the association between Holocaust background and participants' PTSS and psychiatric symptomatology, only among ex-POWs' offspring. This study provides evidence for relatively lower levels of PTSS and psychiatric symptomatology among TGH individuals whose fathers were war veterans. Ex-POWs' adult offspring who are grandchildren of Holocaust survivors reported lower levels of AS that was related to lower levels of PTSS and psychiatric symptomatology. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Psychiatric consultations for nursing-home residents: aspects and course of such consultations].

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Steenbeek, M; van Baarsen, C; Koekkoek, B

2012-01-01

Psychiatric symptoms occur frequently in nursing-home residents. The psychiatric expertise and support available to residents vary from one nursing home to another. International studies show that psychiatric consultations can be effective, but in the Netherlands very little research has been done on this topic. To list the types of psychiatric problems and symptoms for which consultations are requested and to determine whether a psychiatric consultation can have positive results for nursing-home residents and staff. The psychiatric consultations requested were tabulated and were analysed. Details of 71 psychiatric consultations were recorded. The percentage of women (average age 74 years) was slightly higher than the percentage of men. More than 75% of the patients suffered from agitation/aggression or irritability, 65% suffered from depression, 63% from anxiety and 56% from dysinhibition. A post-intervention assessment was performed in 54 patients (76%). In this group psychiatric symptoms were found to be greatly reduced, with regard to both frequency and severity. In addition, nursing staff seemed to suffer less of the stress and strain in their work. The patients for whom a consultation was requested seemed to suffer from serious psychiatric symptoms and were often aggressive. It was possible to achieve substantial progress as a result of a simple intervention. A possible explanation for this effect is probably the nature of the psychiatric consultation used; it was structured, multi-disciplinary and time-consuming. However, since no control group was involved, it is impossible to say with certainty that the reduction in symptoms can be attributed solely to the consultation.

Sex-specific interaction effects of age, occupational status, and workplace stress on psychiatric symptoms and allostatic load among healthy Montreal workers.

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Juster, Robert-Paul; Moskowitz, D S; Lavoie, Joel; D'Antono, Bianca

2013-11-01

Socio-demographics and workplace stress may affect men and women differently. The aim of this cross-sectional study was to assess sex-specific interactions among age, occupational status, and workplace Demand-Control-Support (D-C-S) factors in relation to psychiatric symptoms and allostatic load levels representing multi-systemic "wear and tear". It was hypothesized that beyond main effects, D-C-S factors would be moderated by occupational status and age in sex-specific directions predictive of subjective psychiatric symptoms and objective physiological dysregulations. Participants included healthy male (n = 81) and female (n = 118) Montreal workers aged 20 to 64 years (Men: M = 39.4 years, SD = 11.3; Women: M = 42.8 years, SD = 11.38). The Job Content Questionnaire was administered to assess workplace D-C-S factors that included psychological demands, decisional latitude, and social support. Occupational status was coded using the Nam--Powers--Boyd system derived from the Canadian census. Psychiatric symptoms were assessed using the Beck Anxiety Scale and the Beck Depression Inventory II. Sex-specific allostatic load indices were calculated based on fifteen biomarkers. Regression analyses revealed that higher social support was associated with less depressive symptoms in middle aged (p = 0.033) and older men (p = 0.027). Higher occupational status was associated with higher allostatic load levels for men (p = 0.035), while the reverse occurred for women (p = 0.048). Women with lower occupational status but with higher decision latitude had lower allostatic load levels, as did middle-aged (p = 0.031) and older women (p = 0.003) with higher psychological demands. In summary, age and occupational status moderated workplace stress in sex-specific ways that have occupational health implications.

Common psychiatric symptoms among public school teachers in Palmas, Tocantins, Brazil. An observational cross-sectional study

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Leonardo Baldaçara

Full Text Available CONTEXT AND OBJECTIVE: Teachers are at great risk of physical and mental stress due to material or psychological difficulties associated with their work. This study aimed to assess the prevalence of common psychiatric symptoms measured on the Self-Reporting Questionnaire (SRQ-20 scale that would suggest a diagnosis of psychiatric disorders among public school teachers in Palmas, Tocantins, Brazil, in 2012. DESIGN AND SETTING: Observational cross-sectional study in Palmas, Tocantins, Brazil. METHOD: We assessed 110 municipal teachers in the city of Palmas, Tocantins, Brazil. They were selected randomly from a list of employees of the Municipal Education Department of Palmas. All of them answered the SRQ-20 questionnaire after giving their consent. RESULTS: Between the years 2008 and 2011, 24 cases of absence from work due to mental disorders were found. We excluded one case and 109 teachers answered the SRQ-20questionnaire. Out of the 109 teachers assessed, 54 had ≥ 7 points on the SRQ-20 scale. This finding suggests that 49.5% of the teachers had symptoms that were sufficient to consider a diagnosis of mental disorder, with the need for treatment. CONCLUSION: Our study found that the prevalence of mental disorders among teachers is as high as seen in the literature. Our results suggest that recognition of mental disorders is low and that the current statistics fail to reach the occupational health sector.

Common psychiatric symptoms among public school teachers in Palmas, Tocantins, Brazil. An observational cross-sectional study.

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Baldaçara, Leonardo; Silva, Álvaro Ferreira; Castro, José Gerley Díaz; Santos, Gessi de Carvalho Araújo

2015-01-01

Teachers are at great risk of physical and mental stress due to material or psychological difficulties associated with their work. This study aimed to assess the prevalence of common psychiatric symptoms measured on the Self-Reporting Questionnaire (SRQ-20) scale that would suggest a diagnosis of psychiatric disorders among public school teachers in Palmas, Tocantins, Brazil, in 2012. Observational cross-sectional study in Palmas, Tocantins, Brazil. We assessed 110 municipal teachers in the city of Palmas, Tocantins, Brazil. They were selected randomly from a list of employees of the Municipal Education Department of Palmas. All of them answered the SRQ-20 questionnaire after giving their consent. Between the years 2008 and 2011, 24 cases of absence from work due to mental disorders were found. We excluded one case and 109 teachers answered the SRQ-20questionnaire. Out of the 109 teachers assessed, 54 had ≥ 7 points on the SRQ-20 scale. This finding suggests that 49.5% of the teachers had symptoms that were sufficient to consider a diagnosis of mental disorder, with the need for treatment. Our study found that the prevalence of mental disorders among teachers is as high as seen in the literature. Our results suggest that recognition of mental disorders is low and that the current statistics fail to reach the occupational health sector.

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

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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%…

Food-based diet quality score in relation to depressive symptoms in young and middle-aged Japanese women.

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Sakai, Hiroka; Murakami, Kentaro; Kobayashi, Satomi; Suga, Hitomi; Sasaki, Satoshi

2017-06-01

Only a few studies have focused on the association between overall diet, rather than intakes of individual nutrients or foods, and depressive symptoms in Japanese. This cross-sectional study examined associations between a diet quality score and depressive symptoms in 3963 young (age 18 years) and 3833 middle-aged (mean age 47·9 (sd 4·2) years) Japanese women. Dietary information was collected using a diet history questionnaire. A previously developed diet quality score was computed mainly based on the Japanese Food Guide Spinning Top. The prevalence of depressive symptoms was 22·0 % for young women and 16·8 % for middle-aged women, assessed as a Center for Epidemiologic Studies Depression (CES-D) score ≥23 and ≥19, respectively. As expected, the diet quality score was associated positively with intakes of 'grain dishes', 'vegetable dishes', 'fish and meat dishes', 'milk' and 'fruits' and inversely with intakes of energy from 'snacks, confection and beverages' and Na from seasonings. After adjustment for potential confounders, OR for depressive symptoms in the highest v. lowest quintiles of the diet quality score was 0·65 (95 % CI 0·50, 0·84) in young women (P for trend=0·0005). In middle-aged women, the corresponding value was 0·59 (95 % CI 0·45, 0·78) (P for trenddiet quality and CES-D scores were treated as continuous variables also showed inverse associations. In conclusion, this cross-sectional study showed that a higher diet quality score was associated with a lower prevalence of depressive symptoms in young and middle-aged Japanese women. Prospective studies are needed to confirm a public health relevance of this finding.

Does IQ influence associations between ADHD symptoms and other cognitive functions in young preschoolers?

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Rohrer-Baumgartner, Nina; Zeiner, Pål; Egeland, Jens; Gustavson, Kristin; Skogan, Annette Holth; Reichborn-Kjennerud, Ted; Aase, Heidi

2014-05-01

Working memory, inhibition, and expressive language are often impaired in ADHD and many children with ADHD have lower IQ-scores than typically developing children. The aim of this study was to test whether IQ-score influences associations between ADHD symptoms and verbal and nonverbal working memory, inhibition, and expressive language, respectively, in a nonclinical sample of preschool children. In all, 1181 children recruited from the Norwegian Mother and Child Cohort Study were clinically assessed at the age of 36 to 46 months. IQ-score and working memory were assessed with subtasks from the Stanford Binet test battery, expressive language was reported by preschool teachers (Child Development Inventory), response inhibition was assessed with a subtask from the NEPSY test, and ADHD symptoms were assessed by parent interview (Preschool Age Psychiatric Assessment). The results showed an interaction between ADHD symptoms and IQ-score on teacher-reported expressive language. In children with below median IQ-score, a larger number of ADHD symptoms were more likely to be accompanied by reports of lower expressive language skills, while the level of ADHD symptoms exerted a smaller effect on reported language skills in children with above median IQ-score. The associations between ADHD symptoms and working memory and response inhibition, respectively, were not influenced by IQ-score. Level of IQ-score affected the relation between ADHD symptoms and teacher-reported expressive language, whereas associations between ADHD symptoms and working memory and response inhibition, respectively, were significant and of similar sizes regardless of IQ-score. Thus, in preschoolers, working memory and response inhibition should be considered during an ADHD assessment regardless of IQ-score, while language skills of young children are especially important to consider when IQ-scores are average or low.

Dimensional approach to symptom factors of major depressive disorder in Koreans, using the Brief Psychiatric Rating Scale: the Clinical Research Center for Depression of South Korea study.

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Park, Seon-Cheol; Jang, Eun Young; Kim, Daeho; Jun, Tae-Youn; Lee, Min-Soo; Kim, Jae-Min; Kim, Jung-Bum; Jo, Sun-Jin; Park, Yong Chon

2015-01-01

Although major depressive disorder (MDD) has a variety of symptoms beyond the affective dimensions, the factor structure and contents of comprehensive psychiatric symptoms of this disorder have rarely been explored using the 18-item Brief Psychiatric Rating Scale (BPRS). We aimed to identify the factor structure of the 18-item BPRS in Korean MDD patients. A total of 258 MDD patients were recruited from a multicenter sample of the Clinical Research Center for Depression of South Korea study. Psychometric scales were used to assess overall psychiatric symptoms (BPRS), depression (Hamilton Depression Rating Scale), anxiety (Hamilton Anxiety Rating Scale), global severity (Clinical Global Impression of Severity Scale), suicidal ideation (Scale for Suicide Ideation), functioning (Social and Occupational Functioning Assessment Scale), and quality of life (World Health Organization Quality of Life Assessment-abbreviated version). Common factor analysis with oblique rotation was used to yield factor structure. A four-factor structure was designed and interpreted by the symptom dimensions to reflect mood disturbance, positive symptoms/apathy, bipolarity, and thought distortion/mannerism. These individual factors were also significantly correlated with clinical variables. The findings of this study support the view that the BPRS may be a promising measuring tool for the initial assessment of MDD patients. In addition, the four-factor structure of the BPRS may be useful in understanding the mood and psychotic characteristics of these patients. Copyright © 2014. Published by Elsevier Taiwan.

Dimensional approach to symptom factors of major depressive disorder in Koreans, using the Brief Psychiatric Rating Scale: The Clinical Research Center for Depression of South Korea Study

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Seon-Cheol Park

2015-01-01

Full Text Available Although major depressive disorder (MDD has a variety of symptoms beyond the affective dimensions, the factor structure and contents of comprehensive psychiatric symptoms of this disorder have rarely been explored using the 18-item Brief Psychiatric Rating Scale (BPRS. We aimed to identify the factor structure of the 18-item BPRS in Korean MDD patients. A total of 258 MDD patients were recruited from a multicenter sample of the Clinical Research Center for Depression of South Korea study. Psychometric scales were used to assess overall psychiatric symptoms (BPRS, depression (Hamilton Depression Rating Scale, anxiety (Hamilton Anxiety Rating Scale, global severity (Clinical Global Impression of Severity Scale, suicidal ideation (Scale for Suicide Ideation, functioning (Social and Occupational Functioning Assessment Scale, and quality of life (World Health Organization Quality of Life Assessment-abbreviated version. Common factor analysis with oblique rotation was used to yield factor structure. A four-factor structure was designed and interpreted by the symptom dimensions to reflect mood disturbance, positive symptoms/apathy, bipolarity, and thought distortion/mannerism. These individual factors were also significantly correlated with clinical variables. The findings of this study support the view that the BPRS may be a promising measuring tool for the initial assessment of MDD patients. In addition, the four-factor structure of the BPRS may be useful in understanding the mood and psychotic characteristics of these patients.

Psychiatric comorbidity among patients with hypochondriasis.

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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.

Psychiatric symptomatology after delirium: a systematic review.

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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.

Effect of silodosin on specific urinary symptoms associated with benign prostatic hyperplasia: analysis of international prostate symptom scores in 2 phase III clinical studies

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Lawrence A Hill

2010-12-01

Full Text Available Marc C Gittelman1, Leonard S Marks2, Lawrence A Hill3, Weining Volinn3, Gary Hoel31South Florida Medical Research, Aventura, Florida, USA; 2University of California at Los Angeles and Urological Sciences Research Foundation, Los Angeles, California, USA; 3Watson Laboratories, Salt Lake City, Utah, USAPurpose: Pooled results from 2 randomized, placebo-controlled, US phase III studies (NCT00224107, NCT00224120 showed that silodosin, a uroselective α-blocker, significantly improved International Prostate Symptom Scores (IPSS in men with symptomatic benign prostatic hyperplasia (BPH. This analysis evaluated the effect of silodosin on each symptom assessed by IPSS questionnaire.Materials and methods: Study participants (N = 923 were men aged ≥50 years with IPSS ≥13 and Qmax 4–15 mL/s. They received silodosin 8 mg or placebo once daily for 12 weeks. Patient responses to 7 IPSS questions were collected at weeks 0 (baseline, 0.5, 1, 2, 4, and 12 and scored on a 6-point scale. Efficacy of silodosin versus placebo was assessed by analysis of covariance.Results: For each symptom, the 2 treatment groups had similar mean baseline scores. Decrease in score from baseline (mean ± standard deviation to last observation was significantly greater with silodosin than with placebo for all symptoms (P < 0.005; symptom improvement with silodosin (versus placebo was greatest for weak stream (silodosin, -1.1 ± 1.4 versus placebo, -0.5 ± 1.2; P < 0.0001 and smallest for nocturia (silodosin, -0.6 ± 1.1 versus placebo, -0.4 ± 1.2; P = 0.0037. Compared with placebo, silodosin significantly improved nocturia within 1 week (silodosin, -0.5 ± 1.07 versus placebo, -0.3 ± 1.05; P = 0.009 and all other symptoms within 3 to 4 days (P < 0.01.Conclusions: Silodosin significantly improved all BPH-associated symptoms assessed by IPSS questionnaire within the first week of treatment. All improvements were maintained over the 12-week study period.Keywords: BPH, symptoms

TBI-ROC Part Nine: Diagnosing TBI and Psychiatric Disorders

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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,…

Relationships among participant international prostate symptom score, benign prostatic hyperplasia impact index changes and global ratings of change in a trial of phytotherapy in men with lower urinary tract symptoms.

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Barry, Michael J; Cantor, Alan; Roehrborn, Claus G

2013-03-01

We related changes in American Urological Association symptom index scores with bother measures and global ratings of change in men with lower urinary tract symptoms who were enrolled in a saw palmetto trial. To be eligible for study men were 45 years old or older, and had a peak uroflow of 4 ml per second or greater and an American Urological Association symptom index score of 8 to 24. Participants self-administered the American Urological Association symptom index, International Prostate Symptom Score quality of life item, Benign Prostatic Hyperplasia Impact Index and 2 global change questions at baseline, and at 24, 48 and 72 weeks. In 357 participants global ratings of a little better were associated with a mean decrease in American Urological Association symptom index scores from 2.8 to 4.1 points across 3 time points. The analogous range for mean decreases in Benign Prostatic Hyperplasia Impact Index scores was 1.0 to 1.7 points and for the International Prostate Symptom Score quality of life item it was 0.5 to 0.8 points. At 72 weeks for the first global change question each change measure discriminated between participants who rated themselves at least a little better vs unchanged or worse 70% to 72% of the time. A multivariate model increased discrimination to 77%. For the second global change question each change measure correctly discriminated ratings of at least a little better vs unchanged or worse 69% to 74% of the time and a multivariate model increased discrimination to 79%. Changes in American Urological Association symptom index scores could discriminate between participants rating themselves at least a little better vs unchanged or worse. Our findings support the practice of powering studies to detect group mean differences in American Urological Association symptom index scores of at least 3 points. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Boundary curves of individual items in the distribution of total depressive symptom scores approximate an exponential pattern in a general population

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Tomitaka, Shinichiro; Kawasaki, Yohei; Ide, Kazuki; Akutagawa, Maiko; Yamada, Hiroshi; Furukawa, Toshiaki A.; Ono, Yutaka

2016-01-01

[Background]Previously, we proposed a model for ordinal scale scoring in which individual thresholds for each item constitute a distribution by each item. This lead us to hypothesize that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores follow a common mathematical model, which is expressed as the product of the frequency of the total depressive symptom scores and the probability of the cumulative distribution function of each item th...

Examining the effects of a novel training program and use of psychiatric service dogs for military-related PTSD and associated symptoms.

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Kloep, Megan L; Hunter, Richard H; Kertz, Sarah J

2017-01-01

This study explored an intensive 3-week training program and use of psychiatric service dogs for military-related posttraumatic stress disorder (PTSD) and associated symptoms. The sample included 2 separate cohorts of military veterans (n = 7 and n = 5) with prior diagnoses of PTSD. Participants completed self-report measures assessing PTSD, depression, perception of social support, anger, and overall quality of life 1 month prior to the training (baseline), at arrival to the training site, and 6-month follow-up. Results indicated that, for this sample, there was a statistically significant decrease in PTSD and depression symptoms from pre- to posttreatment, as well as 6-month follow-up. For most participants decreases were both clinically significant and reliable changes. Further, participants reported significant reductions in anger and improvement in perceived social support and quality of life. Limitations of the study include a lack of control group, a limitation of most naturalistic studies, as well as small sample size. Despite this, the findings indicate that utilizing psychiatric service dogs, coupled with an intensive trauma resilience training program for veterans with ongoing symptoms, is feasible as a complementary treatment for PTSD that could yield beneficial results in terms of symptom amelioration and improvement to overall quality of life. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Posttraumatic symptoms in elementary and junior high school children after the 2011 Japan earthquake and tsunami: symptom severity and recovery vary by age and sex.

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Iwadare, Yoshitaka; Usami, Masahide; Suzuki, Yuriko; Ushijima, Hirokage; Tanaka, Tetsuya; Watanabe, Kyota; Kodaira, Masaki; Saito, Kazuhiko

2014-04-01

To measure psychiatric symptoms exhibited by children in Ishinomaki City, Japan, an area severely damaged by the 2011 earthquake and tsunami, at 8 and 20 months post-tsunami to investigate differences in symptom severity and recovery rate by age, sex, and degree of trauma experienced. Prospective data were collected from children in elementary school (5th and 6th grades) and junior high school (8th and 9th grades). Students completed the Post-Traumatic Stress Symptoms for Children-15 (PTSSC-15) survey. Trauma severity was scored according to experiences of bereavement, home damage, and evacuation. In total, 3795 PTSSC-15 surveys were analyzed, yielding total scores, post-traumatic stress disorder (PTSD) factor subscores, and depression factor subscores, which were analyzed according to grade group, sex, and degree of trauma (trauma dose). In the elementary school children, mean total PTSSC-15 score, PTSD factor score, and depression factor score were significantly improved at 20 months post-tsunami compared with 8 months (P junior high school children. In females of the older group, the depression factor score at 20 months post-tsunami was significantly higher than at 8 months (P Elementary school and junior high school children living near the epicenter of the 2011 Japan earthquake and tsunami exhibited marked differences in PTSD and depressive symptoms. The mental health status of elementary school children improved, whereas that of junior high school children did not. Crown Copyright © 2014. Published by Mosby, Inc. All rights reserved.

The effect of L-thyroxine treatment on hypothyroid symptom scores and lipid profile in children with subclinical hypothyroidism.

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Çatlı, Gönül; Anık, Ahmet; Ünver Tuhan, Hale; Böber, Ece; Abacı, Ayhan

2014-12-01

To evaluate i) the frequency of typical hypothyroidism symptoms in children with subclinical hypothyroidism (SH), ii) to evaluate the association of SH with lipoproteins and iii) to investigate possible improving effects of L-thyroxine (LT4) treatment on these findings. Twenty-seven children with SH who had elevated thyroid-stimulating hormone (TSH: >4.94 µIU/L) but normal free T4 levels and healthy euthyroid children of similar age and sex were enrolled in the study. Anthropometric and laboratory (lipid profile and thyroid function tests) measurements were performed at diagnosis and six months after euthyroidism was achieved. All children were also subjected to a questionnaire on hypothyroid symptoms at diagnosis. The SH patients were subjected to the questionnaire also following treatment. Pre-treatment data were compared with those of controls and post-treatment measurements. Anthropometric and laboratory parameters of the groups were not statistically different except for higher TSH levels in the SH group. Serum lipoprotein levels and dyslipidemia frequency were similar between the groups. Compared to the controls, hypothyroidism symptom score was significantly higher in the SH group. Six months after euthyroidism was achieved, a significant reduction in the hypothyroid symptom score was obtained in the SH group. Except for significantly higher serum TSH values, no significant differences regarding demographic characteristics, symptom scores and lipid parameters were present between patients with Hashimoto's thyroiditis and the remaining SH patients. The results of this study showed that in children with SH i) the hypothyroidism symptom score was significantly higher than in euthyroid children, ii) LT4 treatment improved the hypothyroidism symptom score and iii) SH does not seem to be associated with dyslipidemia.

Personality disorder features as predictors of symptoms 5 years post-treatment

DEFF Research Database (Denmark)

Jansson, Irene; Hesse, Morten; Fridell, Mats

2008-01-01

disorders remained associated with SCL-90 score, with the exception of paranoid and schizoid personality disorder. After controlling for baseline score on the SCL-90, conduct disorder, borderline personality disorder, and narcissistic personality disorder remained significantly associated with symptoms......Personality disorders are associated with dysfunction in a variety of areas. Recent longitudinal research has shown that personality disorders are also predictive of problems later in life, as well as of poor response to treatment of depression and anxiety. This study assessed whether personality...... disorder features were associated with psychiatric symptoms in a cohort of women treated for substance abuse in Sweden. Patients were diagnosed with personality disorders using the Structured Clinical Interview for DSM-IV (SCID-II) personality questionnaire and SCID-II interview, and were then administered...

PTSD symptom reports of patients evaluated for the New Mexico Medical Cannabis Program.

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Greer, George R; Grob, Charles S; Halberstadt, Adam L

2014-01-01

New Mexico was the first state to list post-traumatic stress disorder (PTSD) as a condition for the use of medical cannabis. There are no published studies, other than case reports, of the effects of cannabis on PTSD symptoms. The purpose of the study was to report and statistically analyze psychometric data on PTSD symptoms collected during 80 psychiatric evaluations of patients applying to the New Mexico Medical Cannabis Program from 2009 to 2011. The Clinician Administered Posttraumatic Scale for DSM-IV (CAPS) was administered retrospectively and symptom scores were then collected and compared in a retrospective chart review of the first 80 patients evaluated. Greater than 75% reduction in CAPS symptom scores were reported when patients were using cannabis compared to when they were not. Cannabis is associated with reductions in PTSD symptoms in some patients, and prospective, placebo-controlled study is needed to determine efficacy of cannabis and its constituents in treating PTSD.

Psychiatric Aspects of Infertility

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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

Unexplained somatic symptoms during major depression: prevalence and clinical impact in a national sample of Italian psychiatric outpatients.

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Perugi, Giulio; Canonico, Pier Luigi; Carbonato, Paolo; Mencacci, Claudio; Muscettola, Giovanni; Pani, Luca; Torta, Riccardo; Vampini, Claudio; Fornaro, Michele; Parazzini, Fabio; Dumitriu, Arina

2011-01-01

The aim of this study was to explore the prevalence and impact of unexplained somatic symptoms during major depression. A total of 560 consecutive outpatients with a major depressive episode according to the DSM-IV (text revision) were evaluated in 30 psychiatric facilities throughout Italy. 'Unexplained' somatic symptoms were evaluated using the 30-item Somatic Symptoms Checklist (SSCL-30). Somatic symptoms were considered explained if they were best accounted for as coming from a concomitant physical illness or side effects. Patients evaluated their own mood symptomatology using the Zung questionnaires for depression and anxiety and the Hypomania Checklist-32. According to the SSCL-30, only 90 subjects (16.1%) had no unexplained somatic symptoms, while 231 (41.3%) had 1-5 unexplained symptoms and 239 (42.7%) had more than 5. Asthenia was the most commonly observed unexplained somatic symptom (53% of patients). Unexplained somatic symptoms were more common in females and among those suffering from major depression and depression not otherwise specified rather than in patients with recurrent major depression and bipolar disorders. No relationship between unexplained somatic symptoms and hypomanic features was observed. The presence of a large number of unexplained somatic symptoms is associated with more severe depression and higher rates of misdiagnosis and inappropriate treatment. Copyright © 2011 S. Karger AG, Basel.

Concurrent Medical and Psychiatric Disorders among Schizophrenic and Neurotic Outpatients.

Science.gov (United States)

Lima, Bruno R.; Pai, Shaila

Although the occurrence of medical illnesses in psychiatric patients is quite high, medical illnesses manifested by psychiatric symptoms are often overlooked. The higher mortality rates among psychiatric patients when compared to the general population may be a reflection of neglect or inadequate treatment of the psychiatric patients' medical…

Screening of alcohol use disorders in psychiatric outpatients: influence of gender, age, and psychiatric diagnosis.

Science.gov (United States)

Sánchez Autet, Mónica; Garriga, Marina; Zamora, Francisco Javier; González, Idilio; Usall, Judith; Tolosa, Leticia; Benítez, Concepción; Puertas, Raquel; Arranz, Belén

2017-07-14

Alcohol use disorders (AUD) are 2 times higher among psychiatric patients than in the general population. The under-recognition of this dual diagnosis can entail several negative outcomes. Early assessment with a screening tool like the CAGE questionnaire could be an opportunity to improve patients' prognoses. The objective of this study is to assess AUD risk in an outpatient psychiatric sample with a modified CAGE, considering the influence of age, gender and clinical psychiatric diagnosis. An observational, multicentric, descriptive study was carried out. The 4-item CAGE scale, camouflaged in a healthy lifestyle questionnaire, was implemented, using a cut-off point of one. 559 outpatients were assessed. 54% were female and the average age was 50.07 years. 182 patients presented a CAGE score ≥1 (45.1% of men and 21.9% of women). Gender was the strongest predictor of a positive result in CAGE, as men were 3.03 times more likely to score ≥1 on the CAGE questionnaire (p < .001, 95% CI: 0.22-0.49). Patients with bipolar and personality disorders had the highest rates of CAGE scores ≥1 (45.2 and 44.9%, respectively), with a significant association between diagnosis and a positive score (p = .002). Patients above 60 years were 2.5 times less likely to score ≥1 on the CAGE (p = .017, 95% CI: 0.19-0.85). Specific screening questionnaires, like the CAGE scale, can be an easy and useful tool in the assessment of AUD risk in psychiatric outpatients. Male patients with a bipolar or personality disorder present a higher risk of AUD.

Follow-up study of female delinquent adolescents in a detention centre: effectiveness of psychiatric intervention as a mental health service.

Science.gov (United States)

Ariga, Michio; Uehara, Toru; Takeuchi, Kazuo; Ishige, Yoko; Nakano, Reiko; Mikuni, Masahiko

2010-01-01

of previous studies suggest that many female offenders have co-morbid psychiatric disorders, which require mental health services. However, few longitudinal studies examined subjects during incarceration or detention. This study compares depressive symptoms, abnormal eating behaviour and impulsivity before release from a detention centre and after incarceration, thereby indicating the effectiveness of psychiatric intervention in a Japanese detention centre. Of 64 young women, 36 were followed up. Self-report measures were used to assess depression, eating behaviour and impulsivity after incarceration and one month before release. s: Of the 36 participants, nine were diagnosed using the MINI-kids as needing mental health services. Those who received psychiatric intervention were diagnosed as having major depression and/or post-traumatic stress disorder. Significant main effects of intervention and effects of time were shown in the DSD. The EAT-26 score demonstrated the significance of the effects of time and interaction. In the BIS-11 scores, neither intervention nor time showed significant effects. Results of this study showed that the time course and psychiatric intervention contributed to recovery of depression and therapeutic intervention. The time course might reduce eating problems. Psychiatric intervention might be necessary for female juvenile detainees, which presents an important issue for future studies.

The effects of the interplay of genetics and early environmental risk on the course of internalizing symptoms from late childhood through adolescence.

Science.gov (United States)

Musci, Rashelle J; Masyn, Katherine E; Benke, Kelly; Maher, Brion; Uhl, George; Ialongo, Nicholas S

2016-02-01

Internalizing symptoms during adolescence and beyond is a major public health concern, particularly because severe symptoms can lead to the diagnosis of a number of serious psychiatric conditions. This study utilizes a unique sample with a complex statistical method in order to explore Gene × Environment interactions found in internalizing symptoms during adolescence. Data for this study were drawn from a longitudinal prevention intervention study (n = 798) of Baltimore city school children. Internalizing symptom data were collected using self-report and blood or saliva samples genotyped using Affymetrix 6.0 microarrays. A major depression polygenic score was created for each individual using information from the major depressive disorder Psychiatric Genetics Consortium and used as a predictor in a latent trait-state-occasion model. The major depressive disorder polygenic score was a significant predictor of the stable latent trait variable, which captures time-independent phenotypic variability. In addition, an early childhood stressor of death or divorce was a significant predictor of occasion-specific variables. A Gene × Environment interaction was not a significant predictor of the latent trait or occasion variables. These findings support the importance of genetics on the stable latent trait portion of internalizing symptoms across adolescence.

Symptom Profile of ADHD in Youth With High-Functioning Autism Spectrum Disorder: A Comparative Study in Psychiatrically Referred Populations.

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Joshi, Gagan; Faraone, Stephen V; Wozniak, Janet; Tarko, Laura; Fried, Ronna; Galdo, Maribel; Furtak, Stephannie L; Biederman, Joseph

2017-08-01

To compare the clinical presentation of ADHD between youth with autism spectrum disorder (ASD) and ADHD and a sample of youth with ADHD only. A psychiatrically referred sample of autism spectrum disorder (ASD) youth with ADHD attending a specialized ambulatory program for ASD ( n = 107) and a sample of youth with ADHD attending a general child psychiatry ambulatory clinic ( n = 74) were compared. Seventy-six percent of youth with ASD met Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) criteria for ADHD. The clinical presentation of ADHD in youth with ASD was predominantly similar to its typical presentation including age at onset (3.5 ± 1.7 vs. 4.0 ± 1.9; p = .12), distribution of diagnostic subtypes, the qualitative and quantitative symptom profile, and symptom severity. Combined subtype was the most frequent presentation of ADHD in ASD youth. Despite the robust presentation of ADHD, a significant majority of ASD youth with ADHD failed to receive appropriate ADHD treatment (41% vs. 24%; p = .02). A high rate of comorbidity with ADHD was observed in psychiatrically referred youth with ASD, with a clinical presentation typical of the disorder.

[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.

Relationship of functional gastrointestinal disorders and psychiatric disorders: Implications for treatment

Science.gov (United States)

North, Carol S; Hong, Barry A; Alpers, David H

2007-01-01

This article revisits the links between psychopathology and functional gastrointestinal disorders such as irritable bowel syndrome (IBS), discusses the rational use of antidepressants as well as non-pharmacological approaches to the management of IBS, and suggests guidelines for the treatment of IBS based on an interdisciplinary perspective from the present state of knowledge. Relevant published literature on psychiatric disorders, especially somatization disorder, in the context of IBS, and literature providing direction for management is reviewed, and new directions are provided from findings in the literature. IBS is a heterogeneous syndrome with various potential mechanisms responsible for its clinical presentations. IBS is typically complicated with psychiatric issues, unexplained symptoms, and functional syndromes in other organ systems. Most IBS patients have multiple complaints without demonstrated cause, and that these symptoms can involve systems other than the intestine, e.g. bones and joints (fibromyalgia, temporomandibular joint syndrome), heart (non-cardiac chest pain), vascular (post-menopausal syndrome), and brain (anxiety, depression). Most IBS patients do not have psychiatric illness per se, but a range of psychoform (psychological complaints in the absence of psychiatric disorder) symptoms that accompany their somatoform (physical symptoms in the absence of medical disorder) complaints. It is not correct to label IBS patients as psychiatric patients (except those more difficult patients with true somatization disorder). One mode of treatment is unlikely to be universally effective or to resolve most symptoms. The techniques of psychotherapy or cognitive-behavioral therapy can allow IBS patients to cope more readily with their illness. Specific episodes of depressive or anxiety disorders can be managed as appropriate for those conditions. Medications designed to improve anxiety or depression are not uniformly useful for psychiatric complaints in

Relationship of functional gastrointestinal disorders and psychiatric disorders: Implications for treatment

Institute of Scientific and Technical Information of China (English)

Carol S North; Barry A Hong; David H Alpers

2007-01-01

This article revisits the links between psychopathology and functional gastrointestinal disorders such as irritable bowel syndrome (IBS), discusses the rational use of antidepressants as well as non-pharmacological approaches to the management of IBS, and suggests guidelines for the treatment of IBS based on an interdisciplinary perspective from the present state of knowledge. Relevant published literature on psychiatric disorders, especially somatization disorder, in the context of IBS, and literature providing direction for management is reviewed, and new directions are provided from findings in the literature. IBS is a heterogeneous syndrome with various potential mechanisms responsible for its clinical presentations. IBS is typically complicated with psychiatric issues, unexplained symptoms, and functional syndromes in other organ systems. Most IBS patients have multiple complaints without demonstrated cause, and that these symptoms can involve systems other than the intestine, e.g. Bones and joints (fibromyalgia, temporomandibular joint syndrome), heart (non-cardiac chest pain), vascular (post-menopausal syndrome), and brain (anxiety, depression). Most IBS patients do not have psychiatric illness per se, but a range of psychoform (psychological complaints in the absence of psychiatric disorder) symptoms that accompany their somatoform (physical symptoms in the absence of medical disorder) complaints. It is not correct to label IBS patients as psychiatric patients (except those more difficult patients with true somatization disorder).One mode of treatment is unlikely to be universally effective or to resolve most symptoms. The techniques of psychotherapy or cognitive-behavioral therapy can allow IBS patients to cope more readily with their illness.Specific episodes of depressive or anxiety disorders can be managed as appropriate for those conditions.Medications designed to improve anxiety or depression are not uniformly useful for psychiatric complaints in IBS

Reasons for psychiatric consultation referrals in Dutch nursing home patients with dementia: a comparison with normative data on prevalence of neuropsychiatric symptoms.

NARCIS (Netherlands)

Kat, M.G.; Zuidema, S.U.; Ploeg, T. van der; Kalisvaart, K.J.; Gool, W.A. van; Eikelenboom, P.; Jonghe, J.F. de

2008-01-01

OBJECTIVE: To study psychiatric consultation referrals of nursing home patients with dementia and to compare referral reasons with normative data on prevalence of neuropsychiatric symptoms. METHODS: This is part of a cross-sectional study of 787 patients residing in 14 nursing homes in the

Reasons for psychiatric consultation referrals in Dutch nursing home patients with dementia: a comparison with normative data on prevalence of neuropsychiatric symptoms

NARCIS (Netherlands)

Kat, Martin G.; Zuidema, Sytse U.; van der Ploeg, Tjeerd; Kalisvaart, Kees J.; van Gool, Willem A.; Eikelenboom, Piet; de Jonghe, Jos F. M.

2008-01-01

Objective To study psychiatric consultation referrals of nursing home patients with dementia and to compare referral reasons with normative data on prevalence of neuropsychiatric symptoms. Methods This is part of a cross-sectional study of 787 patients residing in 14 nursing homes in the

Reasons for psychiatric consultation referrals in Dutch nursing home patients with dementia: a comparison with normative data on prevalence of neuropsychiatric symptoms

NARCIS (Netherlands)

Kat, M.G.; Zuidema, S.U.; van der Ploeg, T.; Kalisvaart, K.J.; van Gool, W.A.; Eikelenboom, P.; de Jonghe, J.F.M.

2008-01-01

Objective: To study psychiatric consultation referrals of nursing home patients with dementia and to compare referral reasons with normative data on prevalence of neuropsychiatric symptoms. Methods: This is part of a cross-sectional study of 787 patients residing in 14 nursing homes in the

Converting positive and negative symptom scores between PANSS and SAPS/SANS.

Science.gov (United States)

van Erp, Theo G M; Preda, Adrian; Nguyen, Dana; Faziola, Lawrence; Turner, Jessica; Bustillo, Juan; Belger, Aysenil; Lim, Kelvin O; McEwen, Sarah; Voyvodic, James; Mathalon, Daniel H; Ford, Judith; Potkin, Steven G; Fbirn

2014-01-01

The Scale for the Assessment of Positive Symptoms (SAPS), the Scale for the Assessment of Negative Symptoms (SANS), and the Positive and Negative Syndrome Scale for Schizophrenia (PANSS) are the most widely used schizophrenia symptom rating scales, but despite their co-existence for 25 years no easily usable between-scale conversion mechanism exists. The aim of this study was to provide equations for between-scale symptom rating conversions. Two-hundred-and-five schizophrenia patients [mean age±SD=39.5±11.6, 156 males] were assessed with the SANS, SAPS, and PANSS. Pearson's correlations between symptom scores from each of the scales were computed. Linear regression analyses, on data from 176 randomly selected patients, were performed to derive equations for converting ratings between the scales. Intraclass correlations, on data from the remaining 29 patients, not part of the regression analyses, were performed to determine rating conversion accuracy. Between-scale positive and negative symptom ratings were highly correlated. Intraclass correlations between the original positive and negative symptom ratings and those obtained via conversion of alternative ratings using the conversion equations were moderate to high (ICCs=0.65 to 0.91). Regression-based equations may be useful for conversion between schizophrenia symptom severity as measured by the SANS/SAPS and PANSS, though additional validation is warranted. This study's conversion equations, implemented at http:/converteasy.org, may aid in the comparison of medication efficacy studies, in meta- and mega-analyses examining symptoms as moderator variables, and in retrospective combination of symptom data in multi-center data sharing projects that need to pool symptom rating data when such data are obtained using different scales. Copyright © 2013 Elsevier B.V. All rights reserved.

Psychiatric consultations and the management of associated ...

African Journals Online (AJOL)

Psychiatric consultations and the management of associated comorbid medical conditions in a regional referral hospital. NSZ Tema, ABR Janse van Rensburg. Abstract. Background. Psychiatrists are often called upon to evaluate patients with a medical condition and psychiatric symptoms, either as a complication thereof or ...

Effects of transcranial direct current stimulation (tDCS) on cognition, symptoms, and smoking in schizophrenia: A randomized controlled study.

Science.gov (United States)

Smith, Robert C; Boules, Sylvia; Mattiuz, Sanela; Youssef, Mary; Tobe, Russell H; Sershen, Henry; Lajtha, Abel; Nolan, Karen; Amiaz, Revital; Davis, John M

2015-10-01

Schizophrenia is characterized by cognitive deficits which persist after acute symptoms have been treated or resolved. Transcranial direct current stimulation (tDCS) has been reported to improve cognition and reduce smoking craving in healthy subjects but has not been as carefully evaluated in a randomized controlled study for these effects in schizophrenia. We conducted a randomized double-blind, sham-controlled study of the effects of 5 sessions of tDCS (2 milliamps for 20minutes) on cognition, psychiatric symptoms, and smoking and cigarette craving in 37 outpatients with schizophrenia or schizoaffective disorder who were current smokers. Thirty subjects provided evaluable data on the MATRICS Consensus Cognitive Battery (MCCB), with the primary outcome measure, the MCCB Composite score. Active compared to sham tDCS subjects showed significant improvements after the fifth tDCS session in MCCB Composite score (p=0.008) and on the MCCB Working Memory (p=0.002) and Attention-Vigilance (p=0.027) domain scores, with large effect sizes. MCCB Composite and Working Memory domain scores remained significant at Benjamini-Hochberg corrected significance levels (α=0.05). There were no statistically significant effects on secondary outcome measures of psychiatric symptoms (PANSS scores), hallucinations, cigarette craving, or cigarettes smoked. The positive effects of tDCS on cognitive performance suggest a potential efficacious treatment for cognitive deficits in partially recovered chronic schizophrenia outpatients that should be further investigated. Copyright © 2015 Elsevier B.V. All rights reserved.

Immediate therapist self-disclosure bolsters the effect of brief integrative psychotherapy on psychiatric symptoms and the perceptions of therapists: A randomized clinical trial.

Science.gov (United States)

Ziv-Beiman, Sharon; Keinan, Giora; Livneh, Elad; Malone, Patrick S; Shahar, Golan

2017-09-01

We report a first randomized clinical trial examining the effect of immediate and non-immediate therapist self-disclosure in the context of a brief integrative psychotherapy for mild to moderate distress. A total of 86 patients with mild to moderate forms of distress were randomly divided into three 12-session integrative psychotherapy conditions based primarily on [Hill, C. E. (2009). Helping skills: Facilitating, exploration, insight, and action (3rd ed.). Washington, DC: American Psychological Association.] three-stage model. Therapists trained in this treatment modality were instructed to use either immediate self-disclosure (expressing feelings towards the patient/treatment/therapeutic relationship) or non-immediate self-disclosure (expressing personal or factual information regarding the therapist's life outside the treatment). In the comparison condition, the therapists were instructed to refrain from self-disclosure altogether. Immediate therapist self-disclosure reduced psychiatric symptoms among patients with elevated pretreatment symptoms (as assessed by the Brief Symptoms Inventory) and bolstered a favorable perception of the therapist. Therapists in both the immediate and non-immediate self-disclosure group evaluated themselves more favorably than their counterparts in the non-disclosure group. Therapist self-disclosure, particularly of the immediate type, might enhance the effect of brief integrative treatment on psychiatric symptoms of high symptomatic patients and contribute to favorable perception of therapists.

Exploratory Factor Analysis of the Beck Anxiety Inventory and the Beck Depression Inventory-II in a Psychiatric Outpatient Population

Science.gov (United States)

2018-01-01

Background To further understand the relationship between anxiety and depression, this study examined the factor structure of the combined items from two validated measures for anxiety and depression. Methods The participants were 406 patients with mixed psychiatric diagnoses including anxiety and depressive disorders from a psychiatric outpatient unit at a university-affiliated medical center. Responses of the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI)-II, and Symptom Checklist-90-Revised (SCL-90-R) were analyzed. We conducted an exploratory factor analysis of 42 items from the BAI and BDI-II. Correlational analyses were performed between subscale scores of the SCL-90-R and factors derived from the factor analysis. Scores of individual items of the BAI and BDI-II were also compared between groups of anxiety disorder (n = 185) and depressive disorder (n = 123). Results Exploratory factor analysis revealed the following five factors explaining 56.2% of the total variance: somatic anxiety (factor 1), cognitive depression (factor 2), somatic depression (factor 3), subjective anxiety (factor 4), and autonomic anxiety (factor 5). The depression group had significantly higher scores for 12 items on the BDI while the anxiety group demonstrated higher scores for six items on the BAI. Conclusion Our results suggest that anxiety and depressive symptoms as measured by the BAI and BDI-II can be empirically differentiated and that particularly items of the cognitive domain in depression and those of physical domain in anxiety are noteworthy. PMID:29651821

[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.

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

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.

Dimensional psychiatry: reward dysfunction and depressive mood across psychiatric disorders.

Science.gov (United States)

Hägele, Claudia; Schlagenhauf, Florian; Rapp, Michael; Sterzer, Philipp; Beck, Anne; Bermpohl, Felix; Stoy, Meline; Ströhle, Andreas; Wittchen, Hans-Ulrich; Dolan, Raymond J; Heinz, Andreas

2015-01-01

A dimensional approach in psychiatry aims to identify core mechanisms of mental disorders across nosological boundaries. We compared anticipation of reward between major psychiatric disorders, and investigated whether reward anticipation is impaired in several mental disorders and whether there is a common psychopathological correlate (negative mood) of such an impairment. We used functional magnetic resonance imaging (fMRI) and a monetary incentive delay (MID) task to study the functional correlates of reward anticipation across major psychiatric disorders in 184 subjects, with the diagnoses of alcohol dependence (n = 26), schizophrenia (n = 44), major depressive disorder (MDD, n = 24), bipolar disorder (acute manic episode, n = 13), attention deficit/hyperactivity disorder (ADHD, n = 23), and healthy controls (n = 54). Subjects' individual Beck Depression Inventory-and State-Trait Anxiety Inventory-scores were correlated with clusters showing significant activation during reward anticipation. During reward anticipation, we observed significant group differences in ventral striatal (VS) activation: patients with schizophrenia, alcohol dependence, and major depression showed significantly less ventral striatal activation compared to healthy controls. Depressive symptoms correlated with dysfunction in reward anticipation regardless of diagnostic entity. There was no significant correlation between anxiety symptoms and VS functional activation. Our findings demonstrate a neurobiological dysfunction related to reward prediction that transcended disorder categories and was related to measures of depressed mood. The findings underline the potential of a dimensional approach in psychiatry and strengthen the hypothesis that neurobiological research in psychiatric disorders can be targeted at core mechanisms that are likely to be implicated in a range of clinical entities.

A workshop report on the development of the Cow's Milk-related Symptom Score awareness tool for young children

DEFF Research Database (Denmark)

Vandenplas, Yvan; Dupont, Christophe; Eigenmann, Philippe

2015-01-01

help primary healthcare providers. The Cow's Milk-related Symptom Score (CoMiSS), which considers general manifestations, dermatological, gastrointestinal and respiratory symptoms, was developed as an awareness tool for cow's milk related symptoms. It can also be used to evaluate and quantify......Clinicians with expertise in managing children with gastrointestinal problems and, or, atopic diseases attended a workshop in Brussels in September 2014 to review the literature and determine whether a clinical score derived from symptoms associated with the ingestion of cow's milk proteins could...... the evolution of symptoms during therapeutic interventions, but does not diagnose cow's milk protein allergy and does not replace a food challenge. Its usefulness needs to be evaluated by a prospective randomised study. ConclusionThe CoMiSS provides primary healthcare clinicians with a simple, fast and easy...

Comorbid psychiatric disorders in female adolescents with first-onset anorexia nervosa.

Science.gov (United States)

Bühren, K; Schwarte, R; Fluck, F; Timmesfeld, N; Krei, M; Egberts, K; Pfeiffer, E; Fleischhaker, C; Wewetzer, C; Herpertz-Dahlmann, B

2014-01-01

Patients with anorexia nervosa (AN) exhibit high rates of psychiatric comorbidity. To disentangle the effects of duration of illness on comorbid psychiatric symptoms, we investigated the rates of comorbid psychiatric disorders, suicidality and self-harm behaviour in adolescent patients with a first onset of AN. In adolescent females (n = 148) with a first onset of AN, body mass index, psychiatric comorbidity (according to DSM-IV), depressive symptoms, suicidality and self-injurious behaviour were assessed. Seventy patients (47.3%) met the criteria for at least one comorbid psychiatric disorder. The binge-purging subtype was associated with increased rates of psychiatric comorbidity, suicidality and self-injurious behaviour. The severity of eating disorder-specific psychopathology influenced current psychiatric comorbidity and suicidal ideation. Prevalence rates of comorbid psychiatric disorders and suicidal ideation are considerably lower among adolescents with AN compared with adults. An early and careful assessment, along with adequate treatment of the eating disorder, might prevent the development of severe psychiatric comorbidities. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.

Psychiatric Symptoms in Youth with a History of Autism and Optimal Outcome

Science.gov (United States)

Orinstein, Alyssa; Tyson, Katherine E.; Suh, Joyce; Troyb, Eva; Helt, Molly; Rosenthal, Michael; Barton, Marianne L.; Eigsti, Inge-Marie; Kelley, Elizabeth; Naigles, Letitia; Schultz, Robert T.; Stevens, Michael C.; Fein, Deborah A.

2015-01-01

Since autism spectrum disorder (ASD) is often comorbid with psychiatric disorders, children who no longer meet criteria for ASD (optimal outcome; OO) may still be at risk for psychiatric disorders. A parent interview for DSM-IV psychiatric disorders (K-SADS-PL) for 33 OO, 42 high-functioning autism (HFA) and 34 typically developing (TD) youth,…

Predicting asthma in preschool children with asthma-like symptoms : Validating and updating the PIAMA risk score

NARCIS (Netherlands)

Hafkamp-de Groen, Esther; Lingsma, Hester F.; Caudri, Daan; Levie, Deborah; Wijga, Alet; Koppelman, Gerard H.; Duijts, Liesbeth; Jaddoe, Vincent W. V.; Smit, Henriette A.; Kerkhof, Marjan; Moll, Henriette A.; Hofman, Albert; Steyerberg, Ewout W.; de Jongste, Johan C.; Raat, Hein

2013-01-01

Background: The Prevention and Incidence of Asthma and Mite Allergy (PIAMA) risk score predicts the probability of having asthma at school age among preschool children with suggestive symptoms. Objective: We sought to externally validate the PIAMA risk score at different ages and in ethnic and

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.

"Negative symptoms"secondary to intracranial tumor

Directory of Open Access Journals (Sweden)

Natasha Kate

2014-01-01

Full Text Available Intracranial tumors are increasingly common in the elderly population. They may present with varied symptoms, some of which may be psychiatric in nature. In patients with known psychiatric disorders, these symptoms may be misattributed resulting in a delay in diagnosis and management. We present a case of an elderly female with paranoid schizophrenia and new onset symptoms secondary to intracranial tumor, which were initially misdiagnosed.

Amygdala-frontal connectivity predicts internalizing symptom recovery among inpatient adolescents.

Science.gov (United States)

Venta, Amanda; Sharp, Carla; Patriquin, Michelle; Salas, Ramiro; Newlin, Elizabeth; Curtis, Kaylah; Baldwin, Philip; Fowler, Christopher; Frueh, B Christopher

2018-01-01

The possibility of using biological measures to predict the trajectory of symptoms among adolescent psychiatric inpatients has important implications. This study aimed to examine emotion regulation ability (measured via self-report) and a hypothesized proxy in resting-state functional connectivity [RSFC] between the amygdala and frontal brain regions as baseline predictors of internalizing symptom recovery during inpatient care. 196 adolescents (61% female; Mage = 15.20; SD = 1.48) completed the Achenbach Brief Problem Monitor (BPM) each week during their inpatient care. RSFC (n = 45) and self-report data of emotion regulation (n = 196) were collected at baseline. The average internalizing symptom score at admission was high (α 0 = 66.52), exceeding the BPM's clinical cut off score of 65. On average, internalizing symptom scores declined significantly, by 0.40 points per week (p = 0.004). While self-reported emotion regulation was associated with admission levels of internalizing problems, it did not predict change in symptoms. RSFC between left amygdala and left superior frontal gyrus was significantly associated with the intercept-higher connectivity was associated with higher internalizing at admission-and the slope- higher connectivity was associated with a more positive slope (i.e., less decline in symptoms). RSFC between the right amygdala and the left superior frontal gyrus was significantly, positively correlated with the slope parameter. Results indicate the potential of biologically-based measures that can be developed further for personalized care in adolescent psychiatry. Copyright © 2017 Elsevier B.V. All rights reserved.

Difference of achalasia subtypes based on clinical symptoms, radiographic findings, and stasis scores

Directory of Open Access Journals (Sweden)

A. Meillier

2018-01-01

Conclusions: Achalasia subtypes had similar clinical symptoms, except for increased vomiting severity in subtype i. The maximum esophageal diameter in subtype ii was significantly greater than in subtype iii. Esophageal stasis scores were similar. Thus, high-resolution esophageal manometry remains essential in assessing achalasia subtypes.

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 ...

Comorbid psychiatric disorders in 201 cases of encopresis.

Science.gov (United States)

Unal, Fatih; Pehlivantürk, Berna

2004-01-01

Although encopresis is a common and complex disorder, relatively few studies have evaluated the comorbid psychiatric disorders in this condition. This study was performed to investigate the comorbid psychiatric disorders in encopresis. One hundred and sixty boys (79.6%) and 41 girls (20.4%) fulfilled the diagnostic criteria for encopresis according to DSM-IV. There was at least one comorbid diagnosis in 149 (74.1%) patients. The most frequent comorbid diagnosis was enuresis (55.2%). Clinical and demographical data were compared between patients with comorbid disorders and others. Primary encopresis was significantly more frequent in patients with comorbid disorders, and the mean age at admission was lower in these patients. The mean interval between the onset of symptoms and the diagnosis was significantly shorter in secondary encopretic patients with comorbid disorders. Furthermore, there were significantly more psychiatric disorders in the first-degree relatives of patients with comorbid disorders. Encopresis is frequently accompanied with a psychiatric disorder. Clinicians need to inquire about symptoms of other psychiatric disorders in patients who present with encopresis and vice versa.

Psychiatric disorder symptoms, substance use, and sexual risk behavior among African-American out of school youth.

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Turner, Alezandria K; Latkin, Carl; Sonenstein, Freya; Tandon, S Darius

2011-05-01

To examine the association between symptoms of psychiatric disorder (i.e. depression, anxiety, and substance use) and sexual risk behavior in a sample of African-American adolescents and young adults in an employment training program. Baseline data were used from a pilot study of an intervention to reduce depressive symptoms among youth disconnected from school and the workforce. Participants were recruited from two employment training programs in East and West Baltimore (N=617; age 16-23 years). Data were collected through audio computer-assisted self-interview (ACASI). Mental health indicators were measured using the Center for Epidemiological Studies Depression Scale and Beck Anxiety Inventory. Multivariate logistic regression was used to determine the odds of sexual risk behavior for each mental health condition and combinations of conditions. Lack of condom use at last sex was significantly associated with elevated anxiety symptoms. Number of sexual partners was associated with elevated depression symptoms and substance use. Early sexual debut was associated with substance use in the past 30 days. Also, there were differences in the likelihood of engaging in sexual risk behavior comparing groups with different combinations of mental health problems to those with no symptoms of disorder or substance use. The results demonstrate the need for HIV prevention programs that target out-of-school youth, as they are likely to engage in risky sexual behavior. Our findings highlight the need to develop behavioral interventions that address disorder symptoms, substance use, and risky sexual behavior among youth in employment training programs. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Measuring the tridosha symptoms of unmāda (psychosis): a preliminary study.

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Suchitra, Sureshrao P; Devika, Honagalli S; Gangadhar, Bangalore N; Nagarathna, Raghuram; Nagendra, Hongasamudra R; Kulkarni, Ravi

2010-04-01

This is a preliminary report on the development of a scale to measure the symptoms of unmāda (psychosis) attributable to tridosa (metabolic principles) by using the concepts of Ayurvedic medicine. The 67-item unmāda specific symptom scale was developed on the basis of translation of Sanskrit verses describing vātaja (V), pittaja (P), and kaphaja (K) unmāda (specific symptoms of psychosis due to the imbalances of metabolic components) and by taking the opinions of experts (15 Ayurveda experts, 5 psychiatrists, and 5 psychologists). The setting for this study was Spandana Psychiatric Nursing Home Bangalore, India. The scale was administered by an unblinded assessor to 30 consecutive patients with nonaffective psychotic disorders. The unmāda specific symptom scale was associated with excellent internal consistency. The Cronbach's alpha for V, P, and K scales were 0.98, 0.98, and 0.97, respectively. The split-half reliability for V, P, and K scales were 0.97, 0.97, and 0.88 respectively. Scores on vātaja, pittaja, and kaphaja scales were inversely correlated, suggesting that they are mutually exclusive. The three subgroups of psychoses--paranoid schizophrenia, schizophrenia (unspecified), and unspecified nonorganic psychosis--had significantly different loadings on the three scores, having high scores on vātaja, pittaja, and kaphaja, respectively. The tridoshas in psychotic disorders can be measured reliably by this instrument. The scores on each of these doşas help in differentiating three types of psychosis (according to Ayurveda) that have good correspondence with prevailing classification. However, this scale must also be applied to the other 28 separate subcategories of the psychoses that are identified in the International Statistical Classifications of Diseases (version 10) and to the 10 variants of psychosis as defined by the American Psychiatric Association Diagnostic and Statistical Manual-IV-R to help better understand the true utility for use here

Profiles of referrals to a psychiatric service: a descriptive study of survivors of the Nairobi US Embassy terrorist bomb blast.

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Ndetei, D M; Omar, A; Mutiso, V N; Ongecha, F A; Kokonya, D A

2009-11-01

To document the socio-demographic characteristics and psychiatric profiles of the survivors of the Nairobi United States Embassy terrorist bomb blast referred to a psychiatric and psychotherapy (counselling) service. This was a descriptive cross-sectional study. Clinical interviews and structured questionnaires for post-traumatic stress disorder (PTSD) and stress were administered. Survivors of the bomb blast referred to a psychiatric and psychotherapy service one year or more after the bombing were included in the study. These survivors had been treated using psychopharmacotherapy and individualised (not group) therapy/counselling. Eighty-three consecutive referrals to a psychiatric service participated in this study. There were more males and the sample was generally well educated. The referrals made contact with the referring agency for a number of reasons including seeking psychological, financial and medical assistance. All the patients reported varying degrees of psychiatric symptoms and functional impairment on various aspects of social occupational functioning. High scores for PTSD and other related stress were recorded one or more years after the bombing. Although the survivors indicated that initial counselling following the blast had helped them, they still scored high on PTSD suggesting that clinically, the initial counselling had little, if any impact on the development of PTSD. There is need for a holistic approach to the management of psychotrauma in individuals.

Self-Esteem of 8-14-Year-Old Children with Psychiatric Disorders: Disorder- and Gender-Specific Effects.

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Stadelmann, Stephanie; Grunewald, Madlen; Gibbels, Charlotte; Jaeger, Sonia; Matuschek, Tina; Weis, Steffi; Klein, Annette Maria; Hiemisch, Andreas; von Klitzing, Kai; Döhnert, Mirko

2017-02-01

In this study, we investigated the relation between global and domain-specific self-esteem and psychiatric disorders. A sample of 577 children aged 8-14 years was recruited via psychiatric hospitals and from the general population. Parents were given a diagnostic interview to assess children's psychiatric diagnoses (current/past). Parents and children completed questionnaires on child symptoms. Children completed a questionnaire on global and domain-specific self-esteem (scales: scholastic competence, social acceptance, athletic performance and physical appearance, global self-esteem). Self-esteem of children with current psychiatric disorders was lower than that of healthy controls (η p 2 between 0.01 and 0.08). Concerning scholastic competence, social acceptance and global self-esteem, children with past psychiatric disorders scored also lower than healthy controls. Different current psychiatric disorders showed specific but small effects on dimensions of self-esteem (β between -0.08 and 0.19). Moreover, we found a gender × group interaction, indicating that girls with depressive and adjustment disorders were specifically impaired in their global self-esteem and perception of their physical appearance. Findings might help clinicians to focus on particular domains of self-esteem during the diagnostic process and to define adequate treatment goals.

Nonmotor symptoms in genetic Parkinson disease

DEFF Research Database (Denmark)

Kasten, Meike; Kertelge, Lena; Brüggemann, Norbert

2010-01-01

To review current knowledge on nonmotor symptoms (NMS), particularly psychiatric features, in genetic Parkinson disease (PD) and to provide original data for genetic and idiopathic PD.......To review current knowledge on nonmotor symptoms (NMS), particularly psychiatric features, in genetic Parkinson disease (PD) and to provide original data for genetic and idiopathic PD....

Diagnostic and treatment challenges in traumatic brain injury patients with severe neuropsychiatric symptoms: insights into psychiatric practice.

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Lauterbach, Margo D; Notarangelo, Paula L; Nichols, Stephen J; Lane, Kristy S; Koliatsos, Vassilis E

2015-01-01

Traumatic brain injury (TBI) causes a variety of neuropsychiatric problems that pose diagnostic and treatment challenges for providers. In this report, we share our experience as a referral neuropsychiatry program to assist the general psychiatrist when adult TBI patients with psychiatric symptoms present for evaluation and treatment. We completed a retrospective study of patients with moderate-to-severe TBI and severe neuropsychiatric impairments. We collected information on demographics, nature of injury, symptomatology, diagnoses, and treatments. Data analysis indicates that mood stabilization was a key concern, often requiring aggressive pharmacological management. Cognitive dysfunction was a problem for the majority of patients, but was only medicated in a third, due to poor efficacy or behavioral side effects. The co-occurrence of multiple TBI-related symptoms and diagnoses in this patient cohort emphasizes the need for individualized psychopharmacological approaches and interventions.

Symptom assessment in early psychosis: The use of well-established rating scales in clinical high-risk and recent-onset populations

OpenAIRE

Fulford, Daniel; Pearson, Rahel; Stuart, Barbara K.; Fisher, Melissa; Mathalon, Daniel H.; Vinogradov, Sophia; Loewy, Rachel L.

2014-01-01

Symptom assessment in early psychosis research typically relies on scales validated in chronic schizophrenia samples. Our goal was to inform investigators who are selecting symptom scales for early psychosis research. We described measure characteristics, baseline scores, and scale inter-relationships in clinical high-risk (CHR) and recent-onset psychotic disorder (RO) samples using the Positive and Negative Syndrome Scale, Brief Psychiatric Rating Scale, Scale for the Assessment of Positive ...

Encopresis: a guide for psychiatric nurses.

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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.

Negative symptoms in nondeficit syndrome respond to neuroleptic treatment with changes in plasma homovanillic acid concentrations.

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Suzuki, E; Kanba, S; Koshikawa, H; Nibuya, M; Yagi, G; Asai, M

1996-05-01

Deficit syndrome (DS) in schizophrenia is characterized by serious, chronic, and primary negative symptoms. We investigated differences in response to neuroleptic treatment between 8 DS patients and 6 nondeficit syndrome (NDS) patients who had the selective dopamine-D2 receptor blocker bromperidol added to their neuroleptic regimens. First, 9 mg/d was administered for 4 weeks, followed by 18 mg/d for another 4 weeks. Plasma homovanillic acid (pHVA) and plasma bromperidol concentrations were measured, and psychiatric symptoms were scored. In the NDS patients, both positive and negative symptoms improved. However, only the positive symptom scores changed in the DS patients. On day 4, pHVA concentrations of the NDS patients alone were significantly elevated. Plasma bromperidol concentrations did not differ between the groups. These results suggest that bromperidol exerts different effects on negative symptoms and pHVA concentrations between NDS and DS patients, effects that are unrelated to plasma bromperidol concentrations.

Sociodemographic and lifestyle factors affecting the self-perception period of lower urinary tract symptoms of international prostate symptom score items.

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Kim, J H; Shim, S R; Lee, W J; Kim, H J; Kwon, S-S; Bae, J H

2012-12-01

This study investigated the influence of sociodemographic and lifestyle factors on the lower urinary tract symptom (LUTS) self-perception period and International Prostate Symptom Score. This cross-sectional study examined 209 men aged ≥ 40 years with non-treated LUTS who participated in a prostate examination survey. Questions included International Prostate Symptom Score (IPSS) items with self-perception periods for each item. Sociodemographic and lifestyle factors were also assessed. Participants were divided by mild LUTS (IPSS less than 8) and moderate-to-severe LUTS (IPSS 8 or higher). Self-perception period of the moderate-to-severe LUTS (n = 110) was affected by BMI; the self-perception period of the mild LUTS (n = 90) was affected by age, income, occupation and concomitant disease. Moderate-to-severe LUTS were affected by self-perception period (p = 0.03). Self-perception period was affected by concern for health (p = 0.005) by multivariate analysis, and self-perception period of mild LUTS was affected by BMI (p = 0.012). Moderate-to-severe LUTS were affected by age, number of family members, concern for health and drinking (p self-perception period. In moderate-to-severe LUTS, age, concern for health and drinking were affecting factors of self-perception period. © 2012 Blackwell Publishing Ltd.

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

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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.

Initial development and preliminary validation of a new negative symptom measure: the Clinical Assessment Interview for Negative Symptoms (CAINS).

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Forbes, Courtney; Blanchard, Jack J; Bennett, Melanie; Horan, William P; Kring, Ann; Gur, Raquel

2010-12-01

As part of an ongoing scale development process, this study provides an initial examination of the psychometric properties and validity of a new interview-based negative symptom instrument, the Clinical Assessment Interview for Negative Symptoms (CAINS), in outpatients with schizophrenia or schizoaffective disorder (N = 37). The scale was designed to address limitations of existing measures and to comprehensively assess five consensus-based negative symptoms: asociality, avolition, anhedonia (consummatory and anticipatory), affective flattening, and alogia. Results indicated satisfactory internal consistency reliability for the total CAINS scale score and promising inter-rater agreement, with clear areas identified in need of improvement. Convergent validity was evident in general agreement between the CAINS and alternative negative symptom measures. Further, CAINS subscales significantly correlated with relevant self-report emotional experience measures as well as with social functioning. Discriminant validity of the CAINS was strongly supported by its small, non-significant relations with positive symptoms, general psychiatric symptoms, and depression. These preliminary data on an early beta-version of the CAINS provide initial support for this new assessment approach to negative symptoms and suggest directions for further scale development. Copyright © 2010 Elsevier B.V. All rights reserved.

Understanding migraine and psychiatric comorbidity.

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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.

Hospitalization and other risk factors for depressive and anxious symptoms in oncological and non-oncological patients.

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De Fazio, Pasquale; Cerminara, Gregorio; Ruberto, Stefania; Caroleo, Mariarita; Puca, Maurizio; Rania, Ornella; Suffredini, Elina; Procopio, Leonardo; Segura-Garcìa, Cristina

2017-04-01

Depression and anxiety are common in hospitalized patients. In particular, oncological patients might be vulnerable to depression and anxiety. The aim of this study is to assess and compare different variables and the prevalence of anxiety and depression symptoms between oncological and medically ill inpatients and to identify variables that can influence depressive and anxious symptoms during hospitalization of patients. A total of 360 consecutive hospitalized patients completed the following questionnaires: Hospital Anxiety and Depression Scale (HADS), Patients Health Questionnaire-9, General Health Questionnaire (GHQ-12), 12-Item Short-Form Survey: physical component summary (PCS), and mental component summary (MCS). Patients were divided into oncological patients and non-oncological patients: groups 1 and 2. Only two significant differences were evident between the groups: the PCS of 12-item Short-form Survey was higher in non-oncological patient (p < 0.000), and the GHQ total score was higher in oncological patients. Variables significantly associated with HADS-D ≥ 8 were lower MCS, higher GHQ-12 score, lower PCS, more numerous previous hospitalizations, longer duration of hospitalization, and positive psychiatric family history. Variables significantly associated with HADS-A ≥ 8 were lower MCS, higher GHQ-12 score, positive psychiatric family history, longer duration of hospitalization, and younger age. Anxiety and depression symptoms in concurrent general medical conditions were associated with a specific sociodemographic profile, and this association has implications for clinical care. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Impact of child maltreatment on meaning in life in psychiatric patients.

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Weibel, Sébastien; Vidal, Sonia; Olié, Emilie; Hasler, Roland; Torriani, Catherine; Prada, Paco; Courtet, Philippe; Guillaume, Sébastien; Perroud, Nader; Huguelet, Philippe

2017-05-01

Child maltreatment (CM) worsens prognosis and quality of life in several psychiatric conditions. Meaning in life is a construct which relates to the sense of purpose that one can perceive in life, and is a key aspect of recovery in psychiatric patients. The lasting impact of CM on meaning in life and its mediating variables have not been studied in patients with chronic persistent psychiatric conditions. One hundred and sixty-six patients with bipolar disorder (N=35), psychotic disorder (N=73), anorexia nervosa (N=30) or borderline personality disorder (N=28) were assessed for meaning in life (revised version of the Life Regard Index (LRI-R)), for CM (Childhood Trauma Questionnaire (CTQ)) and for internalized/externalized psychopathology. CM was associated with a lower LRI score. Structural Equation Modeling showed that internalized psychopathology (depression, hopelessness and low self-esteem) was the main mediator of the impact of CM on meaning in life. The direct effect of CM on meaning in life was not significant. Having suffered from negligence or abuse during childhood is associated with lower meaning in life in adults with persistent and pervasive psychiatric disorders. Treating depressive symptoms and improving self-esteem may improve meaning in life in patients with severe mental disorders who were affected by CM. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Factors Relating to Self-Efficacy Among Psychiatric Nurses.

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Yada, Hironori; Kobayashi, Mako; Odachi, Ryo; Yamane, Toshie

This study aimed to clarify the factors related to self-efficacy experienced by psychiatric nurses. Analysis of qualitative descriptive data from a free self-description questionnaire administered to 16 psychiatric nurses working in psychiatric hospitals revealed 24 codes across the following 8 categories as factors that increase self-efficacy: A1. possibility of practical use in nursing, A2. nursing judgment, A3. improvement of psychiatric symptoms, A4. the patients presenting a positive attitude, A5. building a relationship of trust with the patients, A6. building a relationship of trust with other nurses, A7. work progressing according to plan and A8. team medical practice. Twenty-five codes across the following 10 categories were identified as factors that decrease self-efficacy: B1. lack of communication, B2. uncertainty in caregiving, B3. recurrence of psychiatric symptoms, B4. feeling overpowered by a patient, B5. sense of being too busy to work adequately, B6. difficulty in bringing about self-improvement, B7. sense of loss regarding one's role as a nurse, B8. lack of physical strength, B9. mechanical performance of nursing and B10. fluctuating view of nursing due to mistakes. These factors require intervention for psychiatric nurses' self-efficacy.

Wechsler Adult Intelligence Scale-Third Edition short form for index and IQ scores in a psychiatric population.

Science.gov (United States)

Christensen, Bruce K; Girard, Todd A; Bagby, R Michael

2007-06-01

An eight-subtest short form (SF8) of the Wechsler Adult Intelligence Scale, Third Edition (WAIS-III), maintaining equal representation of each index factor, was developed for use with psychiatric populations. Data were collected from a mixed inpatient/outpatient sample (99 men and 101 women) referred for neuropsychological assessment. Psychometric analyses revealed an optimal SF8 comprising Vocabulary, Similarities, Arithmetic, Digit Span, Picture Completion, Matrix Reasoning, Digit Symbol Coding, and Symbol Search, scored by linear scaling. Expanding on previous short forms, the current SF8 maximizes the breadth of information and reduces administration time while maintaining the original WAIS-III factor structure. (c) 2007 APA, all rights reserved

Management of Current Psychiatric Disorders

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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.

Latent Classes of Symptoms related to Clinically Depressed Mood in Adolescents.

Science.gov (United States)

Blom, Eva Henje; Forsman, Mats; Yang, Tony T; Serlachius, Eva; Larsson, Jan-Olov

2014-01-01

The diagnosis of major depressive disorder (MDD), according to the Diagnostic and Statistical Manual of Mental Disorders , is based only on adult symptomatology of depression and not adapted for age and gender. This may contribute to the low diagnostic specificity and validity of adolescent MDD. In this study, we investigated whether latent classes based on symptoms associated with depressed mood could be identified in a sample of adolescents seeking psychiatric care, regardless of traditionally defined diagnostic categories. Self-reports of the Strengths and Difficulties Questionnaire and the Development and Well-Being Assessment were collected consecutively from all new patients between the ages of 13 and 17 years at two psychiatric outpatient clinics in Stockholm, Sweden. Those who reported depressed mood at intake yielded a sample of 21 boys and 156 girls. Latent class analyses were performed for all screening items and for the depression-specific items of the Development and Well-Being Assessment. The symptoms that were reported in association with depressed mood differentiated the adolescents into two classes. One class had moderate emotional severity scores on the Strengths and Difficulties Questionnaire and mainly symptoms that were congruent with the Diagnostic and Statistical Manual of Mental Disorders criteria for MDD. The other class had higher emotional severity scores and similar symptoms to those reported in the first class. However, in addition, this group demonstrated more diverse symptomatology, including vegetative symptoms, suicidal ideation, anxiety, conduct problems, body dysmorphic symptoms, and deliberate vomiting. The classes predicted functional impairment in that the members of the second class showed more functional impairment. The relatively small sample size limited the generalizability of the results of this study, and the amount of items included in the analysis was restricted by the rules of latent class analysis. No conclusions

The experience of admission to psychiatric hospital among Chinese adult patients in Hong Kong

Directory of Open Access Journals (Sweden)

Lam Linda

2008-10-01

Full Text Available Abstract Background The paper reports on a study to evaluate the psychometric properties and cultural appropriateness of the Chinese translation of the Admission Experience Survey (AES. Methods The AES was translated into Chinese and back-translated. Content validity was established by focus groups and expert panel review. The Chinese version of the Admission Experience Survey (C-AES was administered to 135 consecutively recruited adult psychiatric patients in the Castle Peak Hospital (Hong Kong SAR, China within 48 hours of admission. Construct validity was assessed by comparing the scores from patients admitted voluntarily versus patients committed involuntarily, and those received physical or chemical restraint versus those who did not. The relationship between admission experience and psychopathology was examined by correlating C-AES scores with the Brief Psychiatric Rating Scale (BPRS scores. Results Spearman's item-to-total correlations of the C-AES ranged from 0.50 to 0.74. Three factors from the C-AES were extracted using factor analysis. Item 12 was omitted because of poor internal consistency and factor loading. The factor structure of the Process Exclusion Scale (C-PES corresponded to the English version, while some discrepancies were noted in the Perceived Coercion Scale (C-PCS and the Negative Pressure Scale (C-NPS. All subscales had good internal consistencies. Scores were significantly higher for patients either committed involuntarily or subjected to chemical or physical restrain, independent on severity of psychotic symptoms. Conclusion The Chinese AES is a psychometrically sound instrument assessing the three different aspects of the experience of admission, namely "negative pressure, "process exclusion" and "perceived coercion". The potential of C-AES in exploring subjective experience of psychiatric admission and effects on treatment adherence should be further explored.

Atypical antipsychotic medications to control symptoms of delirium in children and adolescents.

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Turkel, Susan Beckwitt; Jacobson, Julienne; Munzig, Elizabeth; Tavaré, C Jane

2012-04-01

Atypical antipsychotics have been documented to be effective in the management of delirium in adults, but despite considerable need, their use has been less studied in pediatric patients. A retrospective chart review was done to describe the use of atypical antipsychotics in controlling symptoms of delirium in children and adolescents. Pharmacy records at Children's Hospital Los Angeles were reviewed to identify patients to whom antipsychotic agents were dispensed over a 24-month period. Psychiatric inpatient consultations during the same 24-month period were reviewed. Patients 1-18 years old diagnosed with delirium given antipsychotics constituted the study population. Delirium Rating Scale-Revised-98 (DRS-R98) scores were retrospectively calculated, when possible, at time antipsychotic was started to confirm the initial diagnosis of delirium and evaluate symptom severity, and again when antipsychotic was stopped, to assess symptom response. Olanzapine (n=78), risperidone (n=13), and quetiapine (n=19) were used during the 2 years of the study. Mean patient age, length of treatment, and response were comparable for the three medications. For patients with two DRS-R98 scores available (n=75/110), mean DRS-R98 scores decreased significantly (pdelirium symptoms in pediatric patients while underlying etiology was addressed.

The prevalence and clinical features of the night eating syndrome in psychiatric out-patient population.

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Saraçlı, Özge; Atasoy, Nuray; Akdemir, Asena; Güriz, Olga; Konuk, Numan; Sevinçer, Güzin Mukaddes; Ankaralı, Handan; Atik, Levent

2015-02-01

In this study we aimed to investigate the prevalance and clinical correlations of night eating syndrome (NES) in a sample of psychiatric outpatients. Four hundred thirthy three consecutive psychiatric out-patients older than 18years were evaluated in the outpatient clinics using clinical interview according to the DSM-IV with regard to psychiatric diagnosis. Participants were also screened for presence of NES utilizing both clinical interview and self report based on Night Eating Questionnaire (NEQ) instruments. Sociodemographic and clinical features such as age, gender, education level, socioeconomic level and body mass index (BMI) were also recorded. The Body Shape Questionnaire (BSQ) and the Symptom Checklist-90 Revised (SCL-90R) were administered. Based on the proposed diagnostic criteria of the NES via utilizing clinical interview method, 97 (32 male, 65 female) of the sample met diagnostic criteria for NES. The point prevalence of NES was 22.4%. No statistically significant differences were found between the two groups in terms of age, gender, marital status, education and BMI. The patients with NES had higher NEQ, BSQ and SCL-90R subscale scores than patients without NES. Prevalance of depressive disorder, impulse control disorder, and nicotine dependency was higher among patients with NES. No differences were found with regard to the medication (antipsychotics, antidepressants and mood stabilizers). Night eating syndrome is prevalent among psychiatric outpatients and associated with depression, impulse control disorder, and nicotine dependency. Body dissatisfaction and higher symptom severity are also other risk factors for the development of NES. Copyright © 2014 Elsevier Inc. All rights reserved.

Prevalence of restless legs symptoms according to depressive symptoms and depression type: a cross-sectional study.

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Auvinen, Piritta; Mäntyselkä, Pekka; Koponen, Hannu; Kautiainen, Hannu; Korniloff, Katariina; Ahonen, Tiina; Vanhala, Mauno

2018-01-01

Restless legs syndrome is a sensorimotor disorder and it is associated with several other diseases especially mental illnesses. To analyze the relationship between the symptoms of restless legs syndrome and the severity of depressive symptoms and the prevalence of restless legs symptoms in depression subtypes. A cross-sectional study of primary care patients in the Central Finland Hospital District. The prevalence of restless legs symptoms was studied in 706 patients with increased depressive symptoms and 426 controls without a psychiatric diagnosis by using a structured questionnaire. The depressive symptoms were evaluated with the Beck Depression Inventory (BDI) and the psychiatric diagnosis was confirmed by means of a diagnostic interview (Mini-International Neuropsychiatric Interview). The subjects with increased depressive symptoms were divided into three groups (subjects with depressive symptoms without a depression diagnosis, melancholic depression and non-melancholic depression). In the whole study population, the prevalence of restless legs symptoms increased with the severity of depressive symptoms. The prevalence of restless legs symptoms was highest in the melancholic and non-melancholic depressive patients (52 and 46%, respectively) and then in subjects with depressive symptoms without a depression diagnosis (43.4%), but the prevalence was also substantial (24.6%) in subjects without a psychiatric diagnosis. Restless legs symptoms are very common in primary care among subjects with depression, regardless of the depression type. The prevalence of restless legs symptoms increased with increasing severity of depressive symptoms, regardless of the diagnosis. These findings should be considered in clinical evaluation and treatment of patients visiting their physician due to restless legs or depressive symptoms.

The relationship of PTSD to key somatic complaints and cultural syndromes among Cambodian refugees attending a psychiatric clinic: the Cambodian Somatic Symptom and Syndrome Inventory (CSSI).

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Hinton, Devon E; Kredlow, M Alexandra; Pich, Vuth; Bui, Eric; Hofmann, Stefan G

2013-06-01

This article describes a culturally sensitive questionnaire for the assessment of the effects of trauma in the Cambodian refugee population, the Cambodian Somatic Symptom and Syndrome Inventory (CSSI), and gives the results of a survey with the instrument. The survey examined the relationship of the CSSI, the two CSSI subscales, and the CSSI items to posttraumatic stress disorder (PTSD) severity and self-perceived functioning. A total of 226 traumatized Cambodian refugees were assessed at a psychiatric clinic in Lowell, MA, USA. There was a high correlation of the CSSI, the CSSI somatic and syndrome scales, and all the CSSI items to the PTSD Checklist (PCL), a measure of PTSD severity. All the CSSI items varied greatly across three levels of PTSD severity, and patients with higher levels of PTSD had very high scores on certain CSSI-assessed somatic items such as dizziness, orthostatic dizziness (upon standing), and headache, and on certain CSSI-assessed cultural syndromes such as khyâl attacks, "fear of fainting and dying upon standing up," and "thinking a lot." The CSSI was more highly correlated than the PCL to self-perceived disability assessed by the Short Form-12 Health Survey (SF-12). The study demonstrates that the somatic symptoms and cultural syndromes described by the CSSI form a central part of the Cambodian refugee trauma ontology. The survey indicates that locally salient somatic symptoms and cultural syndromes need be profiled to adequately assess the effects of trauma.

Subtyping patients with heroin addiction at treatment entry: factor derived from the Self-Report Symptom Inventory (SCL-90).

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Maremmani, Icro; Pani, Pier Paolo; Pacini, Matteo; Bizzarri, Jacopo V; Trogu, Emanuela; Maremmani, Angelo Gi; Gerra, Gilberto; Perugi, Giulio; Dell'Osso, Liliana

2010-04-13

Addiction is a relapsing chronic condition in which psychiatric phenomena play a crucial role. Psychopathological symptoms in patients with heroin addiction are generally considered to be part of the drug addict's personality, or else to be related to the presence of psychiatric comorbidity, raising doubts about whether patients with long-term abuse of opioids actually possess specific psychopathological dimensions. Using the Self-Report Symptom Inventory (SCL-90), we studied the psychopathological dimensions of 1,055 patients with heroin addiction (884 males and 171 females) aged between 16 and 59 years at the beginning of treatment, and their relationship to age, sex and duration of dependence. A total of 150 (14.2%) patients with heroin addiction showed depressive symptomatology characterised by feelings of worthlessness and being trapped or caught; 257 (24.4%) had somatisation symptoms, 205 (19.4%) interpersonal sensitivity and psychotic symptoms, 235 (22.3%) panic symptomatology, 208 (19.7%) violence and self-aggression. These dimensions were not correlated with sex or duration of dependence. Younger patients with heroin addiction were characterised by higher scores for violence-suicide, sensitivity and panic anxiety symptomatology. Older patients with heroin addiction showed higher scores for somatisation and worthlessness-being trapped symptomatology. This study supports the hypothesis that mood, anxiety and impulse-control dysregulation are the core of the clinical phenomenology of addiction and should be incorporated into its nosology.

Multidisciplinary, Nurse-Led Psychiatric Consultation in Nursing Homes: A Pilot Study in Clinical Practice.

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Koekkoek, Bauke; van Baarsen, Carlijn; Steenbeek, Mirella

2016-07-01

To determine the effects of multidisciplinary, nurse-led psychiatric consultation on behavioral problems of nursing home residents. Residents often suffer from psychiatric symptoms, while staff psychiatric expertise varies. A pre-post study was conducted in seven homes using the Neuropsychiatric Inventory Nursing Home version (NPI-NH). In 71 consultations during 18 months, 56-75% of residents suffered from agitation/aggression, depression, anxiety, and disinhibition. Post-intervention (n = 54), frequency, and severity of psychiatric symptoms were significantly and clinically meaningfully reduced. Also, staff suffered from less work stress. Nurse-led psychiatric consultation is valuable to both nursing home residents and staff. © 2015 Wiley Periodicals, Inc.

Characteristics associated with presence of depressive symptoms in adults with autism spectrum disorder.

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Sterling, Lindsey; Dawson, Geraldine; Estes, Annette; Greenson, Jessica

2008-07-01

Evidence suggests that individuals with autism spectrum disorders (ASD) often exhibit associated psychiatric symptoms, particularly related to depression. The current study investigated whether individual characteristics, specifically, severity of ASD symptoms, level of cognitive ability, and/or presence of other psychiatric disorders, are associated with occurrence of depressive symptoms in adults with ASD. Forty-six adults with ASD were administered a standardized psychiatric history interview. Twenty participants (43%) endorsed depressive symptoms. It was found that individuals with less social impairment, higher cognitive ability, and higher rates of other psychiatric symptoms, were more likely to report depressive symptoms. These characteristics may be vulnerability factors for the development of depression, and should be considered when screening and treating adults with ASD.

Major depressive disorder and depressive symptoms in intermittent explosive disorder.

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Medeiros, Gustavo C; Seger, Liliana; Grant, Jon E; Tavares, Hermano

2018-04-01

It is estimated that between 1.7 and 2.6 million people have had intermittent explosive disorder (IED) during their life in the United States alone. Co-occurring psychiatric disorders are very common in IED, being major depressive disorder arguably the most common. The objective of this study was to examine the clinical correlates of IED and depressive manifestations in 74 treatment-seeking subjects. After controlling for confounders, there were associations between major depressive disorder and severity of depressive symptoms, and (a) higher assault scores, (b) more severe hostile behavior and (c) worse social adjustment. Management of depressive symptoms may be an important for IED treatment. Copyright © 2018 Elsevier B.V. All rights reserved.

Somatoform symptoms and treatment nonadherence in depressed family medicine outpatients.

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Keeley, R; Smith, M; Miller, J

2000-01-01

To examine whether somatoform symptoms, specifically symptoms of conversion, somatization, and hypochondriasis, are associated with side-effect reporting and treatment nonadherence in depressed family medicine outpatients, and to measure whether symptoms improve with pharmacotherapy. Inception cohort study with 14-week follow-up. Inner-city family medicine residency clinic. Thirty-nine consecutive adults with major depressive disorder were asked to participate, and 30 consented. Antidepressants for 14 weeks. The Personality Assessment Inventory (PAI) was administered before treatment. The PAI is a self-reported inventory compatible with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, designed to measure a broad range of personality characteristics. After 14 weeks, the side-effect incidence and treatment nonadherence rates were determined, and 12 patients were readministered the PAI. Depressed family medicine patients demonstrated trends toward elevated Somatic Complaints scale and conversion subscale scores and a lower Suicidal Ideation scale score relative to those of a standardized depressed psychiatric patient profile. Conversion and hypochondriacal symptoms were associated with side-effect reporting and treatment nonadherence. Somatization and hypochondriacal symptoms improved clinically and statistically during treatment for depression. Somatoform distress is a complex, common, and understudied phenomenon in primary care that can adversely affect the treatment of depression. Somatoform symptoms of conversion and hypochondriasis, but not somatization, were found to be risk factors for treatment nonadherence. Somatization and hypochondriacal symptoms may represent personality states that improve with pharmacotherapy, and conversion symptoms may be a personality trait resistant to medical treatment for depression.

Nonpharmacological therapeutic techniques to decrease agitation in geriatric psychiatric patients with dementia.

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Mitchell, Ann M; Chiappetta, Laurel; Boucek, Lynn; Cain, Michelle; Patterson, Georgia; Owens, Kim; Herisko, Camellia; Stark, Kirsti Hetager

2015-02-01

Agitation is not only a frequent and disturbing behavior for many patients with dementia, but it also troubles their caregivers and families. Many serious problems and side effects are associated with the use of medications to treat agitation; therefore, alternative approaches to treating agitation must be assessed. The current article presents results from a quality improvement pilot project that examined the usefulness of a specially designed, multisensory room intervention for geriatric psychiatric inpatients with mild to moderate agitation. Thirty-two visits to the sensory room were made by 13 inpatients with dementia. A significant decrease occurred in the Pittsburgh Agitation Scale (PAS) total scores over time from pre-room to post-room intervention, as well as 1-hour post-room intervention (F = 95.3, p agitation, and resistance to care), with the exception of the aggression subscale. The multisensory room intervention was effective in decreasing some symptoms of agitation in the geriatric psychiatric patient, thus contributing to positive patient, family, and nursing outcomes. Copyright 2015, SLACK Incorporated.

The Relationship between Depression, Anxiety, Somatization, Personality and Symptoms of Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia.

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Koh, Jun Sung; Ko, Hyo Jung; Wang, Sheng-Min; Cho, Kang Joon; Kim, Joon Chul; Lee, Soo-Jung; Pae, Chi-Un

2015-04-01

This study investigated the relationship of personality, depression, somatization, anxiety with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH). The LUTS/BPH patients were evaluated with the International Prostate Symptom Score (IPSS), 44-item Big Five Inventory (BFI), the Patient Health Questionnaire-9 (PHQ-9), the PHQ-15, and 7-item Generalized Anxiety Disorder Scale (GAD-7). The LUTS/BPH symptoms were more severe in patients with depression (p=0.046) and somatization (p=0.024), respectively. Neurotic patients were associated with greater levels of depression, anxiety and somatisation (p=0.0059, p=0.004 and p=0.0095, respectively). Patients with high extraversion showed significantly low depression (p=0.00481) and anxiety (p=0.035) than those with low extraversion. Our exploratory results suggest patients with LUTS/BPH may need careful evaluation of psychiatric problem including depression, anxiety and somatization. Additional studies with adequate power and improved designs are necessary to support the present exploratory findings.

Psychological Symptoms in Obesity and Related Factors.

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Değirmenci, Taner; Kalkan-Oğuzhanoğlu, Nalan; Sözeri-Varma, Gülfizar; Özdel, Osman; Fenkçi, Semin

2015-03-01

This study aimed to investigate the relationship between levels of depression and anxiety symptoms and quality of life, self-esteem in obesity. Fifty-two subjects whose Body Mass Index (BMI) is 30 kg/m 2 and over and 43 control whose BMI is normal were recruited for this study. The socio demographic data form, Hamilton Depression Rating Scale (HAM-D17), Hamilton Anxiety Rating Scale (HAM-A), Quality of Life Scale Short Form (WHOQOL-Brief-TR), Coopersmith Self Esteem Scale (CSES), The Eating Attitudes (EAT), were applied to the participants. In this study most of the patients are women, married, postgraduated and live in urban areas. It was determined to scores of HAM-D17, HAM-A and EAT are higher in obese group than control group; WHOQOL-Brief-TR physical field scores was lower in obese group than control group. CSES scores wasn't difference between obese and control group. In obese group, there was HAM-D17 and HAM-A scores a negative correlation between quality of life physical field score, negative correlation between CSES score, positive correlation between EAT scale score. There is no correlation between scores of HAM-D17 and HAM-A and BMI. Our results suggest that depressive and anxiety levels are high in induvidual with obesity. They have problems in eating attitudes and their quality of life especially physical field is poor. The psychological symptoms have negative effects on the quality of life, self-esteem, and eating attitudes. Our results suggest that psychiatric support to improving positive effects quality of life and self-esteem in individual with obesity.

Molecular Pathways Bridging Frontotemporal Lobar Degeneration and Psychiatric Disorders

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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.

Intrinsic motivation as a mediator of relationships between symptoms and functioning among individuals with schizophrenia spectrum disorders in a diverse urban community.

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Yamada, Ann-Marie; Lee, Karen K; Dinh, Tam Q; Barrio, Concepción; Brekke, John S

2010-01-01

This study investigated intrinsic motivation as a mediator of the relationship between clinical symptoms and functioning. The mediation model was tested with a sample of 166 adults with schizophrenia spectrum disorders attending psychosocial rehabilitation programs in a diverse urban community. Ethnic minority status was examined as a moderator of the mediation model. Motivation was measured using items reflecting intrapsychic drive. Symptoms were assessed with the expanded Brief Psychiatric Rating Scale and functioning with the Role Functioning Scale. Motivation was a significant mediator of the relationship between functioning and all symptom scores; fully mediating the relationship between functioning and negative, disorganized, and global symptoms, and partially mediating the relationship between positive symptoms and functioning. Motivation scores between ethnic minority and nonminority individuals differed significantly (p moderation effect was indicated. The strong mediation effect schizophrenia of motivation on the symptoms-functioning relationship supports future work to translate findings into effective recovery-oriented services.

Virtual Reality Objectifies the Diagnosis of Psychiatric Disorders: A Literature Review

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Martine J. van Bennekom

2017-09-01

Full Text Available BackgroundTo date, a diagnosis in psychiatry is largely based on a clinical interview and questionnaires. The retrospective and subjective nature of these methods leads to recall and interviewer biases. Therefore, there is a clear need for more objective and standardized assessment methods to support the diagnostic process. The introduction of virtual reality (VR creates the possibility to simultaneously provoke and measure psychiatric symptoms. Therefore, VR could contribute to the objectivity and reliability in the assessment of psychiatric disorders.ObjectiveIn this literature review, we will evaluate the assessment of psychiatric disorders by means of VR environments. First, we investigate if these VR environments are capable of simultaneously provoking and measuring psychiatric symptoms. Next, we compare these measures with traditional diagnostic measures.MethodsWe performed a systematic search using PubMed, Embase, and Psycinfo; references of selected articles were checked for eligibility. We identified studies from 1990 to 2016 on VR used in the assessment of psychiatric disorders. Studies were excluded if VR was used for therapeutic purposes, if a different technique was used, or in case of limitation to a non-clinical sample.ResultsA total of 39 studies were included for further analysis. The disorders most frequently studied included schizophrenia (n = 15, developmental disorders (n = 12, eating disorders (n = 3, and anxiety disorders (n = 6. In attention-deficit hyperactivity disorder, the most comprehensive measurement was used including several key symptoms of the disorder. Most of the studies, however, concerned the use of VR to assess a single aspect of a psychiatric disorder.DiscussionIn general, nearly all VR environments studied were able to simultaneously provoke and measure psychiatric symptoms. Furthermore, in 14 studies, significant correlations were found between VR measures and traditional diagnostic

Psychiatric adverse effects of chloroquine

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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.

Subtypes of ataques de nervios: the influence of coexisting psychiatric diagnosis.

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Salmán, E; Liebowitz, M R; Guarnaccia, P J; Jusino, C M; Garfinkel, R; Street, L; Cárdenas, D L; Silvestre, J; Fyer, A J; Carrasco, J L; Davies, S O; Klein, D F

1998-06-01

The current study assesses the relationship between presenting symptomatology of the self-labeled Hispanic popular diagnosis of ataques de nervios and the specific co-morbid psychiatric diagnoses. Hispanic subjects seeking treatment at an anxiety disorders clinic (n = 156) were assessed with a specially designed self-report instrument for both traditional ataque de nervios and panic symptoms, and with structured or semistructured psychiatric interviews for Axis-I disorders. This report focuses on 102 subjects with ataque de nervios who also met criteria for panic disorder, other anxiety disorders, or an affective disorder. Distinct ataque symptom patterns correlated with co-existing panic disorder, affective disorders, or other anxiety disorders. Individuals with both ataque and panic disorder reported the most asphyxia, fear of dying, and increased fear during their ataques. People with ataques who also met criteria for affective disorder reported the most anger, screaming, becoming aggressive, and breaking things during ataques. Ataque positive subjects with other anxiety disorders were less salient for both panic-like and emotional-anger symptoms. The findings suggest that (a) ataque de nervios is a popular label referring to several distinct patterns of loss of emotional control, (b) the type of loss of emotional control is influenced by the associated psychiatric disorder, and (c) ataque symptom patterns may be a useful clinical marker for detecting psychiatric disorders. Further study is needed to examine the relationship between ataque de nervios and psychiatric disorders, as well as the relationship to cultural, demographic, environmental, and personality factors.

Genome-wide analysis of adolescent psychotic-like experiences shows genetic overlap with psychiatric disorders.

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Pain, Oliver; Dudbridge, Frank; Cardno, Alastair G; Freeman, Daniel; Lu, Yi; Lundstrom, Sebastian; Lichtenstein, Paul; Ronald, Angelica

2018-03-31

This study aimed to test for overlap in genetic influences between psychotic-like experience traits shown by adolescents in the community, and clinically-recognized psychiatric disorders in adulthood, specifically schizophrenia, bipolar disorder, and major depression. The full spectra of psychotic-like experience domains, both in terms of their severity and type (positive, cognitive, and negative), were assessed using self- and parent-ratings in three European community samples aged 15-19 years (Final N incl. siblings = 6,297-10,098). A mega-genome-wide association study (mega-GWAS) for each psychotic-like experience domain was performed. Single nucleotide polymorphism (SNP)-heritability of each psychotic-like experience domain was estimated using genomic-relatedness-based restricted maximum-likelihood (GREML) and linkage disequilibrium- (LD-) score regression. Genetic overlap between specific psychotic-like experience domains and schizophrenia, bipolar disorder, and major depression was assessed using polygenic risk score (PRS) and LD-score regression. GREML returned SNP-heritability estimates of 3-9% for psychotic-like experience trait domains, with higher estimates for less skewed traits (Anhedonia, Cognitive Disorganization) than for more skewed traits (Paranoia and Hallucinations, Parent-rated Negative Symptoms). Mega-GWAS analysis identified one genome-wide significant association for Anhedonia within IDO2 but which did not replicate in an independent sample. PRS analysis revealed that the schizophrenia PRS significantly predicted all adolescent psychotic-like experience trait domains (Paranoia and Hallucinations only in non-zero scorers). The major depression PRS significantly predicted Anhedonia and Parent-rated Negative Symptoms in adolescence. Psychotic-like experiences during adolescence in the community show additive genetic effects and partly share genetic influences with clinically-recognized psychiatric disorders, specifically schizophrenia and

Symptom Profile of Attention-Deficit/Hyperactivity Disorder in Youth with High-functioning Autism Spectrum Disorder: A Comparative Study in Psychiatrically Referred Populations

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Joshi, Gagan; Faraone, Stephen V.; Wozniak, Janet; Tarko, Laura; Fried, Ronna; Galdo, Maribel; Furtak, Stephannie L.; Biederman, Joseph

2014-01-01

Objective To compare the clinical presentation of ADHD between youth with autism spectrum disorder (ASD) and ADHD and a sample of youth with ADHD only. Method A psychiatrically referred sample of autism spectrum disorder (ASD) youth with ADHD attending a specialized ambulatory program for ASD (n = 107) and a sample of youth with ADHD attending a general child psychiatry ambulatory clinic (n = 74) were compared. Results Seventy-six percent of youth with ASD met Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) criteria for ADHD. The clinical presentation of ADHD in youth with ASD was predominantly similar to its typical presentation including age at onset (3.5 ± 1.7 vs. 4.0 ± 1.9; p = .12), distribution of diagnostic subtypes, the qualitative and quantitative symptom profile, and symptom severity. Combined subtype was the most frequent presentation of ADHD in ASD youth. Conclusion Despite the robust presentation of ADHD, a significant majority of ASD youth with ADHD failed to receive appropriate ADHD treatment (41% vs. 24%; p = .02). A high rate of comorbidity with ADHD was observed in psychiatrically referred youth with ASD, with a clinical presentation typical of the disorder. PMID:25085653

The evaluation of voiding patterns. An analysis of frequency-volume charts and symptom scores

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Haarst, E.P. van

2015-01-01

This thesis is an analysis of frequency-volume charts (FVCs) and International Prostate Symptom Scores (IPSS) and their relations, based on 2 large databases: one with 24-hour FVCs of 1152 volunteers of all adult age groups without urological complaints, and one with 7-day FVCs of 378 urological

The Association Between Oxidative Stress and Depressive Symptom Scores in Elderly Population: A Repeated Panel Study

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Changwoo Han

2016-09-01

Full Text Available Objectives Previous epidemiological studies about oxidative stress and depression are limited by hospital-based case-control design, single-time measurements of oxidative stress biomarkers, and the small number of study participants. Therefore, in this study, we analyzed the association between biomarker of oxidative stress and depressive symptom scores using repeatedly measured panel data from a community-dwelling elderly population. Methods From 2008 to 2010, a total of 478 elderly participants residing in Seoul, Korea, were evaluated three times. Participants underwent the Korean version of the Short Form Generic Depression Scale (SGDS-K test for screening depression, and urinary malondialdehyde (MDA levels were measured as an oxidative stress biomarker. We used a generalized estimating equation with a compound symmetry covariance structure to estimate the effects of oxidative stress on depressive symptom scores. Results A two-fold increase in urinary MDA concentration was significantly associated with a 33.88% (95% confidence interval [CI], 21.59% to 47.42% increase in total SGDS-K scores. In subgroup analyses by gender, a two-fold increase in urinary MDA concentration was significantly associated with increased SGDS-K scores in both men and women (men: 30.88%; 95% CI, 10.24% to 55.37%; women: 34.77%; 95% CI, 20.09% to 51.25%. In bivariate analysis after an SGDS-K score ≥8 was defined as depression, the third and the fourth urinary MDA quartiles showed a significantly increased odds ratio(OR of depression compared to the lowest urinary MDA quartile (third quartile OR, 6.51; 95% CI, 1.77 to 24.00; fourth quartile OR, 7.11; 95% CI, 1.99 to 25.42. Conclusions Our study suggests a significant association between oxidative stress and depressive symptoms in the elderly population.

Evaluation of Psychiatric Comorbidity in Adolescence with Excessive Computer Game Players

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Anita alaghmand

2016-12-01

Full Text Available Despite of the increasing use of games, yet assessment of causes and consequences of these games were less considered. The purpose of this study was to determine the psychiatric disorders in comparison with usual game users. Firstly PVGT questionnaire was given to 1056 male students at ages 12-18. Students who had score 70 or higher had eligible criteria for excessive or problematic or addictive game user. In the second stage of study, the addicted user group was interviewed by clinical psychologist (M.S with use of K-SADS. In people that had early symptoms of disorders, questionnaires attachment of K-SADS were used, finally the interview based on DSMIV criteria was performed for confirmation of diagnose of psychiatric disorders. In this study of 1000 male, 46 male equivalents to 4.3 percent were excessive or addictive game users. Prevalence of MDD, types of phobias, TSD, SAD, panic disorder, ADHD and OCD although were predominantly higher percent in addictive game users, difference was not significant based on(P< 0.05. The overall prevalence of anxiety disorders and psychiatric problems was significantly higher in this group. In this study a large range of disorders were found. The excessive users of video game were associated with an increased presence of psychiatric disorders specially anxiety disorders. In the future studies, the causal role of excessive game abuse and side effects of this game on mental health should be considered.

Could symptoms and risk factors diagnose COPD? Development of a Diagnosis Score for COPD

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Salameh P

2012-09-01

Full Text Available Pascale Salameh,1 Georges Khayat,2 Mirna Waked31Faculties of Pharmacy and of Public Health, Lebanese University, Beirut, 2Faculty of Medicine, Hôtel Dieu de France Hospital, Beirut and Saint Joseph University, Beirut, 3Faculty of Medicine, Saint George Hospital, Beirut and Balamand University, Beirut, LebanonBackground: Diagnosing chronic obstructive pulmonary disease (COPD without spirometry is still a challenge. Our objective in this study was to develop a scale for diagnosis of COPD.Methods: Data were taken from a cross-sectional epidemiological study. After reducing chronic respiratory symptoms, a logistic regression was used to select risk factors for and symptoms of COPD. The rounded coefficients generated a Diagnosis Score for COPD (DS-COPD, which was dichotomized and differentiated between COPD and other individuals with respiratory symptoms.Results: We constructed a tool for COPD diagnosis with good properties, comprising 12 items. The area under the curve was 0.849; the positive predictive value was 76% if the DS-COPD was >20 and the negative predictive value was 97% if the DS-COPD was <10. A DS-COPD of 10–19 represented a zone mostly suggestive of no COPD (77%. The score was also inversely correlated with forced expiratory volume in 1 second/forced vital capacity.Conclusion: In this study, a tool for diagnosis of COPD was constructed with good properties for use in the epidemiological setting, mainly in cases of low or high scoring. It would be of particular interest in the primary care setting, where spirometry may not be available. Prospective studies and application in clinical settings would be necessary to validate this scale further.Keywords: diagnosis, scale, development, spirometry

Compliance with therapy in patients with chronic hepatitis C: associations with psychiatric symptoms, interpersonal problems, and mode of acquisition.

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Kraus, M R; Schäfer, A; Csef, H; Faller, H; Mörk, H; Scheurlen, M

2001-10-01

Tolerance of interferon-a therapy for hepatitis C is often poor and medication is expensive. Compliance with diagnostic procedures and, even more important, with medical treatment is obviously critical to minimize the rate of dropouts and to maximize cost efficiency. Moreover, a good concordance with scheduled follow-ups is important for early recognition and treatment of interferon-associated side effects. Therefore, we investigated psychiatric symptoms, interpersonal problems, different modes of acquisition, and sociodemographic factors in HCV-infected patients as possible predictor variables of good versus poor compliance. In a longitudinal study, 74 patients with chronic hepatitis C (CHC) who fulfilled the criteria for treatment with interferon (IFN)-alpha-2b with or without ribavirin were investigated prospectively to identify those at risk for poor compliance during IFN medication. To assess predictive factors, we used both IIP-C (Inventory of Interpersonal Problems) and SCL-90-R (Symptom Check List 90 Items Revised) as psychometric instruments. Sociodemographic and somatic variables as well as compliance during IFN therapy were also evaluated. Poor compliance before or during medication was demonstrated by 23% (N = 17) of HCV patients. Sociodemographic factors and mode of acquisition, particularly former intravenous drug (IVD) abuse were not significantly linked with compliance. Logistic regression analysis demonstrated that the subgroup of patients with compliance problems was best identified by both pretherapeutic psychiatric symptoms and interpersonal problems. Predictive value was best and significant for anger-hostility (P = 0.009), intrusive (P = 0.014), depression (P = 0.015), and phobic anxiety (P = 0.049). Adopting this statistical prediction model, sensitivity was 47.1%, but specificity reached 98.3%. In total, 86.5% of cases were classified correctly. In situations of unclear indication for IFN therapy, psychological variables assessment of before

Influence of polygenic risk scores on lipid levels and dyslipidemia in a psychiatric population receiving weight gain-inducing psychotropic drugs.

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Delacrétaz, Aurélie; Lagares Santos, Patricia; Saigi Morgui, Nuria; Vandenberghe, Frederik; Glatard, Anaïs; Gholam-Rezaee, Mehdi; von Gunten, Armin; Conus, Philippe; Eap, Chin B

2017-12-01

Dyslipidemia represents a major health issue in psychiatry. We determined whether weighted polygenic risk scores (wPRSs) combining multiple single-nucleotide polymorphisms (SNPs) associated with lipid levels in the general population are associated with lipid levels [high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol (TC), and triglycerides] and/or dyslipidemia in patients receiving weight gain-inducing psychotropic drugs. We also determined whether genetics improve the predictive power of dyslipidemia. The influence of wPRS on lipid levels was firstly assessed in a discovery psychiatric sample (n=332) and was then tested for replication in an independent psychiatric sample (n=140). The contribution of genetic markers to predict dyslipidemia was evaluated in the combined psychiatric sample. wPRSs were significantly associated with the four lipid traits in the discovery (P≤0.02) and in the replication sample (P≤0.03). Patients whose wPRS was higher than the median wPRS had significantly higher LDL, TC, and triglyceride levels (0.20, 0.32 and 0.26 mmol/l, respectively; P≤0.004) and significantly lower HDL levels (0.13 mmol/l; Pdyslipidemia prediction of HDL (P=0.03) and a trend for improvement was observed for the prediction of TC dyslipidemia (P=0.08). Population-based wPRSs have thus significant effects on lipid levels in the psychiatric population. As genetics improved the predictive power of dyslipidemia development, only 24 patients need to be genotyped to prevent the development of one case of HDL hypocholesterolemia. If confirmed by further prospective investigations, the present results could be used for individualizing psychotropic treatment.

Clinical diagnosis of diabetic polyneuropathy with the diabetic neuropathy symptom and diabetic neuropathy examination scores

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Meijer, J.W.; Lefrandt, J.D.; Links, T.P.; Smit, J.A.; Stewart, R.E.; van der Hoeven, J.H.; Hoogenberg, K.

OBJECTIVE - To evaluate the discriminative power of the Diabetic Neuropathy Symptom (DNS) and Diabetic Neuropathy Examination (DNE) scores for diagnosing diabetic polyneuropathy (PNP), as well as their relation with cardiovascular autonomic function testing (cAFT) and electro-diagnostic studies

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.

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

IS TREATMENT-RESISTANCE IN PSYCHIATRIC DISORDERS A TRAP FOR POLYPHARMACY?

OpenAIRE

Jašović-Gašić, Miroslava

2015-01-01

Background: Nowadays, more and more mental health professionals manage patients who fail treatment for major psychiatric disorders. There is not a consensus on how to deal with treatment-resistance patients, but usually psychiatrists result to polypharmacy. Method: In reviewing the evidence based clinical research we will try to answer some questions about treatment-resistant psychiatric disorders. Treatment-resistant symptoms complicate the clinical course of all psychiatric diso...

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

Wolfram Syndrome (WFS) is known to involve diabetes mellitus, diabetes insipidus, optic nerve atrophy, vision loss, hearing impairment, motor abnormalities, and neurodegeneration, but has been less clearly linked to cognitive, sleep, and psychiatric abnormalities. We sought to determine whether these abnormalities are present in children, adolescents, and young adults with WFS compared to age- and gender-matched individuals with and without type 1 diabetes using standardized measures. Individuals with genetically-confirmed WFS (n = 19, ages 7-27) were compared to age- and gender- equivalent groups of individuals with type 1 diabetes (T1DM; n = 25), and non-diabetic healthy controls (HC: n = 25). Cognitive performance across multiple domains (verbal intelligence, spatial reasoning, memory, attention, smell identification) was assessed using standardized tests. Standardized self- and parent-report questionnaires on psychiatric symptoms and sleep disturbances were acquired from all groups and an unstructured psychiatric interview was performed within only the WFS group. The three groups were similar demographically (age, gender, ethnicity, parental IQ). WFS and T1DM had similar duration of diabetes but T1DM had higher HbA1C levels than WFS and as expected both groups had higher levels than HC. The WFS group was impaired on smell identification and reported sleep quality, but was not impaired in any other cognitive or self-reported psychiatric domain. In fact, the WFS group performed better than the other two groups on selected memory and attention tasks. However, based upon a clinical evaluation of only WFS patients, we found that psychiatric and behavioral problems were present and consisted primarily of anxiety and hypersomnolence. This study found that cognitive performance and psychological health were relatively preserved WFS patients, while smell and sleep abnormalities manifested in many of the WFS patients. These findings contradict past case and

Symptoms of Autism in Males with Fragile X Syndrome: A Comparison to Nonsyndromic ASD Using Current ADI-R Scores

Science.gov (United States)

McDuffie, Andrea; Thurman, Angela John; Hagerman, Randi J.; Abbeduto, Leonard

2015-01-01

Symptoms of autism are frequent in males with fragile X syndrome (FXS), but it is not clear whether symptom profiles differ from those of nonsyndromic ASD. Using individual item scores from the Autism Diagnostic Inventory-Revised, we examined which current symptoms of autism differed in boys with FXS relative to same-aged boys diagnosed with…

Rasagiline in the Treatment of the Persistent Negative Symptoms of Schizophrenia.

Science.gov (United States)

Buchanan, Robert W; Weiner, Elaine; Kelly, Deanna L; Gold, James M; Keller, William R; Waltz, James A; McMahon, Robert P; Gorelick, David A

2015-07-01

The current study examined the efficacy and safety of rasagiline, a selective MAO-B inhibitor, for the treatment of persistent negative symptoms. Sixty people with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, schizophrenia or schizoaffective disorder, who met a priori criteria for persistent negative symptoms, were randomized to receive rasagiline, 1mg/d (n = 31) or placebo (n = 29) in a 12-week, double-blind, placebo-controlled clinical trial. The Scale for the Assessment of Negative Symptoms (SANS) total score was used to assess change in negative symptoms. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), N-Back test, a probabilistic learning task, and a delayed discounting task were used to assess cognition. In a mixed model analysis of covariance (MM-ANCOVA), with time as a continuous variable, there was a significant treatment × time effect for SANS total score (F = 5.61(df = 1,40.3), P = .023). The treatment × time interaction effect was also significant for the SANS avolition subscale score (F(1,40.2) = 10.41, P = .002). In a post hoc MM-ANCOVA analyses, with time as a categorical variable, group differences were significant at week 12 for SANS total score (t(37.3) = 2.15; P = .04; d = -0.41) and SANS avolition subscale score (t(49.0) = 3.06; P = .004; d = -0.46). There was a significant difference in number of participants with a ≥20% reduction in SANS avolition score (χ(2)(1) = 10.94; P = .0009), but not in SANS total score (χ(2)(1) = 1.11; P = .29). There were no significant group differences on the RBANS, N-Back, probabilistic learning, or delayed discounting tasks. Study results support future studies of the utility of rasagiline for the treatment of negative symptoms, including avolition (clinicaltrials.gov trial number: NCT00492336). © The Author 2014. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please

Prediction of short-term changes in symptom severity by baseline plasma homovanillic acid levels in schizophrenic patients receiving clozapine.

Science.gov (United States)

Sumiyoshi, T; Hasegawa, M; Jayathilake, K; Meltzer, H Y

1997-03-24

The relationship between pretreatment levels of plasma homovanillic acid (pHVA) and the outcome of clozapine treatment was studied in 18 male patients with schizophrenia who were resistant to treatment with conventional neuroleptics. After 6 months of clozapine treatment, 7 patients demonstrated > or = 20% decrease in the Brief Psychiatric Rating Scale (BPRS) (responders), while 11 patients did not (non-responders). Responders and non-responders did not differ with respect to the baseline pHVA level. The BPRS Positive Symptom scores at 6 weeks and 3 months, but not those at baseline and 6 months, following initiation of clozapine treatment negatively correlated with pHVA levels for all patients. The correlations became stronger when only responders were included. No significant correlation between Positive Symptom scores and pHVA levels was observed for non-responders. The BPRS Total and Negative Symptom scores did not correlate with pHVA for all patients, responders or non-responders at any time. The percent decrease in the BPRS Positive Symptom scores from baseline at 6 weeks following clozapine treatment correlated significantly with pHVA levels in responders. These results suggest that pretreatment levels of pHVA can be used to predict relatively short-term changes in the positive symptoms of patients with schizophrenia receiving clozapine treatment, particularly for clozapine responders.

Factors Contributing to Disparities in Baseline Neurocognitive Performance and Concussion Symptom Scores Between Black and White Collegiate Athletes.

Science.gov (United States)

Wallace, Jessica; Covassin, Tracey; Moran, Ryan; Deitrick, Jamie McAllister

2017-11-02

National Collegiate Athletic Association (NCAA) concussion guidelines state that all NCAA athletes must have a concussion baseline test prior to commencing their competitive season. To date, little research has examined potential racial differences on baseline neurocognitive performance among NCAA athletes. The purpose of this study was to investigate differences between Black and White collegiate athletes on baseline neurocognitive performance and self-reported symptoms. A total of 597 collegiate athletes (400 White, 197 Black) participated in this study. Athletes self-reported their race on the demographic section of their pre-participation physical examination and were administered the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) neurocognitive battery in a supervised, quiet room. Controlling for sex, data were analyzed using separate one-way analyses of covariance (ANCOVAs) on symptom score, verbal and visual memory, visual motor processing speed, and reaction time composite scores. Results revealed significant differences between White and Black athletes on baseline symptom score (F (1,542)  = 5.82, p = .01), visual motor processing speed (F (1,542)  = 14.89, p baseline visual motor processing speed and reaction time. Black athletes reported higher baseline symptom scores compared to Whites. There was no statistical difference between race on verbal memory (p = .08) and that on visual memory (p = .06). Black athletes demonstrated disparities on some neurocognitive measures at baseline. These results suggest capturing an individual baseline on each athlete, as normative data comparisons may be inappropriate for athletes of a racial minority.

Comparing Mental Illness Stigma among Nurses in Psychiatric and Non-Psychiatric Wards in Tabriz University of Medical Sciences

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Ebrahimi Hossein

2017-03-01

Full Text Available Stigma can complicate people’s mental health problems by affecting different sides of personal life, increasing negative attitudes, causing discriminatory behavior towards them, and reducing the chances of recovery and returning to normal life. This research aims to compare the stigma of mental illness among nurses working in psychiatric and non-psychiatric wards in Tabriz University of Medical Sciences. A total of 240 nurses participated in this descriptive and analytic study. The data were collected using a demographic questionnaire and the Community Attitudes towards the Mentally Ill (CAMI Scale, which is a 40-item self-report questionnaire. All data were analyzed using SPSS 13. The majority of nurses have a medium level of stigma toward people with mental illness, and there is no significant relation between the type of wards and mean stigma scores. After eliminating factors such as mental illness in nurses and their families, it seems that only working with people with mental illness in psychiatric wards is not enough to create a positive attitude toward them. Additionally, the less physical activity and taking advantage of legal benefits of work hardship for psychiatric nurses, low income, and stigma toward psychiatric nursing, probably may make a difference in inclining to work in psychiatry ward between the two groups in spite of relatively equal stigma scores.

[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.

Correlation between Anger and Job Motivation among Psychiatric Nurses in Kashan Psychiatric Hospital

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Kouchaki E.

2016-12-01

Full Text Available Abstract Aims: In general, nurses who work in department of psychiatric are in fact interacting with emotional disorders of patients once providing their care services. higher levels of job motivation and satisfaction can markedly foster service improvement. The aim of this study was to evaluate the correlation between anger and job motivation in nurses of a psychiatric hospital. Instrument & Methods: In this cross-sectional descriptive research in 2014, all 50 psychiatry nurses working at Kargarnejad Hospital of Kashan City, Iran, were entirely studied. A demographical questionnaire, the Anger Multiple Scale and the Job Motivation Scale were used for data gathering. Data were analyzed by SPSS 19 software using Pearson correlation coefficient. Findings: The mean score of anger was 3.01±0.36 and of job motivation was 1.70±0.86. There was a significant relationship between job motivation and the number of family members and conditions of employment of nurses (p=0.001. There was a significant inverse relationship between scores of anger and job motivation of psychiatry nurses of the hospital (r=-0.712; p=0.001. Conclusion: There is a relationship between anger and job motivation in nurses of Kashan Psychiatric hospital.

Occupational disability on psychiatric grounds in South African ...

African Journals Online (AJOL)

... 81 school-teachers in the Cape Town area who had been declared permanently medically disabled as a consequence of psychiatric disorders. Results: Patients were relatively young (44±6.1 yrs), had experienced symptoms for 5.2±3.8 yrs, and had been treated for 4±3.5 yrs. Almost half had a family history of psychiatric ...

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

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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

Relation of Psychiatric Symptoms with Epilepsy, Asthma, and Allergy in Youth with ASD vs. Psychiatry Referrals.

Science.gov (United States)

Weber, Rebecca J; Gadow, Kenneth D

2017-08-01

The present study aimed to characterize the association of psychopathology with the clinical correlates of epilepsy, asthma, and allergy within and between neurobehavioral syndromes. Participants were consecutively evaluated youth (6-18 years, 75 % male) with autism spectrum disorder (ASD; n = 589) and non-ASD outpatient psychiatry referrals (n = 653). Informants completed a background questionnaire (parents) and a psychiatric symptom severity rating scale (parents, teachers). Youth with ASD had higher rates of epilepsy and allergy but not asthma than psychiatry referrals, even when analyses were limited to youth with IQ ≥ 70. Somatic conditions evidenced variable associations with medical services utilization, educational interventions, family income, and maternal education. Youth with ASD with versus without epilepsy had more severe ASD social deficits (parents' ratings) and less severe ASD repetitive behaviors (teachers' ratings). Epilepsy was associated with more severe depression, mania, and schizophrenia symptoms in youth with ASD. Youth with allergy (psychiatry referrals only) had more severe anxiety and depression symptoms (parents' ratings) but less severe aggression (teachers' ratings) thus providing evidence of both context- and diagnostic-specificity. Youth with ASD versus non-ASD psychiatry referrals evidence a variable pattern of relations between somatic conditions and a range of clinical correlates, which suggests that the biologic substrates and psychosocial concomitants of neurodevelopmental disorders and their co-occurring somatic conditions may interact to produce unique clinical phenotypes.

Problematic internet use and psychiatric co-morbidity in a population of Japanese adult psychiatric patients

NARCIS (Netherlands)

de Vries, Hille T; Nakamae, Takashi; Fukui, Kenji; Denys, D.; Narumoto, Jin

2018-01-01

BACKGROUND: Many studies reported the high prevalence of problematic internet use (PIU) among adolescents (13-50%), and PIU was associated with various psychiatric symptoms. In contrast, only a few studies investigated the prevalence among the adult population (6%). This study aimed to investigate

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.)

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.)

The serotonin transporter in psychiatric disorders

DEFF Research Database (Denmark)

Spies, Marie; Knudsen, Karen Birgitte Moos; Lanzenberger, Rupert

2015-01-01

Over the past 20 years, psychotropics affecting the serotonergic system have been used extensively in the treatment of psychiatric disorders. Molecular imaging, in particular PET, has allowed for elucidation of the essential contribution of the serotonin transporter to the pathophysiology...... of various psychiatric disorders and their treatment. We review studies that use PET to measure cerebral serotonin transporter activity in psychiatric disorders, focusing on major depressive disorder and antidepressant treatment. We also discuss opportunities and limitations in the application...... of this neuroimaging method in clinical practice. Although results from individual studies diverge, meta-analysis indicates a trend towards reduced serotonin transporter availability in patients with major depressive disorder. Inconsistencies in results might suggest symptom heterogeneity in major depressive disorder...

Subtyping patients with heroin addiction at treatment entry: factor derived from the Self-Report Symptom Inventory (SCL-90

Directory of Open Access Journals (Sweden)

Maremmani Icro

2010-04-01

Full Text Available Abstract Background Addiction is a relapsing chronic condition in which psychiatric phenomena play a crucial role. Psychopathological symptoms in patients with heroin addiction are generally considered to be part of the drug addict's personality, or else to be related to the presence of psychiatric comorbidity, raising doubts about whether patients with long-term abuse of opioids actually possess specific psychopathological dimensions. Methods Using the Self-Report Symptom Inventory (SCL-90, we studied the psychopathological dimensions of 1,055 patients with heroin addiction (884 males and 171 females aged between 16 and 59 years at the beginning of treatment, and their relationship to age, sex and duration of dependence. Results A total of 150 (14.2% patients with heroin addiction showed depressive symptomatology characterised by feelings of worthlessness and being trapped or caught; 257 (24.4% had somatisation symptoms, 205 (19.4% interpersonal sensitivity and psychotic symptoms, 235 (22.3% panic symptomatology, 208 (19.7% violence and self-aggression. These dimensions were not correlated with sex or duration of dependence. Younger patients with heroin addiction were characterised by higher scores for violence-suicide, sensitivity and panic anxiety symptomatology. Older patients with heroin addiction showed higher scores for somatisation and worthlessness-being trapped symptomatology. Conclusions This study supports the hypothesis that mood, anxiety and impulse-control dysregulation are the core of the clinical phenomenology of addiction and should be incorporated into its nosology.

Treatment outcome in psychiatric inpatients: the discriminative value of self-esteem.

Science.gov (United States)

Talbot, France; Harris, Gregory E; French, Douglas J

2009-01-01

Self-esteem has been identified as an important clinical variable within various psychological and psychiatric conditions. Surprisingly, its prognostic and discriminative value in predicting treatment outcome has been understudied. The current study aims to assess, in an acute psychiatric setting, the comparative role of self-esteem in predicting treatment outcome in depression, anxiety, and global symptom severity, while controlling for socio-demographic variables, pre-treatment symptom severity, and personality pathology. Treatment outcome was assessed with pre- and post-treatment measures. A heterogeneous convenience sample of 63 psychiatric inpatients completed upon admission and discharge self-report measures of depression, anxiety, global symptom severity, and self-esteem. A significant one-way repeated-measures multivariate analysis of variance (MANOVA) followed up by analyses of variance (ANOVAs) revealed significant reductions in depression (eta2 = .72), anxiety (eta2 = .55), and overall psychological distress (eta2 = .60). Multiple regression analyses suggested that self-esteem was a significant predictor of short-term outcome in depression but not for anxiety or overall severity of psychiatric symptoms. The regression model predicting depression outcome explained 32% of the variance with only pre-treatment self-esteem contributing significantly to the prediction. The current study lends support to the importance of self-esteem as a pre-treatment patient variable predictive of psychiatric inpatient treatment outcome in relation with depressive symptomatology. Generalization to patient groups with specific diagnoses is limited due to the heterogeneous nature of the population sampled and the treatments provided. Implications for clinical practice and future research are discussed.

The Associations Between Pre- and Postnatal Maternal Symptoms of Distress and Preschooler's Symptoms of ADHD, Oppositional Defiant Disorder, Conduct Disorder, and Anxiety.

Science.gov (United States)

Bendiksen, Bothild; Aase, Heidi; Diep, Lien My; Svensson, Elisabeth; Friis, Svein; Zeiner, Pål

2015-12-07

The objective of this article is to examine the associations between pre- and postnatal maternal distress and preschooler's symptoms of ADHD, Oppositional Defiant Disorder (ODD), Conduct Disorder (CD), and anxiety, by timing and gender. Children, aged 3.5 years (N = 1,195), recruited from the Norwegian Mother and Child Cohort Study, were assessed with a semistructured parental psychiatric interview. Perinatal maternal symptoms of distress were assessed by Symptom Checklist (SCL-5); Poisson regression was used to examine the associations. Mid-gestational maternal distress significantly increased the average number of child symptoms, ranging between 3.8% for ADHD hyperactive-impulsive (ADHD-HI) and 8.7% for anxiety. The combination of high maternal scores of distress both pre- and postnatally were associated with increased risk of child symptoms of anxiety (relative risk [RR] = 2.10; 95% confidence interval [CI] = [1.43, 3.07]), CD (RR = 1.83; 95% CI = [1.33, 2.51]), and ODD (RR = 1.30; 95% CI = [1.03, 1.64]), with minor sex differences. Maternal distress during mid-gestation was associated with ADHD, behavioral, and emotional symptoms in preschool children. Continued exposure into the postnatal period may further increase these risk associations . © The Author(s) 2015.

Somatic symptom disorder

Science.gov (United States)

... related disorders; Somatization disorder; Somatiform disorders; Briquet syndrome; Illness anxiety disorder References American Psychiatric Association. Somatic symptom disorder. Diagnostic and Statistical Manual of Mental Disorders . ...

Completion of Multidisciplinary Treatment for Persistent Postconcussive Symptoms Is Associated With Reduced Symptom Burden.

Science.gov (United States)

Janak, Jud C; Cooper, Douglas B; Bowles, Amy O; Alamgir, Abul H; Cooper, Sharon P; Gabriel, Kelley P; Pérez, Adriana; Orman, Jean A

To investigate the pre- to posttreatment changes in both posttraumatic stress disorder (PTSD) and persistent postconcussive symptoms (PPCSs). We studied 257 active-duty patients with a history of mild traumatic brain injury (mTBI) who completed multidisciplinary outpatient treatment at Brooke Army Medical Center TBI Clinic from 2008 to 2013. This treatment program included cognitive rehabilitation; vestibular interventions; headache management; and integrated behavioral healthcare to address co-occurring psychiatric conditions such as PTSD, depression, and sleep disturbance. A 1-group; preexperimental, pre- to posttreatment study. The Neurobehavioral Symptom Inventory (NSI) was used to assess PPCSs, and the PTSD Checklist-Military Version (PCL-M) was used to asses PTSD symptoms. Global PPCS resolution (mean NSI: 35.0 pre vs 23.8 post; P < .0001; d = 0.72) and PTSD symptom resolution (mean PCL-M: 43.2 pre vs 37.7 post; P < .0001; d = 0.34) were statistically significant. Compared with those with only mTBI, patients with mTBI and PTSD reported greater global PPCS impairment both pretreatment (mean NSI: 48.7 vs 27.9; P < .0001) and posttreatment (mean NSI: 36.2 vs 17.4; P < .0001). After adjusting for pretreatment NSI scores, patients with comorbid PTSD reported poorer PPCS resolution than those with mTBI alone (mean NSI: 27.9 pre vs 21.7 post; P = .0009). We found a reduction in both self-reported PPCSs and PTSD symptoms; however, future studies are needed to identify specific components of care associated with symptom reduction.

Comparison between the Reflux Finding Score and the Reflux Symptom Index in the Practice of Otorhinolaryngology.

Science.gov (United States)

Nunes, Heloisa Sobreira; Pinto, José Antonio; Zavanela, Adma Roberta; Cavallini, André Freitas; Freitas, Gabriel Santos; Garcia, Fabiola Esteves

2016-07-01

The Gastroesophageal Reflux Disease has a prevalence of ∼12% of the urban population in Brazil. Koufman proposed the term to designate Laryngeal Pharyngeal Reflux (LPR) symptoms, signs or tissue damage resulting from aggression of the gastrointestinal contents in the upper aerodigestive tract. Belafsky et al proposed a score that points to inflammatory laryngeal signs through videolaryngoscopic findings, the Reflux Finding Score (RFS). Moreover, in 2002, they published the Reflux Symptom Index (RSI). The objective of this study is to provide a comparison between the Reflux Finding Score and the Reflux Symptom Index in the practice of Otorhinolaryngology. Our study involved a total of 135 patients who visited the Ear, Nose, and Throat (ENT) clinic Núcleo de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço de São Paulo between April 2014 and May 2015 with suspected LPR. We excluded nine patients and the study group was 126 patients. All patients were ranked by their RSI and RFS scores. The study group consisted of 126 patients (88 women and 38 men). Their main complaints were cough (40.4%), globus (21.4%), dysphonia (19.8%), throat clearing (15.8%), postnasal drip (3.17%), snoring (1.5%), dysphagia (1.5%), cacosmia (0.7%), and regurgitation (1.5%). The RSI ranges from 13 to 42 with a mean of 20.7 (SD = 6.67). The RFS ranged from 3 to 19 with a mean of 9.53 (SD = 2.64). The RSI and RFS can easily be included in ENT routines as objective parameters, with low cost and high practicality. Based on the clinical index, the specialist can evaluate the need for further tests.

ADHD symptoms in non-treatment seeking young adults: relationship with other forms of impulsivity.

Science.gov (United States)

Chamberlain, Samuel R; Ioannidis, Konstantinos; Leppink, Eric W; Niaz, Faiza; Redden, Sarah A; Grant, Jon E

2017-02-01

Attention-deficit hyperactivity disorder (ADHD) has been associated with various manifestations of impulsivity in adults, including elevated rates of other impulsive disorders, substance use, questionnaire-based impulsivity scores, and inhibitory dysregulation on neurocognitive tests. The relationship between ADHD and all these other forms of impulsivity has yet to be explored within the context of a single comprehensive study. A total of 423 young adults, who gambled ≥5 times in the preceding year, were recruited using media advertisements and undertook detailed assessment including structured psychiatric interview, questionnaires, and neurocognitive tests. Participants with ADHD symptoms were identified using the Adult ADHD Self-Report Scale Screener (ASRS-V1.1) and were compared to controls using multivariate analysis of variance (MANOVA). ADHD symptoms were found in 20.3% of the sample, but only 7.3% of these subjects had ever received a formal diagnosis. ADHD symptoms were associated with significantly lower quality of life, lower self-esteem, higher emotional dysregulation, higher impulsivity questionnaire scores, more problematic Internet use, greater occurrence of psychiatric disorders, and impaired stop-signal reaction times. Of these variables, stop-signal reaction times and Barratt attentional impulsiveness were the strongest predictors of group classification. ADHD symptoms are common and under-diagnosed in young adults who gamble, and are most strongly linked with certain other types of impulsivity (questionnaire- and cognitive-based measures) and with emotional dysregulation, suggesting that these are each important considerations in understanding the pathophysiology of the disorder, but also potential treatment targets. It is necessary to question whether treatment for adult ADHD could be enhanced by considering self-esteem, emotional reactivity, and impaired inhibitory control as specific treatment targets, in addition to the core diagnostic

The accuracy of Internet search engines to predict diagnoses from symptoms can be assessed with a validated scoring system.

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Shenker, Bennett S

2014-02-01

To validate a scoring system that evaluates the ability of Internet search engines to correctly predict diagnoses when symptoms are used as search terms. We developed a five point scoring system to evaluate the diagnostic accuracy of Internet search engines. We identified twenty diagnoses common to a primary care setting to validate the scoring system. One investigator entered the symptoms for each diagnosis into three Internet search engines (Google, Bing, and Ask) and saved the first five webpages from each search. Other investigators reviewed the webpages and assigned a diagnostic accuracy score. They rescored a random sample of webpages two weeks later. To validate the five point scoring system, we calculated convergent validity and test-retest reliability using Kendall's W and Spearman's rho, respectively. We used the Kruskal-Wallis test to look for differences in accuracy scores for the three Internet search engines. A total of 600 webpages were reviewed. Kendall's W for the raters was 0.71 (psearch engines is a valid and reliable instrument. The scoring system may be used in future Internet research. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

X-linked adult-onset adrenoleukodystrophy: Psychiatric and neurological manifestations.

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Shamim, Daniah; Alleyne, Karen

2017-01-01

Adult-onset adrenoleukodystrophy is a rare x-linked inborn error of metabolism occurring predominantly in males with onset in early 30s. Here, we report a 34-year-old male with first signs of disease in early 20s manifesting as a pure psychiatric disorder. Prior to onset of neurological symptoms, this patient demonstrated a schizophrenia and bipolar-like presentation. The disease progressed over the next 10-13 years and his memory and motor problems became evident around the age of 33 years. Subsequently, diagnostic testing showed the typical magnetic resonance imaging and lab findings for adult-onset adrenoleukodystrophy. This case highlights adult-onset adrenoleukodystrophy which may present as a pure psychiatric disturbance in early adulthood and briefly discusses the prolonged time between the onset of psychiatric symptoms and the onset of neurological disease.

The psychoactive effects of psychiatric medication: the elephant in the room.

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Moncrieff, Joanna; Cohen, David; Porter, Sally

2013-01-01

The psychoactive effects of psychiatric medications have been obscured by the presumption that these medications have disease-specific actions. Exploiting the parallels with the psychoactive effects and uses of recreational substances helps to highlight the psychoactive properties of psychiatric medications and their impact on people with psychiatric problems. We discuss how psychoactive effects produced by different drugs prescribed in psychiatric practice might modify various disturbing and distressing symptoms, and we also consider the costs of these psychoactive effects on the mental well-being of the user. We examine the issue of dependence, and the need for support for people wishing to withdraw from psychiatric medication. We consider how the reality of psychoactive effects undermines the idea that psychiatric drugs work by targeting underlying disease processes, since psychoactive effects can themselves directly modify mental and behavioral symptoms and thus affect the results of placebo-controlled trials. These effects and their impact also raise questions about the validity and importance of modern diagnosis systems. Extensive research is needed to clarify the range of acute and longer-term mental, behavioral, and physical effects induced by psychiatric drugs, both during and after consumption and withdrawal, to enable users and prescribers to exploit their psychoactive effects judiciously in a safe and more informed manner.

Plasma biomarkers of depressive symptoms in older adults.

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Arnold, S E; Xie, S X; Leung, Y-Y; Wang, L-S; Kling, M A; Han, X; Kim, E J; Wolk, D A; Bennett, D A; Chen-Plotkin, A; Grossman, M; Hu, W; Lee, V M-Y; Mackin, R Scott; Trojanowski, J Q; Wilson, R S; Shaw, L M

2012-01-03

The pathophysiology of negative affect states in older adults is complex, and a host of central nervous system and peripheral systemic mechanisms may play primary or contributing roles. We conducted an unbiased analysis of 146 plasma analytes in a multiplex biochemical biomarker study in relation to number of depressive symptoms endorsed by 566 participants in the Alzheimer's Disease Neuroimaging Initiative (ADNI) at their baseline and 1-year assessments. Analytes that were most highly associated with depressive symptoms included hepatocyte growth factor, insulin polypeptides, pregnancy-associated plasma protein-A and vascular endothelial growth factor. Separate regression models assessed contributions of past history of psychiatric illness, antidepressant or other psychotropic medicine, apolipoprotein E genotype, body mass index, serum glucose and cerebrospinal fluid (CSF) τ and amyloid levels, and none of these values significantly attenuated the main effects of the candidate analyte levels for depressive symptoms score. Ensemble machine learning with Random Forests found good accuracy (~80%) in classifying groups with and without depressive symptoms. These data begin to identify biochemical biomarkers of depressive symptoms in older adults that may be useful in investigations of pathophysiological mechanisms of depression in aging and neurodegenerative dementias and as targets of novel treatment approaches.

The Twenty-Year Trajectory of Suicidal Activity among Post-Hospital Psychiatric Men and Women with Mood Disorders and Schizophrenia

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Kaplan, Kalman J.; Harrow, Martin; Clews, Kelsey

2016-01-01

The Chicago Follow-up Study has followed the course of severe mental illness among psychiatric patients for over 20 years after their index hospitalization. Among these patients are 97 schizophrenia patients, 45 patients with schizoaffective disorders, 102 patients with unipolar nonpsychotic depression, and 53 patients with a bipolar disorder. Maximum suicidal activity (suicidal ideation, suicidal attempts and suicide completions) generally declines over the three time periods (early, middle, and late follow-ups) following discharge from the acute psychiatric hospitalization for both males and females across diagnostic categories with two exceptions: female schizophrenia patients and female bipolar patients. A weighted mean suicidal activity score tended to decrease across follow-ups for male patients in the schizophrenia, schizoaffective and depressive diagnostic groups with an uneven trend in this direction for the male bipolars. No such pattern emerges for our female patients except for female depressives. Males’ suicidal activity seems more triggered by psychotic symptoms and potential chronic disability while females’ suicidal activity seems more triggered by affective symptoms. PMID:26881891

A serotonin transporter gene polymorphism predicts peripartum depressive symptoms in an at-risk psychiatric cohort.

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Binder, Elisabeth B; Newport, D Jeffrey; Zach, Elizabeth B; Smith, Alicia K; Deveau, Todd C; Altshuler, Lori L; Cohen, Lee S; Stowe, Zachary N; Cubells, Joseph F

2010-07-01

Peripartum major depressive disorder (MDD) is a prevalent psychiatric disorder with potential detrimental consequences for both mother and child. Despite its enormous health care relevance, data regarding genetic predictors of peripartum depression are sparse. The aim of this study was to investigate associations of the serotonin-transporter linked polymorphic region (5-HTTLPR) genotype with peripartum MDD in an at-risk population. Two hundred and seventy four women with a prior history of MDD were genotyped for 5-HTTLPR and serially evaluated in late pregnancy (gestational weeks 31-40), early post-partum (week 1-8) and late post-partum (week 9-24) for diagnosis of a current major depressive episode (MDE) and depressive symptom severity. 5-HTTLPR S-allele carrier status predicted the occurrence of a MDE in the early post-partum period only (OR=5.13, p=0.017). This association persisted despite continued antidepressant treatment. The 5-HTTLPR genotype may be a clinically relevant predictor of early post-partum depression in an at-risk population. Peripartum major depressive disorder is a prevalent psychiatric disorder with potential detrimental consequences for both mother and child. Despite its enormous health care relevance, data regarding genetic predictors of peripartum depression are sparse. The aim of this study was to investigate associations of the serotonin-transporter linked polymorphic region (5-HTTLPR) genotype with peripartum MDD in an at-risk population. Copyright 2009 Elsevier Ltd. All rights reserved.

Cyberbullying: implications for the psychiatric nurse practitioner.

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Carpenter, Lindsey M; Hubbard, Grace B

2014-08-01

The purpose of this article is to inform and educate psychiatric nurse practitioners about the pervasiveness of the rapidly increasing problem of cyberbullying. As more children and adolescents obtain access to the Internet, mobile devices, and social networking sites, the exposure to bullying in the virtual format increases. Cyberbullying is a growing public health concern and can affect mental health and school performance. Cyberbullying often results in a range of psychiatric symptoms and has been linked to suicide attempts and completions. The psychiatric nurse practitioner is uniquely prepared to provide a range of interventions for patients, families, and communities who have experienced cyberbullying. © 2014 Wiley Periodicals, Inc.

Attacking Heterogeneity in Schizophrenia by Deriving Clinical Subgroups From Widely Available Symptom Data.

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Dickinson, Dwight; Pratt, Danielle N; Giangrande, Evan J; Grunnagle, MeiLin; Orel, Jennifer; Weinberger, Daniel R; Callicott, Joseph H; Berman, Karen F

2018-01-13

Previous research has identified (1) a "deficit" subtype of schizophrenia characterized by enduring negative symptoms and diminished emotionality and (2) a "distress" subtype associated with high emotionality-including anxiety, depression, and stress sensitivity. Individuals in deficit and distress categories differ sharply in development, clinical course and behavior, and show distinct biological markers, perhaps signaling different etiologies. We tested whether deficit and distress subtypes would emerge from a simple but novel data-driven subgrouping analysis, based on Positive and Negative Syndrome Scale (PANSS) negative and distress symptom dimensions, and whether subgrouping was informative regarding other facets of behavior and brain function. PANSS data, and other assessments, were available for 549 people with schizophrenia diagnoses. Negative and distress symptom composite scores were used as indicators in 2-step cluster analyses, which divided the sample into low symptom (n = 301), distress (n = 121), and deficit (n = 127) subgroups. Relative to the low-symptom group, the deficit and distress subgroups had comparably higher total PANSS symptoms (Ps symptom, cognitive and personality variables, among others. Initial analyses of functional magnetic resonance imaging (fMRI) data from a 182-participant subset of the full sample also suggested distinct patterns of neural recruitment during working memory. The field seeks more neuroscience-based systems for classifying psychiatric conditions, but these are inescapably behavioral disorders. More effective parsing of clinical and behavioral traits could identify homogeneous target groups for further neural system and molecular studies, helping to integrate clinical and neuroscience approaches. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center 2017.

Psychiatric comorbidities of adults with early- and late-onset attention-deficit/hyperactivity disorder.

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Lin, Yu-Ju; Yang, Li-Kuang; Gau, Susan Shur-Fen

2016-06-01

We evaluated the psychiatric comorbidities in adults who were diagnosed with Diagnostic and Statistical Manual of Mental disorders, 5th edition attention-deficit/hyperactivity disorder as a function of recalled symptom onset before and after the age of 7 years and whether the childhood attention-deficit/hyperactivity disorder symptoms were associated with psychiatric comorbidities. In all, 214 adults who were diagnosed with Diagnostic and Statistical Manual of Mental disorders, 5th edition attention-deficit/hyperactivity disorder and 174 non-attention-deficit/hyperactivity disorder controls (aged 17-40 years) received psychiatric interviews to confirm their previous and current attention-deficit/hyperactivity disorder status and other psychiatric diagnoses. Demographics and risks of lifetime psychiatric disorders were compared among three groups: (1) attention-deficit/hyperactivity disorder, onset attention-deficit/hyperactivity disorder, onset between 7 and 12 years (late-onset) and (3) non-attention-deficit/hyperactivity disorder controls. We also tested the effects of attention-deficit/hyperactivity disorder symptoms on the risk of later psychiatric comorbidities by Cox regression analyses. Regardless of the age of onset, attention-deficit/hyperactivity disorder was significantly associated with a wide range of psychiatric comorbidities. There were similar comorbid patterns between early- and late-onset attention-deficit/hyperactivity disorder. Regardless of attention-deficit/hyperactivity disorder diagnosis, increased severity of attention-deficit/hyperactivity disorder symptoms was associated with higher risks of oppositional defiant disorder, conduct disorder, dysthymia and sleep disorder but not major depression, which was associated with the attention-deficit/hyperactivity disorder diagnosis. Our findings suggest that elevating the threshold of age of onset to 12 years in Diagnostic and Statistical Manual of Mental disorders, 5th edition would not