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Meadows, Graham, Philip Burgess, and Irene Bobevski. "Distributing Mental Health Care Resources: Strategic Implications from The National Survey of Mental Health and Wellbeing." Australian & New Zealand Journal of Psychiatry 36, no. 2 (April 2002): 217–23. http://dx.doi.org/10.1046/j.1440-1614.2002.01011.x.
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Objective: This paper considers mental health services resource distribution under the Australian second national mental health plan, with its direction to mental health services to be more inclusive of people with higher prevalence psychiatric disorders. We consider inequalities in mental health in Australia, and describe the performance of the composite census variable employed in the Victorian mental health funding distribution formula, the index of relative socioeconomic disadvantage (IRSED), in predicting disorder rates and perceived needs for care. Method: We review data sets generated through the National Survey of Mental Health and Wellbeing (NSMHWB) for their utility in development of resource distribution formulae. We present analyses from the 10 641 cases examined in the household survey to explore the role of the IRSED in predicting prevalence rates of anxiety, affective, substance misuse and other disorders, as well as perceived need for care. Results: Recent epidemiological studies provide some additional sources of data to guide resource distribution, although the available data sets are found not to be optimized for examination of this issue. Greater levels of socioeconomic disadvantage of areas are associated with increased rates of morbidity in metropolitan areas, with different patterns for different disorder groups. The influence of the IRSED is more complex outside the major cities. Conclusions: The descriptive epidemiological data now available, despite significant investment, are relatively crude instruments for this current purpose. The findings support the case for using the IRSED as a proxy indicator for morbidity for the high prevalence disorders, but only within metropolitan areas. This examination confirms the existence of significant inequalities in mental health between Australian urban areas with different socioeconomic characteristics.
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Leboyer, M., M. C. Babron, and F. Clerget-Darpoux. "Sampling strategy in linkage studies of affective disorders." Psychological Medicine 20, no. 3 (August 1990): 573–79. http://dx.doi.org/10.1017/s0033291700017074.
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SynopsisEvidence of linkage in families of bipolar patients has so far been identified with genetic markers on chromosome X and 11. However, replications of these data have not consistently been reported in either case, which favours the hypothesis of genetic heterogeneity. Therefore, we have tried to outline a sampling strategy for linkage replication in affective disorders. We estimated the average number of nuclear families required to replicate X or 11 linkage as a function of the degree of heterogeneity as well as the number to prove heterogeneity given that linkage exists. The results are presented and discussed.
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Thacore, Vinod Rai, and Shashjit Lal Varma. "A Study of Suicides in Ballarat, Victoria, Australia." Crisis 21, no. 1 (January 2000): 26–30. http://dx.doi.org/10.1027//0227-5910.21.1.26.
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Objective:To study suicides occurring in Ballarat with regard to incidence, demographic variables, possible causal factors, and association with psychiatric disorders over a period of 5 years. Method:A detailed review of the coroner's record of every suicide occurring during 1992-1996 was undertaken. Information was obtained on socio-demographic variables, method and circumstances of suicide, and associated psychiatric disorders in each case and subjected to psychological autopsy. Results:75 suicides were recorded. The male to female ratio was 4:1 and average age was 43 years. 60% had associated psychiatric illnesses, mainly affective disorders. Carbon monoxide self-poisoning accounted for 40%, firearms for 30%, and hanging, overdose, asphyxia and other methods for the remaining 30%. It was statistically significant that the younger age group preferred firearms to other methods, and that their suicides were precipitated by interpersonal conflicts. Social and personal difficulties were associated in 33%, and triggering factors were present in 40%. Previous suicide attempts were present in 28%, while 32% had manifest behavior changes preceding suicides or verbalized their intent to suicide. Conclusions:Suicide rates in Ballarat were higher than the average overall Victorian and Australian rates. After a consistent decline over 4 years an increase occurred in 1996. The preferred method of suicide was carbon monoxide, although the young preferred firearms. Demographic and other psychosocial factors were similar to the rest of Australia. Unemployment was not a significant factor. Psychiatric conditions, personal and social problems figured prominently as factors of etiological significance in suicide subjects.
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Roberts, Susan B., Christine A. Hill, Brian Dean, Nicholas A. Keks, Ken Opeskin, and David L. Copolov. "Confirmation of the Diagnosis of Schizophrenia after Death Using DSM-IV: A Victorian Experience." Australian & New Zealand Journal of Psychiatry 32, no. 1 (February 1998): 73–76. http://dx.doi.org/10.3109/00048679809062709.
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Objective: This study examines the reliability of antemortem diagnoses of schizophrenia using DSM-IV criteria. Method: The case histories of 83 subjects with a provisional diagnosis of schizophrenia at autopsy were retrospectively reviewed using a semi-structured chart review and application of DSM-IV criteria. Agreement between antemortem and postmortem diagnoses of schizophrenia was examined, as well as the concordance between DSM-IV diagnoses and previously obtained diagnoses using DSM-Ill-R and ICD-10 criteria for schizophrenia. Results: According to DSM-IV, 30.1% of cases did not have schizophrenia, compared to 36.1% using DSM-Ill-R criteria and 51.8% of cases using ICD-10 criteria. Concordance between DSM-IV and DSM-Ill-R diagnoses of schizophrenia was excellent (k = 0.81), but only fair between DSM-IV and ICD-10 (k = 0.57). Of the cases that did not meet the formal criteria for schizophrenia, the majority were reassigned diagnoses of schizoaffective disorder and affective disorder. Conclusions: The use of human brain tissue in postmortem studies of schizophrenia must be linked to standardised diagnostic assessment procedures. Diagnoses can be upgraded with the development of new criteria, providing sufficient clinical data is available in case histories.
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Wallace, Cameron, Paul E. Mullen, Philip Burgess, Simon Palmer, David Ruschena, and Chris Browne. "Serious criminal offending and mental disorder." British Journal of Psychiatry 172, no. 6 (June 1998): 477–84. http://dx.doi.org/10.1192/bjp.172.6.477.
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BackgroundA relationship exists between mental disorder and offending behaviours but the nature and extent of the association remains in doubt.MethodThose convicted in the higher courts of Victoria between 1993 and 1995 had their pyschiatric history explored by case linkage to a register listing virtually all contacts with the public psychiatric services.ResultsPrior psychiatric contact was found in 25% of offenders, but the personality disorder and substance misuse accounted for much of this relationship. Schizophrenia and affective disorders were also over-represented, particularly those with coexisting substance misuse.ConclusionsThe increased offending in schizophrenia and affective illness is modest and may often be mediated by coexisting substance misuse. The risk of a serious crime being committed by someone with a major mental illness is small and does not justify subjecting them, as a group, to either increased institutional containment or greater coercion.
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Schosser, A., D. Gaysina, S. Cohen-Woods, P. C. Chow, L. Martucci, N. Craddock, A. Farmer, et al. "Association of DISC1 and TSNAX genes and affective disorders in the depression case–control (DeCC) and bipolar affective case–control (BACCS) studies." Molecular Psychiatry 15, no. 8 (March 3, 2009): 844–49. http://dx.doi.org/10.1038/mp.2009.21.
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da Silva, Joaquim, Manuel Gonçalves-Pereira, Miguel Xavier, and Elizabeta B. Mukaetova-Ladinska. "Affective disorders and risk of developing dementia: systematic review." British Journal of Psychiatry 202, no. 3 (March 2013): 177–86. http://dx.doi.org/10.1192/bjp.bp.111.101931.
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BackgroundAffective disorders are associated with cognitive disturbances but their role as risk factors for dementia is still not fully investigated.AimsTo evaluate the risk of developing dementia in individuals with a history of affective disorder.MethodWe conducted a systematic review of case-control and cohort studies addressing the risk of developing dementia in people with affective disorders. To the best of our knowledge, this is the first systematic review that has included studies evaluating this risk specifically in people with bipolar disorder.ResultsFifty-one studies were included. Most of the studies found an increased risk for developing dementia in individuals with depression. Greater frequency and severity of depressive episodes seem to increase this risk. The evidence is contradictory regarding whether there is a difference in risk in people with early- or late-onset depression. The few available risk estimates for dementia in people with bipolar disorder suggest an even higher risk than for those with depression.ConclusionsAffective disorders appear to be associated with an increased risk of developing dementia, and one that is dependent on clinical and demographic variables. Depression may be both a prodrome and a risk factor for dementia. Future research should aim to elucidate the mechanisms that mediate these links.
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Balestrieri, M., P. Williams, and M. Tansella. "4. Affective disorders at the general and specialist levels of care." Psychological Medicine. Monograph Supplement 19 (1991): 35–39. http://dx.doi.org/10.1017/s0264180100000266.
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The socio-demographic characteristics and the distribution of affective disorders have been investigated in several epidemiological studies. Some of them have been conducted on community samples or in general practice settings, while others have been based on in-patient admissions or on contacts with psychiatric services (case register studies).
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Peixoto, I., C. Santos, M. Sousa, and S. Pimenta. "Catatonic features in adolescence: Interfaces with affective disorders." European Psychiatry 33, S1 (March 2016): S356. http://dx.doi.org/10.1016/j.eurpsy.2016.01.1273.
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IntroductionCatatonia is a potentially life-threatening but treatable neuropsychiatric syndrome. The prevalence of catatonia in children and adolescents is probably underestimated since investigation on this matter is still lacking. Different studies have led to the recognition of catatonia as a separate psychiatric entity, as reflected in DSM-5, renewing interest on this subject. While in the adult population there is evidence highlighting the strong association between catatonia and affective disorders, this has been poorly reflected in child and adolescent psychiatry literature. In fact, most of the research in this population focuses on associations with organic, psychotic or developmental disorders.ObjectivesWe aim to illustrate the diagnostic challenges when facing an adolescent with catatonia encompassing psychiatric, neurologic and immunologic factors known as possible causes for this condition. We aim to explain the diagnostic procedure and the possible clinical results of this workup, as well as raise the discussion around treatment options.MethodsWe used a clinical case vignette of a 14-year-old adolescent, presenting with a stress-induced catatonic syndrome and depressive symptoms without any prior organic or psychiatric condition. We reviewed the most relevant literature in order to contextualize our clinical case.Results and conclusionCatatonia is an under-recognized condition in children and adolescents without a prior medical or psychiatric condition, especially when associated with affective disorders. The inclusion of catatonia as a specific syndrome in the psychiatric nosography may help its recognition. Case reports on this matter are therefore especially important as a way of pushing clinical investigation on this matter forward.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Mesquita, Maria Eugênia, Maria Eliza Finazzi, Bruno Gonçalves, Lee Fu-I, Leandro L. Duarte, José Ricardo Lopes, José Alberto Del-Porto, and Luiz Menna-Barreto. "Activity/rest rhythm of depressed adolescents undergoing therapy: case studies." Trends in Psychiatry and Psychotherapy 38, no. 4 (December 2016): 216–20. http://dx.doi.org/10.1590/2237-6089-2015-0053.
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Abstract Introduction: Disorders of circadian rhythms have been reported in studies of both depressed children and of depressed adolescents. The aim of this study was to evaluate whether there is a relationship between the 24-hour spectral power (24h SP) of the activity/rest rhythm and the clinical course of depression in adolescents. Methods: Six 14 to 17-year-old adolescents were recruited for the study. They were all suffering from major depressive disorder, according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria, as identified by the Schedule for Affective Disorders and Schizophrenia for School Aged Children: Present and Lifetime Version (K-SADS-PL). Depressive symptoms were assessed using the Children's Depression Rating Scale - Revised (CDRS-R) and clinical evaluations. Locomotor activity was monitored over a period of 13 consecutive weeks. Activity was measured for 10-minute periods using wrist-worn activity monitors. All patients were prescribed sertraline from after the first week up until the end of the study. Results: We found a relationship between high CDRS values and low 24-hour spectral power. Conclusions: The 24h SP of the activity/rest rhythm correlated significantly (negatively) with the clinical ratings of depression.
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Surtees, P. G., and S. P. Sashidharan. "The epidemiology of affective disorders: national secular trends and local findings." Psychiatry and Psychobiology 4, no. 5 (1989): 287–98. http://dx.doi.org/10.1017/s0767399x00000195.
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SummaryThis paper examines aspects of the epidemiology of affective disorders in Scotland. Results from 3 investigations are described, each one indicative of a particular research approach (the use of national, case-register and direct-interview based data). In Part I of the paper secular trends in Scottish national and local (Edinburgh city) first admission rates of affective disorders, based upon ICD-9, are examined. The results, based upon the national data, show that during the last two decades the male admission rate declined by 29.4% and the female rate by 37.3%. However, the female rate has remained 1.8 to 2.2-fold that of the male rate throughout this period. Further investigation of these changes was undertaken after dividing the affective disorder category into either the “affective psychoses” or the “depressive neuroses”. Results revealed that whilst there was only a slight change in the Scottish national rate of affective psychoses, marked decreases in rates were revealed for the depressive neuroses for both sexes (males by 39.4% and females by 39.3%). Age-specific secular trends also demonstrated the extent to which the older age groups of both sexes experienced the highest rates of affective psychoses.Results based upon first admissions for affective disorder to the Royal Edinburgh Hospital over the years 1976-1987 showed that the overall male rate had remained relatively unchanged, whilst that for females had declined by about 24%. Subsequent analysis showed that the rates for affective psychoses had declined over the 12 years to a level which for the females was close to the national rate but that the male rate for these conditions had remained (in 1985) at 70% above the Scottish national rate.Part II of this paper presents results from two further studies concerned with investigating rates of affective disorder amongst women. The first of these was a general population survey of a random sample, the second a hospital study. Both studies were designed to be complementary, in that each was based upon samples of women living in the same geographical area of Edinburgh city. Results revealed that the hospital prevalence estimate for affective disorders was only about 1% of the community estimate, but over 5% of the community inception rate. Analyses examining the demographic correlates of affective disorders revealed the extent to which age and marital status differentially determined the ease with which women entered hospital care. Results revealed that being single and of older age was associated with an increased chance of receiving treatment for women with affective disorders.
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Kessing, Lars Vedel, Tom Gert Bolwig, Per Kragh Andersen, and Preben Bo Mortensen. "Recurrence in affective disorder." British Journal of Psychiatry 172, no. 1 (January 1998): 23–28. http://dx.doi.org/10.1192/bjp.172.1.23.
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BackgroundIn recent years, studies of the risk of recurrence in affective disorder in relation to the number of prior episodes have given contradictory results.MethodSurvival analysis was used to calculate the rate of recurrence after successive episodes in a case register study including all hospital admissions with primary affective disorder in Denmark during 1971–1993. A total of 20 350 first-admission patients were discharged with a diagnosis of affective disorder, depressive or manic/cyclic type.ResultsThe rate of recurrence increased with the number of previous episodes in both unipolar and bipolar disorder. Initially, the two types of disorders followed markedly different courses, but later in the course of the illness the rate of recurrence was the same for the two disorders.ConclusionsThe course of severe unipolar and bipolar disorder seems to be progressive in nature despite the effect of treatment.
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Preve, M., P. Salvatore, M. Mula, E. Favaretto, M. Godio, R. Traber, and R. A. Colombo. "Towards a redefinition of dissociative spectrum dimensions inside Capgras and misidentification syndromes in bipolar disorder: Case series and literature review." European Psychiatry 33, S1 (March 2016): S124. http://dx.doi.org/10.1016/j.eurpsy.2016.01.163.
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IntroductionMisidentification phenomena and Capgras Syndrome (CS) occur in different psychiatric (psychotic or major affective illnesses) and neurological (traumatic brain injury, epilepsy, neurosyphilis, etc.) disorders [1,2]. The aim of this report is to redefine dissociative spectrum dimensions inside CS and misidentification syndromes in patients with Bipolar Disorder (BD).MethodFive inpatients were assessed with the SCID-P, SCID-DER, DSS, HRSD, YMRS, a neurological and general medicine review, a first-level brain imaging examination (CT and/or MRI). We conducted a systematic literature review (PubMed, Embase, PsychInfo) using the key terms “Capgras Syndrome” and “Misidentificaition”.ResultsAll patients were diagnosed with type-I BD and had concomitant CS that presented with misidentification phenomena in the context of psychotic mixed state. They reported high scores for autopsychic and affective depersonalization symptoms as well as high SCI-DER (mean = 24.4) and DSS (mean = 13) total scores.Discussion and conclusionTo our knowledge in literature, there are not studies that evaluated dissociative spectrum symptoms in CS in BD. This condition of identity and self fragmentation could be the key to shedding light on the interconnection between affective and non-affective psychotic disorders from schizophrenia to BD, and may underscore the possible validity of the concept of the unitary psychosis proposed by Griesinger [3–5]. Further research is warranted to replicate our clinical and qualitative observations and, in general, quantitative studies in large samples followed up over time are needed. Methodological limitations are considered.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Safonova, N. Yu, M. R. Sapronova, O. A. Gavrilyuk, T. E. Popova, and A. A. Tappakhov. "Prevalence of non-motor disorders in Parkinson`s disease." Personalized Psychiatry and Neurology 1, no. 2 (November 14, 2021): 117–25. http://dx.doi.org/10.52667/2712-9179-2021-1-2-117-125.
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(1) Background: to reveal the prevalence of non-motor disorders in Parkinson’s disease (PD), we analyzed both Russian and international studies on the issue of PD-associated non-motor disorders in Caucasian patients; (2) Methods: We have carried out a search for full-text Englishand Russian-language articles published during the last ten years (from 2010 to 2020) in PubMed, Scopus, Web of Science, Springer, Clinical case, and E-library databases using multiple versions of keywords and their combinations. (3) Results: General prevalence of PD-associated non-motor disorders proved to be high. At the same time, we did not find significant differences between the prevalence of cognitive, affective, or behavioral disorders in PD patients. However, depression was found to be more common in PD patients in the Russian Federation; (4) Conclusions: According to the results of our review, cognitive and affective disorders in PD represent the issues of major concern.
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Pinto, Jairo Vinícius, Gayatri Saraf, Christian Frysch, Daniel Vigo, Kamyar Keramatian, Trisha Chakrabarty, Raymond W. Lam, Márcia Kauer-Sant’Anna, and Lakshmi N. Yatham. "Cannabidiol as a Treatment for Mood Disorders: A Systematic Review." Canadian Journal of Psychiatry 65, no. 4 (December 13, 2019): 213–27. http://dx.doi.org/10.1177/0706743719895195.
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Objective: To review the current evidence for efficacy of cannabidiol in the treatment of mood disorders. Methods: We systematically searched PubMed, Embase, Web of Science, PsychInfo, Scielo, ClinicalTrials.gov , and The Cochrane Central Register of Controlled Trials for studies published up to July 31, 2019. The inclusion criteria were clinical trials, observational studies, or case reports evaluating the effect of pure cannabidiol or cannabidiol mixed with other cannabinoids on mood symptoms related to either mood disorders or other health conditions. The review was reported in accordance with guidelines from Preferred Reporting Items for Systematic reviews and Meta-Analyses protocol. Results: Of the 924 records initially yielded by the search, 16 were included in the final sample. Among them, six were clinical studies that used cannabidiol to treat other health conditions but assessed mood symptoms as an additional outcome. Similarly, four tested cannabidiol blended with Δ-9-tetrahydrocannabinol in the treatment of general health conditions and assessed affective symptoms as secondary outcomes. Two were case reports testing cannabidiol. Four studies were observational studies that evaluated the cannabidiol use and its clinical correlates. However, there were no clinical trials investigating the efficacy of cannabidiol, specifically in mood disorders or assessing affective symptoms as the primary outcome. Although some articles point in the direction of benefits of cannabidiol to treat depressive symptoms, the methodology varied in several aspects and the level of evidence is not enough to support its indication as a treatment for mood disorders. Conclusions: There is a lack of evidence to recommend cannabidiol as a treatment for mood disorders. However, considering the preclinical and clinical evidence related to other diseases, cannabidiol might have a role as a treatment for mood disorders. Therefore, there is an urgent need for well-designed clinical trials investigating the efficacy of cannabidiol in mood disorders.
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Baxter, David, and Louis Appleby. "Case register study of suicide risk in mental disorders." British Journal of Psychiatry 175, no. 4 (October 1999): 322–26. http://dx.doi.org/10.1192/bjp.175.4.322.
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BackgroundThere have been few large-scale studies of long-term suicide risk in mental disorders in the UK.AimsTo estimate the long-term risk of suicide in psychiatric patients.MethodA sample of 7921 individuals was identified from the Salford Psychiatric Case Register. Mortality by suicide or undetermined external cause during a follow-up period of up to 18 years was determined using the NHS Central Register; suicide risks were estimated as rate ratios.ResultsSuicide risk was increased more than ten-fold in both genders: the rate ratio for males was 11.4; for females it was 13.7. The risk was highest in young patients, but high risk continued into late life. The diagnoses with the highest risk were schizophrenia, affective disorders, personality disorder and (in males) substance dependence. Risk was also associated with recent initial contact and number of admissions but not comorbidity.ConclusionsThe suicide risks estimated in this study are generally higher than those previously reported, notably in schizophrenia and personality disorder, and in previous in-patients. Patients with these high-risk diagnoses, an onset of illness within the previous 1–3 years, or more than one previous admission should be regarded as priority groups for suicide prevention by mental health services.
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Wolf-Meyer, Matthew. "Neurological disorders, affective bioethics, and the nervous system: reconsidering the Schiavo case from a materialist perspective." Medical Humanities 46, no. 3 (April 6, 2019): 166–75. http://dx.doi.org/10.1136/medhum-2018-011568.
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This article proposes a novel approach to bioethics, referred to as “affective bioethics”, which draws on traditions in anthropology, science and technology studies, disability studies, and Spinozist materialism. By focusing on the case of Michael and Terri Schiavo, in which Terri’s personhood and subjectivity are challenged by dominant forms of neurological reductivism in the USA, this article suggests that approaching her condition as a set of relations with the people in her life and her socio-technical environment may have helped to develop new ways to conceptualise personhood and subjectivity moving beyond the view of her as a non-person. Drawing on Michael Schiavo’s memoir of his legal battles, and Terri’s diagnosis and care, this article shows how Terri’s connections to the world disrupt American ideas about the isolatable individual as the basis for personhood and subjectivity. Attending to these interpersonal and socio-technical connections focuses bioethical attention on the worlds that individuals inhabit, and how those worlds might be designed to make more kinds of life livable and new forms of personhood and subjectivity possible.
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Ramirez, Nicolas, Belén Arranz, Carmen Martín, and Luis San. "Combined use of platelet serotonergic markers and psychopathological scales as diagnostic screening of a psychotic versus a depressive disorder." European Psychiatry 18, no. 7 (November 2003): 369–71. http://dx.doi.org/10.1016/j.eurpsy.2003.06.005.
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AbstractA single case of a patient suffering from a first psychotic episode and the differential diagnoses between affective and psychosis is performed throughout the combined use of peripheral serotonergic markers and clinical psychopathological scales during a 6-months follow-up. The results suggest the need of performing further studies combining biological and clinical markers of psychiatric disorders.
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Mirijello, Antonio, Maria Maddalena D’Errico, Serafino Curci, Fabrizio Bossa, Cristina d’Angelo, Gianluigi Vendemiale, Antonio Gasbarrini, Giovanni Addolorato, and Salvatore De Cosmo. "Takotsubo Syndrome and Inflammatory Bowel Diseases: Does a Link Exist?" Digestive Diseases 38, no. 3 (August 13, 2019): 204–10. http://dx.doi.org/10.1159/000502088.
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Background: Takotsubo syndrome (TTS) is an acute cardiac dysfunction in the absence of viral causes or obstructive coronary disease completely reversible within 4–8 weeks. Inflammatory bowel diseases (IBD) are a group of diseases caused by the interaction between immune system, genetic, and environmental factors against intestinal mucosa. Both these syndromes are characterized by complex mechanisms involving endothelial dysfunction and affective disorders. Aim: To assess the possibility of an association between IBD and TTS. Methods: First, we present a case of TTS in a patient affected by active stenosing Crohn’s disease. Articles in English language were collected from PubMed and Google Scholar databases with the search terms “takotsubo,” “IBD,” “crohn disease,” “ulcerative colitis”. Results: Both TTS and IBD show multiple common features: preference for female patients, recurrent course of disease, association with endothelial dysfunction, and affective disorders. Patients affected by IBD could show specific triggers for TTS, such as malabsorption, electrolytes disturbances, and affective disorders. Conclusions: Despite pathophysiological similarities between TTS and IBD in active phase, future studies are needed to confirm this apparently possible association and to assess the presence of a pathophysiological link between these diseases.
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Siracusano, R., E. Germanò, T. Calarese, A. Magazù, V. Cigala, M. Lamberti, E. Spina, and A. Gagliano. "Aripiprazole in children with multiple-complex developmental disorder (McDD): a case series." European Psychiatry 26, S2 (March 2011): 1284. http://dx.doi.org/10.1016/s0924-9338(11)72989-3.
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IntroductionMultiple-complex Developmental Disorder (McDD) is a developmental disorder characterized by peculiar clinical features: affective dysregulation (anxiety, panic and aggressivity), impairment of social behaviour and hypersensitivity, impaired cognitive processing. McDD is usually included within the Pervasive Developmental Disorders not otherwise specified (PDD NOS) (Cohen et al. 1986; Towbin et al. 1993). Aripiprazole is a new atypical antipsychotic drug. Efficacy of aripiprazole in children and adolescents is supported by some studies (Findling et al. 2007, Wink at al 2010; Kim et al 2010).AimsThe aim of our study is to describe the efficacy and safety of aripiprazole in 4 children with Multiple-complex Developmental Disorder.MethodsMean dosage of aripiprazole was 5 mg/day. Response was evaluated by clinical assessment and by Clinical Global Impressions Scale-Severity, Clinical Global Impressions Scale- Improvement, Children's Global Assessment Scale (CGAS) and by Brief Psychiatric Rating Scale. This assessment was administered at baseline, and at weeks 4, 12 and 24.ResultsA significant reduction of social impairments, thought disorders and affective dysregulation was observed. Drug therapy was well tolerated, even though children complained of mild and transient nausea and somnolence.ConclusionTo date there are only a few reports on the use of aripiprazole in McDD patients. The present case series suggest that aripiprazole may be effective and well tolerated in McDD patients.
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Milosevic, Luka, Robert F. Dallapiazza, Renato P. Munhoz, Suneil K. Kalia, Milos R. Popovic, and William D. Hutchison. "Case Studies in Neuroscience: Lack of inhibitory synaptic plasticity in the substantia nigra pars reticulata of a patient with lithium-induced tremor." Journal of Neurophysiology 122, no. 4 (October 1, 2019): 1367–72. http://dx.doi.org/10.1152/jn.00203.2019.
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Tremor is a well-known side effect from many psychiatric medications, including lithium and dopamine antagonists. In patients whose psychiatric symptoms are stabilized and only respond to certain medications, deep brain stimulation may offer relief of the consequent motor complications. We report the case of an elderly male with disabling tremor related to lithium therapy for bipolar affective disorder, who was subsequently treated with deep brain stimulation. In this patient, we obtained recordings from the substantia nigra pars reticulata and performed a high-frequency stimulation protocol that robustly elicits long-term potentiation (LTP)-like changes in patients with Parkinson’s disease. We hypothesized that in this patient, who did not have Parkinson’s disease, the levels of inhibitory plasticity would be much greater. However, we found an unanticipated lack of plasticity in the patient with lithium-induced tremor, compared with two de novo control patients with Parkinson’s disease. This patient was successfully treated with deep brain stimulation in the vicinity of the ventral oral posterior nucleus, an area of the thalamus that receives inputs from the basal ganglia. We postulate that the lithium-induced blockade of LTP may bring about motor complications such as tremor while simultaneously contributing to the therapeutic mechanism for treating the symptoms of psychiatric disorders such as bipolar affective disorder. NEW & NOTEWORTHY Use of a dual-microelectrode technique enabled us to compare long-term potentiation (LTP)-like changes in a patient with lithium-induced tremor to that of patients with Parkinson’s disease. This study corroborated the findings in rodent brain slices that chronic lithium treatment may block LTP. Whereas a deficit in LTP may underlie the therapeutic mechanism for treating psychiatric disorders such as bipolar affective disorder, it may simultaneously contribute to consequent appearance of tremor.
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Cerejeira, J. Gonçalves, I. Santos Carrasco, C. Capella Meseguer, E. Rodríguez Vázquez, M. Óscar, M. Queipo De Llano, G. Guerra Valera, and A. Gonzaga Ramírez. "Covid 19, lockdown and brief psychotic disorders." European Psychiatry 64, S1 (April 2021): S543. http://dx.doi.org/10.1192/j.eurpsy.2021.1448.
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IntroductionAcute and transient psychotic disorders are a rare condition entity as the sudden appearance of affective, confusional symptoms and paranoia triggered by some psychological trauma. The current pandemic caused by COVID-19 is an important psychological stressor that could favor the appearance of acute psychotic disorders. Several studies have been recently published proposing that the multifactorial stress associated with lockdown could function as a catalyst for acute psychotic disorders.ObjectivesTo present a case of a brief psychotic disorder during the national lockdown in Spain and to review the literature about the relationship between the current pandemic and psychosis.MethodsWe will present a case report and a literature review.ResultsWe report a case of a 27-year-old woman, with no previous psychiatric history. Three weeks after the start of Spain lockdown sudden symptoms appeared with psychomotor restlessness, confused speech, emotional lability, thought blocking and persecutory and referential delusions. Physical exam, blood analysis and cerebral CT scan with no alterations. Treatment was performed with aripiprazole 10 mg and lorazepam 1 mg daily with clinical improvement in one weeks. She was diagnosed of Acute transient psychotic disorder.ConclusionsStressful life events that can trigger psychosis in vulnerable individuals and the current pandemic and lockdown context could favor the appearance of acute psychotic disorders. The case reported here is in line with other current studies that show a preliminary intuition of this trend.
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El-Guebaly, N. "Risk Research in Affective Disorders and Alcoholism: Epidemiological Surveys and Trait Markers." Canadian Journal of Psychiatry 31, no. 4 (May 1986): 352–61. http://dx.doi.org/10.1177/070674378603100415.
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Traditional designs in risk research have been in the form of epidemiologic surveys aimed at assessing a genetic contribution or search for broader indicators of vulnerability, resulting from the interaction of both nature and nurture. Recently, an interest in biological markers has resulted in the search for possible trait markers identifying more specifically, individuals with a life-long risk for an illness that may be expressed or not. The contributions, limitations and evolution of these strategies are reviewed in the syndromes of affective disorders and alcoholism. Recommendations include the use of biotypes rather than phenomenotypes for the diagnosis of the index case. Current promising approaches include the study of pedigrees biased towards a particular variable, a discriminant analysis of the variation in expressivity of the syndrome and the genetic linkage studies. While there is so far no established trait marker, research strategies are emerging and withstanding the test of time. The present technological explosion will undoubtedly further our understanding of risk factors.
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Poynton, A., P. K. Bridges, and J. R. Bartlett. "Resistant Bipolar Affective Disorder Treated by Stereotactic Subcaudate Tractotomy." British Journal of Psychiatry 152, no. 3 (March 1988): 354–58. http://dx.doi.org/10.1192/bjp.152.3.354.
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The results of stereotactic subcaudate tractotomy in nine patients with resistant bipolar affective disorder are presented in the form of a single case study with a summary of the other eight cases. Follow-up studies at 2–4 years showed substantial improvement in five patients and amelioration of symptoms in a further four patients, with a tendency for a greater improvement in the manic than in the depressive episodes. These preliminary results suggest that there is a place for this operation in the management of severe bipolar affective disorders which are not responding to any other treatment, although decisive recovery occurs less often than with unipolar depression.
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Lilford, Philippa, and Julian C. Hughes. "Epidemiology and mental illness in old age." BJPsych Advances 26, no. 2 (February 24, 2020): 92–103. http://dx.doi.org/10.1192/bja.2019.56.
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SUMMARYThis is an overview of epidemiology relevant to mental health problems in old age. We start by reviewing some basic terminology: the definitions of prevalence and incidence; the difference between descriptive and analytical epidemiology; the differences between study designs, including cross-sectional, case–control and cohort studies. We then cover the main epidemiological features of the major psychiatric diseases that affect older people (dementia and its different types, depression, late-onset schizophrenia, bipolar affective disorder, delirium, anxiety-related disorders, eating disorders, alcohol and substance misuse, personality disorders) and suicide.We end with some descriptive statistics regarding quality of life in older people.
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Baxter, D. N. "The Mortality Experience of Individuals on the Salford Psychiatric Case Register." British Journal of Psychiatry 168, no. 6 (June 1996): 772–79. http://dx.doi.org/10.1192/bjp.168.6.772.
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BackgroundSeveral studies, mainly non-UK based, have reported higher than expected mortality for individuals with mental illness. This investigation in Salford (England) was undertaken to determine local experiences.MethodAn historical cohort design was employed with record linkage to determine status at study end: maximum follow-up was 18 years. All 6952 individuals with schizophrenia, neuroses, affective or personality disorders, enrolled on the psychiatric case register between 1 January 1968 and 31 December 1975 were recruited: there were 199 exclusions. Death was the study end-point.ResultsObserved mortality was 65% higher than expected and elevated throughout the whole of follow-up. Mortality was highest in younger ages, females and subjects born locally. Circulatory disorders, injury and poisoning each caused approximately one-third of the excess deaths.ConclusionsDocumenting mortality risk has important applications for prioritisation, resource allocation, developing control programmes, evaluating service effectiveness, disease forecasting and future research.
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Romero-Godoy, Rosalinda, Sara Raquel Romero-Godoy, Manuel Romero-Acebal, and Mario Gutiérrez-Bedmar. "Psychiatric Comorbidity and Emotional Dysregulation in Chronic Tension-Type Headache: A Case-Control Study." Journal of Clinical Medicine 11, no. 17 (August 30, 2022): 5090. http://dx.doi.org/10.3390/jcm11175090.
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Background: Chronic tension-type headache (CTTH) is frequently associated with a psychiatric comorbidity of depression and anxiety. Most studies focus their attention on this association, and only few link CTTH with psycho-affective emotional regulation disorders. Objective: To evaluate the association of CTTH with anxiety, depression, positive and negative affectivity, and emotional management in CTTH patients with neither a previous diagnosis of psychiatric disorder nor use of psychoactive drugs or abuse of analgesics. Design: Case-control study. Methods: Validated scores for state and trait anxiety, depression, positive and negative state and trait affect, cognitive reappraisal, and expressive suppression were assessed in 40 subjects with CTTH and 40 healthy subjects. Associations between CTTH and psychological status were assessed through linear multivariate regression models. Results: CTTH was associated with higher scores for depression (Beta = 5.46, 95% CI: 1.04–9.88), state and trait anxiety (Beta = 12.77, 95% CI: 4.99–20.56 and Beta = 8.79, 95% CI: 2.29–15.30, respectively), and negative state affect (Beta = 5.26, 95% CI: 0.88–9.64). Conclusions: CTTH is directly associated with depression, anxiety, and negative affectivity signs despite the absence of a previously diagnosed psychiatric disorder or psychopharmacological intake. The recognition of these comorbid and psycho-affective disorders is essential to adapt the emotional management of these patients for better control.
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Mallol Castaño, L., P. Del Sol Calderón, and R. Paricio Del Castillo. "Electroconvulsive therapy in children and adolescents: a case report." European Psychiatry 65, S1 (June 2022): S434—S435. http://dx.doi.org/10.1192/j.eurpsy.2022.1103.
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Introduction Electroconvulsive therapy is a proven treatment for mood and psychotic disorders in adult patients. It is estimated that in children and adolescents this type of therapy is underutilised despite the fact that the most recent studies have supported the success of ECT in these patients. A case is described of a 15-year-old male patient diagnosed with psychotic disorder who was previously treated with several antipsychotics, including clozapine, and finally treated with electroconvulsive therapy. Objectives Review of the clinical indications of electroconvulsive therapy in children and adolescents with psychotic or mood disorders through a clinical case of a patient admitted to a Psychiatric Short Stay Unit Methods Detailed psychopathological description of the case as well as the treatments used (psychotropic drugs and electroconvulsive therapy). Results After the administration of electroconvulsive therapy, an improvement in both positive and negative psychotic symptomatology was observed, with a decrease in soliloquies and an improvement in affective flattening. Conclusions Electroconvulsive therapy is an effective treatment in adolescent patients with psychotic and mood disorders, which should be considered as indicated as an effective treatment. Disclosure No significant relationships.
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Stafford, Jean, Robert Howard, and James B. Kirkbride. "The incidence of very late-onset psychotic disorders: a systematic review and meta-analysis, 1960–2016." Psychological Medicine 48, no. 11 (December 4, 2017): 1775–86. http://dx.doi.org/10.1017/s0033291717003452.
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A substantial subset of people with psychotic disorders are first diagnosed in old age, yet little is known about the epidemiology of very late-onset schizophrenia-like psychosis. We investigated the incidence of affective and non-affective psychotic disorders in those aged 65 and above, and examined variation related to potential risk factors via systematic literature review. We searched PubMed, PsychInfo, Web of Science and bibliographies and directly contacted authors to obtain citations published between 1960 and 2016 containing (derivable) incidence data. Cases were those diagnosed with non-organic psychotic disorders after age 65. Findings were presented narratively, and random-effects meta-analyses were used to obtain pooled incidence rates. From 5687 citations, 41 met inclusion criteria. The pooled incidence of: affective psychoses was 30.9 per 100 000 person-years at risk (100 kpy) [95% confidence interval (CI) 11.5–83.4; I2 = 0.99], and schizophrenia was 7.5 per 100 kpy (95% CI 6.2–9.1; I2 = 0.99), with some evidence of higher schizophrenia rates in women [odds ratio (OR) = 1.6; 95% CI 1.0–2.5, p = 0.05]. We found narrative evidence of increasing incidence rates of non-affective psychoses with age, and higher rates amongst migrants than baseline populations, but no evidence that incidence varied by study quality or case ascertainment period (quality OR = 1.04; 95% CI 0.74–1.48; time period OR = 1.00; 95% CI 0.95–1.05). Substantial heterogeneity in the incidence of very late-onset schizophrenia-like psychoses was observed. No identified studies examined possible risk factors which may account for such variation, including socio-economic status, sensory impairment, traumatic life events, or social isolation.
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Whiskey, Eromona, and David Taylor. "Pramipexole in unipolar and bipolar depression." Psychiatric Bulletin 28, no. 12 (December 2004): 438–40. http://dx.doi.org/10.1192/pb.28.12.438.
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Aims and MethodTo review the evidence for this use of pramipexole in the treatment of unipolar and bipolar depression, a literature search on Embase and Medline was conducted in December 2003. The search was updated in July 2004. The reference sections of retrieved papers were searched for further relevant references.ResultsThere are limited data on the clinical use of pramipexole in affective disorders. Only two double-blind trials in bipolar depression and one in unipolar depression were retrieved. Most information is in the form of case reports and open studies. No dose-response relationships have been established and a wide range of doses has been employed in the reports.Clinical ImplicationsIn view of the fact that the evidence for the use of pramipexole is still limited at the time of writing, its routine clinical use cannot be recommended. The data appear promising, but further research is required to determine its role in affective disorders.
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Ballesteros, A., A. Petcu, B. Cortés, L. Montes, F. Inchausti, W. Jaimes, J. Collantes, and B. Zubizarreta. "Differentiating Between Bipolar Affective Disorder (Bd) and Borderline Personality Disorder (BPD) – a Clinical Case." European Psychiatry 33, S1 (March 2016): S504. http://dx.doi.org/10.1016/j.eurpsy.2016.01.1854.
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IntroductionRecent studies suggest that Borderline Personality Disorder (BPD) could be regarded as an affective disorder within the Bipolar Affective Disorder (BP) spectrum. This is supported by evidence suggesting a clinical/neurobiological overlap between these two disorders. The Temperament and Character Inventory Revised (TCI-R) may help differentiate between the two disorders and orientate the clinical approach, considering the evidence of the medium-term temporal stability of TCI-R in a clinical population.ObjectiveWe present a clinical case diagnosed with BD which underwent testing using TCI-R. TCI-R orientated towards a secondary diagnosis of BPD and the case further received a course of Dialectical Behavior Therapy (DBT) which led to clinical improvement. We therefore study the usefulness of TCI-R in this clinical setting.AimsTo study whether TCI-R may help differentiate between BD and BPD in mood stabilized patients.MethodOur patient is a 52-year-old married male diagnosed with BD. Considering his clinical features of impulsivity/instability of behaviors and pathological interpersonal relationships, patient was started on individual DBT (fortnightly, 4 months). Psychotropic treatment (paroxetine 30 mg/day, lithium 1000 mg/day, aripiprazole 15 mg/day) was not modified.ResultsTCI-R scores: harm avoidance (100%), novelty seeking (53%), reward dependence (20%), persistence (18%), self-directedness (1%), cooperativeness (2%) and self-transcendence (48%). After 4 months of therapy, the patient improved in distress tolerance, acceptance, behavioral activation and assertiveness.ConclusionsTCI-R is an inventory for personality traits in which character scores differ markedly between PD and non-PD patients. It is a useful tool in BPD patients orientating the clinician in the differential diagnosis and the treatment approach.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Ballesteros, A., Á. S. Rosero, F. Inchausti, E. Manrique, H. Sáiz, C. Carlos, and Z. María. "Clinical case: Phelan–McDermid and pharmacological management." European Psychiatry 41, S1 (April 2017): S430. http://dx.doi.org/10.1016/j.eurpsy.2017.01.410.
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IntroductionThe Phelan–McDermid syndrome is a chromosomal disorder consisting of a selection on chromosome 22q13.3 associated psychiatric and emotional level, behavioral and traits of autism spectrum disorders. During the neurodevelopmental such chromosomal deletion, which associated with haplo insufficiency Shank 3 causes alterations in the synaptogenesis altering the balance of activating and inhibitory transmission. Throughout the various studies, it is considered that this syndrome has a psychiatric disorder bipolar like.Case presentationHere, we present s 13-year-old female diagnosed with autism spectrum disorders in childhood and presented regression with catatonia features and behavioral disorders. Interestingly, she presented mutation/microdeletion of the SHANK3 gene, inducing a premature stop codon in exon 21. Different pharmacological treatments (antipsychotics at high doses and benzodiazepines) failed to improve clinical symptoms and lead to multiple adverse events. In contrast, lithium therapy reversed clinical regression, stabilized behavioral symptoms and allowed patients to recover their pre-catatonia level of functioning. After the first menstruation there was a cycling psychiatric worsening with a similar clinical pattern so risperidone as adjunctive therapy. As a result of this, this patient recovered clinical and socio-functional stability.ConclusionsThey are previous cases where there affective and behavioral improvement after use of mood stabilizer molecules such as valproate or lithium. There is also evidence of the benefit of risperidone low to have a beneficial effect on the balance of activatory and inhibitory transmission level doses of NMDA receptors.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Kruijt, Anne-Wil, Peter Putman, and Willem Van der Does. "A Multiple Case Series Analysis of Six Variants of Attentional Bias Modification for Depression." ISRN Psychiatry 2013 (March 21, 2013): 1–8. http://dx.doi.org/10.1155/2013/414170.
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Background. Attention bias modification (ABM) is a new treatment for affective disorders. A meta-analysis of ABM for anxiety disorders showed that the effect size may be large but the number of studies is low. The working mechanism is still unclear, and little is known about the optimal treatment parameters. ABM for depression is much less studied. A few studies claimed positive effects but the sample sizes are low. Furthermore, the treatment parameters varied widely and differed from the anxiety literature. Aim. To select the most promising version of ABM for depression for further evaluation in clinical trials. Methods. Multiple case series design. We tested six versions of ABM that varied on stimulus duration and training direction. Thirty students with mild to moderate symptoms of depression underwent four sessions of ABM. Change of attentional bias was measured during each session. Generalization of treatment effects and the role of awareness of receiving training were also investigated. Results. None of the investigated versions of ABM had a consistent effect on attentional bias. Changes of attentional bias in individual participants the effects did not generalize to untrained stimuli. Conclusion. It is unlikely that any of these ABM versions will have a specific effect on symptoms in controlled studies.
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Zaidi, Muhammad, Anurag Prabhu, Jose Perez Martell, and Sakshi Dhir. "59 “Lithium Damaged My Spine” Might not Be a Delusion After All." CNS Spectrums 24, no. 1 (February 2019): 206–7. http://dx.doi.org/10.1017/s1092852919000464.
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AbstractBackgroundLithium remains to be the drug of choice for treating BPAD for the past few decades. There is extensive literature showing the effectiveness of Lithium when used as a mood stabilizing agent in bipolar spectrum disorders. However significant number of articles show that a third of the patients who receive lithium for their symptomology not only do not show any response but also may show deterioration of their clinical symptoms. (However, research shows that Lithium may negatively affect a third of the patients depending on various factors). The side effect profile of Lithium and especially its neurotoxic effects were discussed in depth in literature over the last decade. Although Lithium remains first choice as maintenance treatment for bipolar affective disorder, about half of all individuals may stop their treatment at some point, despite its proven benefits concerning the prevention of severe affective episodes and suicide.MethodsThe authors performed a systematic literature review to recognize the significance of negative effects of Lithium in a minority of patient population and also comment on the factors influencing patient compliance. We ran a literature search on Pubmed using the following terms: “Lithium” AND (“schizoaffective disorder [MeSH terms]” OR “Bipolar Affective disorder [MeSH terms]” ). Our inclusion criteria were studies which have observed effects of Lithium in schizoaffective patient population or bipolar affective patient population. Studies with other concurrent diagnoses were excluded.Case presentationWe discuss a fifty nine year old male with a history of multiple admissions to a forensic hospital care setting. He initially endorsed a diagnosis of Psychotic disorder NOS which was later changed to schizoaffective disorder during his subsequent admissions. He presented with affective psychotic features where his mood was labile shifting from melancholic to euphoric and a concurrent history of auditory verbal hallucinations. He displayed paranoid non-bizarre persecutory delusions and also alleged that one of his doctors had hated him and put him on Lithium as a form of punishment. He claims that Lithium, as a result, has significantly affected him negatively and also damaged his nerves. This led the authors to explore the significance of use of Lithiumin people with schizoaffective disorders and also bipolar affective disorders. We also discuss the disease course in the patient and his clinical response to use of various psychotropic medications.ConclusionsThe case exemplifies the negative effects of Lithium when used as a mood stabilizer in patient population that is susceptible to its adverse effects due to various factors.
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FORRESTER, A., D. G. C. OWENS, and E. C. JOHNSTONE. "Diagnostic stability in subjects with multiple admissions for psychotic illness." Psychological Medicine 31, no. 1 (January 2001): 151–58. http://dx.doi.org/10.1017/s0033291799003116.
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Background. Although studies investigating changes in diagnosis between psychotic episodes have differed in design, some consistent findings have emerged. This study seeks to clarify and extend these findings by describing and comparing clinical and operationally defined diagnostic stability in a group of subjects with multiple episodes of functional psychotic illness.Methods. The OPCRIT programme was applied to case notes of 204 subjects with multiple admissions for psychotic illness. Clinical and operationally defined diagnoses were compared and the spread and stability of diagnoses determined.Results. An increase in the frequency of diagnosis of schizophrenia from initial to subsequent episodes was demonstrated. High levels of stability were found for schizophrenia (58 to 98%), moderate levels for affective disorders (24 to 83%), low levels for other non-organic psychotic conditions (27 to 54%) and atypical psychosis (27 to 53%), and very low levels for schizoaffective disorder (5 to 39%) and other conditions (0 to 4%).Conclusions. The stability levels for schizophrenia and affective disorders are adequate, but the low levels for a range of other psychotic conditions raise questions regarding their predictive validity.
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Mors, Ole, Henrik Ewald, Douglas Blackwood, and Walter Muir. "Cytogenetic abnormalities on chromosome 18 associated with bipolar affective disorder or schizophrenia." British Journal of Psychiatry 170, no. 3 (March 1997): 278–80. http://dx.doi.org/10.1192/bjp.170.3.278.
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BackgroundA few recent linkage studies have shown a possible locus for bipolar disorder on chromosome 18. Cytogenetic studies may assist in the further localisation of susceptibility loci on this chromosome.MethodA search was made for abnormalities of chromosome 18 in two separate large cytogenetic databases. In Denmark detection of mental illness in subjects with chromosome abnormalities was done by cross-linking the two separate register of psychiatric and chromosome disorders. In Scotland the Cytogenetic Registry of the MRC Human Genetics Unit undertakes long-term clinical follow-up of all cases with chromosome abnormalities.ResultsCross-linking the two Danish register's revealed a family with the rare karyotype abnormality inv(18) (p11.3;q21.1) with one inversion carrier who also suffered from bipolar disorder. In this family there were two other cases of bipolar disorder, but the karyotype of these cases could not be established. One family in Scotland showed a case of schizophrenia in a carrier of inv(18) with the same breakpoints as the Danish family.ConclusionsWe suggest further studies of the 18p11.3 and 18q21.1 regions in order to identify genes involved in bipolar affective disorder and schizophrenia.
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Clauer, Joerg. "Elements of Comprehending Change-Processes in BA." Clinical Journal of the International Institute for Bioenergetic Analysis 26, no. 1 (March 2016): 75–110. http://dx.doi.org/10.30820/0743-4804-2016-26-75.
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On behalf of two case studies this paper aims to present some elements in comprehending change-processes of patients suffering from severe disorders. Knowledge of infant research and neurobiology are used as a blueprint for that. Healing processes are considered to take place on the level of implicit embodied relational knowledge – and embodied resonance (empathy), physical cooperation and rhythms to be fundamental elements. Spatiotemporal, affective and bodily proprioceptive forms of communicative exchange – and less the psychodynamic content – are of fundamental importance to self-development of patients in this perspective.
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Antioch, Iulia, Ovidiu-Dumitru Ilie, Alin Ciobica, Bogdan Doroftei, and Michele Fornaro. "Preclinical Considerations about Affective Disorders and Pain: A Broadly Intertwined, yet Often Under-Explored, Relationship Having Major Clinical Implications." Medicina 56, no. 10 (September 25, 2020): 504. http://dx.doi.org/10.3390/medicina56100504.
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Background: Pain, a distinctive undesirable experience, encompasses several different and fluctuating presentations across varying mood disorders. Therefore, the present narrative review aimed to shed further light on the matter, accounting for both experimental animal models and clinical observations about major depressive disorder (MDD) pathology. Method: Major databases were inquired from inception until April 2016 for records about MDD and pain. Results: Pain and MDD are tightly associated with each other in a bi-directional fashion. Several cross-sectional and retrospective studies indicated a high presence of pain in the context of mood disorders, including MDD (up to 65%), but also increased prevalence rates in the case of mood disorders documented among people with a primary diagnosis of either psychological or somatic pain (prevalence rates exceeding 45%). The clinical implications of these observations suggest the need to account for mood and pain manifestations as a whole rather than distinct entities in order to deliver more effective interventions. Limitations: Narrative review, lack of systematic control groups (e.g., people with the primary diagnosis at review, but not the associated comorbidity as a study) to allow reliable comparisons. Prevalence rates and clinical features associated with pain varied across different studies as corresponding operational definitions did. Conclusions: Pain may have a detrimental effect on the course of mood disorders—the opposite holds. Promoting a timely recognition and management of such an often neglected comorbidity would therefore represent a primary goal toward the delivery of effective, multi-disciplinary care.
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Fitriyani, Fitriyani, Mohamad Syarif Sumantri, and Asep Supena. "Language development and social emotions in children with speech delay: case study of 9 year olds in elementary school." Jurnal Konseling dan Pendidikan 7, no. 1 (May 30, 2019): 23. http://dx.doi.org/10.29210/130600.
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This research was conducted to describe language development and social-emotional behavior that affect children with speech delays, ranging from early detection of language and speech problems, intervention programs, academic development in schools and social-emotional development and accompanying factors. children with late talk. This study is based on observations of a 9-year-old child, conducted from September 2018 to January 2019, with several data acquisitions since 2012 when early detection of language disorders and speech. It conducted the study using a qualitative approach with a case study method. Collecting data through observation, interviews and document studies. This study describes develop children with problems with speech and language delay (speech delay), seen from the cognitive, affective and psychomotor aspects and the influence of their social-emotional behavior. The findings in this study are social-emotional behaviors that have a major influence on develop children with language delay disorders, which require intervention programs suitable with the support of the family and the surrounding environment.
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Mitoma, Hiroshi, Mario Manto, and Jordi Gandini. "Recent Advances in the Treatment of Cerebellar Disorders." Brain Sciences 10, no. 1 (December 23, 2019): 11. http://dx.doi.org/10.3390/brainsci10010011.
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Various etiopathologies affect the cerebellum, resulting in the development of cerebellar ataxias (CAs), a heterogeneous group of disorders characterized clinically by movement incoordination, affective dysregulation, and cognitive dysmetria. Recent progress in clinical and basic research has opened the door of the ‘‘era of therapy” of CAs. The therapeutic rationale of cerebellar diseases takes into account the capacity of the cerebellum to compensate for pathology and restoration, which is collectively termed cerebellar reserve. In general, treatments of CAs are classified into two categories: cause-cure treatments, aimed at arresting disease progression, and neuromodulation therapies, aimed at potentiating cerebellar reserve. Both forms of therapies should be introduced as soon as possible, at a time where cerebellar reserve is still preserved. Clinical studies have established evidence-based cause-cure treatments for metabolic and immune-mediated CAs. Elaborate protocols of rehabilitation and non-invasive cerebellar stimulation facilitate cerebellar reserve, leading to recovery in the case of controllable pathologies (metabolic and immune-mediated CAs) and delay of disease progression in the case of uncontrollable pathologies (degenerative CAs). Furthermore, recent advances in molecular biology have encouraged the development of new forms of therapies: the molecular targeting therapy, which manipulates impaired RNA or proteins, and the neurotransplantation therapy, which delays cell degeneration and facilitates compensatory functions. The present review focuses on the therapeutic rationales of these recently developed therapeutic modalities, highlighting the underlying pathogenesis.
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Smith, Daniel A., and Paul J. Perry. "Nonneuroleptic Treatment of Disruptive Behavior in Organic Mental Syndromes." Annals of Pharmacotherapy 26, no. 11 (November 1992): 1400–1408. http://dx.doi.org/10.1177/106002809202601114.
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OBJECTIVE: To summarize the literature describing nonneuroleptic treatments of unacceptably disruptive behavior in chronically institutionalized psychiatric patients with mental retardation, autism, organic brain syndrome, and dementia. DATA SOURCES: Relevant articles were identified from a MEDLINE search of the above diagnoses linked with “aggression” and “psychomotor agitation.” Additional references were found in the bibliographies of these articles. STUDY SELECTION/DATA EXTRACTION: The studies reviewed were limited to prospective evaluations of nonneuroleptic drug therapy of these behavior disturbances. Case reports, case series, and retrospective studies were excluded. Studies of patients with schizophrenia, affective disorders, and personality disorders were also excluded. DATA SYNTHESIS: Studies of lithium, beta-blockers, carbamazepine, benzodiazepines, and buspirone were adequate for review. As a rule, these studies are hampered by poor design. The lithium studies suggest that mentally retarded patients with behavior disturbances may respond to lithium treatment. The beta-blocker studies suggest improvement in patients with mental retardation, autism, organic brain syndrome, and dementia. Neuroleptic discontinuation or a decrease in dose was possible in some patients. The carbamazepine studies were inconclusive. Carbamazepine should be reserved for patients with concomitant seizure disorders. Benzodiazepines were helpful in treating elderly demented patients. Thus far, buspirone has been evaluated in only a few, poorly designed studies and is not yet recommended for treatment of behavior disturbances. CONCLUSIONS: Legislation has restricted the use of neuroleptics in many patients receiving long-term healthcare. Despite the questionable validity of the studies reviewed, lithium, beta-blockers, carbamazepine, and benzodiazepines may be considered as alternatives to neuroleptics in selected cases.
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Hosang, G. M., A. Korszun, L. Jones, I. Jones, J. M. Gray, C. M. Gunasinghe, P. McGuffin, and A. E. Farmer. "Adverse life event reporting and worst illness episodes in unipolar and bipolar affective disorders: measuring environmental risk for genetic research." Psychological Medicine 40, no. 11 (February 5, 2010): 1829–37. http://dx.doi.org/10.1017/s003329170999225x.
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BackgroundStudies exploring gene–environment interplay in affective disorders now include very large numbers of participants. Methods for evaluating the role of adversity in such studies need to be developed that do not rely on lengthy and labour-intensive interviews. In the present study, a brief questionnaire method for measuring 11 adverse events reported before interview and before their worst illness episodes by bipolar, unipolar and healthy control participants, participating in genetic association studies, was evaluated.MethodFive hundred and twelve bipolar disorder (BD) participants, 1447 participants with recurrent unipolar depression (UPD) and 1346 psychiatrically healthy control participants underwent the researcher-administered version of the List of Threatening Experiences Questionnaire (LTE-Q) for the 6 months before their worst affective episodes for UPD and BD participants, and for the 6 months before interview for the UPD participants and controls.ResultsUPD and BD cases were significantly more likely to report at least one event, as well as more events in the 6 months before interview and before their worst illness episodes, than healthy controls. Both manic and depressive episodes were significantly associated with adverse events in the BD cases. Depressed mood at the time of interview influenced event reporting in UPD and control participants but not the BD cases. Age was negatively correlated with the number of events reported by controls.ConclusionsThe researcher-administered LTE-Q provides a measure of case-control differences for adversity that is applicable in large genetic association studies. Confounding factors for event reporting include present mood and age.
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Zwil, Alexander S., and Rodney J. Pelchat. "ECT in the Treatment of Patients with Neurological and Somatic Disease." International Journal of Psychiatry in Medicine 24, no. 1 (March 1994): 1–29. http://dx.doi.org/10.2190/5hxy-acm5-q6pk-04h5.
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Objective: An evaluation of the safety and efficacy of electroconvulsive therapy (ECT), for the treatment of patients with severe medical and neurological illness, was undertaken. Method: The English-language literature reporting the use of ECT in patients with neurological and somatic disease was reviewed. This review included reports describing ECT used for the treatment of affective disturbances and catatonia in patients with concurrent neurological or somatic disease, as well as reports dealing with the efficacy of ECT for the treatment of certain neurological conditions for which it has been reported to have some benefit independent of its psychiatric effect. Conclusions: ECT is safe and effective for the treatment of affective and catatonic disorders in patients with most neurological and medical diseases, including elderly and debilitated patients with multiple illnesses, if the specific medical risks are carefully evaluated in each case, and appropriate modifications of technique are used to reduce the risk of potential complications. Apart from its use in psychiatry, ECT has been reported to have therapeutic effects in Parkinson's disease, neuroleptic malignant syndrome, aggressive behavioral disorders following brain injury, certain forms of epilepsy, and some forms of delirium due to toxic or metabolic encephalopathies. The potential for ECT to play an active role in the clinical management of patients with these disorders, many of whom are presently refractory to maximal medical treatment, should be evaluated by systematic studies.
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Morgan, C., J. Lappin, M. Heslin, K. Donoghue, B. Lomas, U. Reininghaus, A. Onyejiaka, et al. "Reappraising the long-term course and outcome of psychotic disorders: the AESOP-10 study." Psychological Medicine 44, no. 13 (February 26, 2014): 2713–26. http://dx.doi.org/10.1017/s0033291714000282.
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BackgroundStudies of the long-term course and outcome of psychoses tend to focus on cohorts of prevalent cases. Such studies bias samples towards those with poor outcomes, which may distort our understanding of prognosis. Long-term follow-up studies of epidemiologically robust first-episode samples are rare.MethodAESOP-10 is a 10-year follow-up study of 557 individuals with a first episode of psychosis initially identified in two areas in the UK (South East London and Nottingham). Detailed information was collated on course and outcome in three domains (clinical, social and service use) from case records, informants and follow-up interviews.ResultsAt follow-up, of 532 incident cases identified, at baseline 37 (7%) had died, 29 (6%) had emigrated and eight (2%) were excluded. Of the remaining 458, 412 (90%) were traced and some information on follow-up was collated for 387 (85%). Most cases (265, 77%) experienced at least one period of sustained remission; at follow-up, 141 (46%) had been symptom free for at least 2 years. A majority (208, 72%) of cases had been employed for less than 25% of the follow-up period. The median number of hospital admissions, including at first presentation, was 2 [interquartile range (IQR) 1–4]; a majority (299, 88%) were admitted a least once and a minority (21, 6%) had 10 or more admissions. Overall, outcomes were worse for those with a non-affective diagnosis, for men and for those from South East London.ConclusionsSustained periods of symptom remission are usual following first presentation to mental health services for psychosis, including for those with a non-affective disorder; almost half recover.
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Allkoja, B., E. Mitro, B. Zenelaj, and V. Alikaj. "Relationship Between Brain Structural Abnormalities and Early Onset Psychotic Disorder–case Presentation." European Psychiatry 41, S1 (April 2017): s800—s801. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1544.
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IntroductionContemporary structural models of several psychiatric disorders propose abnormalities in the structure and function of distinct neural networks. Clinical observations of affective and cognitive changes arising from cerebellar lesions and stimulation permit the hypothesis that the cerebellum may not be irrelevant in some neuropsychiatric states. There is evidence that patients with schizophrenia have altered corticocerebellar connectivity.ObjectivesTo evidence a case with early onset psychosis accompanied with brain structural abnormalities.MethodCase description.ResultsThe patient is 15 years old girl with an acute psychotic episode. For more than two months she had demonstrated odd behavior, getting around all the time purposelessly, abandoned school etc. She presented with disorders of perceptions, disorganized speech, insomnia and fluctuations in her mood and behavior. In her brain, MRI was found vermian atrophy, and CT was found hypocampal glyosis and dilatation of temporal corn.ConclusionsAlthough the structural mapping studies have been equivocal, the weight of evidence supports extending the study of cerebellar activity in schizophrenia. For example, the finding that unaffected first-degree relatives of probands with schizophrenia have reduced cerebellar volumes, along with the observation of reduced cerebellar volumes in neurolepticnaïve patients with schizophrenia, suggests that cerebellar atrophy may be a hereditary trait rather than a psychotropic associated epiphenomenon.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Leshinsky, Rebecca, and Clare M. Mouat. "Towards better recognising ‘community’ in multi-owned property law and living." International Journal of Housing Markets and Analysis 8, no. 4 (October 5, 2015): 484–501. http://dx.doi.org/10.1108/ijhma-07-2015-0031.
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Purpose – This paper aims to advance best practice by gaining insights into key multi-owned property (MOP) issues challenging policymakers and communities. Ontario (Canada) and Victoria (Australia) are internationally recognised for best practice in MOP living and law. Yet, both jurisdictions struggle with the emerging urbanism related to condominium MOP. Design/methodology/approach – Different ways of recognising community in MOP urbanism will be examined against public policy and political theory perspectives promoting social sustainability. A rich mixed-data and content analysis method is relied upon which synthesises three pillars of MOP community governance: harmonious high-rise living; residential-neighbourhood interface; and metropolitan community engagement. The article cross-examines Canadian policy and law reform documents and Australian dispute case law from the state of Victoria to explore and showcase critical MOP management, residential and policy issues. Findings – A theory-building typology formally recognises “community” as an affective performance across MOP governance contexts: cosmopolitan, civic-citizen and neighbourly. These ideal types differentiate community affects in and beyond (case) law and land-use planning: from determining alternative dispute resolution remedies; addressing neighbourhood and metropolitan NIMBY-ism in urban consolidation to bridging the critical policy and civic gap between the limits and aims of socially sustainable MOP vertical-tenured community affects. Research limitations/implications – Strong cross-jurisdictional MOP community lessons exist, as other cities follow best practice in legal and governance structures to effect change at the frontiers of twenty-first century urbanism. Originality/value – Past studies emphasise classifying dispute issues, single-issue concerns or historical and life cycle evaluations. This theory-building article advances why and how community must be better understood holistically across community contexts to inform cutting-edge governance practices.
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Castagnini, A. C., and P. Fusar-Poli. "Diagnostic validity of ICD-10 acute and transient psychotic disorders and DSM-5 brief psychotic disorder." European Psychiatry 45 (September 2017): 104–13. http://dx.doi.org/10.1016/j.eurpsy.2017.05.028.
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AbstractBackground:Short-lived psychotic disorders are currently classified under “acute and transient psychotic disorders” (ATPDs) in ICD-10, and “brief psychotic disorder” (BPD) in DSM-5. This study's aim is to review the literature and address the validity of ATPDs and BPD.Method:Papers published between January 1993 and December 2016 were identified through searches in Web of Science. Reference lists in the located papers provided further sources.Results:A total of 295 articles were found and 100 were included in the review. There were only a few studies about the epidemiology, vulnerability factors, neurobiological correlates and treatment of these disorders, particularly little interest seems to exist in BPD. The available evidence suggests that short-lived psychotic disorders are rare conditions and more often affect women in early to middle adulthood. They also are neither associated with premorbid dysfunctions nor characteristic family predisposition, while there seems to be greater evidence of environmental factors particularly in developing countries and migrant populations. Follow-up studies report a favourable clinical and functional outcome, but case identification has proved difficult owing to high rates of transition mainly either to schizophrenia and related disorders or, to a lesser extent, affective disorders over the short- and longer-terms.Conclusions:Although the lack of neurobiological findings and little predictive power argue against the validity of the above diagnostic categories, it is important that they are kept apart from longer-lasting psychotic disorders both for clinical practice and research. Close overlap between ATPDs and BPD could enhance the understanding of these conditions.
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Lemire, Isabelle. "Revue du syndrome de Kleine-Levin: vers une approche intégrée." Canadian Journal of Psychiatry 38, no. 4 (May 1993): 277–84. http://dx.doi.org/10.1177/070674379303800410.
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Kleine-Levin syndrome is a characterized by a periodic hypersomnia crisis as well as dietary and variable significant psychic symptoms. Its rarity makes its definition and study complex. Many etiologies have been considered, especially regarding a hypothalamic dysfunction. Physiological, radio-logic, anatomical and Polysomnographic studies have not shown clearly conclusive results, but the syndrome appears to be related to affective disorders. This hypothesis is supported by the findings of a positive therapeutic response to lithium. However, we are interested in the related psychological factors, whether they are primary or secondary. A clinical case illustrates these factors, and a basic neuropsychiatric intervention concept is proposed.
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Matheson, S. L., A. M. Shepherd, R. M. Pinchbeck, K. R. Laurens, and V. J. Carr. "Childhood adversity in schizophrenia: a systematic meta-analysis." Psychological Medicine 43, no. 2 (April 30, 2012): 225–38. http://dx.doi.org/10.1017/s0033291712000785.
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BackgroundChildhood adversity is a putative risk factor for schizophrenia, although evidence supporting this suggestion is inconsistent and controversial. The aim of this review was to pool and quality assess the current evidence pertaining to childhood adversity in people with schizophrenia compared to other psychiatric disorders and to non-psychiatric controls.MethodIncluded were case-control, cohort and cross-sectional studies. Medline, EMBASE and PsycINFO databases were searched. Study reporting was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist and pooled evidence quality was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.ResultsTwenty-five studies met inclusion criteria. Moderate to high quality evidence suggests increased rates of childhood adversity in schizophrenia compared to controls [odds ratio (OR) 3.60, p < 0.00001]. Increased childhood adversity was also reported in schizophrenia compared to anxiety disorders (OR 2.54, p = 0.007), although the effect was not significant in the subgroup analysis of five studies assessing only sexual abuse. No differences in rates of childhood adversity were found between schizophrenia and affective psychosis, depression and personality disorders whereas decreased rates of childhood adversity were found in schizophrenia relative to dissociative disorders and post-traumatic stress disorder (OR 0.03, p < 0.0001).ConclusionsThis is the first meta-analysis to report a medium to large effect of childhood adversity in people with schizophrenia and to assess specificity for schizophrenia. Further research is required that incorporates longitudinal design and other potentially causal variables to assess additive and/or interactive effects.
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Stip, Emmanuel, Syed Javaid, Jonathan Bayard-Diotte, Karim Abdel Aziz, and Danilo Arnone. "Use of long acting antipsychotics and relationship to newly diagnosed bipolar disorder: a pragmatic longitudinal study based on a Canadian health registry." Therapeutic Advances in Psychopharmacology 10 (January 2020): 204512532095711. http://dx.doi.org/10.1177/2045125320957118.
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Background: There is limited data from large naturalistic studies to inform prescribing of long-acting injectable medication (LAIs). Guidance is particularly rare in the case of primary mood disorders. Methods: This study describes prescribing trends of LAIs in 3879 patients in Quebec, Canada, over a period of 4 years. Health register data from the Quebec provincial health plan were reviewed. Results: In this specific registry, 32% of patients who received LAIs drugs for schizophrenia had a confirmed diagnosis of bipolar disorder and 17% had a diagnosis of major depressive disorder. Non-schizophrenia syndromes were preferentially prescribed risperidone long-acting antipsychotic, whereas patients with schizophrenia were prescribed an excess of haloperidol decanoate. Patients with non-schizophrenia disorders prescribed long-acting antipsychotics were more frequently treated in primary care compared with patients with schizophrenia. Conclusion: Data from a large number of patients treated naturalistically in Quebec with long-acting antipsychotics suggests that these compounds, prescribed to treat symptoms of schizophrenia and schizoaffective disorders, were maintained when mood symptoms emerged, even in cases when the diagnosis changed to bipolar disorder. This pragmatic study supports the need to explore this intervention as potential treatment for affective disorders.