Journal articles on the topic 'Psychiatric symptoms in organic conditions'
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Bennett, Benjamin, Ajay Mansingh, Cormac Fenton, and Jonathan Katz. "Graves’ disease presenting with hypomania and paranoia to the acute psychiatry service." BMJ Case Reports 14, no. 2 (February 2021): e236089. http://dx.doi.org/10.1136/bcr-2020-236089.
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This manuscript describes the case of a young woman, with no prior psychiatric history, who developed hypomania and paranoia as the principal presenting features of Graves’ disease. After starting treatment with carbimazole and propranolol, symptoms resolved without the use of antipsychotic drugs. Close liaison between psychiatry and endocrinology services was essential. This demonstrates that treating underlying thyrotoxicosis in patients presenting with psychiatric symptoms may lead to recovery without the use of antipsychotic medication. While agitation, irritability and mood lability are well-recognised thyrotoxic symptoms, psychosis is a rare presenting feature of Graves’ disease. All patients with agitation, delirium or psychiatric symptoms should have thyroid function checked as part of initial tests screening for organic disease. In new or relapsing psychiatric conditions, it is important to ask patients, their carers or relatives about symptoms of hypothyroidism or thyrotoxicosis.
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de Jaime Ruiz, Pilar, Jose Luis García-Fogeda Romero, and Luis Gutiérrez-Rojas. "Catatonia and Mutism: Neurotic, Psychotic, or Organic Disorder?" Case Reports in Psychiatry 2021 (October 28, 2021): 1–5. http://dx.doi.org/10.1155/2021/5936673.
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Background. Catatonia is caused by a variety of psychiatric and organic conditions. The onset, clinical profile, and response to treatment may vary depending on the underlying cause. Catatonia is more likely to be associated with neurotic and psychotic disorders, but some psychiatric symptoms are key components in the clinical presentation of other medical conditions. Case Report. We report the case of a woman who started showing paroxysmal recurrent episodes since the age of 57 years, characterized by surrounding disconnection, disorientation, and muscle spasm (myoclonus), followed by a postictal state. In the following months, the symptoms evolved to akinetic mutism, catatonia, and rapidly progressive vision and audition loss. She underwent a battery of tests, most of them inconclusive, until a neoplastic meningoencephalitis was diagnosed after more than two years of symptoms. Numerous medical conditions can mimic psychiatric disorders. This uncommon presentation may lead to a late diagnosis and treatment initiation, increasing significantly morbidity and mortality. A differential diagnosis with infectious, autoimmune, and neoplastic etiologies should always be carried out.
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Skakic, Olivera, and Ljiljana Trajanovic. "Consultative psychiatry examinations of patients: Review of twelve months retrospective follow up." Medical review 62, no. 11-12 (2009): 569–72. http://dx.doi.org/10.2298/mpns0912569s.
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Introduction. Psychiatric symptoms in hospitalized somatic patients are not rare in practice, and therefore consultative psychiatric examinations are an important part of the treatment of patients in non-psychiatric departments. The term consultative psychiatry refers to psychiatric evaluation, advising and treatment of numerous and various psychiatric disorders in physically ill patients in non-psychiatric departments. The aim of the research was to determine the wards at which psychiatric consultations were the most frequent as well as the prevalence of psychiatric disorders. Material and method. The research included 887 patients hospitalized at the clinics of the Clinical Centre Nis, examined by consultant psychiatrists during the twelve month period. The research instrument was medical documentation (files of psychiatrist-consultants after the completed consultation). Results and conclusion. The greatest number of psychiatric consultations was made at the Endocrinology Clinic, followed by the Neurology Clinic and the Surgery Clinic, and then at the Clinic for Cardiovascular Diseases. Most diagnoses were syndromological-descriptive, which entailed a relatively high percentage of multiple diagnoses. The most frequent diagnostic groups were chronic and acute psycho-organic syndromes, which cause a bad compliance and can lead to difficulties during somatic examination, intervention or pharmacological treatment. Immediately following are mental disorders due to the use of psychoactive substances, situational reactions and suicide attempts. The obtained results have shown that consultative psychiatric examinations were made in urgent conditions (aggressive patients), with few control examinations, which means without the follow up of the given therapy, without the use of psychotherapy and the principles of liaison psychiatry.
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Hernández Sánchez, J. M., M. C. Cancino Botello, M. F. Molina Lopez, M. Á. Canseco Navarro, S. Arnés González, M. Muñoz Carril, and J. A. Monzó. "Major Depressive Disorder With Psychotic Symptoms in Elderly. A Case Report." European Psychiatry 33, S1 (March 2016): S531. http://dx.doi.org/10.1016/j.eurpsy.2016.01.1964.
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IntroductionThe proportion of elderly people and affective syndromes are more and more common in developed countries. Elderly people have physiological conditions that may limit our intervention.ObjectivesTo present a case of a major depressive disorder with psychotic symptoms in a 72-year-old woman.MethodsMedline search and review of the clinical history and the related literature.ResultsWe present the case of a 72-year-old woman with psychiatric history of a major depressive disorder 14 years ago with ad integrum restitution after pharmacological treatment. In 2015, our patient was admitted to the psychiatry ward due to major depressive symptomatology (apathy, anhedonia, global insomnia, weight loss) that associated mood-congruent delusions (nihilistic, ruin, guilt, catastrophic) with deregulated behaviour. The patient was resistant to combined pharmacological treatment with aripiprazole, desvenlafaxine, mirtazapine and lorazepam, therefore, we decided to administer ECT, with successful results after 5 sessions. Brain tomography, blood and urine tests were normal. Clinical signs of dementia were not present.ConclusionsInpatients with deregulated behaviour; it is important to rule out organic causes, especially in elderly, in whom dementia, brain tumors or metabolic disturbances may simulate psychiatric syndromes.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Lemey, L., J. Godderis, and H. van den Ameele. "Psychiatric complications of drug treatment of Parkinson's disease." Acta Neuropsychiatrica 13, no. 1 (March 2001): 29–36. http://dx.doi.org/10.1017/s092427080003533x.
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SUMMARYDrug-induced psychiatric conditions are a common and severe problem in the treatment of patients with Parkinson's disease. Psychotic symptoms are the most frequent reason for nursing home placement of patients with Parkinson's disease. The psychotic symptoms seem to present themselves in a continuum where alterations in dreaming patterns often precede visual hallucinations, which often progress into delusional syndromes and, finally, into confusional organic syndromes. When evaluating a patient on dopaminergic treatment, it is important to inquire systematically about abnormal sleep related phenomena, for these are important clues in the early detection of psychotic symptoms. The pathogenesis of the psychotic symptoms is not yet fully understood but complex adaptations of various neurotransmitter systems seem to be involved. In the treatment of these drug-induced psychotic symptoms, the atypical antipsychotic drug clozapine plays an important role. Drug-induced mania, hypersexuality and anxiety, although less frequent than the psychotic symptoms, also occur as a complication of dopaminergic treatment. Depressive symptoms, although common in Parkinson's disease, are less likely to occur as a side effect of the drug treatment.
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Collison-Ani, Emma, Anissa Faher, Marcus Au, and Gayathri Burrah. "Cariprazine for treating coprophagia and organic psychosis in a young woman with acquired brain injury." BMJ Case Reports 16, no. 1 (January 2023): e248855. http://dx.doi.org/10.1136/bcr-2022-248855.
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Coprophagia or the ingestion of faeces has been associated with medical conditions (seizure disorders, cerebral atrophy and tumours) and psychiatric disorders (mental retardation, alcoholism, depression, obsessive compulsive disorder, schizophrenia, fetishes, delirium and dementia). The case of a woman in her 30s presenting with coprophagia and psychotic symptoms following hypoxic brain injury is reported. The case is discussed and literature is reviewed. We investigate cariprazine, a relatively new atypical antipsychotic for treating coprophagia, associated with psychotic symptoms. Psychiatric evaluation revealed cognitive dysfunction and psychotic symptoms. Physical examination and laboratory evaluation were unremarkable. She was treated with haloperidol resulting in resolution of coprophagia. Attempts at switching to alternative antipsychotics, due to side effects, resulted in recurrence of coprophagia. Subsequent relapses required higher doses of haloperidol for remission of coprophagia and psychotic symptoms. She finally responded to cariprazine. While firm conclusions are not possible from the experience of a single case, we suggest cariprazine may also be a treatment option for coprophagia, particularly in patients with psychotic symptoms.
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Akyıldırım Çor, S., M. Duman, and Ö. Uzun. "A Case of Adult Attention Deficit Hyperactivity Disorder with Non-Organic Psychosis Comorbidity." European Psychiatry 65, S1 (June 2022): S468—S469. http://dx.doi.org/10.1192/j.eurpsy.2022.1190.
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Introduction Although ADHD is the most frequently diagnosed psychiatric disorder in childhood, the majority of adults with ADHD are not diagnosed and 90% of the cases remain untreated. One of the main reasons that may lead to the missed diagnosis of ADHD in adults may be the high rate of comorbid psychiatric conditions masking the main symptoms. Objectives In this study, it was aimed to present a case who was followed up with the diagnosis of ADHD since childhood and developed psychosis after a recent traumatic life event. Methods A 19-year-old male patient was consulted because of his complaints of persecution delusions, and disorganized speech that started 2 years ago. IIt was learned that the first psychiatry application of the patient was 10 years ago with complaints of impulsivity, aggression, increased psychomotor movements, and methylphenidate treatment was started during this period. The patient, whose current clinical picture was evaluated as psychosis, was discharged after the symptoms subsided with paliperidone depot 100mg/month treatment after hospitalization. It is understood that his psychotic complaints completely regressed in the follow-ups. Results It is stated that approximately 80% of adult ADHD cases have at least one accompanying psychiatric disorder. However, there are limited studies in the literature on the relationship between psychotic disorders and ADHD. Conclusions Recent studies indicate that beyond the fact that ADHD is a feature of the schizophrenia prodrome, ADHD diagnosis may be associated with an increased risk of psychosis in the future. Therefore, this association can be better clarified in further studies on comorbidities. Disclosure No significant relationships.
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Dimitrov, Iv, S. Atanasova, A. Kaprelyan, B. Ivanov, V. Nestorova, K. Drenska, Zh Chuperkova, and Iv Aleksandrov. "Gerstmann syndrome in a young man: a case report." Trakia Journal of Sciences 16, no. 3 (2018): 239–41. http://dx.doi.org/10.15547/tjs.2018.03.011.
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Gerstmann syndrome is a classical cerebral syndrome in neurology, named after Joseph Gerstmann, a Jewish Austrian-born American neurologist. Patients present with a tetrad of cognitive symptoms, including agraphia, acalculia, finger agnosia and left-right disorientation. The syndrome is known to result from a lesion of the posterior portion of the dominant parietal lobe and is usually due to stroke or to developmental problems. We describe the case of a 35-year-old man whose illness debuted about 9 months before the initial presentation to the neurology clinic, with memory complaints, anxiety, verbal aggression, sleeping problems, as well as subjective word finding difficulty and depressed mood. The patient had 3 out of the 4 classic symptoms of Gerstmann syndrome, among other, mostly neuropsychiatric symptoms. Initially, structural lesions were sought for, but were not found on magnetic resonance imaging. Psychiatric conditions were discussed but not confirmed by the consulting psychiatrist. We are prone to accepting a non-organic reason for the condition of the patient, but follow-up of the clinical course and repeated assessments, including neuropsychological and psychiatric evaluations, structural and possibly functional neuroimaging will be required to verify and confirm this presumption.
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Perju-Dumbrava, Laura, and Peter Kempster. "Movement disorders in psychiatric patients." BMJ Neurology Open 2, no. 2 (December 2020): e000057. http://dx.doi.org/10.1136/bmjno-2020-000057.
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The observability of movement gives it advantages when trying to draw connections between brain and mind. Disturbed motor function pervades schizophrenia, though it is difficult now to subtract the effects of antipsychotic treatment. There is evidence from patients never exposed to these drugs that dyskinesia and even parkinsonism are to some degree innate to schizophrenia. Tardive dyskinesia and drug-induced parkinsonism are the most common movement disorders encountered in psychiatric practice. While D2 dopamine receptor blockade is a causative factor, both conditions defy straightforward neurochemical explanation. Balanced against the need to manage schizophrenic symptoms, neither prevention nor treatment is easy. Of all disorders classified as psychiatric, catatonia sits closest to organic neurology on the neuropsychiatric spectrum. Not only does it occur in the setting of unequivocally organic cerebral disease, but the alterations of consciousness it produces have ‘organic’ qualities even when the cause is psychiatric. No longer considered a subtype of schizophrenia, catatonia is defined by syndromic features based on motor phenomenology. Both severe depression and obsessive-compulsive disorder may be associated with ‘soft’ extrapyramidal signs that resemble parkinsonian bradykinesia. As functional neuroimaging studies suggest, movement and psychiatric disorders involve the same network connections between the basal ganglia and the cerebral cortex.
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Hernández Sánchez, J. M., M. C. Cancino Botello, M. F. Molina Lopez, M. Muñoz Carril, S. Arnés González, and J. A. Monzó. "Late Onset Schizophrenia. A Case Report." European Psychiatry 33, S1 (March 2016): S530—S531. http://dx.doi.org/10.1016/j.eurpsy.2016.01.1963.
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IntroductionThe presence of elderly people is more and more common in developed countries. Unlike other medical conditions, late onset psychosis includes organic and mental precipitants in its differential diagnosis.ObjectivesTo present a case of late onset schizophrenia.MethodsMedline search and review of the clinical history and the related literature.ResultsWe present the case of a 71-year-old woman with organic medical history of rectum adenocarcinoma in 2008 that underwent radiotherapy, chemotherapy and surgical resection with successful results. According to the psychiatric history, this patient has needed two admissions to the psychiatry ward, the first of them in 2012, (when the delusional symptoms started), due to deregulated behaviour in relation to persecutory delusions and auditory pseudo-hallucinations. In 2012, she was diagnosed with late onset schizophrenia. Blood tests (hemograme, biochemistry) and brain image were normal. Despite treatment with oral amisulpride and oral paliperidone and due to low compliance, delusional symptoms have remained. We started treatment with long-acting injectable papliperidone 75 mg/28 days having reached clinical stability.ConclusionsLate onset psychosis is due to a wide range of clinical conditions. In this case, our patient had no organic precipitants. The evolution and presentation of delusional symptoms in this patient made us think of late onset schizophrenia as main diagnosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Garcia Ayala, L., M. Gomez Revuelta, C. Martin Requena, E. Saez de Adana Garcia de Acilu, O. Porta Olivares, M. Juncal Ruiz, N. Nuñez Morales, et al. "I Don't Recycle! An Organic Hoarding Disorder." European Psychiatry 41, S1 (April 2017): S640—S641. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1057.
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IntroductionHoarding often occurs without the presence of obsessive-compulsive disorder (OCD), showing distinguishable neuropsychological and neurobiological correlates and a distinct comorbidity spectrum. Furthermore, it presents itself secondarily to other psychiatric and neurobiological disorders. Therefore hoarding disorder has been included as independent diagnosis in DSM-5.ObjectivesWe aim to expose the possible organic etiology of a hoarding disorder case with atypical presentation.Materials and methodsWe present a case of a 48 years old male patient who was brought to the hospital by the police after being reported for unhealthy conditions in his home. In the home visit paid by the Social Services an excessive hoarding of objects and trash was detected. A possible hoarding disorder was diagnosed in the psychiatric assessment. Among other diagnostic test, a brain CT was conducted, in which a frontal meningioma was identified. After surgical treatment, hoarding symptoms diminished significantly.DiscussionA significant part of the hoarding disorders are attributed to primary psychiatric disorders, resulting in potentially treatable organic pathology going unnoticed.ConclusionIt's important to rule out organic etiology before proceeding to make a definitive hoarding disorder diagnosis, optimizing that way the treatment options.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Lundberg, Ante. "Psychiatric Aspects of Air Pollution." Otolaryngology–Head and Neck Surgery 114, no. 2 (February 1996): 227–31. http://dx.doi.org/10.1016/s0194-59989670172-9.
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Psychological and toxic effects of air pollution can lead to psychiatric symptoms, including anxiety and changes in mood, cognition, and behavior. Increased levels of some air pollutants are accompanied by an increase in psychiatric admissions and emergency calls and, in some studies, by changes in behavior and a reduction in psychological well-being. Numerous toxic pollutants interfere with the development and adult functioning of the nervous system. Manifestations are often insidious or delayed, but they can provide a more sensitive indicator of toxic effects than cancer rates or mortality data. Other medical effects of air pollution, such as asthma, can indirectly affect psychological health. The sick building syndrome and multiple chemical sensitivity are conditions with toxicologic and psychiatric aspects. Psychosocial stress can cause symptoms similar to those of organic mental disorders. Reactions to stress depend on cultural, individual, and situational variables. We must understand these factors to be able to alleviate and prevent the consequences of environmental trauma. Expanded research is recommended in three main areas: (1) how people perceive and cope with environmental health risks, (2) the effects of air pollution on behavior and neuropsychological functioning, and (3) neurotoxicologic evaluation of air pollutants with both behavioral and in Vitro Studies.
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Operto, Francesca Felicia, Grazia Maria Giovanna Pastorino, Chiara Padovano, Chiara Scuoppo, Valentina Vivenzio, and Giangennaro Coppola. "Psychogenic Seizures in Adolescents: An “Evergreen” Diagnostic Challenge." BRAIN. Broad Research in Artificial Intelligence and Neuroscience 11, no. 3sup1 (2020): 153–62. http://dx.doi.org/10.18662/brain/11.3sup1/131.
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Paroxysmal events are classified as non-epileptic or epileptic symptoms. The first ones are distinguished in psychogenic and organic/physiological paroxysmal events (Lüders et al., 2019). In organic and physiological disorders there are several symptoms: inattention, daydreaming, staring, sleep myoclonus, stereotyped movements, hypnotic spasms, tonic postures, parasomnia, movement disorders. Psychogenic non-epileptic seizures (PNES) are not associated with abnormal brain EEG activity and cannot be explained by other neurological disorders. PNES are also defined as functional neurological disorders and are included among the Conversion Disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (American Psychiatric Association, 2013). This disorder is characterized by symptoms of impaired voluntary or sensorimotor function without the presence of other neurological or clinical conditions.
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Rodin, Ian, and Richard Braithwaite. "Festival psychiatry." BJPsych Advances 24, no. 2 (March 2018): 123–31. http://dx.doi.org/10.1192/bja.2017.17.
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SUMMARYThis article is based on our experience of volunteering for the charity Festival Medical Services, to provide mental healthcare at the Glastonbury Festival of Contemporary Performing Arts and the Reading Festival. It describes the history of these annual events and the development of medical and psychiatric services offered. Principles of assessment and management of mental disorder in festival settings are outlined and common psychiatric presentations are described. Legal aspects of care are discussed. The article is intended primarily to inform others of this interesting and unusual form of mental healthcare and we hope that aspects of our experience will prompt reflection on psychiatric practice in other settings.LEARNING OBJECTIVES•Understand how psychiatric care is provided at the Glastonbury and Reading Festivals•Recognise the symptoms and signs of organic and functional conditions likely to present to psychiatrists at festivals•Identify the principles of psychiatric management in festival settingsDECLARATION OF INTERESTI.R. and R.B. gain free entry to the Glastonbury and Reading Festivals through their voluntary work with Festival Medical Services.
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Bozzatello, Paola, Maria Laura De Rosa, Paola Rocca, and Silvio Bellino. "Effects of Omega 3 Fatty Acids on Main Dimensions of Psychopathology." International Journal of Molecular Sciences 21, no. 17 (August 21, 2020): 6042. http://dx.doi.org/10.3390/ijms21176042.
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The usefulness of polyunsaturated fatty acids on inflammatory, cardiovascular, and the nervous system was studied in the last decades, but the mechanisms underlying their benefic properties are still partially unknown. These agents seem to express their action on the membrane phospholipid composition and permeability and modulation of second messenger cascades. In psychiatry, the efficacy and tolerability of omega-3 fatty acids were investigated in several psychiatric disorders, including major depression, bipolar disorder, personality disorders, high-risk conditions to develop psychosis, attention-deficit hyperactivity disorder, and autism spectrum disorders. Initial findings in this field are promising, and some relevant questions need to be addressed. In particular, the effects of these agents on the main symptom dimensions have to be investigated in a trans-diagnostic perspective. The present systematic review is aimed to examine the available data on the efficacy of omega-3 fatty acids on domains of psychotic symptoms, affective symptoms, impulsivity, and aggressiveness, and harmful behaviors, and suicide risk.
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Carr, Vaughan J., Terry J. Lewin, Jane M. Walton, Catherine Faehrmann, and Alexander L. A. Reid. "Consultation—Liaison Psychiatry in General Practice." Australian & New Zealand Journal of Psychiatry 31, no. 1 (February 1997): 85–94. http://dx.doi.org/10.3109/00048679709073804.
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Objective:This paper describes the characteristics of 303 consecutive referrals, over a 12-month period, to a consultation—liaison (C—L) psychiatry service provided to eight group general practices in Newcastle, Australia. Method:A purpose designed service audit form was used throughout the evaluation period to collect information about demographic characteristics, reasons for referral, service contacts, psychiatric diagnoses and clinical management. In addition, patients were invited to participate in a separate, prospective outcome evaluation study, which involved structured interviews and questionnaires. Results:The most common reasons for referral were: depression (33%); anxiety (12%); diagnostic assessment (9%); and impaired relationships (8%). The most common psychiatric diagnoses were: mood disorders (29%); mild, transient conditions (29%); anxiety (14%); and substance abuse disorders (12%). Following the psychiatric consultation(s), GPs were actively involved in patients’ treatment in 53% of cases. However, there was a higher than expected rate of referral (44%) to another mental health agency. Selected comparisons are also reported between patients referred to the C—L service (n = 303) and a sample of non-referred GP attenders (n = 535). Conclusions:As expected, the diagnostic profiles of patients attending the C—L service differed in several respects from those using similar services in general hospitals. There were comparatively low rates of organic brain syndromes, suicide risk evaluations, and problems of differential diagnosis of somatic symptoms. Greater emphasis needs to be placed on more formal psychiatric education for GPs, on ways of screening out from the referral process those patients with mild, transient conditions who do not require specialist expertise, and on the development of strategies to help GPs manage such conditions.
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Göy, D., Ö. Şahmelikoğlu Onur, and U. Yesilkaya. "Schizophrenia likely related to be with cadasil: A case report." European Psychiatry 64, S1 (April 2021): S810. http://dx.doi.org/10.1192/j.eurpsy.2021.2141.
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IntroductionCADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy) is an inherited disease caused by mutations in the Notch3 gene in chromosome 19.The clinical features are primarily neurological, which include recurrent transient ischaemic attacks, strokes, and migraines.However, psychiatric manifestations such as severe depression, psychosis, changes in behavior and personality have also been reported in CADASIL. Symptoms and disease onset vary widely, with signs typically appearing in the mid-30s.Some individuals may not show signs of the disease until later in life.ObjectivesIn this case report, we present a possible case of CADASIL, a 67-year old female patient diagnosed with schizophrenia fifteen years ago to discuss the co-occurrence of these conditions in the light of the literature.MethodsHospitalization records of the patient viewed.ResultsOur patient suffered from sleep disturbances, hearing religious voices and in psychiatric examination resistant to treatment psychotic symptoms such as blunted affect, mystic, persecutory delusions, auditory hallucinations were present.Cranial magnetic resonance imaging scan was performed and revealed leukoencephalopathy, high-signal intensity lesions in the periventricular white matter consistent with a diagnosis of CADASIL.Atypical antipsychotics found to be effective in treating psychotic symptoms in our case.ConclusionsPersistent psychotic symptoms despite adequate antipsychotic treatment in patients diagnosed with schizophrenia, also with pathological findings in MRI an organic cause such as CADASIL must be considered. Further studies are needed to better understand the exact impacts of cerebral tissue lesions and psychiatric symptoms in CADASIL patients.DisclosureNo significant relationships.
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Nombora, O. "It might not be just an intellectual disability: Change of behavior masking the diagnosis of cancer in a psychiatry unit." European Psychiatry 64, S1 (April 2021): S385. http://dx.doi.org/10.1192/j.eurpsy.2021.1032.
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IntroductionIntellectually disabled people are vulnerable to somatic and mental illnesses, often presenting behaviour changes. Moreover, difficulties in describing symptoms can limit their access to healthcare system and adequate treatment.ObjectivesThrough a case report, we aim to provide an overview on behaviour changes in people with intellectual disability (ID), emphasizing the screening for organic conditions.MethodsDescription of a clinical case and a qualitative review about the assessment of behaviour changes in persons with ID, using PubMed database.ResultsWe present a clinical case of a 57-year-old man with history of ID, alcohol and tobacco abuse and Epilepsy. He had previous acute psychiatric admissions due to behaviour disorganization and irritability. In January he was admitted with disorganized behaviour and caregiver exhaustion, and stabilized with Olanzapine 20mg/day. On the 28th day of hospitalization, he fell of his of bed and suffered a mild traumatic brain injury. Cerebral CT scan revealed two metastatic lesions in the brain. Further investigations found out primary neoplastic lung lesion and multiple metastasis. Afterwards, his relatives mentioned a heavy familiar history of cancer and that he had postural instability signs that they did not value.ConclusionsAlthough psychiatric disorders are common in patients with ID, we must always remind that behaviour changes can mask the presentation of an organic disease. Despite a long follow-up in Psychiatry, organic conditions should be considered when patients with ID present behaviour changes. Further studies are needed in the assessment of this particular population to provide proper medical, psychological and social care.
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Perez, I. Martine, F. Garcia Sánchez, A. L. Gonzalez Galdamez, M. D. Piqueras Acevedo, A. Belmar Simo, A. Lopez Eugenio, M. E. Felices Quesada, and C. J. Garcia Briñol. "Just Hypochondria or Something Else?" European Psychiatry 41, S1 (April 2017): S657. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1104.
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IntroductionIn the older adult hypochondria is one of the most common somatoform disorders, and represents a particular challenge for approach, diagnosis and treatment, since in this age group, non-psychiatric medical comorbidity and concomitant presence of other psychiatric disorders very high. It is therefore very complex differentiate hypochondria disease with a real organic cause [1].MethodsReview of the relevant literature on the subject by searching PUBMED, limited to studies of greater scientific hierarchy.ResultsAnalysis of symptoms present in a hypochondriac patient with comorbid psychiatric disorders and organic pathology, valuing the importance it has in its clinical manifestations and the difficulty of differential diagnosis.ConclusionsIn the elderly, the high frequency of somatic disease conditions the need for a deeper physical and mental examination to avoid subjecting patients to unnecessary scrutiny and risky complementary tests [1].The evolution of hypochondriacs, dragging hypochondria from youth is not good, persisting in his complaint and his need to see a doctor for diagnostic examinations [2]. The therapeutic approach depends on the type of complaint, in which the treatment of the underlying disease as a psychotherapeutic and pharmacological mixed approach may be the right things [2].Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Boukdir, A., A. Khallouk, A. Rhaouti, S. Stati, H. Nafiaa, and A. Ouanass. "Treatment methods for patients with psychosomatic illnesses." European Psychiatry 65, S1 (June 2022): S399. http://dx.doi.org/10.1192/j.eurpsy.2022.1010.
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Introduction Psychosomatic illnesses correspond to physical symptoms (with or without objectivable organic lesions), that psychological factors such as stress and personality type, would have a potential effect on their appearance, evolution and / or worsening. These psychosomatic conditions are quite common but difficult to diagnose. Doctors from different specialties are consulted by the patients and multiple examinations and investigations are run by specialists in order to get to the final diagnosis. These psychosomatic conditions may appear under different types of illnesses : respiratory (asthma), dermatological (psoriasis, eczema), digestive (gastric ulcer, ulcerative colitis, Crohn’s disease), cardiovascular (arterial hypertension, infarction), neurological (migraine)… Objectives Study management modalities of psychosomatic disorders through cases followed in consultation at the university psychiatric hospital Ar-razi of Salé in Morocco Methods through cases followed in consultation at the university psychiatric hospital Ar-razi of Salé in Morocco Results From the results observed in the patients recruited in this study, we retain the need for a bio-psycho-social approach, through a global approach of the patient in all its dimensions, not only biological, but also psychological and social ; we also retain the essential role of the psychiatrist in the management of these psychosomatic disorders, both in preventive and curative terms, by allowing a better understanding of the interactions between physical and mental health. Conclusions psychosomatic conditions are quite common but difficult to diagnose and the need for a bio-psycho-social approach, through a global approach of the patient in all its dimensions, not only biological, but also psychological and social is crucial. Disclosure No significant relationships.
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Gambogi, Leandro Boson, Henrique Cerqueira Guimarães, Maurício Viotti Daker, Leonardo Cruz de Souza, and Paulo Caramelli. "Kraepelin’s description of chronic mania: a clinical picture that meets the behavioral variant frontotemporal dementia phenotype." Arquivos de Neuro-Psiquiatria 74, no. 9 (September 2016): 775–77. http://dx.doi.org/10.1590/0004-282x20160111.
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ABSTRACT Chronic mania is an under-investigated condition and few reports have associated this disorder with an organic background. The present work examines Kraepelin’s reliable description of chronic mania from a current behavioral neurology viewpoint. Kraepelin had described a cluster of symptoms that are now recognized as core manifestations of the behavioral variant frontotemporal dementia (bvFTD) clinical phenotype. We also carried out additional reviews of original manuscripts from Kraepelin’s peers, in order to find any case reports that might fulfill the current diagnostic proposal for bvFTD. Even though we failed to find an ideal case, we found some scholars who seemed to agree that chronic mania should be considered a special form of dementia. The present work highlights, through historical data, the possible overlapping features between primary psychiatric disorders and neuropsychiatric symptoms secondary to neurodegenerative conditions.
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Endres, Dominique, Harald Prüss, Andrea Dressing, Johanna Schneider, Bernd Feige, Tina Schweizer, Nils Venhoff, et al. "Psychiatric Manifestation of Anti-LGI1 Encephalitis." Brain Sciences 10, no. 6 (June 16, 2020): 375. http://dx.doi.org/10.3390/brainsci10060375.
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Background: Anti-leucine-rich glioma-inactivated 1 (LGI1) encephalitis is typically characterized by limbic encephalitis, faciobrachial dystonic seizures and hyponatremia. The frequency with which milder forms of anti-LGI1 encephalitis mimic isolated psychiatric syndromes, such as psychoses, or may lead to dementia if untreated, is largely unknown. Case presentation: Here, the authors present a 50-year-old patient who had suffered from neurocognitive deficits and predominant delusions for over one and a half years. He reported a pronounced feeling of thirst, although he was drinking 10–20 liters of water each day, and he was absolutely convinced that he would die of thirst. Due to insomnia in the last five years, the patient took Z-drugs; later, he also abused alcohol. Two years prior to admission, he developed a status epilepticus which had been interpreted as a withdrawal seizure. In his serum, anti-LGI1 antibodies were repeatedly detected by different independent laboratories. Cerebrospinal fluid analyses revealed slightly increased white blood cell counts and evidence for blood–brain-barrier dysfunction. Magnetic resonance imaging showed hyperintensities mesio-temporally and in the right amygdala. In addition, there was a slight grey–white matter blurring. A cerebral [18F] fluorodeoxyglucose positron emission tomography (FDG-PET) examination of his brain showed moderate hypometabolism of the bilateral rostral mesial to medial frontal cortices. Treatment attempts with various psychotropic drugs remained unsuccessful in terms of symptom relief. After the diagnosis of probable chronified anti-LGI1 encephalitis was made, two glucocorticoid pulse treatments were performed, which led to a slight improvement of mood and neurocognitive deficits. Further therapy was not desired by the patient and his legally authorized parents. Conclusion: This case study describes a patient with anti-LGI1 encephalitis in the chronified stage and a predominant long-lasting psychiatric course with atypical symptoms of psychosis and typical neurocognitive deficits. The patient’s poor response to anti-inflammatory drugs was probably due to the delayed start of treatment. This delay in diagnosis and treatment may also have led to the FDG-PET findings, which were compatible with frontotemporal dementia (“state of damage”). In similar future cases, newly occurring epileptic seizures associated with psychiatric symptoms should trigger investigations for possible autoimmune encephalitis, even in patients with addiction or other pre-existing psychiatric conditions. This should in turn result in rapid organic clarification and—in positive cases—to anti-inflammatory treatment. Early treatment of anti-LGI1 encephalitis during the “inflammatory activity state” is crucial for overall prognosis and may avoid the development of dementia in some cases. Based on this case, the authors advocate the concept—long established in many chronic inflammatory diseases in rheumatology—of distinguishing between an “acute inflammatory state” and a “state of organ damage” in autoimmune psychosis resembling neurodegenerative mechanisms.
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Bedlinskyi, V. O. "IMMUNOLOGICAL CHANGES AS A RESULT OF HEAD INJURY, THAT LEAD TO DEPRESSION." Ukrainian Scientific Medical Youth Journal, no. 2(106) (September 14, 2018): 4–8. http://dx.doi.org/10.32345/usmyj.2(106)().2018.4-8.
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Relevance. Depression is the one of the most frequent psychiatric conditions, that is developed as a result of head injury. The frequency of post-traumatic depression accounts from 6% to 77%. The etiology is still unknown, although one of the main etiopathogenic link are changes in the immunological reactivity.
Aim. Analysis of the main mechanisms of the influence of immune system, triggered by head injury, on development of depression symptoms. Methods. Data from Web of Science, Pubmed and Google Scholar were analyzed with
Results. Current methods in the treatment of the organic depression can’t fully influence on main pathogenic link. It can complicate the treatment and lead to exacerbation or delayed outcomes of the head injury.
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Jahan, Sultana. "The Dilemma, Conversion Disorder or Stiff Person Syndrome, a Case Report." CNS Spectrums 26, no. 2 (April 2021): 145–46. http://dx.doi.org/10.1017/s1092852920002308.
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AbstractStudy ObjectivesThe main objectives of this case study are 1. Clinicians facing symptoms that are difficult to interpret should exercise caution in diagnosing conversion disorder. 2. Increasing awareness about rare neurological conditions may appear as psychogenic illnesses. 3. Clinicians be advocate for their patients.IntroductionConversion disorder is a mental condition in which a person present with one or more symptoms of altered voluntary motor or sensory function, or other neurologic symptoms that cannot be explained by medical evaluation. Stiff person syndrome (SPS) is a disabling autoimmune central nervous system disorder characterized by progressive muscle rigidity, gait impairment, with superimposed painful spasms. SPS is commonly associated with high anti-glutamic acid decarboxylase (GAD) antibody titers. The dominant antigen recognized by these antibodies is the GABA-synthesizing enzyme GAD.MethodPatient X, a 17-year-old Hispanic American female who presented to the Child and Adolescent Psychiatry Clinic with the complaint of ataxia & aphasia associated with anxiety. Patient was referred by the neurology clinic after they could not establish any organic cause of her ataxia or aphasia. After thorough evaluation at the child psychiatry clinic she was given the diagnosis of anxiety secondary to ataxia and aphasia and r/o Conversion Disorder. She was initiated treatment with sertraline for her anxiety. Her sertraline dose was increased gradually up to 100 mg daily. From the beginning the patient also received counseling & physical therapy. With these combination of treatments, patient’s symptoms did not get any better. Her symptoms actually got worse over time. At this point, the Child Psychiatry Clinic sent a message to the neurology clinic for further evaluation of patient due to her progressive gait and speech impairments.ResultsThe neurology clinic saw the patient again and did further testing. The patient was positive for high titers of anti-glutamic acid decarboxylase antibodies (Anti-GAD). At this point, the patient was given the diagnosis of Stiff Person Syndrome. Patient was admitted to the hospital for further management. She was treated with benzodiazepines, IV immune globulin, & steroid. Soon after discharge from the hospital, the patient was seen at the Child Psychiatric Clinic. The patient’s mother reported, after the in-patient treatment, the patient’s symptoms improved.DiscussionIt is essential for clinicians to look for neurologic & other general medical conditions while evaluating a patient with possible conversion disorder. A systematic review of 27 studies found that among 1466 patients initially diagnosed with conversion symptoms, the frequency of misdiagnosis was approximately 4 percent.References. BMJ. 2005;331(7523):989. Epub Oct 13. Childhood onset of stiff-man syndrome. JAMA Neurol. 2013;70(12):1531. J Neurol Neurosurg Psychiatry. 2015 Aug; 86(8):840–8. Epub 2014 Dec 15.
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Kapfhammer, H. P. "CS03-04 - Concept of somatoform disorder." European Psychiatry 26, S2 (March 2011): 1777. http://dx.doi.org/10.1016/s0924-9338(11)73481-2.
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Patients presenting with bodily symptoms and complaints that are not sufficiently explained by organic pathology or well known pathophysiological mechanisms present a major challenge to any health delivery system. From a perspective of psychiatric classification these medically unexplained somatic symptoms may be diagnosed as primary psychiatric disorders such as depressive and anxiety disorders on the one hand, as somatoform disorders on the other. Among medical specialties a separate diagnostic approach is taken to conceptualize functional somatic syndromes. Unfortunately, both diagnostic systems do not conform to each other very well.The concept of somatoform disorders as outlined in DSM-III to DSM-IV-TR and in ICD-10 refers to a group of heterogeneous disorders with prominent somatic symptoms or special body-focussed anxieties, or convictions of illness. These disorders seem to indicate medical conditions that cannot, however, fully be explained either in terms of medical diagnostics or of other primary psychiatric disorders. There is one major conceptual assumption that postulates a decisive impact of psychosocial stress on the origin, onset and/or course of these somatic symptoms and complaints. And there is one major path of diagnostic steps to be taken, i.e. just to count the number of medically unexplained somatic symptoms, to determine their reference to any main organ system, to prove that they are not self-induced, to put special stress on prevailing pain symptoms and to separately assess dominant health anxieties or illness convictions.Since introduction of the diagnostic concept of somatoform disorders there have been arising many critical issues regarding the soundness of this diagnostic category. These issues, among other things, refer to a problematic mind-body dichotomy overemphasizing psychosocial and psychological factors and neglecting major neurobiological processes, to the impracticable criterion of “medically unexplained”, to the demand of conceptual clarity and coherence of this diagnostic category, to the rather trivial diagnostic procedure of just counting the number of medically unexplained somatic symptoms whereas not assessing typical dimensions of illness behaviour in a corresponding way, to the major overlap between subgroups of somatoform disorders on the one hand and factitious disorders, anxiety disorders and depressive disorders on the other, to a principal focus on the epidemiologically rare condition of somatisation disorder as core disorder thereby undervaluing much more prevalent subthreshold conditions, to the difficult communication of the whole diagnostic group to medical colleagues dealing with the same problems by using a different conceptual approach, however.These critical issues surrounding the concept of somatoform disorder will be reflected in respect of some major revisions projected in future diagnostic classification systems of DSM-V and ICD-11.
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da S. Hage-Melim, Lorane I., Jaderson V. Ferreira, Nayana K. S. de Oliveira, Lenir C. Correia, Marcos R. S. Almeida, João G. C. Poiani, Carlton A. Taft, and Carlos H. T. de Paula da Silva. "The Impact of Natural Compounds on the Treatment of Neurodegenerative Diseases." Current Organic Chemistry 23, no. 3 (May 9, 2019): 335–60. http://dx.doi.org/10.2174/1385272823666190327100418.
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Neurodegenerative diseases (NDDs) are characterized by a progressive deterioration of the motor and/or cognitive function, that are often accompanied by psychiatric disorders, caused by a selective loss of neurons in the central nervous system. Among the NDDs we can mention Alzheimer’s disease (AD), Parkinson’s disease (PD), Huntington’s disease (HD), amyotrophic lateral sclerosis (ALS), spinocerebellar ataxia 3 (SCA3), spinal and bulbar muscular atrophy (SBMA) and Creutzfeldt-Jakob disease (CJD). AD and HD are characterized mainly by massive neuronal loss. PD, ALS, SCA3 and SBMA are agerelated diseases which have characteristic motor symptoms. CJD is an NDD caused by prion proteins. With increasing life expectancy, elderly populations tend to have more health problems, such as chronic diseases related to age and disability. Therefore, the development of therapeutic strategies to treat or prevent multiple pathophysiological conditions in the elderly can improve the expectation and quality of life. The attention of researchers has been focused on bioactive natural compounds that represent important resources in the discovery and development of drug candidates against NDDs. In this review, we discuss the pathogenesis, symptoms, potential targets, treatment and natural compounds effective in the treatment of AD, PD, HD, ALS, SCA3, SBMA and CJD.
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Sharquie, Khalifa Ebeid, and Maha Sulaiman Younis. "Delusional parasitosis as a tactile hallucination handled by dermatologists." Our Dermatology Online 13, no. 3 (July 1, 2022): 254–58. http://dx.doi.org/10.7241/ourd.20223.3.
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Background: Delusional parasitosis (DP) is a false, unshakable belief that pathogens have infested one’s own skin or body. Objective: The objective was to record all patients with DP, a rare presentation of monosymptomatic delusion, in Iraq. Patients and Methods: This was a descriptive study of 21 cases diagnosed with DP in Medical City Teaching Hospital in Baghdad, Iraq, between 2013 and 2021. A detailed history and clinical examination were conducted to exclude actual organic disease. Results: All patients were females with a mean age of 65 years. They believed strongly to have pathogens in their skin or scalp, carrying containers with samples of skin debris, fibers, dead insects, hair waste, and small stones as proofs of their infestation. Careful psychiatric assessment ruled out schizophrenia, substance use disorders, and dementia, and proved the psychiatric diagnosis of monosymptomatic delusion. The patients described their symptoms as something crawling, stinging, and biting sensations. On examination, we often saw shaved scalp hair with injured skin in the form of excoriations, ulcerations, scarring, and pyogenic infections in a localized area. Conclusion: DP is a single symptom-sign complex manifestation in a person with a well-preserved personality apart from a single tactile hallucination of some sort of pathogens infesting their skin. It is commonly a disease of the scalp of elderly females that run a chronic course and rarely remits in a short time. Proper liaison between dermatologists and psychiatrists assisted by laboratory facilities is required for diagnosis and follow-up. Empathetic rapport, psychiatric referral, and early treatment by atypical anti-psychotics significantly improve such conditions.
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Nath, Santanu, Rosali Bhoi, Biswaranjan Mishra, and Susanta Padhy. "Does recurrent catatonia manifest in a similar fashion in all the episodes of mood disorder? A case series with literature review." General Psychiatry 34, no. 5 (September 2021): e100494. http://dx.doi.org/10.1136/gpsych-2021-100494.
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Catatonia, originally conceptualised by Kahlbaum in 1868, is a neuropsychiatric condition that has been found to occur concomitantly with several organic and psychiatric conditions. Starting from the era of Kraepelin and Bleuler, this condition was faultily linked with schizophrenia alone; however, over time, greater associations have been found between catatonia and mood disorders. Despite the availability of several reports supporting this finding, there is a relative paucity of studies that specifically focus on catatonia to be the first symptom manifestation heralding a subsequent mood episode. In addition, there is scant literature to determine whether there are specific presentations of catatonia that show greater associations with mood disorders and whether these signs and symptoms recur in a stereotypical fashion in the subsequent mood episodes in the lifetime of an individual. We hereby report two cases with a diagnosis of mood disorders (bipolar disorder and recurrent depressive disorder) who had catatonia as the initial symptom not only at presentation but also at subsequent episodes. The report emphasises that recurrent catatonia can be the initial clinical manifestation of an underlying mood episode, which appears otherwise masked behind the catatonic presentation. These catatonic symptoms can be interestingly similar in all the subsequent episodes. A detailed clinical evaluation is thus warranted after catatonia has been duly treated to provide a holistic management.
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Gruenbaum, Benjamin F., Alexander Zlotnik, Ilya Fleidervish, Amit Frenkel, and Matthew Boyko. "Glutamate Neurotoxicity and Destruction of the Blood–Brain Barrier: Key Pathways for the Development of Neuropsychiatric Consequences of TBI and Their Potential Treatment Strategies." International Journal of Molecular Sciences 23, no. 17 (August 25, 2022): 9628. http://dx.doi.org/10.3390/ijms23179628.
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Traumatic brain injury (TBI) is associated with significant cognitive and psychiatric conditions. Neuropsychiatric symptoms can persist for years following brain injury, causing major disruptions in patients’ lives. In this review, we examine the role of glutamate as an aftereffect of TBI that contributes to the development of neuropsychiatric conditions. We hypothesize that TBI causes long-term blood–brain barrier (BBB) dysfunction lasting many years and even decades. We propose that dysfunction in the BBB is the central factor that modulates increased glutamate after TBI and ultimately leads to neurodegenerative processes and subsequent manifestation of neuropsychiatric conditions. Here, we have identified factors that determine the upper and lower levels of glutamate concentration in the brain after TBI. Furthermore, we consider treatments of disruptions to BBB integrity, including repairing the BBB and controlling excess glutamate, as potential therapeutic modalities for the treatment of acute and chronic neuropsychiatric conditions and symptoms. By specifically focusing on the BBB, we hypothesize that restoring BBB integrity will alleviate neurotoxicity and related neurological sequelae.
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Meade, Elaine, and Mary Garvey. "The Role of Neuro-Immune Interaction in Chronic Pain Conditions; Functional Somatic Syndrome, Neurogenic Inflammation, and Peripheral Neuropathy." International Journal of Molecular Sciences 23, no. 15 (August 2, 2022): 8574. http://dx.doi.org/10.3390/ijms23158574.
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Functional somatic syndromes are increasingly diagnosed in chronically ill patients presenting with an array of symptoms not attributed to physical ailments. Conditions such as chronic fatigue syndrome, fibromyalgia syndrome, or irritable bowel syndrome are common disorders that belong in this broad category. Such syndromes are characterised by the presence of one or multiple chronic symptoms including widespread musculoskeletal pain, fatigue, sleep disorders, and abdominal pain, amongst other issues. Symptoms are believed to relate to a complex interaction of biological and psychosocial factors, where a definite aetiology has not been established. Theories suggest causative pathways between the immune and nervous systems of affected individuals with several risk factors identified in patients presenting with one or more functional syndromes. Risk factors including stress and childhood trauma are now recognised as important contributors to chronic pain conditions. Emotional, physical, and sexual abuse during childhood is considered a severe stressor having a high prevalence in functional somatic syndrome suffers. Such trauma permanently alters the biological stress response of the suffers leading to neuroexcitatory and other nerve issues associated with chronic pain in adults. Traumatic and chronic stress results in epigenetic changes in stress response genes, which ultimately leads to dysregulation of the hypothalamic-pituitary axis, the autonomic nervous system, and the immune system manifesting in a broad array of symptoms. Importantly, these systems are known to be dysregulated in patients suffering from functional somatic syndrome. Functional somatic syndromes are also highly prevalent co-morbidities of psychiatric conditions, mood disorders, and anxiety. Consequently, this review aims to provide insight into the role of the nervous system and immune system in chronic pain disorders associated with the musculoskeletal system, and central and peripheral nervous systems.
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Rodado León, B., M. Huete Naval, A. García Carpintero, M. Jiménez Cabañas, A. Bermejo Pastor, and M. Pérez Lombardo. "Is it psychosis? Heads or tails. A case report." European Psychiatry 65, S1 (June 2022): S780—S781. http://dx.doi.org/10.1192/j.eurpsy.2022.2016.
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Introduction Psychotic disorders usually come with diagnosis difficulties, especially when the clinical presentation is recent or if there are organic factor associated. Regarding this, we propose the clinical case of a man 47 years old without psychiatric history, who is brought to the hospital after being run over by the subway. At his arrival, he verbalizes delirious thoughts of persecution and harm. Objectives The objective is to emphasize the importance of making an appropriate somatic study in psychosis cases, especially when we don’t know the time of setting or we can’t make a psychiatric interview in optimal conditions. Methods The study included a blood test including methemoglobine, cranial tomography, serologies and a heavy metals test. We reviewed the scientific literature in Pubmed and Web of Science about the possible association between the psychiatric and the dermatological symptoms. Results During his admission, the patient recognizes delusional thoughts of harm since he was young and he was so frightened because of this that he tried to commit suicide in the subway. Moreover, he also thinks that silver can heal any disease, so he has licked silver coins for years. The final diagnosis was schizophrenia, and argyria due to a chronic silver intoxication. Conclusions Heavy metals intoxications can be associated to acute psychotic disorders, so we must take them into account. As well, schizophrenia can cause bizarre believes which can lead to the intoxication. Disclosure No significant relationships.
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Craig, T. K. J., A. P. Boardman, K. Mills, O. Daly-Jones, and H. Drake. "The South London Somatisation Study." British Journal of Psychiatry 163, no. 5 (November 1993): 579–88. http://dx.doi.org/10.1192/bjp.163.5.579.
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In a two-year longitudinal study, a two-stage screening procedure was used to identify subjects in primary care with emotional disorder presenting with a recent onset of physical symptoms and a comparison sample of patients presenting with physical symptoms only. Somatisers (n = 44) were defined as subjects who had an emotional disorder but who presented with physical symptoms that could not be attributed to organic disease. The course and outcome of these conditions were compared with those of pure emotional disorder (n = 11), pure physical disorder (n = 90) and ‘mixed’ conditions (n = 39). The physical symptoms of somatisers were less likely to improve and lagged behind those of the other groups, and 16 of these acute somatisers went on to develop chronic somatoform disorders. Among somatisers, changes in physical symptom levels throughout the follow-up closely mirrored changes in emotional arousal. Emotionally disordered subjects reported more instances of parental lack of care, but somatisers were also more likely than other groups to report parental physical illness and to have had more physical illness themselves in childhood. A logistic regression suggests that adult somatisation is best modelled by parental lack of care followed by childhood illness.
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Blanchet, Corinne, Sébastien Guillaume, Flora Bat-Pitault, Marie-Emilie Carles, Julia Clarke, Vincent Dodin, Philibert Duriez, et al. "Medication in AN: A Multidisciplinary Overview of Meta-Analyses and Systematic Reviews." Journal of Clinical Medicine 8, no. 2 (February 25, 2019): 278. http://dx.doi.org/10.3390/jcm8020278.
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Drugs are widely prescribed for anorexia nervosa in the nutritional, somatic, and psychiatric fields. There is no systematic overview in the literature, which simultaneously covers all these types of medication. The main aims of this paper are (1) to offer clinicians an overview of the evidence-based data in the literature concerning the medication (psychotropic drugs and medication for somatic and nutritional complications) in the field of anorexia nervosa since the 1960s, (2) to draw practical conclusions for everyday practise and future research. Searches were performed on three online databases, namely MEDLINE, Epistemonikos and Web of Science. Papers published between September 2011 and January 2019 were considered. Evidence-based data were identified from meta-analyses, if there were none, from systematic reviews, and otherwise from trials (randomized or if not open-label studies). Evidence-based results are scarce. No psychotropic medication has proved efficacious in terms of weight gain, and there is only weak data suggesting it can alleviate certain psychiatric symptoms. Concerning nutritional and somatic conditions, while there is no specific, approved medication, it seems essential not to neglect the interest of innovative therapeutic strategies to treat multi-organic comorbidities. In the final section we discuss how to use these medications in the overall approach to the treatment of anorexia nervosa.
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Serrano Díaz de Otálora, M., J. Gómez-Arnau Ramírez, R. Martínez de Velasco, and P. Artieda Urrutia. "Prevalence of paranoid symptomatology in the elderly and relationship to organic brain factors." European Psychiatry 26, S2 (March 2011): 853. http://dx.doi.org/10.1016/s0924-9338(11)72558-5.
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IntroductionPsychotic diseases in the elderly are underdiagnosed due to the limited use of medical resources. Advanced age makes psychoses of any cause less pure and differentiated, since old age adds a cognitive-impairment component to the basal psychotic defect.ObjectivesWe intend to estimate the prevalence of paranoid symptoms in older patients, and to study the many medical conditions associated with psychosis.MethodsWe conducted a literature review and we have performed a review of several clinical trials.ResultsWe found 12.1% of paranoid symptoms in the elderly with cognitive impairment. In absence of this factor, we found a prevalence of 14.1% for suspicion tendencies, 6.9% for paranoid thoughts and 5.5% for evident delusions. These figures were significantly higher in old black people.We present a table of the main medical conditions that can produce psychotic symptoms. Some cases of apparently typical delusional disorder can appear as a long-term complication of some of these diseases. If organic factors are subtle and long lasting, the clinical may reproduce a fairly typical delusional disorder and may respond to treatment with neuroleptic drugs.ConclusionsIt seems possible that organic brain factors are more common that we believe, becoming essential a comprehensive study of the old psychotic patient. We should pay more attention to psychotic symptoms in elderly patients and avoid conclusions based on cross-evaluations. Diagnosis will be defined by evolution in most of the cases.
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Bellino, Silvio, Paola Bozzatello, Cristina Badino, Emanuela Mantelli, and Paola Rocca. "Efficacy of Polyunsaturated Fatty Acids (PUFAs) on Impulsive Behaviours and Aggressiveness in Psychiatric Disorders." International Journal of Molecular Sciences 22, no. 2 (January 9, 2021): 620. http://dx.doi.org/10.3390/ijms22020620.
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It is the focus of increasing interest to investigate the effects of long-chain n-3 and long-chain n-6 polyunsaturated fatty acids (LC n-3 PUFAs; LC n-6 PUFAs) on psychiatric symptoms in a transdiagnostic perspective. There is some evidence that low levels of LC n-3 PUFAs and a higher ratio of LC n-6 to LC n-3 PUFAs in plasma and blood cells are associated with aggressive and impulsive behaviours. Therefore, implementation of LC n-3 PUFAs may produce positive effects on hostility, aggression, and impulsivity in both psychiatric and non-psychiatric samples across different stages of life. A possible mechanism of action of LC n-3 PUFAs in conditions characterized by a high level of impulsivity and aggression is due to the effect of these compounds on the serotonin system and membrane stability. Studies that evaluated the effects of LC n-3 PUFAs on impulsivity and aggressiveness indicated that addition of rather low doses of these agents to antipsychotic treatment might reduce agitation and violent behaviours in psychosis, attention deficit hyperactivity disorder, personality disorders, and impulsive control and conduct disorders. The present review is aimed at examining and discussing available data from recent trials on this topic.
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Bellino, Silvio, Paola Bozzatello, Cristina Badino, Emanuela Mantelli, and Paola Rocca. "Efficacy of Polyunsaturated Fatty Acids (PUFAs) on Impulsive Behaviours and Aggressiveness in Psychiatric Disorders." International Journal of Molecular Sciences 22, no. 2 (January 9, 2021): 620. http://dx.doi.org/10.3390/ijms22020620.
Full textAbstract:
It is the focus of increasing interest to investigate the effects of long-chain n-3 and long-chain n-6 polyunsaturated fatty acids (LC n-3 PUFAs; LC n-6 PUFAs) on psychiatric symptoms in a transdiagnostic perspective. There is some evidence that low levels of LC n-3 PUFAs and a higher ratio of LC n-6 to LC n-3 PUFAs in plasma and blood cells are associated with aggressive and impulsive behaviours. Therefore, implementation of LC n-3 PUFAs may produce positive effects on hostility, aggression, and impulsivity in both psychiatric and non-psychiatric samples across different stages of life. A possible mechanism of action of LC n-3 PUFAs in conditions characterized by a high level of impulsivity and aggression is due to the effect of these compounds on the serotonin system and membrane stability. Studies that evaluated the effects of LC n-3 PUFAs on impulsivity and aggressiveness indicated that addition of rather low doses of these agents to antipsychotic treatment might reduce agitation and violent behaviours in psychosis, attention deficit hyperactivity disorder, personality disorders, and impulsive control and conduct disorders. The present review is aimed at examining and discussing available data from recent trials on this topic.
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Genovese, Ann, and Merlin G. Butler. "Clinical Assessment, Genetics, and Treatment Approaches in Autism Spectrum Disorder (ASD)." International Journal of Molecular Sciences 21, no. 13 (July 2, 2020): 4726. http://dx.doi.org/10.3390/ijms21134726.
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Autism spectrum disorder (ASD) consists of a genetically heterogenous group of neurobehavioral disorders characterized by impairment in three behavioral domains including communication, social interaction, and stereotypic repetitive behaviors. ASD affects more than 1% of children in Western societies, with diagnoses on the rise due to improved recognition, screening, clinical assessment, and diagnostic testing. We reviewed the role of genetic and metabolic factors which contribute to the causation of ASD with the use of new genetic technology. Up to 40 percent of individuals with ASD are now diagnosed with genetic syndromes or have chromosomal abnormalities including small DNA deletions or duplications, single gene conditions, or gene variants and metabolic disturbances with mitochondrial dysfunction. Although the heritability estimate for ASD is between 70 and 90%, there is a lower molecular diagnostic yield than anticipated. A likely explanation may relate to multifactorial causation with etiological heterogeneity and hundreds of genes involved with a complex interplay between inheritance and environmental factors influenced by epigenetics and capabilities to identify causative genes and their variants for ASD. Behavioral and psychiatric correlates, diagnosis and genetic evaluation with testing are discussed along with psychiatric treatment approaches and pharmacogenetics for selection of medication to treat challenging behaviors or comorbidities commonly seen in ASD. We emphasize prioritizing treatment based on targeted symptoms for individuals with ASD, as treatment will vary from patient to patient based on diagnosis, comorbidities, causation, and symptom severity.
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Teles, Luís. "Erdheim-Chester Disease: Case Report with Aggressive Multiple Organ Manifestations." Biomedical Research and Clinical Reviews 1, no. 1 (May 6, 2020): 01–03. http://dx.doi.org/10.31579/2692-9406/002.
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Erdheim-Chester disease (ECD) is a rare non-Langerhans cell, lipid-laden histiocytosis with specific histological and radiological findings. The diagnosis sometimes is established lately in the course of the disease. We present a case of a 64-year-old female with elevated inflammatory markers for one year and symptoms related with her comorbidities, particularly bone pain and short of breath. Past medical history includes a stage III chronic kidney disease, central diabetes diagnosed when she was 38 years old, Paget Disease, metabolic syndrome and ischemic cardiopathy. Computed tomography in the near past showed a tissue densification in the thoracic vertebral column and kidneys with hairy aspect. X-ray of the arms, legs, skullcap, and demonstrated sclerotic changes. F-fluorodeoxyglucose positron emission tomography showed uptake in the skull, mediastinum, abdomen and long bones from arms and legs. Biopsy of the hairy kidney was consent after 4 years of an unknown disease in progression. Histological findings of the biopsy reported a diffuse infiltration by foamy histiocytes. On immunohistochemical staining, the histiocytes were positive for CD68 and negative for CD1 and S100. Mutation of BRAF V600E was present and ECD was established. Tocilizumab was initiated off label due to psychiatric contra indication for interferon use and no clinical conditions for BRAF inhibitors and symptoms started being controlled. The diagnosis of ECD is usually challenging due to the rarity of the disease and clinical overlapping with many other conditions. The rarity and variable presentation of this disease usually leads to delayed diagnosis and to high morbidity and mortality rates from associated complications.
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Calvin, J. L. Rodriguez. "Treatment of Depressive Patients with Duloxetine in a Hospital Consulting Department." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)70741-2.
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Objective:Depressive symptoms present quite frequently in in-patients in general hospitals with a variety of organic conditions. The main aim of treatment is to manage the symptoms and prevent them from recurring.The primary endpoint for this study was to assess the effectiveness of treatment with duloxetine in a group of in-patients with depressive symptoms in the general hospital.Methods:This was an observational study with duloxetine, in which a total of 40 patients were included who presented depressive symptoms while in-patients in a general hospital and who had the established inclusion criteria.The clinical effectiveness of the treatment was assessed with the Hamilton scale and the Clinical Global Impression scales for severity and change.Results:A total of 40 patients were treated with duloxetine, 6 of whom (15%) dropped out of the study. The average maintenance dose administered at the baseline visit was 60 mg/day and at discharge was 75 mg/day. At the end of follow-up, there was a reduction with respect to the baseline values of 13.6 points on the Hamilton scale and 2.4 points on the CGI of severity scale. 63.4% of the patients felt “much better” at the final visit, according to the CGI of change scale.Conclusions:According to the results, it seems that DULOXETINE may be a good treatment option for patients admitted to general hospital for different conditions of organic origin who present depressive symptoms while in hospital, both for its therapeutic effectiveness and for its good tolerability profile.
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Milatovic, Jovan. "Traumatic brain injury and adjustment disorders." Medical review 70, no. 7-8 (2017): 249–56. http://dx.doi.org/10.2298/mpns1708249m.
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Introduction. Traumatic brain injury and reactive psychiatric disorders are universal health problems, both individually and in comorbidity. Traffic accidents are the most common cause of traumatic head injury, followed by falls, violence, and sports injuries. Due to the fact that they are associated with rapid, stressful events, they clearly trigger or generate reactive psychiatric disorders. What makes them special in this area is their organic substrate. Almost all patients with severe head injuries, more than half with moderate, and one tenth with mild head injuries suffer neuropsychiatric sequelae. Discussion and Conclusion. Among the published papers on this topic, prospective epidemiological analytical studies are dominant. Most articles deal with injured soldiers, injured children or adolescents. Recent papers emphasize the need for a timely, multidisciplinary care for the affected people and the primary community. It is very important to initiate early rehabilitation and psychotherapy. Due to non-specific and limited pharmacotherapeutic options, especially evident in organ damage and pediatric population, special attention is given to occupational, psychological rehabilitation, and cognitive-behavioral psychotherapy, as well as psycho-pharmacological drugs in case of clear clinical indications. As potentially the most important for further research, are the results on the genetic predisposition of individuals for clinical outcomes of associated conditions, structural and functional visualization of brain regions associated with specific psychological symptoms, and psycho-protective role of morphine and amnesia. Involvement of the wider community in a range of activities that contribute to poor outcomes is of utmost importance.
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Danilova, S. "Expert Evaluation of «Another Unhealthy Conditions»." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)71057-0.
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Patients who have had chronic mental disorders, another unhealthy conditions, mental retardation are considered to be irresponsible. Special interest represent is disorders, which expect as “another unhealthy conditions”. Mental disorders consider without process basis (pathokinesis have has chronic or acute psychosis), dementia. Another unhealthy conditions is quality differences from mental standard, but it does happen expressive that does irresponsible.56 men have been examined in the department of Personality Disorders and psyhogenias. Age: 20-60 years old. Disorders experts as “another unhealthy conditions” includes of the Classification ICD-10: Personality Disorders (F 60 - F 61), organic Personality Disorders (F 06.3 - F 07.9), mentally retardness of slight degree with breach of behaviour (F 70.1). Diagnosis of Paranoid Personality Disorder and Schizoid Personality Disorder were most common.Analysis of expert evaluation is show that it is necessary to estimate psychological criteria of irresponsibility. Analysis of pathological symptoms, structure of personality and cognitive disorders, disposition of crime, situational and motivational factors are show that it is necessary to estimate a depth of mental pathology, disturbance of critical abless and defects of personality and intellectual functions to expects conclusions of irresponsibility.
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Kouba, Bruna R., Anderson Camargo, Joana Gil-Mohapel, and Ana Lúcia S. Rodrigues. "Molecular Basis Underlying the Therapeutic Potential of Vitamin D for the Treatment of Depression and Anxiety." International Journal of Molecular Sciences 23, no. 13 (June 25, 2022): 7077. http://dx.doi.org/10.3390/ijms23137077.
Full textAbstract:
Major depressive disorder and anxiety disorders are common and disabling conditions that affect millions of people worldwide. Despite being different disorders, symptoms of depression and anxiety frequently overlap in individuals, making them difficult to diagnose and treat adequately. Therefore, compounds capable of exerting beneficial effects against both disorders are of special interest. Noteworthily, vitamin D deficiency has been associated with an increased risk of developing depression and anxiety, and individuals with these psychiatric conditions have low serum levels of this vitamin. Indeed, in the last few years, vitamin D has gained attention for its many functions that go beyond its effects on calcium–phosphorus metabolism. Particularly, antioxidant, anti-inflammatory, pro-neurogenic, and neuromodulatory properties seem to contribute to its antidepressant and anxiolytic effects. Therefore, in this review, we highlight the main mechanisms that may underlie the potential antidepressant and anxiolytic effects of vitamin D. In addition, we discuss preclinical and clinical studies that support the therapeutic potential of this vitamin for the management of these disorders.
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Santos, C. Fernandes, A. B. Medeiros, R. Gomes, and N. Descalço. "Neuropsychiatric complications of traumatic brain injury." European Psychiatry 64, S1 (April 2021): S251. http://dx.doi.org/10.1192/j.eurpsy.2021.674.
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IntroductionTraumatic brain injury (TBI) is a leading cause of morbidity and mortality, giving rise to a variety of neuropsychiatric syndromes associated with great functional impairments, chronic disability and poor quality of life. Depending on diagnostic criteria, 20-90% of victims of TBI develop at least one neuropsychiatric manifestation in the first month, and about 40% present at least three symptoms during three months, with higher incidence in females. Survivors of TBI are at increased risk for development of severe, long-term psychiatric disorders. The aetiology of these disturbances remains unclear.ObjectivesTo review current knowledge on the neuropsychiatric consequences associated with TBI.MethodsNon-systematic review of literature through search on PubMed/MEDLINE database for publications up to 2020, following the terms “traumatic brain injury” and “neuropsychiatry”.ResultsAlthough the experience of neuropsychiatric symptoms may be temporary and may resolve in the acute period, many patients with TBI can experience psychopathology that is persistent or that develops in the post-acute period, regardless of injury severity. These symptoms can involve personality changes, psychosis, major depression, generalized anxiety disorder, post-traumatic stress disorder, maladaptive social behaviours, poor disability adjustment, reduced coping skills and cognitive impairment. Evidence remains insufficient to conclude the role of TBI-related neuropathological consequences in the development of post-TBI neuropsychiatric disorder. Non-organic factors are also implicated in its generation and maintenance.ConclusionsNeuropsychiatric sequelae are common following TBI. Several of these syndromes are amenable to treatment. Further investigations are required to better understand the mechanistic aetiology of these conditions and the effectiveness of therapeutic modalities.
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Baj, Jacek, Alicja Forma, Elżbieta Sitarz, Kaja Karakuła, Wojciech Flieger, Monika Sitarz, Cezary Grochowski, Ryszard Maciejewski, and Hanna Karakula-Juchnowicz. "Beyond the Mind—Serum Trace Element Levels in Schizophrenic Patients: A Systematic Review." International Journal of Molecular Sciences 21, no. 24 (December 15, 2020): 9566. http://dx.doi.org/10.3390/ijms21249566.
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The alterations in serum trace element levels are common phenomena observed in patients with different psychiatric conditions such as schizophrenia, autism spectrum disorder, or major depressive disorder. The fluctuations in the trace element concentrations might act as potential diagnostic and prognostic biomarkers of many psychiatric and neurological disorders. This paper aimed to assess the alterations in serum trace element concentrations in patients with a diagnosed schizophrenia. The authors made a systematic review, extracting papers from the PubMed, Web of Science, and Scopus databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Among 5009 articles identified through database searching, 59 of them were assessed for eligibility. Ultimately, 33 articles were included in the qualitative synthesis. This review includes the analysis of serum levels of the following trace elements: iron, nickel, molybdenum, phosphorus, lead, chromium, antimony, uranium, magnesium, aluminum, zinc, copper, selenium, calcium, and manganese. Currently, there is no consistency regarding serum trace element levels in schizophrenic patients. Thus, it cannot be considered as a reliable prognostic or diagnostic marker of schizophrenia. However, it can be assumed that altered concentrations of those elements are crucial regarding the onset and exaggeration of either psychotic or negative symptoms or cognitive dysfunctions.
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Luca, Maria, Clara Grazia Chisari, Aurora Zanghì, and Francesco Patti. "Early-Onset Alcohol Dependence and Multiple Sclerosis: Diagnostic Challenges." International Journal of Environmental Research and Public Health 18, no. 11 (May 24, 2021): 5588. http://dx.doi.org/10.3390/ijerph18115588.
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Multiple sclerosis (MS) is an inflammatory demyelinating disorder characterized by the progressive disruption of the myelin sheath around the nerve fibres. The early initiation of disease-modifying treatments is crucial for preventing disease progression and neurological damage. Unfortunately, a diagnostic delay of several years is not uncommon, particularly in the presence of physical and mental comorbidities. Among psychiatric comorbidities, the role of alcohol misuse is still under debate. In this paper, we discuss a case of early-onset alcohol dependence and its possible role in delaying the initiation of a specific therapy for MS. The differential diagnosis between idiopathic and secondary neurodegenerative disorders is often challenging. When dealing with patients reporting an early-onset substance abuse (likely to present organic damage), clinicians may be prone to formulate a diagnosis of secondary neuropathy, particularly when facing non-specific symptoms. This case report highlights the need for in-depth medical investigations (including imaging) in the presence of neurological signs suggesting a damage of the central nervous system, prompting a differential diagnosis between idiopathic and secondary neurodegenerative conditions. Indeed, a timely diagnosis is crucial for the initiation of specific therapies positively affecting the outcome.
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Semke, V. Y. "Prevalence of mental disorders in late life." European Psychiatry 26, S2 (March 2011): 852. http://dx.doi.org/10.1016/s0924-9338(11)72557-3.
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In late life patients considerably more seldom than patients of other age groups reach attention of psychiatrists due to obliteration of symptoms of mental suffering, their masked by somatic symptoms manifestation, not seldom - negative attitude of relatives toward psychiatric assistance etc.Study of patients of elder and older age at units of somatic hospital of another profile (therapeutic, cardiologic, neurological, traumatologic) has shown that mental disturbances are revealed in 74,4 % of them. Non-psychotic forms of disorders are basic (73,8 %), more seldom psychoses are found (18,6 %) and dementias of various nature (7,6 %). Of most prevalence in this contingent were disorders related with cerebral-vascular diseases (42,6 %), including those with acute disturbances of brain blood circulation (20,5 %). Somatogenic mental disorders occupy more modest place counting 8,8%. Neuroses including nosogenias are observed in 9,2 % of cases. Endogenous diseases are rarely found in patients of a somatic institution (6,7 %).In recent years significant growth of organic mental disorders in Russian Federation occurs predominantly at the expense of the elderly. In structure of this pathology as selective epidemiological investigations show the first place according to incidence rate is occupied by cerebral-vascular diseases (34,1 %); the second place is occupied by neurotic disturbances (26,0 %); the third one - affective disorders (15,4 %).Differences in sickness rate and morbidity in such conditions identified by researchers in different populations may reflect more particularly their diagnostic approaches than the true differences in incidence and prevalence.
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Lopes, L., B. Moura, and S. Pereira. "“This is not a doctors thing, it is witchcraft” - A case report of acute psychosis concomitant to primary hyperparathyroidism." European Psychiatry 64, S1 (April 2021): S250. http://dx.doi.org/10.1192/j.eurpsy.2021.672.
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IntroductionPrimary hyperparathyroidism (PHPT), usually caused by a parathyroid adenoma, is characterized by a pathologically high secretion of parathyroid hormone and consequent hypercalcemia. PHPT has a high prevalence among elderly patients and might be responsible for neuropsychiatric symptoms.ObjectivesWe aim to report the rare manifestation of acute psychosis accompanying a PHPT diagnosis, and to discuss the neurobiological relationship between hyperparathyroidism, hypercalcaemia and neuropsychiatric symptoms.MethodsWe present a clinical case based on patient’s history and clinical data, along with a literature review on PHPT neuropsychiatric symptons.ResultsWe present the case of a 68-year-old man diagnosed with PHPT in November 2019. He was brought up to psychiatric evaluation for the first time in May 2020 upon behavioral changes (aggressiveness and bizarre rituals). The patient described the sensation of burns scattered throughout the body since January 2020, felling anxious and frightened, sleeping poorly and progressive social isolation. He presented delusional ideas of mystical and paranoid content. No significant cognitive impairments were found. The patient’s psychosis was partially responsive to atypical antipsychotics. He’s waiting for surgery. Hypercalcaemia might manifest as mood disorders, cognitive changes and rarely as acute psychosis. Although there is not yet a clear mechanism to explain it, high calcium levels seem to cause neurotoxicity and neurotransmission dysfunction. Restoration of normal calcium levels tend to resolve neuropsychiatric symptoms, but in PHPT parathyroidectomy is usually recommended.ConclusionsNeuropsychiatric symptoms are responsible for great disability, and demand an organic in-depth investigation. A multidisciplinary team approach must always be considered in the management of such conditions.
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Kim, Chaebin, Ali Yousefian-Jazi, Seung-Hye Choi, Inyoung Chang, Junghee Lee, and Hoon Ryu. "Non-Cell Autonomous and Epigenetic Mechanisms of Huntington’s Disease." International Journal of Molecular Sciences 22, no. 22 (November 19, 2021): 12499. http://dx.doi.org/10.3390/ijms222212499.
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Huntington’s disease (HD) is a rare neurodegenerative disorder caused by an expansion of CAG trinucleotide repeat located in the exon 1 of Huntingtin (HTT) gene in human chromosome 4. The HTT protein is ubiquitously expressed in the brain. Specifically, mutant HTT (mHTT) protein-mediated toxicity leads to a dramatic degeneration of the striatum among many regions of the brain. HD symptoms exhibit a major involuntary movement followed by cognitive and psychiatric dysfunctions. In this review, we address the conventional role of wild type HTT (wtHTT) and how mHTT protein disrupts the function of medium spiny neurons (MSNs). We also discuss how mHTT modulates epigenetic modifications and transcriptional pathways in MSNs. In addition, we define how non-cell autonomous pathways lead to damage and death of MSNs under HD pathological conditions. Lastly, we overview therapeutic approaches for HD. Together, understanding of precise neuropathological mechanisms of HD may improve therapeutic approaches to treat the onset and progression of HD.
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Nepal, S., D. Gupta, and D. Neupane. "Symptom Profile of Patients with Psychotic Disorders." Journal of Psychiatrists' Association of Nepal 7, no. 2 (December 31, 2018): 55–58. http://dx.doi.org/10.3126/jpan.v7i2.24616.
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Introduction: According to WHO, schizophrenia is a severe mental disorder affecting about 23 million people worldwide. Psychoses, including schizophrenia, are characterized by distortions in thinking, perception, emotions, language, sense of self and behavior. The impacts of these disorders are severe, with approximately 1 million people committing suicide annually. There is also an increase in co morbidity of these different conditions. So, this study was carried out to assess the symptom profile of patients with schizophrenia and other psychotic disorders (excluding mood disorders, substance induced psychotic disorders, organic psychotic disorders).
Material and Method: Discharge record sheets of all cases admitted (Total 86) to the psychiatric ward over the study period were reviewed. Cases diagnosed as schizophrenia and other psychotic disorders were enrolled. Major symptoms were listed from the discharge papers.
Results: Out of the total number of patients enrolled in the research, 68.6% were male while 31.4% were female. The mean age of the patients was found to be 31.03 years with a minimum age of 16 years and maximum 63 years. Most were from lower middle class family, Hindu by religion and unmarried. Among 86 cases, 26(30.2%) were diagnosed as Unspecified nonorganic psychosis, 24(27.9%) as Schizophrenia, 19(22.1%) as Schizoaffective disorder, 14(16.3%) as Acute & Transient Psychotic Disorder, 3(3.5%) as Persistent delusional disorder. Delusion of persecution was present in 46 cases (53.5%), Delusion of reference in 33 cases (38.4%) and Hallucinations in 32 cases (37.2%). Out of the 86 patients enrolled in the study, 15 (17.4%) had at least one suicidal attempt.
Conclusion: Significant number of patients were diagnosed as Schizophrenia which is itself a chronic, debilitating illness. Hallucinations and delusions were present in most of the cases.
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Hughes, Francis M., Michael R. Odom, Anissa Cervantes, Austin J. Livingston, and J. Todd Purves. "Why Are Some People with Lower Urinary Tract Symptoms (LUTS) Depressed? New Evidence That Peripheral Inflammation in the Bladder Causes Central Inflammation and Mood Disorders." International Journal of Molecular Sciences 24, no. 3 (February 1, 2023): 2821. http://dx.doi.org/10.3390/ijms24032821.
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Anecdotal evidence has long suggested that patients with lower urinary tract symptoms (LUTS) develop mood disorders, such as depression and anxiety, at a higher rate than the general population and recent prospective studies have confirmed this link. Breakthroughs in our understanding of the diseases underlying LUTS have shown that many have a substantial inflammatory component and great strides have been made recently in our understanding of how this inflammation is triggered. Meanwhile, studies on mood disorders have found that many are associated with central neuroinflammation, most notably in the hippocampus. Excitingly, work on other diseases characterized by peripheral inflammation has shown that they can trigger central neuroinflammation and mood disorders. In this review, we discuss the current evidence tying LUTS to mood disorders, its possible bidirectionally, and inflammation as a common mechanism. We also review modern theories of inflammation and depression. Finally, we discuss exciting new animal studies that directly tie two bladder conditions characterized by extensive bladder inflammation (cyclophosphamide-induced hemorrhagic cystitis and bladder outlet obstruction) to neuroinflammation and depression. We conclude with a discussion of possible mechanisms by which peripheral inflammation is translated into central neuroinflammation with the resulting psychiatric concerns.