General Hospital Psychiatry, Author at primarypsychiatry.com

Abstract: Objective: Wolff–Parkinson–White (WPW) syndrome is characterized by premature ventricular excitation due to the presence of an abnormal accessory pathway. Electrocardiography (ECG) of patients with WPW syndrome portrays a short PR interval and a wide QRS interval with a delta wave.Methods: Herein, we report the case of a patient with schizophrenia who developed a wide QRS interval with a delta wave immediately following electroconvulsive therapy (ECT).Results: Initially, the delta wave disappeared within 2 days after ECT. However, the duration of the delta wave increased exponentially to 4 months when ECT was repeated.Conclusion: Although the patient’s cardiocirculatory dynamics remained normal, we continued to monitor her ECG until the delta wave disappeared because WPW syndrome can lead to serious arrhythmia.
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Abstract: Objective: Data on psychiatric morbidity in high-risk pregnant Singaporean women are limited. This study aimed to establish the prevalence of antenatal depression and anxiety in high-risk pregnancies, compare the prevalence of antenatal depression in high-risk pregnancies vs.
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Abstract: Objective: The safety of concurrent mood stabilizers during the course of electroconvulsive therapy (ECT) is yet to be clearly established. Delirium with concurrent administration of ECT and lithium carbonate is described in this case report.Methods: A 30-year-old male with a past history of significant head injury developed delirium during the course of bitemporal ECT.Results: The clinical picture and the details of the cognitive impairment have been discussed in the report with a focus on relationship between the lithium carbonate administration and the concurrent ECT.Conclusion: Patients with preexisting organic brain damage could be prone to develop the cognitive adverse effect while on a combination of lithium and ECT.
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Abstract: Context: Delirium is prevalent in the intensive care unit (ICU) and has been associated with negative clinical outcomes. However, a quantitative and systematic assessment of published studies has not been conducted.Objective: Meta-analysis of clinical observational studies was performed to investigate the association between delirium and clinical outcomes.Data sources and study selection: Relevant studies were identified by investigators from databases including Medline, Embase, OVID and EBSCO from inception to May 2012.
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Abstract: Objective: The objective was to determine the impact of stimulant use on antiviral treatment for chronic hepatitis C patients in an integrated hepatitis clinic.Methods: A retrospective chart review of 449 consecutive patients seen in an integrated hepatitis clinic that included co-located mental health clinicians was performed. Psychiatric measures included drug use questionnaire, Beck Depression Inventory (BDI), Alcohol Use Disorders Identification Test-Consumption questions (AUDIT-C), urine drug screen and antiviral treatment outcomes. Patients with stimulant use were compared to patients with no drug use, other drug users and an unknown drug use group using χ2 and analysis of variance tests.Results: Over 15% of hepatitis C patients presenting to the clinic were using stimulants
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Abstract: Objective: Physician suicide is an important public health problem as the rate of suicide is higher among physicians than the general population. Unfortunately, few studies have evaluated information about mental health comorbidities and psychosocial stressors which may contribute to physician suicide.
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Abstract: Objective: The objective of this study was to investigate the frequency and clinical features of suicide attempts in adults with autism spectrum disorders (ASDs).Methods: We enrolled 587 consecutive patients aged 18 or over who attempted suicide and were hospitalized for inpatient treatment. Psychiatric diagnoses, suicide attempt frequency and clinical features were compared between ASD and non-ASD patients.Results: Forty-three (7.3%) of the 587 subjects who attempted suicide had ASDs.
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Abstract: Objective: To examine suicidal ideation in a sample of German primary care patients.Methods: We conducted a cross-sectional study and included 1455 primary care patients who visited 1 of 41 general practitioners (GPs) working at 19 different sites. Suicidal ideation and psychopathology were assessed with the Patient Health Questionnaire (PHQ) in an anonymous screening together with health care utilization.Results: One hundred seventy-one (11.8%) of 1455 patients endorsed the suicidal ideation item of the PHQ.
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Guidelines to prevent or treat gambling addiction should mirror those for alcohol addiction, according to a new report from the Royal College of Psychiatrists. Medscape Medical News
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Abstract: Granulocyte colony-stimulating factor agents such as filgrastim can be administered in order to reduce the duration of clozapine-induced agranulocytosis. Successful long-term combination treatment with filgrastim and clozapine in patients with previous clozapine-induced agranulocytosis has been described in several cases. We describe a patient with schizophrenia who developed agranulocytosis during treatment with clozapine and who did not respond to other antipsychotics
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Abstract: Objectives: To evaluate the self-esteem and quality of life in adolescents with extreme obesity before and one year after laparoscopic sleeve gastrectomy as obesity is a major challenging medical problem, not only in adults but also in children and adolescents in Saudi Arabia.Methods: In a prospective cohort study, 32 adolescents (aged 13–17 years) with extreme obesity (Group 1) presenting for laparoscopic sleeve gastrectomy (LSG) were compared with 32 matched, healthy, nonobese adolescents (aged 14–17 years) (Group 2) with regards to self-esteem and quality of life. Assessment was done using the Rosenberg Self-Esteem Scale and Pediatric Quality of Life Inventory version 4.0 (self- and parent report), respectively. Body mass index (BMI) Z scores were calculated for both groups.Results: We found significantly poor self-esteem and impairment in all domains of quality of life (self- and parent report) in Group 1 compared with Group 2 (P
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Abstract: Objective: Erectile dysfunction (ED), defined as the inability to achieve or maintain an erection sufficient for satisfactory sexual performance, is the most common sexual problem in men. ED arises when there is disruption of the complex interplay between vascular, neurologic, hormonal and psychologic factors necessary for normal erectile function. It may have a significant effect on quality of life and portend undetected cardiovascular disease.
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Abstract: Objective: The study aimed to assess psychiatric morbidity in stable chronic respiratory disorders and to examine the pattern of psychiatric illness in specific respiratory disorders in Northern India.Methods: All consecutive patients with stable chronic respiratory illnesses who attended the respiratory disease clinic were recruited in the study. Their healthy attendants were interviewed as a control group.
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Abstract: Objective: Psychiatric morbidity is quite common in vasovagal syncope (VVS), but findings are sometimes contradictory. Among patients with suspected VVS, up to 40% has a negative response to Head-Up Tilt test (HUT), the cause of syncope remaining unexplained (US).
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Abstract: Object: We sought to explore factors associated with persistence of antidepressant treatment in Taiwan and to compare persistence rates across various antidepressants.Method: This was a retrospective cohort study using medical claims in Taiwan. We collected data of all new antidepressant users with depressive disorder, aged 18 years or older, during the study period from January 1, 1998, to July 4, 2009. Overall antidepressant treatment persistence was defined as undergoing treatment for 180 days without exceeding a 30-day gap
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Abstract: Objective: Patients with chronic kidney disease (CKD) who are undergoing maintenance hemodialysis have a higher prevalence of depression than the general population. The underlying cause of this association is unknown, but may be related to accumulation of uremic toxins. Little is known about the association of accumulation of uremic toxins and depression in hemodialysis patients.Method: We conducted a cross-sectional study of 209 CKD patients from a single institution to evaluate the associations of a soluble small uremic toxin (urea), a soluble large uremic toxin (β2 microglobulin) and two protein-bound uremic toxins [total p-cresol sulfate (PCS) and indoxyl sulfate (IS)] with the presence of depression.Results: A total of 47 patients (22.4%) had depression.
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Abstract: Objective: Cognitive impairment, depression, sleep disorders and impaired quality of life are very common in hemodialysis (HD) patients. However, whether there are any seasonal changes of cognitive impairment, depression, sleep disorders and quality of life in HD patients is not known.Methods: The laboratory parameters, depressive symptoms, health-related quality of life, sleep quality (SQ) and cognitive function, were measured twice.Results: A total of 66 HD patients were enrolled. Pre-dialysis systolic blood pressure (BP) and pre-dialysis diastolic BP were higher, whereas predialysis creatinine and sodium were lower in January compared to July.
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Abstract: Objectives: To estimate risk of comorbid depression on all-cause mortality over time among individuals with diabetes.Methods: The Medline, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Embase and Science Direct databases were searched through September 30, 2012. We limited our search to longitudinal or prospective studies reporting all-cause mortality among those having depression and diabetes, compared with those having diabetes alone that used hazard ratios (HRs) as the main outcome. Two reviewers independently extracted primary data and evaluated the quality of studies using predetermined criteria.
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Abstract: Objective: The objective was to explore perspectives on reasons for psychotropic medication use in prisons.Method: We recruited a purposive sample of healthcare staff and patients prescribed psychotropic medicines from four East of England prisons. Participants took part in qualitative, semistructured interviews, which were recorded, transcribed and analyzed thematically.Results: While patients and healthcare staff viewed psychotropic medicines primarily as a treatment for reducing symptoms of mental illness, they were also used as a coping strategy and to reduce insomnia. Appropriate psychotropic prescribing was also thought to contribute towards the rehabilitation agenda and helped to maintain order in prisons.
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Abstract: Objective: To systematically review the literature to determine if health risk behaviors in patients with schizophrenia or bipolar disorder are associated with subsequent symptom burden or level of functioning.Method: Using the PRISMA systematic review method we searched PubMed, Cochrane, PsychInfo and EMBASE databases with key words: health risk behaviors, diet, obesity, overweight, BMI, smoking, tobacco use, cigarette use, sedentary lifestyle, sedentary behaviors, physical inactivity, activity level, fitness, sitting AND schizophrenia, bipolar disorder, bipolar illness, schizoaffective disorder, severe and persistent mental illness, and psychotic to identify prospective, controlled studies of greater than 6 months duration. Included studies examined associations between sedentary lifestyle, smoking, obesity, physical inactivity and subsequent symptom severity or functional impairment in patients with schizophrenia or bipolar disorder.Results: Eight of the 2130 articles identified met inclusion criteria and included 508 patients with a health risk behavior and 825 controls. Six studies examined tobacco use, and two studies examined weight gain/obesity.
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Abstract: Objective: To investigate sociodemographic-, living situation- and substance-related variables as predictors of current risky alcohol use for both female and male general hospital inpatients.Method: The sample of 6050 female and 8282 male general hospital inpatients was recruited in 2002–2004. Using the Alcohol Use Disorder Identification Test-Consumption, they were assigned to four drinking groups: abstinent, moderate use, slightly increased use and notably increased use. Gender-specific predictors of group affiliation were determined using multivariate multinomial logistic regressions.Results: In both genders, younger age, rural living environment, the occurrence of lifetime alcohol use disorders (AUDs) and current tobacco smoking were positively associated with risky alcohol use.
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Abstract: Objective: The aim of this study is to assess the quality of life (QoL), family burden and psychiatric disorders in first-degree relatives of patients with obsessive–compulsive disorder (OCD) and to compare them with healthy controls and their relatives.Methods: Forty patients with OCD and 47 of their first-degree relatives as well as 40 healthy subjects and 45 of their first-degree relatives were recruited in this study. OCD and comorbid anxiety or mood disorders were determined by means of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders. Comorbid Axis II disorders were diagnosed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition Personality Disorders.
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Abstract: Anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis is a new, severe and possibly life-threatening disorder as illustrated by a 25% mortality or severe disability rate. Its neuropsychiatric presentation closely resembles schizophrenia. In this paper, the relationship of anti-NMDAR encephalitis to schizophrenia and its consequences in Consultation–Liaison service for diagnostic workup in patients with first-episode psychosis are addressed.
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Physician suicides evoke more public interest than most other suicides. Is this because physicians are expected to be superhuman, impeccable and flawless? Do some patients perceive a physician suicide as the ultimate proof of total sacrifice and devotion
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Abstract: Objective: Benzodiazepines (BDZs) safety profiles in pregnancy suggest that the risk of major malformations (MMs) cannot be considered simply as a “class effect”. The aim of this paper was to review and update the available literature on the risks of MMs in women exposed to BDZs in the first trimester of pregnancy.Methods: PubMed was searched for English-language articles, from January 2001 to November 2011, introducing as keywords “teratogens”, “ major malformation”, “foetus”, “infant”, “newborn”, “pregnancy”, in conjunction with “benzodiazepines” as a keyword or BDZ generic name as text words.Results: Twelve studies were selected for the review.
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Author Archives: General Hospital Psychiatry

Electroconvulsive therapy-induced Wolff–Parkinson–White syndrome: a case report – Corrected Proof

Depression and anxiety in Singaporean high-risk pregnancies — prevalence and screening

Delirium during the course of electroconvulsive therapy in a patient on lithium carbonate treatment – Corrected Proof

Impact of delirium on clinical outcome in critically ill patients: a meta-analysis

The effect of stimulant use on antiviral treatment in an integrated hepatitis clinic – Corrected Proof

Details on suicide among US physicians: data from the National Violent Death Reporting System

Clinical features of suicide attempts in adults with autism spectrum disorders

Suicidal ideation in German primary care – Corrected Proof

A Safe Bet: Treat Pathologic Gambling Like Alcohol Addiction

Add-on filgrastim during clozapine rechallenge unsuccessful in preventing agranulocytosis – Corrected Proof

Self-esteem and quality of life in adolescents with extreme obesity in Saudi Arabia: the effect of weight loss after…

Male erectile dysfunction: integrating psychopharmacology and psychotherapy

Psychiatric morbidity in chronic respiratory disorders in an Indian service using GMHAT/PC

Persistence of antidepressant treatment for depressive disorder in Taiwan – Corrected Proof

Association between uremic toxins and depression in patients with chronic kidney disease undergoing maintenance…

Are there any seasonal changes of cognitive impairment, depression, sleep disorders and quality of life in hemodialysis…

Depression and risk of mortality in individuals with diabetes: a meta-analysis and systematic review – Corrected Proof

Staff and patient perspectives on the purpose of psychotropic prescribing in prisons: care or control? – Corrected Proof

Associations between health risk behaviors and symptoms of schizophrenia and bipolar disorder: a systematic review

Gender-specific predictors of risky alcohol use among general hospital inpatients

Quality of life, family burden and associated factors in relatives with obsessive–compulsive disorder – Corrected…

First-onset psychosis, anti-NMDAR encephalitis, schizophrenia and Consultation–Liaison psychiatry – Corrected Proof

Physician suicide—why?

Benzodiazepine exposure in pregnancy and risk of major malformations: a critical overview