Abstract: Objective: To examine factors predicting psychiatric morbidity, taking into account the full range of psychiatric disorders before and after burn injury.Method: A cohort of 107 patients consecutively admitted to a Swedish national burn center was examined for lifetime psychiatric morbidity, and 94 patients at one year postinjury. Sixty-seven individuals, some from that same cohort, were interviewed at 2 to 7years postinjury.
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Abstract: According to the Hunter Serotonin Toxicity Criteria, the presence of either clonus or hyperreflexia is a must for making a diagnosis of Serotonin syndrome (SS). We report five patients with SS who had areflexia because of associated polyneuropathy. None of the patients fulfilled the Hunter criteria for SS.
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Abstract: Skilled clinical decision making in the diagnosis and treatment of chronic pain can create unique clinical and ethical challenges, particularly when opioid medications are involved. This report presents the case of a pregnant woman who sought treatment for an illicit opioid dependence, initiated by opioid analgesic treatment of chronic pain. While recognizing opioids’ high level of effectiveness for pain relief, the case demonstrates the potential harms of opioid medications for particular patients
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Abstract: Purpose: Exploring three perspectives on differences between general practitioners (GP) and psychiatrists in clinical decision making about depressed patients. The gold standard perspective focuses on differences in decisions (output) as a result of lack of expertise, the input perspective relates differences to different information use and to other roles, and the throughput perspective attributes differences to other information processing.Methods: 26 psychiatrists and 25 general practitioners (GPs) gave their clinical judgment on four on-line vignettes of increasingly severely depressed patients. Supplementary information on 15 themes could be asked for by clicking on underlined phrases.
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Abstract: Objective: The number of psychiatric hospital beds in England has declined since the 1950s. Since the early 2000s mental health staff increasingly work in community treatment teams.We analysed recent trends in hospital and community treatment in England for eight mental health diagnoses.Method: We obtained data from the UK Government Health and Social Care Information Centre covering the period 1998 to 2012.
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Abstract: Objective: Monitoring PTSD symptoms after a traumatic injury is beneficial for patients and providers. Text messages can be used to automatically monitor symptoms and impose minimal burden to patients and providers. The present study piloted such a strategy with traumatic injury patients.Method: An automated daily text message was piloted to evaluate PTSD symptoms after discharge from the hospital.
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Abstract: Methicillin Resistant Staphylococcus Aureus (MRSA) infection and colonization is a significant health problem. Hospitals have developed extensive infection control policies to curb the spread of infection amongst patients and staff.
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Abstract: Objective: Cretzfeldt-Jacob Disease (CJD) is a rapidly progressive spongiform disease of the central nervous system. Psychiatric symptoms, though considered rare, can be the presenting symptoms of CJD and impose diagnosis difficulties. We reviewed prospectively our database to identify the frequency of psychiatric symptoms as identifying symptoms among our community.Metods: We included all patients in Sheba Medical Center who were diagnosed with CJD between the years 2006 – 2012.
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Syphilis has been called the “great imitator” because of the plethora of signs and symptoms it presents . Neurosyphilis can present with neuropsychiatric symptoms ranging from abnormal pupillary reflex to complex constellations manifesting cognitive, psychotic, and mood dysfunction . However, some patients remain asymptomatic.
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People with serious mental illness (SMI) experience higher rates of chronic care conditions (CCCs) (e.g., cardiovascular disease, diabetes, hypertension,) and experience many years of lost life compared to the general population . We define SMI as meeting criteria for one DSM-IV/SCID diagnosis (e.g., schizophrenia, bipolar disorder), other than a substance use disorder, and having serious functional limitations . Poor management of CCCs is a major source of disability, and can lead to unnecessary health care expenditures including emergency room use , and increased mortality
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Abstract: Objective: To describe eating disorders inpatients with severe medical complications and elucidate the problems in managing them on a psychiatric ward.Method: Of the 111 eating disorders patients hospitalized on our psychiatric ward from January 2005 to December 2012, 9 had eating disorders with severe medical complications. Through chart review and computerized data collection, we retrospectively evaluated patient clinical data.Result: All 9 patients were women, with a mean age of 22.4±5.7 years, mean body weight of 26.2±3.0 kg, and mean body mass index of 10.5±1.5 on admission. Severe medical complications commonly seen were severe hypoglycemia, refeeding syndrome, coagulation abnormality, and severe liver dysfunction.
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Abstract: Background: For pathological gambling (PG) a 12 month prevalence rate of up to 0.66% has been reported. Multiple financial, occupational and relationship problems and losses, humiliation of the person and the environment are possible side effects and may lead to hopelessness, suicidal ideation and behaviour. Suicide attempt rates among pathological gamblers of between 4 and 40% and suicidal ideation of between 12 and 92% have been reported.Aim: This study aims at assessing the prevalence of suicide attempts in PG and at elucidating differences between the patients with and without suicide attempt history (SAH) in a large nationwide Austrian sample.Methods: Between 2002 and 2011 the Austrian Society for the Research of Non-Substance Related Addiction collected 862 questionnaires of pathological gamblers undergoing outpatient and inpatient treatment for pathological gambling in Austria.Results: 1) Of all pathological gamblers 9.7% had a suicide attempt history
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Abstract: Objective: This study aimed to identify primary care practice characteristics associated with the quality of depression care in patients with comorbid chronic medical and/or psychiatric conditions.Method: Using data from cross-sectional organizational and patient surveys conducted within 61 primary care clinics in Quebec, Canada, the relationships between primary care practice characteristics, comorbidity profile, and the recognition and minimally adequate treatment of depression were assessed using multilevel logistic regression analysis with 824 adults with past-year depression and comorbid chronic conditions.Results: Likelihood of depression recognition was higher in clinics where accessibility of mental health professionals was not viewed to be a major barrier to depression care (OR=1.61; 95% CI 1.13-2.30). Four practice characteristics were associated with minimal treatment adequacy: greater use of treatment algorithms for depression (OR=1.77; 95% CI=1.18-2.65), high value given to teamwork (OR=2.48; 95% CI=1.40-4.38), having at least one GP at the clinic devote significant time in practice to mental health (OR=1.54; 95% CI=1.07-2.21), and low perceived barriers to depression care due to inadequate payment models (OR=2.12; 95% CI=1.30-3.46).Conclusions: Several primary care practice characteristics significantly influence the quality of care provided to patients with depression and comorbid chronic conditions and should be targeted in quality improvement efforts.
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Abstract: Objective: In psychiatry, pain disorders not explained by structural lesions have been classified for decades as somatoform pain disorders, the underlying concept being somatization. In a parallel move, somatic medicine has defined an expanding group of similar pain disorders, known as functional pain syndromes.
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Abstract: Background: The aim was to measure symptoms of depression and anxiety in patients with bronchiectasis and evaluate their relationship with a Mediterranean diet.Methods: This cross-sectional study recruited patients with bronchiectasis at four Spanish centers. Patients completed the hospital anxiety and depression scale (HADS) and the Mediterranean diet questionnaire (Predimed). Demographic, health and outcome data were recorded from medical charts
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Abstract: Objective: To examine the relationship of poor dental health and depression, controlling for markers of inflammation (C-Reactive Protein; CRP) and adiposity (Body Mass Index; BMI).Method: Data from two National Health and Nutrition Examination Surveys (NHANES) (2005–2008) were utilized (n=10,214). Dental health was assessed using the Oral Health Questionnaire (OHQ). Depression was measured using the Patient Health Questionnaire-9 (PHQ-9), where cases were identified using a cut off score of 10 or above.
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Abstract: Objectives: Individuals with bipolar disorder (BP) are often misdiagnosed with major depressive disorder (MDD). In this study, we developed a Chinese version of 15-point hypomania scale (HCL-15) in order to determine its sensitivity and specificity in the diagnosis of BP and BP-II in particular.Methods: A total of 623 individuals suffering a major depressive episode (MDE) were systematically interviewed with both Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Patient Edition, and HCL-15. A cutoff score of 8 or more in HCL-15 was suggested for BP.Results: Of the 623 depressed patients, 115 (18.5%) actually required a diagnosis of BP-I, and another 159 (25.5%) could be more appropriately diagnosed with BP-II, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria.
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Abstract: Objective: The objective was to investigate impulsiveness among chronic hepatitis C (CHC) patients and its association with sociodemographic, clinical and psychopathological factors.Method: Ninety-one CHC individuals were enrolled in a cross-sectional study at a Brazilian public university-based outpatient’s service for infectious diseases. They were assessed using the Barrat Impulsiveness Scale, Brief Fatigue Inventory, Beck Depression Inventory and Hamilton Anxiety Scale. Structured psychiatric interview was performed according to the Mini International Neuropsychiatric Interview.
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Abstract: Objective: The aim of this study is to investigate the development of depression during interferon-alpha (IFN-α) therapy and the variations in the expression of the serotonin receptor (5-HTR) and transporter (5-HTT) in hepatitis C patients.Method: Hepatitis C patients (n=277) were given the Mini International Neuropsychiatric Interview at the end of IFN-α therapy. Three polymorphisms were genotyped: the serotonin transporter repeat length polymorphic region [5-HTT gene-linked polymorphic region (5-HTTLPR)], as well as SNPs rs25531 and rs6295, located within the 5-HTTLPR and the transcriptional control region of the 5-HTR1A gene, respectively.Results: The diagnosis of current depression, which was associated with IFN-α-related depression (P
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In the above article, in Section “3.2. Clinical Outcomes,” the sentence: “Within-group effect sizes for these measures ranged between 0.08 (HADS anxiety, active control group) and 0.63 (SOMS, ASTPP)” needs to be corrected as follows: “Within-group effect sizes for these measures ranged between 0.08 (HADS anxiety, active control group) and 0.52 (PID, ASTPP).”
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Introduction: Huntington disease (HD) is an inherited, progressive, autosomal dominant disorder. Some patients develop severe chorea or cognitive symptoms.
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Abstract: Objective: Persons with thoughts of self-harm may need evaluation for suicide risk. We examine the prevalence of thoughts of self-harm and whether persons with thoughts of self-harm are identified when two-stage depression screening is used.Methods: Data are from the 2005–2010 National Health and Nutrition Examination Surveys. Persons responding positively to question nine of the Patient Health Questionnaire-9 (PHQ-9) are identified as having thoughts of self-harm.
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Abstract: Dystonia is a syndrome characterized by sustained muscle contractions frequently causing twisting and repetitive movements or abnormal postures. Dystonic reactions may be a complication of many drugs such as antipsychotics, anti-emetics and antidepressants. This report presents a 25 year- old patient who was admitted to an emergency department with acute dystonia following the use of varenicline, a pharmacological agent used for the treatment of nicotine addiction
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Abstract: Objectives: This study investigates the possibility of introducing depression and developmental screening tools into the National Programme on Immunization (NPI) in southeast Nigeria. The specific objectives were to determine the prevalence of postpartum depression (PPD) among mothers attending immunization clinics and to assess the association of maternal PPD and infant growth in relation to World Health Organization (WHO) recommendations.Methods: Four hundred and eight (408) mothers completed the sociodemographic questionnaire and the self-report Edinburgh Postnatal Depression Scale (EPDS).
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Abstract: Objective: Misophonia is a potentially debilitating condition characterized by increased sensitivity to specific sounds, which cause subsequent behavioral and emotional responses. The nature, clinical phenomenology and etiology of misophonia remain unclear, and misophonic clinical presentations are not currently accounted for by existing psychiatric or audiological disorders.Method: We present a case of pediatric misophonia in the context of comorbid obsessive–compulsive disorder and Tourette’s syndrome.Results: Given the interrelationships among obsessive–compulsive spectrum disorders and misophonia, these disorders may share underlying pathophysiology, particularly within the dopaminergic and serotonergic neural systems.
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