Abstract: Objective: The prevalence of opioid therapy for chronic noncancer pain has increased dramatically in recent years, with a parallel increase in opioid abuse, misuse and deaths from accidental overdose. We review epidemiological and clinical data that point to the important roles psychiatric disorders have in the use and abuse of opioids in patients with chronic pain.Method: We conducted literature searches on the PubMed with the key phrases “chronic pain” and “opioid therapy” and selected those articles on the epidemiology of comorbidity between chronic pain and psychiatric disorders, the trends in long-term opioid therapy and the clinical trials that involved using opioid therapy for chronic pain or for mental health disorders.
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Abstract: Objective: Little attention has been paid to the role of holding back sharing concerns in the psychological adaptation of women newly diagnosed with gynecological cancers. The goal of the present study was to evaluate the role of holding back concerns in psychosocial adjustment and quality of life, as well as a possible moderating role for emotional expressivity and perceived unsupportive responses from family and friends.Method: Two hundred forty-four women diagnosed with gynecological cancer in the past 8 months completed measures of holding back, dispositional emotional expressivity, perceived unsupportive responses from family and friends, cancer-specific distress, depressive symptoms and quality of life.Results: Emotional expressivity moderated the association between holding back and cancer-specific distress and quality of life, but not depressive symptoms. Greater holding back was more strongly associated with higher levels of cancer-related distress among women who were more emotionally expressive than among women who were less expressive.
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Abstract: Purpose: The purpose of the study was to compare behavioral outcomes (physical activity, sedentary behavior, smoking cessation, diet) between the intervention and usual care conditions from the TEAMcare trial.Methods: TEAMcare was a randomized trial among 214 adults with depression and poorly controlled diabetes and/or coronary heart disease that promoted health behavior change and pharmacotherapy to improve health. Behavioral outcomes were measured with the International Physical Activity Questionnaire (physical activity, sitting time) and the Summary of Diabetes Self-Care Activities Measure (smoking, diet, exercise).
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Abstract: Objective: Posttraumatic stress disorder (PTSD) is significantly and positively associated with several physical conditions. We aimed to examine whether the nature and number of trauma(s) experienced may be related to physical conditions using a population-based sample.Methods: Data came from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (N=34,653; age 20 years and older).
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Abstract: Objective: Depression is common in cancer patients but frequently undetected. Consensus regarding validity and optimal thresholds of screening measures is lacking.
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Abstract: Objective: The objective was to compare weight-bias attitudes among treatment-seeking obese patients with and without binge eating disorder (BED vs. NBO) and to explore racial and sex differences and correlates of weight-bias attitudes.Method: Participants included 221 obese patients (169 female, 52 male) seeking treatment for weight and eating, recruited through primary care settings; of these, 168 patients met BED criteria.
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Abstract: Objective: Although the Internet is used effectively in many areas of life, some users experience problems because of over-use due to a lack of control. The diagnostic criteria for Internet addiction include disruptions in family relationships, but adequate data on the attachment styles and family functioning associated with this condition are limited. This study aimed to investigate the attachment styles and family functioning of patients with Internet addiction.Method: The sample included 30 male patients consecutively admitted to the Bakırköy Mental Health and Research Hospital Internet Addiction Outpatient Clinic, who were diagnosed in clinical interviews as having Internet addiction according to Young’s (1998) criteria.
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Abstract: Transient left ventricular apical ballooning syndrome (TLVABS), also known as takotsubo cardiomyopathy, is characterized by transient left ventricular dysfunction, electrocardiographic changes, and release of myocardial enzymes that mimic acute myocardial infarction in patients without angiographic evidence of coronary artery disease. Most patients are post-menopausal women and an emotional or physiologic stressor frequently precedes the presentation.Psychogenic or dissociative amnesia is a memory disorder characterized by sudden retrograde memory loss with inability to recall personal information said to occur for a period of time ranging from hours to years after a stressful event.Interestingly, the mechanism of both disorders has been linked to plasma elevation in catecholamines.Here we present the case of a 66-year-old female diagnosed with both TLVABS and dissociative amnesia following the sudden unexpected death of her sister. To our knowledge, this is surprisingly the first report of the co-occurrence of TLVABS and dissociative amnesia, two processes with a potential shared underlying etiology.
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Abstract: Objectives: Treatment noncompliance is one of the most frequent causes of relapse and recurrence in patients with bipolar I disorder. Treatment compliance among patients with bipolar disorder is affected by individual patients’ features, the disease itself, doctor-patient relationships and patients’ socio-economic and cultural characteristics. This study aimed to determine the factors affecting treatment compliance during the treatment of bipolar disorder and contribute to current clinical strategies.Methods: Data were collected from 78 volunteers with bipolar I disorder in remission; all volunteers were being treated solely with mood stabilisers.
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In a recently published paper in General Hospital Psychiatry , we described the association between a diagnosis of a serious mental illness and a chronic pain condition. In a national sample of all patients who utilized services from the Veterans Health Administration within a given year, those individuals with schizophrenia and bipolar disorder were significantly more likely to have a chart diagnosis of chronic pain compared to those without these psychiatric diagnoses. We concluded that this line of research has important implications for understanding how chronic pain might impact mental health recovery.
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Birgenheir et al found that a chart diagnosis of a chronic pain condition occurred approximately two times as often in veterans with a documented diagnosis of bipolar disorder compared to those without bipolar disorder. These findings are important for addressing the overall health of patients with bipolar disorder . The authors noted that the veteran population was a limitation of their study
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Abstract: Hashimoto’s encephalopathy (HE) which carries kaleidoscopic clinical presentations, is easily misdiagnosed in clinical practice. Early diagnosis and prompt initiation of steroid therapy are associated with good prognosis. We describe a 50-year-old female patient who had subclinical hypothyroidism, presented herself with gradual cognitive impairment, accompanied with auditory hallucination and delusion
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Abstract: Objectives: Serious adverse effects such as acute psychoses have been reported following treatment with chloroquine. Chloroquine can cause cell death, including neurons.
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Abstract: Psychotic symptoms and cognitive fluctuation are common manifestations of dementia with Lewy bodies (DLB). However, the differentiation of these symptoms is difficult because many psychiatric, neurologic, and medical conditions in addition to drug effects can mimic DLB in elderly people. We report on an 83-year-old woman who complained of vivid, recurrent visual hallucinations associated with fluctuating cognition
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Abstract: Objective: The objective was to estimate the prevalence of both dementia and depression among community-dwelling older Americans and to determine if hospitalization is independently associated with dementia or depression in this population.Method: This cross-sectional study utilized data from a nationally representative, population-based sample of 7197 community-dwelling adults ≥65 years old interviewed in 2011 as part of the National Health and Aging Trends Study. Information on hospitalizations was obtained from self- or proxy-report.
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Abstract: Objective: Psychosis is a recognized but often forgotten side effect of many commonly prescribed medications.Method: A case of psychosis in a 27-year-old female related to metronidazole treatment is presented along with review of possible mechanisms.Results: The onset and resolution of psychosis appeared to coincide with metronidazole treatment.Conclusions: Clinicians should be aware of medication-related psychosis.
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Abstract: Background: The objective of this study is to investigate the association between childhood trauma and lipid profiles in adults from a highly traumatized population at-risk for cardiovascular disease.Method: We recruited 452 participants, primarily African-American and of low socioeconomic status, from general medical clinics in a large urban hospital. We performed direct comparisons, univariate analysis of variance and regression analyses together and separated by sex, examining the associations of child abuse, body mass index, lipid lowering drug use, blood pressure, age, and substance use to HDL levels and HDL/LDL ratios.Results: A history of moderate to severe levels of childhood trauma and abuse was associated with a significant decrease in HDL levels (P≤.01) and HDL/LDL ratios (P≤.001) relative to males with low levels of abuse.
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Abstract: Objective: To examine primary care clinician actions following positive suicide risk assessments administered to Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans.Methods: We identified OEF/OIF veterans with positive templated suicide risk assessments administered in primary care settings of three VA Medical Centers. National VA datasets and manual record review were used to identify and code clinician discussions and actions following positive assessments. Bivariate analyses were used to examine relationships between patient characteristics and discussions of firearms access and alcohol/drug use.Results: Primary care clinicians documented awareness of suicide risk assessment results for 157 of 199 (79%) patients with positive assessments.
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Abstract: Objective: Evaluate determinants of mental health service use among depressed adolescents.Method: We assessed mental health services use over the 12 months following screening among 113 adolescents (34 males, 79 females) from an integrated healthcare system who screened positive for depression (Patient Health Questionnaire-9 score ≥11). Youth characteristics (demographics, depression severity, and co-morbidity) and parent characteristics (parent history of depression, parent-report of youth externalizing and internalizing problems) were compared among youth who had received mental health services and those who had not.
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Abstract: New antiepileptic drugs have been known to increase the risk of suicide. Among them, levitracetam is a widely used antiepileptic drug approved as a monotherapy treatment for partial seizures or as an adjunctive therapy for partial, myoclonic and generalized tonic-clonic seizures. It has been reported that the incidence of suicidal ideation during treatment with levitracetam was about 0.5-0.7%, but an explanation regarding a mechanism by which it causes suicidality is lacking.
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Abstract: Objective: The aim of this study is to explore the prevalence of hospital-treated suicide attempts in a large clinical population of eating disorder patients.Method: Follow-up study of adults (N=2462, 95% women, age 18–62years) admitted to the Eating Disorder Clinic of Helsinki University Central Hospital in the period 1995–2010. For each patient four controls were selected and matched for age, sex and place of residence. The end-point events were modeled using Cox’s proportional hazard model, taking matching into account.Results: We identified 156 patients with eating disorder (6.3%) and 139 controls (1.4%) who had required hospital treatment for attempted suicide.
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Abstract: Objective: This study assessed the role of self-reported facial scar severity as a possible influencing factor on self-esteem and depressive symptoms in patients with facial burns.Method: A prospective multicentre cohort study with a 6 months follow-up was conducted including 132 patients with facial burns. Patients completed the Patient and Observer Scar Assessment Scale, the Rosenberg Self-esteem Scale and the Hospital Anxiety and Depression Scale. Structural Equation Modeling was used to assess the relations between depressive symptoms, self-esteem and scar severity.Results: The model showed that patient-rated facial scar severity was not predictive for self-esteem and depressive symptoms six months post-burn
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We read the work done by Huang et al with great interest, the fact that the results of clinical studies evaluating Antidepressant exposure in the prenatal period and the risk of preterm birth and low birth weight has yielded conflicting results attracted us this work. The analysis by Huang et al which was conducted with an objective to resolve this disagreement provides substantial evidence favouring the higher risk of adverse outcomes with the use of antidepressants during pregnancy. The search strategy, moderator analysis, sensitivity analysis and the assessment of publication bias using trim and fill method performed by the authors are praiseworthy.
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Abstract: Objectives: Paliperidone- Associated Motor TicsMethod: Case reportResults: We report a 30 -year-old man with schizophrenia who developed motor tics (eye-blinking) after treatment of paliperidone up to 15 mg daily.Conclusion: Tic-like symptoms, from simple eye blinking to complex Tourette-like syndrome, may occur during paliperidone treatment, especially with high dose.
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Abstract: Objective: To examine the psychometric properties of two brief screening questionnaires for common mental disorders in general practices in areas speaking the three main Nigerian languages.Method: Consecutives attendees of selected general practices in Ibadan, Enugu and Kaduna were screened with the GHQ 12 and K6. We selected all cases and 50% of non cases for second stage interview with the Composite International Diagnostic Interview (CIDI).
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