RESUMEN
OBJECTIVE: The aim of the study is to examine whether electroconvulsive therapy (ECT) was associated with the subsequent risk of being involved in a road traffic accident. METHODS: A cohort of all 375,435 patients older than 18 years with their first psychiatric hospital contact between 2003 and 2017 in the Danish National Patient Registry was followed for road traffic accidents until December 2018. Associations between ECT and road traffic accidents were examined using Cox regression analyses with multiple adjustments and using propensity score matching on sociodemographic and clinical variables. RESULTS: A total of 8486 patients (0.2%) were treated with ECT. During the median follow-up of 5.9 years, 778 of these patients (12.5%) were involved in a road traffic accident and the unadjusted incidence of road traffic accidents was lower among these patients (incidence rate, 15.5 per 1000 patient-years; 95% confidence interval [CI], 14.5-16.7) compared with patients not treated with ECT (incidence rate, 20.0 per 1000 patient-years; 95% CI, 20.0-20.3). Electroconvulsive therapy was not associated with road traffic accidents in the Cox regression models after adjustment for all covariables (hazard ratio, 1.00; 95% CI, 0.92-1.08) or in the propensity score-matched sample (hazard ratio, 0.91; 95% CI, 0.83-1.08). The HRs did not vary materially with follow-up time or when analyses were stratified on sex, age, or type of hospital contact. CONCLUSIONS: The analysis of Danish National registry data indicates that ECT is not associated with the risk of being involved in major road traffic accidents.
Asunto(s)
Accidentes de Tránsito , Terapia Electroconvulsiva , Humanos , Estudios de Cohortes , Terapia Electroconvulsiva/efectos adversos , Incidencia , Dinamarca/epidemiologíaRESUMEN
Vitamin D receptors have recently been identified in immune cells as well as various parts of the brain. Vitamin D deficiency seems to be involved in the patho-immunological process of multiple sclerosis. Hypovitaminosis D has also been associated with different psychiatric conditions, including depression and schizophrenia. Results from more than 250 publications concluded that patients with both schizophrenia and bipolar condition are more frequently born in winter and spring, the periods which have the largest maternal decline in plasma concentrations of vitamin D.
Asunto(s)
Trastornos Mentales/etiología , Esclerosis Múltiple/etiología , Deficiencia de Vitamina D/complicaciones , Animales , Humanos , Receptores de Calcitriol/metabolismo , Vitamina D/metabolismoRESUMEN
INTRODUCTION: Due to a reduction in the number of psychiatric hospital beds and the establishment of places at residential institutions, a large number of patients with severe mental illness receive limited attention from psychiatrists and psychiatric nurses. This situation mandates an investigation whether this leads to health-related problems. MATERIAL AND METHODS: All patients at the social-psychiatric residential institution Tangkaercentret were offered an extensive health check, and use of medication as well as somatic and psychiatric morbidity were recorded. RESULTS: The investigation revealed a group of people with very severe mental illness and several sub-optimally treated bodily diseases. Furthermore, a high incident of violent episodes and psychotic behaviour among the patients and a high use of short admissions among a few of the patients were observed. Metabolic syndrome occurred twice as frequently as in the background population. This may be due to an unhealthy lifestyle and psychopharmacological treatment. CONCLUSION: Regular screening for psychiatric and somatic illnesses of such populations should be mandatory to ensure the best possible treatment. In some of the cases, optimal treatment would probably require admission to a long-stay psychiatric ward and use of the options provided by psychiatric legislation.
Asunto(s)
Trastornos Mentales/terapia , Instituciones Residenciales , Adulto , Anciano , Desinstitucionalización , Dinamarca , Femenino , Estado de Salud , Capacidad de Camas en Hospitales/estadística & datos numéricos , Hospitales Psiquiátricos , Humanos , Estilo de Vida , Masculino , Trastornos Mentales/complicaciones , Trastornos Mentales/diagnóstico , Persona de Mediana Edad , Admisión del Paciente , Trastornos Psicóticos/complicaciones , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/terapia , Psicotrópicos/administración & dosificación , Psicotrópicos/efectos adversos , Índice de Severidad de la Enfermedad , Asistencia Social en Psiquiatría , ViolenciaRESUMEN
Studies have shown increased prevalence of brain white matter lesions (WML) in patients with late-onset depression. WML are associated with cardio-vascular risk factors, cognitive dysfunction and poor treatment response. Until now, systematic neuropsychiatric assessment with MRI and psychological tests has mainly been used in research, but may also be helpful in clinical work. In 2005, a Neuropsychiatric Unit was established at the Psychiatric Hospital in Aarhus, Denmark to assess all patients with late-onset depression using a standard neuropsychiatric assessment program.