No association between history of psychiatric treatment and postoperative weight reduction after bariatric surgery.

PURPOSE: The objective of the study was to assess whether the history of psychiatric treatment was associated with (1) body weight and BMI on admission for bariatric surgery, (2) weight loss > 5 kg prior to bariatric surgery, and (3) postoperative body weight reduction. METHODS: Data from medical records of all consecutive patients admitted for surgical treatment of obesity in the 2nd Department of General Surgery Jagiellonian University Medical College were obtained. There were 1452 records of patients who underwent bariatric surgery between 2009 and 2021 included in the study. RESULTS: History of psychiatric treatment was found in 177 (12%) of the sample and was inversely associated with body weight and BMI on admission for surgery in women. Men with history of psychiatric treatment were 54% less likely to lose > 5 kg before the surgery (OR = 0.46 95% CI = 0.24-0.88). Both in men and women %TWL did not differ significantly by history of psychiatric treatment (Me: 40.7 vs. 45.9; p = 0.130 and Me: 27.0 vs. 23.9; p = 0.383, respectively). After adjustment for covariates no association was found between history of psychiatric treatment and body weight reduction one year after surgery. CONCLUSION: Although men with preoperative history of psychiatric treatment had lower odds of losing weight before the surgery, psychiatric treatment did not differentiate the effectiveness of bariatric treatment in 1 year of observation. Bariatric surgery appears to be an effective obesity care for people treated for mental disorders. LEVEL OF EVIDENCE: III Evidence obtained from cohort or case-control analytic studies.

Importance of Magnesium Status in COVID-19.

A large amount of published research points to the interesting concept (hypothesis) that magnesium (Mg) status may have relevance for the outcome of COVID-19 and that Mg could be protective during the COVID disease course. As an essential element, Mg plays basic biochemical, cellular, and physiological roles required for cardiovascular, immunological, respiratory, and neurological functions. Both low serum and dietary Mg have been associated with the severity of COVID-19 outcomes, including mortality; both are also associated with COVID-19 risk factors such as older age, obesity, type 2 diabetes, kidney disease, cardiovascular disease, hypertension, and asthma. In addition, populations with high rates of COVID-19 mortality and hospitalization tend to consume diets high in modern processed foods, which are generally low in Mg. In this review, we review the research to describe and consider the possible impact of Mg and Mg status on COVID-19 showing that (1) serum Mg between 2.19 and 2.26 mg/dL and dietary Mg intakes > 329 mg/day could be protective during the disease course and (2) inhaled Mg may improve oxygenation of hypoxic COVID-19 patients. In spite of such promise, oral Mg for COVID-19 has thus far been studied only in combination with other nutrients. Mg deficiency is involved in the occurrence and aggravation of neuropsychiatric complications of COVID-19, including memory loss, cognition, loss of taste and smell, ataxia, confusion, dizziness, and headache. Potential of zinc and/or Mg as useful for increasing drug therapy effectiveness or reducing adverse effect of anti-COVID-19 drugs is reviewed. Oral Mg trials of patients with COVID-19 are warranted.

Psychomotor Agitation Non-responsive to Treatment: A Case Report of Phenibut Withdrawal Syndrome.

Background and Objectives: Phenibut (4-amino-3-phenyl-butyric acid), acting as a GABA-B receptor agonist, has a beneficial effect on anxiety. Although its medical use is not approved in western countries, it can be easily obtained worldwide via the Internet, so it spread as a substance of abuse. In recent years, some case reports have, therefore, highlighted episodes of acute toxicity or withdrawal, but it is still a largely unknown phenomenon. Methods: In this case report, a 50-year-old woman was admitted to the emergency room with psychomotor agitation, psychotic symptoms, and insomnia, and was non-responsive to treatment. She was hospitalized at the psychiatry ward for 25 days and gave her consent for the publication of the present case report. Results: The suspicion of phenibut withdrawal allowed to establish the appropriate management, leading to the restitutio ad integrum of the psychopathological case. Conclusions: In the face of an incoercible psychomotor agitation case, the knowledge of the so-called novel psychoactive substances allows for more appropriate clinical management of intoxication and withdrawal syndromes. This is a scientifically significant report as it provides therapeutic and outcome data concerning a syndrome that is still quite unfamiliar.

Impact of Depression on Weight Variation after Bariatric Surgery: A Three-Year Observational Study.

INTRODUCTION: The association between obesity and depression has been repeatedly established. However, little is known about the impact that the diagnosis of depression before bariatric surgery (DDBS) may have on weight loss. OBJECTIVE: To evaluate the impact of DDBS on weight outcomes. METHODS: Retrospective study of patients submitted to BS. Patients with no weight, no current medication data, or those submitted to revision surgery were excluded. Patients were considered to have DDBS based on taking antidepressants prior to BS or if there was a medical history of past or current depression. Patients with and without a depression history were compared using independent t test. A multivariate logistic regression model was created to evaluate predictors of weight variation (variables included: age, sex, and type of surgery). RESULTS: A total of 616 patients did not have a history of depression and 230 had DDBS. There was a statistically significant difference in the BMI variation between groups. On average, individuals with DDBS lost 1.4 kg/m2 less than those without DDBS. In the multivariate analysis, the group with DDBS, compared with the group without DDBS, presented on average less -0.9 kg/m2 (95% CI -1.7 to -0.2, p = 0.018) BMI variation. CONCLUSION: DDBS is a predictor of lower weight loss after the surgical procedure. Even after adjusting for confounding variables such as age, sex, and BS type, this effect remains.

Psychiatric Aspects of Lung Disease in Critical Care.

Respiratory conditions are some of the most common indications for admission to critical care units. Psychiatric disorders and symptoms are highly comorbid with lung disease. They can occur as a risk factor to lung disease, as a co-occurring condition, as a consequence of a pulmonary condition, or as a treatment side effect either from medications or assistive devices. Patients can experience a myriad of mood, anxiety, and cognitive disorder symptoms and conditions in critical care units. Intensivists and psychiatrists must be aware of the interplay between pulmonary and psychiatric symptoms as well as medication effects and interactions.

[Psychiatric aspects of rheumatoid arthritis: Review of literature]. / Les manifestations psychiatriques dans la polyarthrite rhumatoïde.

BACKGROUND: Rheumatoid arthritis (RA) is a chronic inflammatory degenerative disease whose symptoms are mainly joint with significant functional impact, resulting in a restriction of the activities of the patient and increasing the impact on mental well-being. Several studies have been conducted to explore psychiatric disorders comorbid with RA. OBJECTIVE: The objective of this review is to present the various psychiatric manifestations of RA reported in the medical literature. METHODS: A literature review was conducted using the Pubmed search with the following keywords: psychiatry, psychiatric manifestations, rheumatoid arthritis. Three hundred and sixty-one articles were reviewed for relevance and 47 references were selected. RESULTS: Among the major psychiatric disorders found in RA, the anxiety and depressive disorders are prevalent (13 to 48% of patients), as well as suicide, insomnia and tiredness. The impairment of quality of life is markedly after age 65. The association between RA and schizophrenia seems negative so that factors predisposing one is protective for the other. CONCLUSION: Comorbid psychiatric disorders with RA are prevalent and may increase the impairment of quality of life for patients. The detection and treatment of psychiatric disorders improve the care of patients with RA.

Obesity and co-morbid psychiatric disorders as contraindications for bariatric surgery?-A case study.

INTRODUCTION: Many patients undergoing bariatric surgery report current or past psychiatric disorders and controversy exists regarding their outcome after bariatric surgery. PRESENTATION OF CASE: We present a case of an obese patient with a borderline personality disorder, a recurrent depressive disorder, post-traumatic stress symptoms and binge eating episodes who underwent bariatric surgery. DISCUSSION: Although the psychiatric disorders remained, the procedure contributed to an improvement of the health status and well-being of the patient. Adequate psychological care after the surgical procedure is necessary to enable a long-term stabilization of patients with mental co-morbidities. CONCLUSION: Patients with psychiatric co-morbidities should not be excluded from the procedure if adequate post-operative support is provided.

The different faces of Creutzfeldt-Jacob disease CJD in psychiatry.

OBJECTIVE: Creutzfeldt-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. METHODS: We included all patients in Sheba Medical Center who were diagnosed with CJD between the years 2006 and 2012. Data were collected retrospectively. RESULTS: Twenty-three patients with CJD were admitted to our hospital during this 6-year period. Among them, 10 (44%) were diagnosed first as "psychiatric patients" due to psychiatric presenting symptoms. CONCLUSION: In our series, the frequency of misleading psychiatric symptom was 44%. Clinicians should therefore include CJD in their differential diagnoses of new onset dementia, particularly when associated psychosis and depression symptoms persist and worsen, despite standard psychiatric treatments.

Integrative parietal cortex processes: neurological and psychiatric aspects.

For many decades the parietal cortex (PC) has been considered the key area in tasks which involve the integration of different stimuli. PC is fundamental to determine spatial sense, information navigation and integration, and is involved in several aspects of the complex motor repertoire and in neurological and psychiatric disorders. In this review, we focus on seven different aspects of PC: (i) neuroanatomy of the parietal cortex; (ii) sensory motor integration processes; iii) hand movement control: reaching, grasping, and pointing; (iv) saccadic eye movements; (v) movement observation; (vi) neurological aspects: ataxia, autism and Parkinson's disease; and (vii) psychiatric aspects: schizophrenia, bipolar disorder and depression. Among these, we related the perspectives which involve the functions of the parietal cortex and mirror neurons and that seem to play a fundamental role in action prediction, planning, observation and execution. Furthermore, we focused on the relationship between posterior parietal cortex (PPC) and hand-guided movements. For this review, we conducted an academic paper search which fulfilled the objective of the study. We conclude that the PC has great participation in different motor functions and neurological/psychiatric disorders.

Association between spinocerebellar ataxias caused by glutamine expansion and psychiatric and neuropsychological signals - a literature review.

The autosomal dominant cerebellar ataxias, also known as spinocerebellar ataxias (SCA), are characterized by cerebellar degeneration and by their afferent and efferent connections. Currently, at least 31 types of SCA are described, among which a subset, comprising types 1, 2, 3, 6, 7, 17 of the disease, is distinguished due to sharing the same form of mutation involving the repetition of the series of CAG triplets, known as polyglutamine diseases (SCApolyQ). Through a systematic literature review using the Pubmed, PsycoINFO, LILACS and SciELO databases and the keywords Spinocerebellar Ataxia in association with the words neuropsychiatric, psychological, cognitive impairment(s) and psychiatric comorbidities this study aimed to identify the possible associations between SCApolyQ and neuropsychological and psychiatric symptoms/disorders. A greater presence of symptoms of depression and anxiety was evidenced, as well as the existence of cognitive impairments in the patients with SCApolyQ when compared with the general population, with important differences in the profile of these impairments among the types of SCA. It was observed that the findings, in general, indicated greater impairment in the executive functions, verbal fluency and verbal memory and that there was a higher concentration of studies for SCA2 and SCA3. However, there is a need for a greater number of studies using a more homogeneous methodology, which perform direct comparisons between the types of ataxias and that explore some of the still little evaluated neuropsychological functions and the different psychiatric disorders in their amplitude.

Evaluation of psychological aspects among subtypes of irritable bowel syndrome.

CONTEXT: While some studies have found disparities between subtypes of irritable bowel syndrome (IBS), others did not found such differences. AIM: This study aimed to investigate whether there are differences in psychological features between the subtypes of IBS. SETTINGS AND DESIGN: A cross-sectional study was performed on all consecutive outpatients IBS diagnosed (from Oct. 2010 to Oct. 2011) in Taleghani Hospital gastroenterology clinic, Tehran, Iran. MATERIALS AND METHODS: A total of 153 consecutively diagnosed IBS patients (using Rome III criteria); including 80 constipation-predominant (IBS-C), 22 diarrhea-predominant (IBS-D), and 51 mixed IBS (IBS-M) were asked to complete the Symptom Checklist 90 Revised (SCL-90-R). STATISTICAL ANALYSIS: Pearson's chi-square test was used to compare nominal variables. One-way ANOVA was used to compare continuous variables. RESULTS: Although IBS-C patients were more suffered from psychiatric disorders, there were no statistical differences between mean score of IBS-C, IBS-D, and IBS-M patients regarding to all of SCL-90-R subscales and three global indices including Global Severity Index (GSI), Positive Symptom Distress Index (PSDI) and Positive Symptom Total (PST) (P<0.05). CONCLUSION: Our finding showed that there are no different symptomatic profiles between IBS subtypes.

Psychiatric aspects of organ transplantation.

Surgical transplantation of human organs from deceased as well as living donors to sick and dying patients began after the Second World War. Over the past 50 years the transplantation of human organs, tissues and cells has become a worldwide practice which has extended, and greatly enhanced the quality of hundreds of thousands of lives. The field of transplantation medicine provides an important chance for liaison between psychiatric professionals and other transplant physicians and surgeons. The discrepancy between the ever-increasing demand for organs but the decreasing supply makes it important to evaluate and prioritize individuals who are in dire need of the organ. However, this also gives rise to certain ethical questions. The following paper discusses various psychiatric aspects of organ transplantation in general.

Alterações psiquiátricas após corticoterapia em paciente com rara manifestação neurológica de Síndrome de Behçet e o papel da interconsulta psiquiátrica / Behavior disturbances after corticotherapy in a patient with uncommom neurological manifestation of Behcet Syndrome and the role of the consultation liaison psychiatry

A Interconsulta Psiquiátrica (IP) trata-se do estudo da relação entre a psiquiatria e todas as outras áreas dos conhecimentos do processo saúde-doença, visando, sob uma perspectiva biopsicossocial, atender sua demanda clínica (prestação da assistência ao paciente) e institucional (relacionada aos serviços). É descrito o caso de uma paciente que apresentou rara manifestação fisiopatológica da Síndrome de Behçet e que evoluiu com transtorno psiquiátrico após a instituição de terapêutica com corticoesteróides. Apesar da remissão dos sintomas mentais e comportamentais com tratamento psicofarmacológico de curta duração, a evolução do quadro demandou a reintrodução de corticoterapia, com recrudescência de quadro psiquiátrico e necessidade de instituição de tratamento de manutenção para seu manejo. Além de ilustrativo, no sentido de discutir uma rara condição clínica, o caso descrito exemplifica os benefícios da atuação conjunta e planejada entre psiquiatras e outros profissionais na assistência integral ao paciente.

Consultation Liaison Psychiatry studies the relationship between psychiatry and all other areas of knowledge of the health-disease process and intends to propose solutions, under a biopsychosocial perspective, to the clinical (assistant) or institutional (service-related) problems. It is described the case of a patient who presented unusual pathophysiologic manifestation of the Behcet's syndrome and also developed mental disorder after the pharmacological treatment with corticosteroids. Despite the remission of mental and behavioral symptoms with psychopharmacological treatment of short duration, her clinical outcome made it need the reintroduction of corticotherapy, with recrudescence of the psychiatric disorder and the need for maintenance treatment to assure its management. Besides illustrating a rare clinical condition, the case described exemplifies the benefits of joint and planned actions between psychiatrists and other professionals involved in an individual assistance at the hospital ward.

Psychiatric issues in renal failure and dialysis.

This article aims to bring to the fore, issues regarding the interface of psychiatry and renal failure. Depression, anxiety, suicide and delirium are common complications observed in patients with renal failure. Pharmacological management of these problems need stringent monitoring on part of the psychiatrist. This article examines the various complications that may be observed in patients with renal failure while discussing treatment approaches and also emphasizing the need for interdisciplinary team work in improving the quality of life of patients with renal failure and those on dialysis.

Psychiatric sequelae of amputation : I immediate effects.

Twenty-five subjects, who had undergone amputation within last 6 weeks, were studied for psychiatric complications, including phantom limb phenomena. The patients were interviewed on SCID, HRSD and HARS. Out of a total of 25 subjects, 8 (34.6%) developed psychiatric disorders - PTSD and major depression. The whole sample was thus divided into 2 groups-sick and nonsick. Phantom limb was seen in 88% subjects. No significant difference was present between the two groups with regard to presence of phantom, its associated phenomena of pain, telescopy and movement. A statistically significant difference was seen in psychiatric sickness in relation to upper and lower limb.

Psychiatric sequelae of amputation : ii long term effects.

Psychiatric sequelae present after 6 months to 2 years following amputation were studied in a group of 25 subjects. The subjects were screened on SCID, HRSD and HARS. The most common diagnoses were depressive disorder NOS (20.6%) and major depressive disorder (10.3%). Patients having right sided amputation were more psychiatrically ill than those with loss of a left limb. Phantom limb was seen in about two-thirds of the total sample-more in the sick group (about 88%) than in the non-sick group (about 55%). Pain in the phantom limb was seen more in the sick group, but telescopy and movement were more frequently complained of by subjects of the non-sick group.