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Antipsicóticos , Atrofia Muscular Espinal , Curvaturas de la Columna Vertebral , Humanos , Antipsicóticos/efectos adversos , Atrofia Muscular Espinal/tratamiento farmacológico , Curvaturas de la Columna Vertebral/tratamiento farmacológico , Curvaturas de la Columna Vertebral/inducido químicamenteRESUMEN
BACKGROUND: Traumatic brain injury (TBI) is linked with an increased risk of schizophrenia and other non-mood psychotic disorders (psychotic disorders), but the prevalence and contributing factors of these psychiatric conditions post-TBI remain unclear. This study explores this link to identify key risk factors in TBI patients. METHODS: We used the 2017 National Inpatient Sample dataset. Patients with a history of TBI (nâ =â 26 187) were identified and matched 1:1 by age and gender to controls without TBI (nâ =â 26 187). We compared clinical and demographic characteristics between groups. The association between TBI and psychotic disorders was explored using the logistic regression analysis, and results were presented as Odds ratio (OR) and 95% confidence interval (CI). RESULTS: Psychotic disorders were significantly more prevalent in TBI patients (10.9%) vs controls (4.7%) (Pâ <â .001). Adjusted odds of psychotic disorders were 2.2 times higher for TBI patients (95% CI 2.05-2.43, Pâ <â .001). Male TBI patients had higher psychotic disorders prevalence than females (11.9% vs 8.4%). Younger age, bipolar disorder, anxiety disorders, substance abuse, personality disorders, and intellectual disability are associated with an increased risk of psychotic disorders in men. CONCLUSION: Our study found that hospitalized TBI patients had 2.2 times higher odds of Schizophrenia non-mood psychotic disorder, indicating an association. This highlights the need for early screening of psychotic disorders and intervention in TBI patients, calling for more research.
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Lesiones Traumáticas del Encéfalo , Trastornos Psicóticos , Esquizofrenia , Humanos , Masculino , Femenino , Esquizofrenia/epidemiología , Trastornos Psicóticos/epidemiología , Adulto , Estados Unidos/epidemiología , Persona de Mediana Edad , Lesiones Traumáticas del Encéfalo/epidemiología , Adulto Joven , Bases de Datos Factuales , Adolescente , Prevalencia , Pacientes Internos/estadística & datos numéricos , Anciano , Comorbilidad , Factores de RiesgoRESUMEN
ABSTRACT: Bullying victimization has been identified as a significant factor influencing academic outcomes. We sought to evaluate the educational outcomes and psychiatric comorbidities in children and adolescents who are victims of bullying using the National Survey of Children's Health dataset for the study. The participants were children and adolescents (age: 6-17 years) categorized into two groups: group 1, not bullied ( n = 21,015), and group 2, bullied more than once ( n = 21,775). Individuals whose health status was fair or poor have experienced more bullying (2.4% vs . 1.4%, p < 0.001). Individuals in the group 2 were more likely to repeat the grades than the group 1 (7.1% vs . 5.9%, p = 0.039). Individuals who were missing ≥11 school days and sometimes or never engaged in school were observed to be more in the group 2 compared with the group 1 (5.9% vs . 3.2% and 20.3% vs . 10.6%, p < 0.001). In conclusion, bullying victimization could be a risk factor and associated with decreased academic outcomes.
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Acoso Escolar , Víctimas de Crimen , Humanos , Acoso Escolar/estadística & datos numéricos , Acoso Escolar/psicología , Adolescente , Masculino , Niño , Víctimas de Crimen/estadística & datos numéricos , Víctimas de Crimen/psicología , Femenino , Éxito Académico , Estados Unidos/epidemiología , Factores de Riesgo , Estado de SaludRESUMEN
ABSTRACT: Mixed connective tissue disease (MCTD) is a systemic autoimmune disease with features overlapping multiple autoimmune disorders. One study found that over 55% of patients with MCTD experienced neuropsychiatric symptoms, the most common of which was an "aseptic meningitis-like syndrome." We present a case of a 17-year-old adolescent girl presenting with abnormal speech and behavior, auditory hallucinations, and paranoid delusions after an isolated episode of fever. She was treated for her psychotic symptoms but later developed symptoms resembling neuroleptic malignant syndrome. An antibody screen revealed elevated anti-U1-ribonucleoprotein antibodies with a possible diagnosis of MCTD. She finally responded to steroid therapy. To our knowledge, this is the first reported case of MCTD initially presenting with psychosis. A diagnosis of autoimmune disorders should be kept in the differential of similar clinical presentations including connective tissue disorders and autoimmune thyroid conditions.
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Enfermedades Autoinmunes , Enfermedad Mixta del Tejido Conjuntivo , Trastornos Psicóticos , Adolescente , Femenino , Humanos , DelucionesRESUMEN
Transgender adolescents have unique mental health needs. This demographic has increased rates of mood disorders, anxiety, and depression compared to their cisgender peers. Large-scale studies focused on mental health outcomes, including suicidality, in the transgender adolescent population remain unknown. This study tries to fill these gaps in the literature. Data for this study was taken from the National Inpatient Sample 2016-2018. Transgender adolescents were identified using the ICD-10 codes related to transsexualism diagnoses. These individuals were compared to adolescents without transsexualism diagnoses. To mitigate imbalances in baseline characteristics, we utilized a 1:2 nearest neighbor propensity score matching with a caliper width of 0.0001, considering variables such as age, year of hospitalization, and psychiatric disorders. Following propensity score matching, the study cohort comprised 2635 transgender and 5270 non-transgender adolescents (Mean age 15.2 years). The transgender group demonstrated a notably higher prevalence of mood disorders (91%) and anxiety disorders (65%). Furthermore, the prevalence of suicidal ideation was significantly higher in the transgender group (52.4% vs. 39.2%, p < 0.001). However, there was no significant difference in the prevalence of suicide attempts between the groups. After controlling for psychiatric comorbidities, age, and gender, the odds ratio for the composite outcome of suicidal ideation or attempt was 1.99 (95% CI 1.58-2.12, p < 0.001). Our study identifies elevated mood and anxiety disorders and suicidality rates in hospitalized transgender adolescents compared to cisgender peers. Mood disorders notably amplify the risk of suicidal attempts. These findings urgently call for targeted mental health interventions and policy changes to serve this vulnerable population in healthcare settings better.
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Suicidio , Personas Transgénero , Transexualidad , Humanos , Adolescente , Transexualidad/epidemiología , Transexualidad/psicología , Ideación Suicida , Estudios Transversales , Pacientes Internos , Puntaje de Propensión , Evaluación de Resultado en la Atención de SaludAsunto(s)
Trastorno Depresivo Mayor , Trastorno Depresivo Resistente al Tratamiento , Ketamina , Humanos , Ketamina/farmacología , Ketamina/uso terapéutico , Depresión , Antidepresivos/farmacología , Antidepresivos/uso terapéutico , Trastorno Depresivo Mayor/tratamiento farmacológico , Trastorno Depresivo Resistente al Tratamiento/tratamiento farmacológicoAsunto(s)
Mpox , Humanos , Cidofovir , Benzamidas , Interacciones Farmacológicas , Isoindoles , PsicotrópicosAsunto(s)
Inhibidores Selectivos de la Recaptación de Serotonina , Síndrome de la Serotonina , Humanos , Estados Unidos , Inhibidores Selectivos de la Recaptación de Serotonina/efectos adversos , Síndrome de la Serotonina/inducido químicamente , Síndrome de la Serotonina/diagnóstico , Triptaminas/efectos adversos , Serotoninérgicos , United States Food and Drug AdministrationRESUMEN
Objective: To assess the prevalence of psychiatric disorders among children and adolescents in child welfare custody admitted to the hospital.Methods: Data were collected from the 2016-2017 National Inpatient Sample of the US population of general hospital admissions. Data for patients aged 12-17 years who were in child welfare custody were obtained using the ICD-10 diagnosis code Z6221: child in welfare custody. The control group comprised patients not in child welfare custody. Groups were compared for demographic, clinical, and hospital characteristics.Results: The study group included 879 child welfare patients, of whom 38.9% were male, with a mean age of 14.7 years. The control group comprised 222,494 patients, of whom 41.2% were male, with a mean age of 14.9 years. In the study group, 69.4% of patients had mood disorders compared to 28.6% in the control group. Half of the patients in the study group had anxiety disorders and almost 44% had ADHD and other conduct disorders compared to 19.3% and 14.2%, respectively, in the control group. Prevalence of suicidal ideation/attempt was almost 3 times higher in the study group compared to controls (41.0% vs 14.8%), and 18.3% of study group patients had a substance use disorder compared to 8.3% of controls. Mood disorders were the most common reason for hospitalization (44.8% vs 19.2%), followed by ADHD/other conduct disorders (5.3% vs 1.1%) and anxiety disorders (4.9% vs 0.9%).Conclusions: Children and adolescents in the child welfare system are associated with a higher risk of mental health problems. More studies are needed to identify the factors that contribute to psychiatric comorbidities in this population and to determine and address the factors that can prevent mental health issues.Prim Care Companion CNS Disord 2023;25(6):22m03238. Author affiliations are listed at the end of this article.
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Pacientes Internos , Trastornos Mentales , Niño , Humanos , Masculino , Adolescente , Femenino , Prevalencia , Trastornos Mentales/epidemiología , Trastornos Mentales/diagnóstico , Hospitalización , Hospitales , Protección a la InfanciaRESUMEN
ABSTRACT: Research plays a crucial role in advancing health care. Physician scientists, who bring together clinical and scientific perspectives, are integral to this effort. However, the pursuit of research careers among physicians has declined due to several obstacles, including inadequate support, training, time, and financial constraints. Emergency medicine and psychiatric specialties receive less support than other specialties, and COVID-19 has worsened the challenges. The COVID-19 has made things harder for physician scientists, increasing clinical demands and causing research delays. To tackle this, future physician scientists should receive organized training that includes mandatory research activities during their training. Large-scale studies should identify barriers to research and offer mentoring for young physician scientists. Encouraging female researchers and involving research faculty in residency training is crucial. Collaboration between physician and PhD researchers is essential for the future of medical research. It is vital to address these to advance health care and improve mental health outcomes.
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Investigación Biomédica , COVID-19 , Médicos , Humanos , Femenino , Salud Mental , Personal de SaludRESUMEN
Objective: To assess the prevalence of psychiatric comorbidities in patients with neurofibromatosis.Methods: In this cross-sectional study, we used the 2010-2014 National Inpatient Sample database. Patients ≥ 18 years of age with a primary or secondary diagnosis of neurofibromatosis and psychiatric comorbidities were queried.Results: A total of 43,270 patients with a mean age of 48.7 years (female: 55.7%, White: 70.1%) were included in the study. Overall, psychiatric comorbidities were present in 46.5% of patients; mood disorders (22.1%) and anxiety disorders (12.2%) were the most prevalent comorbidities. Although previous studies report prevalence rates of attention-deficit/hyperactivity disorder in up to 50% of patients with neurofibromatosis, our study found that the rate was much lower at 1.10%. Female sex and non-White race were less associated with psychiatric comorbidities (odds ratio = 0.868 [P = .003] and 0.689 [P < .001], respectively). The moderate-to-extreme loss of function illness severity category was associated with 1.35-times higher odds of having psychiatric comorbidities compared to mild-to-moderate or no loss of function (P < .001). The total length of stay was similar in patients with and without psychiatric comorbidities (mean = 4.98 [95% CI, 4.72-5.24] vs mean = 4.83 [95% CI, 4.60-5.07], respectively; P = .34).Conclusions: In adult patients with neurofibromatosis, 46.5% were found to have at least one psychiatric comorbid diagnosis. The most frequent psychiatric comorbid disorders were mood disorders and anxiety disorders. Female sex and non-White race predicted a lower likelihood of having a psychiatric disorder.Prim Care Companion CNS Disord 2023;25(5):23m03514. Author affiliations are listed at the end of this article.
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Trastorno por Déficit de Atención con Hiperactividad , Neurofibromatosis , Adulto , Humanos , Femenino , Persona de Mediana Edad , Prevalencia , Estudios Transversales , Comorbilidad , Trastornos del Humor/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/psicología , Neurofibromatosis/epidemiologíaRESUMEN
Objective: To analyze the safety and efficacy of repetitive transcranial magnetic stimulation (rTMS) for major depressive disorder, schizophrenia, and obsessive-compulsive disorder (OCD) via umbrella meta-analysis.Data Sources: Meta-analysis studies were searched in PubMed from inception to May 2021 using the keywords anxiety, depression, ADHD, schizophrenia, mood disorder, OCD, psychiatric disorders, GAD, bipolar disorders, ASD, PTSD, transcranial magnetic stimulation, transcranial, magnetic, stimulation. PRISMA guidelines were followed.Study Selection: Abstracts and full-length articles were reviewed for meta-analysis studies with data on the safety and efficacy of rTMS and sham and were collected for quantitative analysis. The full texts of all identified studies were independently screened and assessed to determine eligibility. Any disagreement was resolved through consensus.Data Extraction: The descriptive variables extracted included the author names, study year, sample size, studies included in the meta-analysis, study period, and type of intervention.Results: 28 meta-analyses were included; 13 were on treatment-resistant depression, 9 on schizophrenia, and 6 on OCD. In treatment-resistant depression, the rTMS group had higher odds of response compared to sham (odds ratio [OR] = 3.27; 95% CI, 2.76-3.87; P < .00001) and higher odds of remission (secondary outcome) (OR = 2.83; 95% CI, 2.33-3.45; P < .00001). rTMS was superior to sham in the reduction of negative symptoms of schizophrenia (mean difference [MD]: 0.47; 95% CI, 0.23-0.7; P < .0001). However, no significant difference was found between the effects of rTMS and sham on auditory hallucinations (MD: 0.24; 95% CI, 0.26-0.74; P = .35), which resulted in 94% heterogeneity. TMS was better than sham in reducing the severity of OCD symptoms (MD: 0.81; 95% CI, 0.53-1.10; P < .00001).Conclusions: The effectiveness of rTMS for symptom reduction in various psychiatric disorders is associated with differences in neuropathology, disease-specific target site, and frequency of rTMS.Prim Care Companion CNS Disord 2023;25(5):22r03423. Author affiliations are listed at the end of this article.
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Trastorno Depresivo Mayor , Trastorno Obsesivo Compulsivo , Esquizofrenia , Humanos , Esquizofrenia/terapia , Trastorno Depresivo Mayor/terapia , Estimulación Magnética Transcraneal/métodos , Depresión , Trastorno Obsesivo Compulsivo/terapia , Resultado del TratamientoAsunto(s)
Acoso Escolar , Víctimas de Crimen , Humanos , Niño , Acoso Escolar/psicología , Víctimas de Crimen/psicologíaRESUMEN
Objective: To explore paternal depression (before, during, and after pregnancy) and its association with neurodevelopmental disorders in children.Data Sources: A systematic, English-language review was conducted in PubMed, PubMed Central, MEDLINE, Web of Science, BIOSIS Previews, and SciELO. All relevant literature published from inception to March 31, 2021, was included. The MeSH terms used in the search included paternal behavior, fathers, or father-child relations in the context of depression, postpartum depression, and neurodevelopmental disorders.Data Extraction: The PICOS (Population, Intervention, Comparison, Outcomes, and Study design) tool was used to enhance reporting of the findings. Twenty-six articles were included in the review.Results: Paternal depression during the perinatal period resembles maternal perinatal depression. Early paternal depression has considerable emotional, behavioral, and developmental impacts on their children. Genetic endowment and environmental factors induced by paternal depression-related behaviors may lead to adverse neurodevelopmental outcomes.Conclusions and Relevance: The findings suggest that paternal depression negatively influences neurodevelopmental disorders in the offspring.
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Depresión Posparto , Trastorno Depresivo , Masculino , Embarazo , Femenino , Humanos , Depresión/epidemiología , Factores de Riesgo , Padre/psicología , Trastorno Depresivo/psicologíaRESUMEN
ABSTRACT: Cognitive behavioral therapy for insomnia (CBT-I) has shown promising results in the adult population. However, there is not enough evidence for children and adolescents. Hence, we evaluated the current evidence of CBT-I in the treatment of anxiety and depression in children and adolescents. Published randomized clinical trials published before June 2020 were searched from PubMed, Cochrane Library of database, clinicaltrials.gov, and Google Scholar. Out of seven included studies, six studies assessed the effect of CBT-I on depression, and five assessed the effect on anxiety. In this review, most studies in this review showed a strong effect of CBT-I on symptoms of depression. Although a positive effect of CBT-I on anxiety was noted, only a small number of studies have considered this management. These findings should be considered preliminary, and further large-scale studies are warranted to further explore this finding further.