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1.
Psychiatr Danub ; 33(1): 18-26, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33857036

RESUMEN

BACKGROUND: Patients with chronic mental illness are frequently hospitalized and discharged from psychiatry wards. This situation is referred to as the "revolving door phenomenon" (RDP). In addition to factors related to the patient and the disease, limited number of beds leading to shortened hospital stay are among the reasons associated with frequent hospitalization. This study aims to compare patients with RDP and patients with single hospitalization in terms of clinical, sociodemographic, and treatment-oriented characteristics in order to evaluate the risk factors causing frequent hospitalization. SUBJECTS AND METHODS: In this study, patients who were admitted and hospitalized between May 1, 2011 - May 1, 2016 were retrospectively evaluated from patient records. The RDP group consisted of 74 patients and the single-hospitalization group consisted of 59 patients who met inclusion criteria. RESULTS: The RDP group had significantly higher rates of male gender, ECT history, past suicide attempts, multiple drug treatment, clozapine use, legal incidents, and noncompliance to follow up following discharge compared to the single-hospitalization group (p<0.05). CONCLUSION: This study demonstrates that Turkey also has RDP patients with characteristics and hospitalization patterns similar to patients in countries with different cultural, social, and economic conditions. It is important to identify and correct factors that cause frequent hospitalization as it will reduce the burden of the health system as well as provide benefit to the patient.


Asunto(s)
Trastorno Bipolar , Trastornos Psicóticos , Esquizofrenia , Trastorno Bipolar/epidemiología , Hospitalización , Humanos , Masculino , Trastornos del Humor , Trastornos Psicóticos/epidemiología , Estudios Retrospectivos , Esquizofrenia/epidemiología , Turquia/epidemiología
2.
Psychiatr Danub ; 33(1): 36-47, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33857038

RESUMEN

BACKGROUND: Previous studies reported deficits in pleasure experience in schizophrenia, but little is known about anhedonia in psychosis risk syndrome. Aim of this study was: (1) to assess anhedonia in distinct help-seeking subgroups of young people identified through the Ultra-High Risk (UHR) criteria, (2) to explore its association with functioning and psychopathology in the UHR group, and (3) to monitor longitudinally its stability in UHR individuals along 1-year follow-up period. SUBJECTS AND METHODS: All participants (78 UHR, 137 with a First Episode Psychosis (FEP), and 95 non-UHR/FEP), aged 13-35 years, completed the Comprehensive Assessment of At-Risk Mental States (CAARMS), the Beck Depression Inventory-II (BDI-II), the Schizotypal Personality Questionnaire - Brief version (SPQ-B), the Brief O-LIFE questionnaire (BOL), and the World Health Organization Quality of Life - Brief version (WHOQOL-BREF). We adopted two different indexes of anhedonia: i.e. CAARMS "Anhedonia" item 4.3 and BOL "Introvertive Anhedonia" subscale scores. RESULTS: In comparison with non-UHR/FEP, UHR individuals showed higher baseline CAARMS item 4.3 and BOL "Introvertive Anhedonia" subscale scores. No difference in anhedonia scores between UHR and FEP patients was found. After 1-year follow-up period, UHR subjects had a significant decrease in severity exclusively on CAARMS item 4.3 subscore. CONCLUSIONS: In the UHR group, CAARMS anhedonia showed significant correlations with functioning deterioration, negative symptoms, and comorbid depression (including suicide ideation), while BOL anhedonia with a poorer self-perceived quality of life and specific schizotypal personality traits (i.e. interpersonal deficits and disorganization). Anhedonia is prominent in the psychosis risk syndrome and its severity is indistinguishable from that of FEP patients.


Asunto(s)
Trastornos Psicóticos , Esquizofrenia , Adolescente , Adulto , Anhedonia , Humanos , Escalas de Valoración Psiquiátrica , Psicopatología , Trastornos Psicóticos/epidemiología , Calidad de Vida , Adulto Joven
3.
Psychiatr Danub ; 33(1): 76-85, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33857050

RESUMEN

Since December 2019, the havoc caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has increased exponentially in a short period of time. As the COVID-19 pandemic is raging around the world, scientists are trying to reveal its mysteriousness. Although COVID-19 is predominantly a respiratory disease, the most common symptoms are fever, dry cough, and fatigue, but extrapulmonary manifestations are increasingly recognized. Recent studies have shown that there is a strong genetic correlation between one or more psychiatric disorders and the occurrence of SARS-CoV-2 infection. Historical epidemiological perspectives and recent neurobiological evidence link infection and psychosis. What is the relationship between COVID-19 and psychiatric disorders? In this article, we will review the correlation between COVID-19 and psychoses, the possible reasons, and the possible pathophysiological mechanisms. The purpose of this review is to provide a reference for clinicians to make correct judgment and treatment when facing patients with COVID-19 and/or psychiatric disorders.


Asunto(s)
Trastornos Psicóticos , Fatiga , Humanos , Pandemias , Trastornos Psicóticos/epidemiología
4.
Ned Tijdschr Tandheelkd ; 128(4): 197-201, 2021 Apr.
Artículo en Holandés | MEDLINE | ID: mdl-33890934

RESUMEN

Patients with a psychotic disorder have certain symptoms, movement disorders resulting from the pharmacological effects of medication. Knowing about this is important to the patients' dental treatment. A very small group will present with delusions about teeth or the benevolent or malevolent intentions of the dentist. Negative symptoms are an important characteristic of schizophrenic psychoses, meaning the absence of normal behaviour. Patients neglect personal hygiene and their lives have hardly any structure. They do not concern themselves with appointments, daily routines and social expectations. In such cases, prosthetic measures may be necessary. In addition, antipsychotic medications have adverse effects such as increased risk of caries, bruxism, oral and facial tardive dyskinesia, xerostomia, swallowing disorders and orthostatic hypotension. Suggestions for dental treatment and advice on how best to approach these patients are provided.


Asunto(s)
Antipsicóticos , Trastornos Psicóticos , Esquizofrenia , Antipsicóticos/efectos adversos , Humanos , Trastornos Psicóticos/tratamiento farmacológico , Trastornos Psicóticos/epidemiología , Esquizofrenia/tratamiento farmacológico , Esquizofrenia/epidemiología
5.
BMC Psychiatry ; 21(1): 147, 2021 03 10.
Artículo en Inglés | MEDLINE | ID: mdl-33691655

RESUMEN

BACKGROUND: The World Health Organization Disability Assessment Schedule 2.0 (WHODAS-2.0) is a self-administered instrument to assess functional impairment. It is used in the general population as well as different patient groups. However, its application to patients with psychotic disorders may be hampered by disease-specific difficulties of self-estimation. This study aimed to examine the psychometric properties of the short (12-item) WHODAS-2.0 in a naturalistic sample of outpatients attending a psychosis clinic in Gothenburg, Sweden. METHODS: Annual data from two outpatient clinics registered 2016-2019 were analyzed retrospectively. The assessment of the short WHODAS-2.0 was based on the first questionnaire completed by 881 patients. Confirmatory factor analysis evaluated previously validated models. Item convergent and discriminant validity as well as internal reliability were computed. Construct validity was assessed by comparing mean differences in accord with previous research regarding patients' characteristics associated with functioning such as advanced age, diagnosed comorbidities, antipsychotic treatment status, and symptom severity measured with PANSS-8 remission items. RESULTS: A heterogeneous sample was obtained in terms of age (range: 20-92), various living situations, and different geographic areas of birth. Most patients (75%) had been diagnosed with psychotic disorders more than 10 years ago and the majority (89%) were on antipsychotic medication. We confirmed an adjusted two-level factor model with a single second-order disability factor and six first-order factors representing the six IFC dimensions. The WHODAS-2.0 sum score measuring general disability showed good reliability (Cronbach's alpha = 0.89). Construct validity was confirmed as older patients, patients with comorbidities, and patients in assisted living had higher WHODAS-2.0 scores. Patients with no or mild psychotic symptoms had significantly lower WHODAS-2.0 sum scores than patients with more severe symptoms. CONCLUSIONS: The findings further validate the 12-item WHODAS-2.0 in a naturalistic sample of outpatients with psychotic disorders. This study corroborates the clinical significance of the short, 12-item WHODAS-2.0 by demonstrating consistent associations between patients' age, medical comorbidities, living situation, antipsychotic treatment status, and psychotic symptom severity.


Asunto(s)
Pacientes Ambulatorios , Trastornos Psicóticos , Evaluación de la Discapacidad , Humanos , Psicometría , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/tratamiento farmacológico , Trastornos Psicóticos/epidemiología , Reproducibilidad de los Resultados , Estudios Retrospectivos , Suecia , Organización Mundial de la Salud
6.
Harefuah ; 160(2): 104-109, 2021 Feb.
Artículo en Hebreo | MEDLINE | ID: mdl-33760412

RESUMEN

INTRODUCTION: Psychotic disorders are associated with a severe functional decline and a significant impact on the quality of life. These disorders usually develop gradually, lasting days to months-years. The early phase of psychotic disorders is termed "pre-psychotic" or "prodromal". It is estimated that 30% of the individuals presenting with prodromal symptoms will develop psychosis in three years. This high-risk state is also known as "clinical high risk" (CHR), "ultra-high risk" (UHR), and "at-risk mental state" (ARMS). The diagnostic criteria of high-risk subjects include 3 groups: 1) genetic risk with a functional decline; 2) brief limited intermittent psychotic symptoms group (BLIPS); 3) subthreshold positive psychotic symptoms. In addition to the psychosis risk, these subjects suffer from distress, functional deterioration and psychiatric comorbidities that influence their quality of life. Therefore, many efforts are invested in early identification of the high-risk for psychosis subjects with the primary aim of using interventions to delay or prevent conversion to psychosis. Studies in the field have highlighted specific factors that predict the risk to develop psychosis and even developed predictive models. Interventions including cognitive-behavioral therapy, integrative psychological therapy and pharmacological therapy were found to be associated with postponing the conversion to psychosis. According to current guidelines, cognitive behavioral therapy is the first-choice intervention, and pharmacological interventions should be reserved for patients with comorbidities in need of stabilization of severe and progressive symptoms. Further prospective studies will allow a better identification of high-risk patients and enable the development of interventions for prevention and treatment of this population.


Asunto(s)
Trastornos Psicóticos , Calidad de Vida , Humanos , Síntomas Prodrómicos , Estudios Prospectivos , Escalas de Valoración Psiquiátrica , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/epidemiología , Trastornos Psicóticos/etiología
7.
BMC Pulm Med ; 21(1): 52, 2021 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-33546651

RESUMEN

OBJECTIVE: To develop and validate a clinical risk prediction score for noninvasive ventilation (NIV) failure defined as intubation after a trial of NIV in non-surgical patients. DESIGN: Retrospective cohort study of a multihospital electronic health record database. PATIENTS: Non-surgical adult patients receiving NIV as the first method of ventilation within two days of hospitalization. MEASUREMENT: Primary outcome was intubation after a trial of NIV. We used a non-random split of the cohort based on year of admission for model development and validation. We included subjects admitted in years 2010-2014 to develop a risk prediction model and built a parsimonious risk scoring model using multivariable logistic regression. We validated the model in the cohort of subjects hospitalized in 2015 and 2016. MAIN RESULTS: Of all the 47,749 patients started on NIV, 11.7% were intubated. Compared with NIV success, those who were intubated had worse mortality (25.2% vs. 8.9%). Strongest independent predictors for intubation were organ failure, principal diagnosis group (substance abuse/psychosis, neurological conditions, pneumonia, and sepsis), use of invasive ventilation in the prior year, low body mass index, and tachypnea. The c-statistic was 0.81, 0.80 and 0.81 respectively, in the derivation, validation and full cohorts. We constructed three risk categories of the scoring system built on the full cohort; the median and interquartile range of risk of intubation was: 2.3% [1.9%-2.8%] for low risk group; 9.3% [6.3%-13.5%] for intermediate risk category; and 35.7% [31.0%-45.8%] for high risk category. CONCLUSIONS: In patients started on NIV, we found that in addition to factors known to be associated with intubation, neurological, substance abuse, or psychiatric diagnoses were highly predictive for intubation. The prognostic score that we have developed may provide quantitative guidance for decision-making in patients who are started on NIV.


Asunto(s)
Reglas de Decisión Clínica , Intubación Intratraqueal/estadística & datos numéricos , Ventilación no Invasiva , Insuficiencia Respiratoria/terapia , Afroamericanos/estadística & datos numéricos , Anciano , Asma/epidemiología , Estudios de Cohortes , Registros Electrónicos de Salud , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Insuficiencia Cardíaca/epidemiología , Mortalidad Hospitalaria , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Infarto del Miocardio/epidemiología , Enfermedades del Sistema Nervioso/epidemiología , Neumonía/epidemiología , Trastornos Psicóticos/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Respiración Artificial/estadística & datos numéricos , Insuficiencia Respiratoria/epidemiología , Estudios Retrospectivos , Medición de Riesgo , Sepsis/epidemiología , Accidente Cerebrovascular/epidemiología , Trastornos Relacionados con Sustancias/epidemiología , Insuficiencia del Tratamiento
8.
Psychiatry Res ; 298: 113802, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33592401

RESUMEN

The ongoing Corona Virus Disease 2019 (COVID-19) pandemic appears to increase risk for mental illness, either directly due to inflammation caused by the virus or indirectly due to related psychosocial stress, resulting in the development of both anxious-depressive and psychotic symptoms. The purpose of the present study was to assess the frequency and characteristics of all patients with First Episodes Psychosis (FEP) without COVID-19 infection hospitalized in the first four months since lockdown in Milan. We recruited sixty-two patients hospitalized between March 8 to July 8, 2020 versus those first  hospitalized in the same period in 2019. The two subgroups were compared for sociodemographic variables and clinical characteristics of the episodes. Patients with FEP in 2020 were significantly older than patients with FEP in 2021, and presented with significantly less substances abuse. Interestingly, patients presenting with FEP in 2020 were significantly older than patients with FEP in 2019. These data are compatible with the greater vulnerability to stressful factors during the pandemic, as well as with the greater concern regarding a possible COVID-19 infection producing brain damage causing the FEP.


Asunto(s)
Control de Enfermedades Transmisibles , Hospitalización , Trastornos Psicóticos , Adulto , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Italia/epidemiología , Masculino , Trastornos Psicóticos/epidemiología , Trastornos Psicóticos/etiología , Trastornos Psicóticos/terapia
10.
Res Dev Disabil ; 110: 103856, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33497856

RESUMEN

During the COVID-19 pandemic, the Oasi Research Institute of Troina (Italy) became an important hotbed for infection; in fact, 109 patients with different levels of Intellectual Disability (ID) tested positive for COVID-19. The procedures and interventions put in place at the Oasi Research Institute due to the COVID-19 pandemic are exhaustively reported in this paper. The description of the clinical procedures as well as remote/in person psychological support services provided to people with ID and their families are here divided into three different sections: Phase I (or Acute phase), Phase II (or Activity planning), and Phase III (or Activity consolidation). In each section, the main psycho-pathological characteristics of patients, the reactions of family members and the multidisciplinary interventions put in place are also described.


Asunto(s)
/epidemiología , Discapacidades del Desarrollo/rehabilitación , Discapacidad Intelectual/rehabilitación , Sistemas de Apoyo Psicosocial , Telemedicina , Academias e Institutos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Trastorno del Espectro Autista/epidemiología , Trastorno del Espectro Autista/psicología , Trastorno del Espectro Autista/rehabilitación , /fisiopatología , Niño , Preescolar , Comorbilidad , Discapacidades del Desarrollo/epidemiología , Discapacidades del Desarrollo/psicología , Brotes de Enfermedades , Epilepsia/epidemiología , Femenino , Hospitales Especializados , Humanos , Hipotiroidismo/epidemiología , Lactante , Discapacidad Intelectual/epidemiología , Discapacidad Intelectual/psicología , Italia , Masculino , Persona de Mediana Edad , Trastornos del Humor/epidemiología , Trastornos del Humor/psicología , Trastornos del Humor/rehabilitación , Obesidad/epidemiología , Sobrepeso/epidemiología , Trastornos de la Personalidad/epidemiología , Trastornos de la Personalidad/psicología , Trastornos de la Personalidad/rehabilitación , Trastornos Psicóticos/epidemiología , Trastornos Psicóticos/psicología , Trastornos Psicóticos/rehabilitación , Índice de Severidad de la Enfermedad , Adulto Joven
11.
J Sex Med ; 18(3): 457-466, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33504468

RESUMEN

BACKGROUND: Sexual dysfunction among psychotic patients is highly prevalent. However, most research has focused on antipsychotic side effects on sexual functioning. AIM: To provide evidence by means of a systematic review of the literature about the impact of psychosis on sexual functioning among unmedicated patients. METHODS: Systematic search of MEDLINE (PubMed), Scopus, and Google Scholar for studies that reported sexual functioning among psychotic patients, who were drug-naïve or drug-free for at least 3 weeks before the study. Studies were published in English language between January 1994 and October 2019. We used the approach recommended by PRISMA, and the selection process was carried out by 2 reviewers. OUTCOMES: The outcome measures were sexual function and sexual dysfunctions. RESULTS: A total of 734 articles were obtained, 658 were obtained after duplicates were removed, 612 were excluded after reading the title and abstract, and 46 were included for a complete review of the articles. 5 papers were finally included. A total of 770 cases were included in the systematic review. The prevalence of sexual dysfunction in psychosis varied from 16.8% to 70% and in ultra-high state was 50%. It is noteworthy that those ultra-high-risk (prodromal) patients who develop psychosis had higher rates of sexual impairment. Therefore, we found higher rates of sexual dysfunction among untreated patients, both psychotic and ultra-high risk patients, than healthy controls. CLINICAL IMPLICATIONS: The assessment of sexual behavior should be a part of routine psychiatric examination not only in psychotic but also in ultra-high-risk patients. STRENGTHS & LIMITATIONS: This is the first systematic review about the impact of psychosis on sexual functioning among unmedicated patients. However, scarce and heterogeneous studies were identified. CONCLUSIONS: Impaired sexual functioning is common in the onset of psychosis (or during ultra-high-risk state) and prior to the beginning of treatment. This suggests that psychotic symptoms and sexual dysfunction may have common etiological pathways at the psychosocial and neurobiological levels. Vargas-Cáceres S, Cera N, Nobre P, et al. The Impact of Psychosis on Sexual Functioning: A Systematic Review. J Sex Med 2021;18:457-466.


Asunto(s)
Antipsicóticos , Trastornos Psicóticos , Disfunciones Sexuales Fisiológicas , Antipsicóticos/uso terapéutico , Humanos , Prevalencia , Trastornos Psicóticos/epidemiología , Disfunciones Sexuales Fisiológicas/epidemiología , Disfunciones Sexuales Fisiológicas/etiología
12.
BMC Psychiatry ; 21(1): 9, 2021 01 07.
Artículo en Inglés | MEDLINE | ID: mdl-33413179

RESUMEN

BACKGROUND: Psychosis can be a sufficiently traumatic event to lead to post-traumatic stress disorder (PTSD). Previous research has focussed on the trauma of first episode psychosis (FEP) and the only review to date of PTSD beyond the first episode period was not systematic and is potentially outdated. METHODS: We searched electronic databases and reference lists using predetermined inclusion criteria to retrieve studies that reported prevalence rates and associated factors of psychosis-related PTSD across all stages of the course of psychosis. Studies were included if they measured PTSD specifically related to the experience of psychosis. Risk of bias was assessed using an adapted version of the Newcastle Ottawa Scale. Results were synthesised narratively. RESULTS: Six papers met inclusion criteria. Prevalence estimates of psychosis-related PTSD varied from 14 to 47%. Studies either assessed first-episode samples or did not specify the number of episodes experienced. Depression was consistently associated with psychosis-related PTSD. Other potential associations included treatment-related factors, psychosis severity, childhood trauma, and individual psychosocial reactions to trauma. CONCLUSIONS: Psychosis-related PTSD is a common problem in people with psychosis. There is a lack of published research on this beyond first episode psychosis. Further research is needed on larger, more generalizable samples. Our results tentatively suggest that prevalence rates of psychosis-related PTSD have not reduced over the past decade despite ambitions to provide trauma-informed care. Prospero registration number: CRD42019138750.


Asunto(s)
Trastornos Psicóticos , Trastornos por Estrés Postraumático , Niño , Humanos , Prevalencia , Trastornos Psicóticos/epidemiología , Trastornos por Estrés Postraumático/epidemiología
13.
BMC Psychiatry ; 21(1): 30, 2021 01 11.
Artículo en Inglés | MEDLINE | ID: mdl-33430829

RESUMEN

BACKGROUND: Psychotic experiences (PEs) are not uncommon in young people and are associated with both psychopathology and compromised global functioning. Although psychotic experiences are transient (short-lived, self-resolving and non-recurring) for most people who report them, few studies have examined the association between early transient PEs and later functioning in population samples. Additionally, studies using self-report measures of interpersonal and educational/ vocational difficulties are lacking. The aim of this study was to examine the relationship between transient psychotic experiences and self-reported interpersonal and educational/vocational difficulties in adolescence and young adulthood. METHODS: Participants were 103 young people from a longitudinal population-based study cohort of mental health in Ireland. They attended for baseline clinical interviews in childhood (age 11-13) and were followed up in young adulthood (age 19-25). Participants who reported psychotic experiences at baseline but not at follow-up were classified as having transient psychotic experiences. Data from both time-points were used to examine the association between transient psychotic experiences and self-reported interpersonal and educational/ vocational difficulties in young adulthood using poisson regression modelling. RESULTS: Young people with a history of transient psychotic experiences reported significantly higher interpersonal (adj IRR: 1.83, 95%ileCI: 1.10-3.02, p = .02) and educational/vocational (adj IRR: 2.28, 95%ileCI: 1.43-3.64, p = .001) difficulties during adolescence. However, no significant differences in interpersonal (adj IRR: 0.49, 95%ileCI: 0.10-2.30, p = .37) or educational/vocational (adj IRR: 0.88, 95%ileCI: 0.37-2.08, p = .77) difficulties were found in young adulthood. Self-reported interpersonal and educational/vocational difficulties in young people both with and without a history of transient psychotic experiences decreased between adolescence and young adulthood. CONCLUSIONS: Young people with transient psychotic experiences have increased interpersonal and educational/vocational difficulties in adolescence but these may not persist into the young adult years. This finding indicates that early psychotic experiences may not confer high risk for long-term interpersonal or educational/vocational deficits among young people who experience these phenomena transiently.


Asunto(s)
Trastornos Psicóticos , Adolescente , Adulto , Niño , Humanos , Irlanda/epidemiología , Estudios Longitudinales , Salud Mental , Psicopatología , Trastornos Psicóticos/epidemiología , Autoinforme , Adulto Joven
14.
Neurosci Lett ; 743: 135588, 2021 01 19.
Artículo en Inglés | MEDLINE | ID: mdl-33359543

RESUMEN

INTRODUCTION: Mild cognitive dysfunction has been implicated in a number of psychiatric diseases and affects social functioning. Although clinical criteria were recently proposed for autoimmune psychosis (AP), biomarkers have not yet been established for the severity and prognosis of cognitive dysfunction. We herein investigated the relationships between 3 types of serum antibodies and cognitive dysfunction in chronic psychiatric patients suspected of AP. METHODS: We included 31 patients suspected of AP and obtained information on their clinical characteristics. Three types of autoantibodies (the anti-N-methyl-D-aspartate receptor (anti-NMDAR Ab), anti-N-terminal of GluN1 (anti-GluN1-NT Ab), and anti-thyroid antibodies) were evaluated in serum. Cognitive function was assessed using Wechsler Adult Intelligence Scale-III. We examined the relationships between serum autoantibodies and cognitive dysfunction in patients using multiple regression models. RESULTS: Serum titers of anti-GluN1-NT Ab significantly contributed to the estimated score of working memory (B= -55.85, ß= -0.46, p= 0.01), while no correlation was observed between the other 2 types of antibodies and cognitive function. CONCLUSIONS: The present results indicate the potential of serum anti-GluN1-NT Ab as a biomarker for the severity and prognosis of cognitive dysfunction underlying various psychiatric symptoms in patients with AP. The pathological significance of anti-GluN1-NT Ab needs to be verified in future studies.


Asunto(s)
Autoanticuerpos/sangre , Enfermedades Autoinmunes del Sistema Nervioso/sangre , Disfunción Cognitiva/sangre , Proteínas del Tejido Nervioso/sangre , Trastornos Psicóticos/sangre , Receptores de N-Metil-D-Aspartato/sangre , Adulto , Enfermedades Autoinmunes del Sistema Nervioso/epidemiología , Enfermedades Autoinmunes del Sistema Nervioso/psicología , Biomarcadores/sangre , Enfermedad Crónica , Disfunción Cognitiva/epidemiología , Disfunción Cognitiva/psicología , Femenino , Células HEK293 , Humanos , Masculino , Persona de Mediana Edad , Trastornos Psicóticos/epidemiología , Trastornos Psicóticos/psicología
15.
Artículo en Inglés | MEDLINE | ID: mdl-33166098

RESUMEN

Objective: To report the clinical characteristics and transmission rate of coronavirus disease 2019 (COVID-19) in a community inpatient long-term care psychiatric rehabilitation facility designed for persons with serious mental illness to provide insight into transmission and symptom patterns and emerging testing protocols, as well as medical complications and prognosis. Methods: This study examined a cohort of 54 residents of a long-term care psychiatric rehabilitation program from March to April 2020. Baseline demographics, clinical diagnoses, and vital signs were examined to look for statistical differences between positive versus negative severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) groups. During the early phase of the pandemic, the facility closely followed the local shelter-in-place order (starting March 19, 2020) and symptom-based testing. Results: Of the residents, the primary psychiatric diagnoses were schizoaffective disorder: 28 (51.9%), schizophrenia: 21 (38.9%), bipolar I disorder: 3 (5.5%), and unspecified psychotic disorder: 2 (3.7%). Forty (74%) of 54 residents tested positive for SARS-COV-2, with a doubling time of 3.9 days. There were no statistical differences between the positive SARS-COV-2 versus negative groups for age or race/ethnicity. Psychiatric and medical conditions were not significantly associated with contracting SARS-COV-2, with the exception of obesity (n = 17 [43%] positive vs n = 12 [86%] negative, P = .01). Medical monitoring of vital signs and symptoms did not lead to earlier detection. All of the residents completely recovered, with the last resident no longer showing any symptoms 24 days from the index case. Conclusion: Research is needed to determine optimal strategies for long-term care mental health settings that incorporate frequent testing and personal protective equipment use to prevent rapid transmission of SARS-COV-2.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Trastornos Psicóticos/rehabilitación , Centros de Rehabilitación , Esquizofrenia/rehabilitación , Adulto , Afroamericanos , Americanos Asiáticos , Betacoronavirus , Trastorno Bipolar/epidemiología , Trastorno Bipolar/rehabilitación , California/epidemiología , Técnicas de Laboratorio Clínico , Comorbilidad , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/transmisión , Diabetes Mellitus/epidemiología , Grupo de Ascendencia Continental Europea , Reflujo Gastroesofágico/epidemiología , Hispanoamericanos , Humanos , Hiperlipidemias/epidemiología , Hipertensión/epidemiología , Hipotiroidismo/epidemiología , Control de Infecciones , Cuidados a Largo Plazo , Tamizaje Masivo , Persona de Mediana Edad , Obesidad/epidemiología , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/fisiopatología , Neumonía Viral/transmisión , Rehabilitación Psiquiátrica , Psicoterapia de Grupo , Trastornos Psicóticos/epidemiología , Recreación , Rehabilitación Vocacional , Esquizofrenia/epidemiología , Fumar/epidemiología , Visitas a Pacientes
16.
Psychiatr Danub ; 32(Suppl 3): 349-352, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33030451

RESUMEN

Sexual abuse in childhood is associated with many adverse consequences for survival during their lifetime. Numerous research studies clearly show the link between sexual abuse of children and the spectrum of unfavorable mental, social, sexual, interpersonal and behavioral as well as physical health consequences. Current research shows the strongest link between sexual abuse of children and the presence of depression, alcohol and abuse of other psychoactive substances and nutritional disorders in surviving women and anxiety-related disorders in male survivors. There is also an increased risk of re-victimization, especially for girls. Negative effects of mental health in children with sexual abuse include posttraumatic symptoms, depression, helplessness, negative evaluation, aggressive behavior and behavioral problems. Recent research links sexual assault on children with psychotic disorders, including schizophrenia and dysfunctional disorders, as well as personality disorders. Sexual abuse of children involving penetration is specifically identified as a risk factor for the development of psychotic and schizophrenic symptoms. Many studies have shown that sexual victimization in childhood is a significant risk factor for suicidal ideation and suicidal behaviors.


Asunto(s)
Abuso Sexual Infantil/psicología , Abuso Sexual Infantil/estadística & datos numéricos , Trastornos Mentales/epidemiología , Trastornos de Ansiedad/epidemiología , Niño , Humanos , Trastornos Psicóticos/epidemiología , Conducta Sexual
17.
J Clin Psychiatry ; 81(5)2020 09 15.
Artículo en Inglés | MEDLINE | ID: mdl-32936544

RESUMEN

​​ Along with cognitive decline, 90% of patients with dementia experience behavioral and psychological symptoms, such as psychosis, aggression, agitation, and depression. Dementia-related psychosis (DRP), which includes delusions and hallucinations, contributes to institutionalization, cognitive decline, and caregiver burden. Delusions and hallucinations tend to increase with the duration and severity of the disease, but there are also individual fluctuations. While a variety of symptoms can occur in all types of dementia, visual hallucinations are particularly common in the Lewy body dementias (dementia with Lewy bodies and Parkinson disease dementia). Mechanisms behind DRP are multifactorial, including different neurobiological factors as well as environmental, social, and psychological factors. This report examines the frequency, symptoms, and pathophysiology of DRP and communication about psychotic symptoms with patients with dementia (if possible) and their care partners.


Asunto(s)
Demencia/complicaciones , Trastornos Psicóticos/etiología , Anciano , Cuidadores/psicología , Demencia/fisiopatología , Demencia/psicología , Humanos , Trastornos Psicóticos/epidemiología , Trastornos Psicóticos/fisiopatología
18.
Rev. psiquiatr. salud ment. (Barc., Ed. impr.) ; 13(3): 131-139, jul.-sept. 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-199844

RESUMEN

INTRODUCCIÓN: El maltrato infantil se ha asociado a un mayor riesgo de psicosis, a una mayor severidad en síntomas psicopatológicos y a un peor pronóstico funcional en pacientes con un trastorno psicótico. El presente estudio pretende evaluar la relación entre el maltrato infantil, psicopatología y la adaptación social en una muestra de primeros episodios psicóticos (PEP) y de estados mentales de alto riesgo (EMAR). MATERIAL Y MÉTODOS: La muestra incluyó 114 jóvenes (18-35 años, 81 PEP y 33 EMAR) atendidos en un Servicio de Intervención Precoz en Psicosis. Se evaluaron síntomas positivos, negativos y depresivos con las escalas PANSS y Calgary de Depresión; los antecedentes de maltrato infantil con el Childhood Trauma Questionnaire; la adaptación social con la Escala Autoaplicada de Adaptación Social (SASS). Se utilizó el modelo de ecuaciones estructurales (SEM) para explorar relaciones entre psicopatología, maltrato infantil y dimensiones de la SASS en toda la muestra (incluyendo PEP y EMAR). Se repitió un análisis SEM exploratorio en la submuestra de PEP. RESULTADOS: Los EMAR presentaron más negligencia emocional y peor adaptación social, comparados con los PEP. El SEM muestra que el maltrato se asocia con una peor adaptación social en todos los dominios, de forma directa en dominios que implican relaciones interpersonales, y por una vía mediada por síntomas depresivos en los dominios que implican ocio y trabajo e intereses socioculturales. CONCLUSIONES: El maltrato infantil tiene un efecto negativo sobre la adaptación social en jóvenes en fases tempranas de las psicosis. Los síntomas depresivos son mediadores de una peor adaptación en aspectos funcionales relacionados con el ocio y el trabajo


INTRODUCTION: Childhood trauma has been associated with an increased risk of psychosis, a greater severity of psychopathological symptoms, and a worse functional prognosis in patients with psychotic disorders. The current study aims to explore the relationship between childhood trauma, psychopathology and social adaptation in a sample of young people with first episode psychosis (FEP) or at-risk mental states (ARMS). MATERIAL AND METHODS: The sample included 114 young people (18-35 years old, 81 FEP and 33 ARMS) who were attending an Early Intervention Service for Psychosis. Positive, negative and depressive symptoms were assessed with the PANSS and the Calgary Depression Scale; history of childhood trauma was assessed with the Childhood Trauma Questionnaire; social adaptation was assessed with the Social Adaptation Self-evaluation Scale (SASS). Structural equation modeling (SEM) was used to explore the relationship between childhood trauma, psychopathology and SASS dimensions in the global sample (including FEP and ARMS). An exploratory SEM analysis was repeated in the subsample of FEP patients. RESULTS: ARMS individuals reported more emotional neglect and worse social adaptation compared to FEP. SEM analysis showed that childhood trauma is associated with a worse social adaptation, in a direct way with domains involving interpersonal relationships, and mediated by depressive symptoms with those domains involving leisure, work and socio-cultural interests. CONCLUSIONS: Childhood trauma has a negative effect on social adaptation in young people with early psychosis. Depressive symptoms play a mediation role in this association, especially in domains of leisure and work


Asunto(s)
Humanos , Niño , Maltrato a los Niños/psicología , Adultos Sobrevivientes del Maltrato a los Niños/psicología , Resiliencia Psicológica/clasificación , Trastornos Psicóticos/epidemiología , Trastornos Mentales/epidemiología , Factores de Riesgo , Síntomas Psíquicos/análisis , Depresión/epidemiología , Ajuste Social
20.
Epidemiol Psychiatr Sci ; 29: e153, 2020 Aug 12.
Artículo en Inglés | MEDLINE | ID: mdl-32782057

RESUMEN

AIMS: Epidemiological studies indicate that individuals with one type of mental disorder have an increased risk of subsequently developing other types of mental disorders. This study aimed to undertake a comprehensive analysis of pair-wise lifetime comorbidity across a range of common mental disorders based on a diverse range of population-based surveys. METHODS: The WHO World Mental Health (WMH) surveys assessed 145 990 adult respondents from 27 countries. Based on retrospectively-reported age-of-onset for 24 DSM-IV mental disorders, associations were examined between all 548 logically possible temporally-ordered disorder pairs. Overall and time-dependent hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards models. Absolute risks were estimated using the product-limit method. Estimates were generated separately for men and women. RESULTS: Each prior lifetime mental disorder was associated with an increased risk of subsequent first onset of each other disorder. The median HR was 12.1 (mean = 14.4; range 5.2-110.8, interquartile range = 6.0-19.4). The HRs were most prominent between closely-related mental disorder types and in the first 1-2 years after the onset of the prior disorder. Although HRs declined with time since prior disorder, significantly elevated risk of subsequent comorbidity persisted for at least 15 years. Appreciable absolute risks of secondary disorders were found over time for many pairs. CONCLUSIONS: Survey data from a range of sites confirms that comorbidity between mental disorders is common. Understanding the risks of temporally secondary disorders may help design practical programs for primary prevention of secondary disorders.


Asunto(s)
Trastornos Mentales/epidemiología , Adolescente , Adulto , Anciano , Comorbilidad , Estudios Transversales , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Trastornos Mentales/clasificación , Persona de Mediana Edad , Prevalencia , Modelos de Riesgos Proporcionales , Trastornos Psicóticos/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Adulto Joven
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