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1.
Psychiatr Prax ; 47(1): 29-34, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31910458

RESUMO

Formal thought disorders are common in people diagnosed with schizophrenia. Among them, concretism stands for deficiencies in the understanding of idiomatic expressions, metaphors and proverbs. However, little is known as to whether concretism is a correlate of the acuteness or severity of schizophrenia within patients. In this pilot study data of 28 patients was collected in the process of implementing a proverb test for screening purposes as part of an enhancement to the standard assessment of the general cognitive functioning of the patients. Our findings support the argument for such a coherence as a significant correlation between the degree of acuteness and concretism was found. However, the proverb test also correlated significantly with our standard cognitive assessment so the question as to which degree the proverb test will add further information regarding the general cognitive functioning needs to be addressed. Finally, the question as to whether there is an indication to specifically approach concretism in the treatment of patients with schizophrenia is discussed.


Assuntos
Transtornos Cognitivos , Esquizofrenia , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/terapia , Alemanha , Humanos , Metáfora , Projetos Piloto , Esquizofrenia/diagnóstico , Esquizofrenia/terapia
2.
J Nerv Ment Dis ; 208(2): 118-126, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31985560

RESUMO

This study investigated the seroprevalence of Toxoplasma gondii in a cohort of 101 Italian inpatients affected by mood or schizophrenia-spectrum disorders and compared clinical features between seronegative and seropositive subjects. Patients diagnosed according to DSM-5 criteria underwent clinical assessments and blood collection to test parasite-specific IgG/IgM serum levels. Twenty-eight patients (27.7%) had IgG anti-T. gondii, and none had IgM antibodies. We found higher prevalence rate in patients aged 40 years or older, as compared with younger. No significant association was detected between T. gondii and a specific diagnostic category; however, bipolar disorder (BD)-II showed the highest positivity rate (40.9%). The seropositive status was significantly associated with a lower presence of psychotic symptoms, higher number of total episodes of predominant excitatory polarity, longer illness duration, and lower severity of current episode, particularly anxiety, depressive, and withdrawal/retardation symptoms. These preliminary results seem to point out an association between chronic toxoplasmosis and a specific subtype of BD.


Assuntos
Transtorno Bipolar/diagnóstico , Esquizofrenia/diagnóstico , Psicologia do Esquizofrênico , Toxoplasmose/diagnóstico , Toxoplasmose/psicologia , Adulto , Idoso , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/psicologia , Doença Crônica , Estudos de Coortes , Comorbidade , Correlação de Dados , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Esquizofrenia/epidemiologia , Estudos Soroepidemiológicos , Toxoplasmose/epidemiologia , Adulto Jovem
3.
Nervenarzt ; 91(1): 10-17, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31858162

RESUMO

The last two decades of clinical research have clearly demonstrated the comprehensive benefits of the early recognition and treatment of psychotic disorders. The attenuated and transient positive symptoms according to the ultrahigh risk criteria and the basic symptom criterion "Cognitive disturbances" are the main approaches for an indicated prevention. They have recently been recommended as criteria for a clinical high-risk (CHR) state of psychosis by the European Psychiatric Association (EPA) and, following these, in the German S3 guidelines for the treatment of schizophrenia by the German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN); however, the efficacy of early treatment of patients with a CHR for psychoses critically depends on the development of prognostic instruments, which enable healthcare professionals to reliably identify these patients based on the individual objective risk profiles. An important goal is the treatment of functional deficits, which can be identified by an individual risk profile. The treatment of existing comorbid mental disorders, psychosocial problems and the prevention of potential future disorders also characterizes the recommendations of the EPA and DGPPN for early treatment, which favor psychotherapeutic, especially cognitive behavioral interventions over pharmacological treatment. The close interdisciplinary cross-sectoral cooperation between the disciplines of child and adolescent psychiatry, and adult psychiatry is of outstanding importance in this context.


Assuntos
Transtornos Psicóticos , Esquizofrenia , Adolescente , Adulto , Criança , Terapia Cognitivo-Comportamental , Humanos , Psicoterapia , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/prevenção & controle , Transtornos Psicóticos/terapia , Esquizofrenia/diagnóstico , Esquizofrenia/prevenção & controle , Esquizofrenia/terapia
4.
Metas enferm ; 22(10): 50-55, dic. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-185330

RESUMO

La investigación sobre la eficacia de la arteterapia en el ámbito de la salud mental es poco concluyente. Pacientes y terapeutas coinciden a menudo en señalar su utilidad para el desarrollo de la expresión, la comunicación, la socialización y la autoconciencia, pero al ceñirse en la investigación, no se encuentra evidencia de que lo consiga. Tomando el diagnóstico de esquizofrenia como referente se encuentra que frente a los estudios que sugieren una mejoría en la salud mental global, el funcionamiento social y la calidad de las relaciones interpersonales, hay otros que no encuentran mejoría significativa ni en variables principales, como funcionalidad global y sintomatología global, ni en otras asociadas como asistencia al grupo, funcionamiento social, satisfacción con el tratamiento o impacto sobre la sintomatología negativa. Las sucesivas revisiones consultadas sugieren que esta contradicción en los resultados podría deberse a limitaciones metodológicas y recomiendan clarificar aspectos relacionados con el cómo, por qué y para quién es útil la arteterapia, así como identificar los mecanismos que dan soporte o vehiculizan la intervención. A partir de aquí, en el presente artículo, décimo y último de la Serie Arteterapia, se expone una vía de trabajo que se ha ido desarrollando a lo largo de 20 años en un hospital de día de psiquiatría, como coadyuvante del tratamiento de personas con diagnóstico de enfermedad mental grave, mayoritariamente esquizofrenia


Research on the efficacy of Art Therapy in the mental health setting has been inconclusive. Patients and therapists often coincide in highlighting its usefulness for developing expression, communication, socialization and self-awareness; but in terms of strict research, there is no evidence showing that this is achieved. Taking the diagnosis of schizophrenia as reference, there are studies suggesting an improvement in overall mental health, social performance and the quality of interpersonal relationships; however, other studies have found no significant improvement either in primary variables, such as overall functionality and overall symptomatology, or in other associated variables, such as attendance to the group, social performance, satisfaction with treatment or impact on negative symptomatology. The subsequent reviews consulted suggest that this contradictory results could be due to methodological limitations, and recommend clarifying aspects regarding how, why and for whom is Art Therapy useful, as well as to identify those mechanisms supporting or conveying the intervention. From now on, this article, the tenth and last in the Art Therapy Series, presents a way of working that has been developing over 20 years in a Psychiatry Day Hospital, as coadjuvant treatment for persons diagnosed with severe mental disease, mostly schizophrenia


Assuntos
Humanos , Terapia pela Arte , Saúde Mental , Enfermagem Psiquiátrica , Esquizofrenia/diagnóstico , Transtornos Mentais , Transtornos Psicóticos Afetivos
6.
Psychopathology ; 52(4): 221-231, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31610542

RESUMO

Recently, there has been renewed interest in Schneider's first-rank symptoms (FRS) of schizophrenia, thanks in part to a meta-analysis of their diagnostic accuracy, which deserves much credit for its methodological rigor. Conceptualising FRS as a diagnostic test whose performance can be measured in terms of sensitivity and specificity involves some issues that require reflection. First, the full adequacy of sensitivity as a measure of diagnostic accuracy for FRS might be questioned. However, it is conceptually acceptable, though FRS are at a disadvantage as compared with many other psychiatric "diagnostic tests" that should have perfect sensitivity under ideal conditions. Also, from a psychopathological perspective it may well be argued that FRS cannot be conceptualised as a simple, inexpensive diagnostic test suitable for screening purposes; however, the history of the concept reveals some reasons why it may be legitimate to view them this way. While no other relevant study has appeared after the publication of the meta-analysis, data on a further 166 patients from a study that could not be included due to incompletely reported data were located. This brought the total to 4,236 patients from 17 studies on the ability of FRS to differentiate schizophrenia from other psychoses. The resulting summary estimates of sensitivity, specificity and positive and negative likelihood ratios are 60.2%, 75.9%, 2.50, and 0.52, respectively. FRS have a kind of double nature, as they can be legitimately considered as belonging to both a sophisticated framework grounded in phenomenological psychopathology and an eminently pragmatic framework grounded in clinical epidemiology. When FRS are conceptualised as simple clinical indicators that require low levels of inference, the available estimates of their diagnostic accuracy are a fairly valid appraisal of their performance and usefulness, and suggest that FRS have some value in differential diagnosis. However, when FRS are conceptualised as profoundly anomalous experiences that can be properly identified and evaluated only by using a phenomenological approach, these estimates can hardly be seen as a valid evaluation of their diagnostic significance. Phenomenologically informed studies are needed to address this research gap.


Assuntos
Psicopatologia/métodos , Transtornos Psicóticos/psicologia , Esquizofrenia/diagnóstico , Feminino , Humanos , Masculino
8.
Psychiatr Danub ; 31(Suppl 3): 261-264, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488738

RESUMO

BACKGROUND: Schizophrenia can be interpreted as a pathology involving the neocortex whose cognitive dysfunctions represent a central and persistent characteristic of the disease, as well as one of the more important symptoms in relation to the impairment of psychosocial functioning and the resulting disabilities. Given the implication of cognitive functions in everyday life, they can better predict the degree of schizophrenia. The study proposes to use Machine Learning techniques to identify the specific cognitive deficits of schizophrenia that mostly characterize the disorder, as well as to develop a predictive system that can diagnose the presence of schizophrenia based on neurocognitive tests. BACKGROUND: The study employs a dataset of neurocognitive assessments carried out on 201 people (86 schizophrenic patients and 115 healthy patients) recruited by the Neuroscience Group of the University of Bari "A. Moro". A data analysis process has been carried out, with the aim of selecting the most relevant features as well as to prepare data for training a number of "off-the-shelf" machine learning methods (Decision Tree, Random Forest, Logistic Regression, k-Nearest Neighbor, Neural Network, Support Vector Machine), which have been evaluated in terms of classification accuracy according to stratified 20-fold cross-validation. RESULTS: Among all variables, 14 were selected as the most influential for the classification problem. The variables with greater influence are related to working memory, executive functions, attention, verbal fluency, memory. The best algorithms turned out to be Support Vector Machine (SVM) and Neural Network, showing an accuracy of 87.8% and 84.8% on a test set. CONCLUSIONS: Machine Learning provides "cheap" and non-invasive methods that potentially enable early intervention with specific rehabilitation interventions. The results suggest the need to integrate a thorough neuropsychological evaluation into the more general diagnostic evaluation of patients with schizophrenia disorder.


Assuntos
Transtornos Cognitivos/complicações , Transtornos Cognitivos/diagnóstico , Disfunção Cognitiva/complicações , Disfunção Cognitiva/diagnóstico , Aprendizado de Máquina , Esquizofrenia/complicações , Esquizofrenia/diagnóstico , Cognição , Humanos , Testes Neuropsicológicos , Psicologia do Esquizofrênico
9.
Niger J Clin Pract ; 22(9): 1281-1285, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31489867

RESUMO

Background: The Medication Adherence Rating Scale (MARS) is a 10-item self-report measure of medication adherence in psychosis which is a vital predictor of illness course and outcome in patient with schizophrenia. The initial and subsequent studies have shown that MARS has good reliability and validity scores after correction for the small sample size in the index study. Aim: This study aimed to determine the psychometric properties of MARS among outpatients with schizophrenia at the outpatient clinic of the Neuropsychiatric Hospital Aro Abeokuta Ogun State Nigeria. Methods: Intra-class correlation coefficient (ICC) was used to determine the internal consistency, item-total correlations, and reliability of the instrument. Factor analysis was done using principal component analysis with varimax rotation. Results: The intra-class correlation coefficient (ICC) for these 10 items (at time T1) was 0.6 with a P value of <0.001 while for the test--retest analysis was 0.7 with a P value of 0.04. A principal components factor analysis with varimax rotation produced a four-factor solution and factor 4 was found to be the most internally consistent, with Cronbach's alpha of 0.63. Conclusion: This study supports the internal consistency, test--retest reliability, and constructs validity of the MARS.


Assuntos
Adesão à Medicação/psicologia , Adesão à Medicação/estatística & dados numéricos , Psicometria/instrumentação , Esquizofrenia/tratamento farmacológico , Inquéritos e Questionários/normas , Adulto , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Pacientes Ambulatoriais , Transtornos Psicóticos , Reprodutibilidade dos Testes , Esquizofrenia/diagnóstico , Autorrelato
10.
Nord J Psychiatry ; 73(7): 451-461, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31393751

RESUMO

Objective: Neurological soft signs (NSS) are a group of minor non-localizable neurological abnormalities found more often in patients with schizophrenia. The aim of the current study was to investigate their temporal stability and relationship to the overall outcome over a 12-month period. Material and methods: The study sample included 133 stabilized patients suffering from schizophrenia (77 males and 56 females; aged 33.55 ± 11.22 years old). The assessment included the application at baseline and after 12 months of the Neurological Evaluation Scale (NES), and a number of scales assessing the clinical symptoms and adverse effects. The statistical analysis included ANOVA, exploratory t-test and Pearson correlation coefficients with Bonferroni correction. Results: In stabilized patients, NSS are stable over a 12-month period with only the subscale of NES-sensory integration manifesting a significant worsening, while, in contrast, most of the clinical variables improved significantly. There was no relationship of NES scores with the magnitude of improvement. The only significant negative correlation was between NES-motor coordination and Positive and Negative Syndrome Scale-GP change at 1 year. Discussion: The results of the current study suggest that after stabilization of patients with schizophrenia, there are probably two separate components, a 'trait' which is stable over a 12-month period, and a 'degenerative' component with a tendency to worsen probably in parallel with the progression of the illness and in correlation with the worsening of negative symptoms. However, the statistical support of the 'degenerative' component is weak. Significant outcomes Neurological softs signs are stable over a 12-month period, with the exception of 'sensory integration' which manifests significant improvement irrespective of treatment response. They do not respond to treatment with antipsychotics. They do not constitute a prognostic factor to predict improvement over a period of 1 year. Neurological soft signs constitute a trait symptom of schizophrenia which is stable though time. Limitations All the subjects have been previously hospitalized which may represent a more severe form of schizophrenia. Also, all patients were under antipsychotic and some also under benzodiazepine medications. Patients with comorbid somatic disorders were excluded which may decrease generalizability of results.


Assuntos
Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso/epidemiologia , Exame Neurológico/tendências , Esquizofrenia/diagnóstico , Esquizofrenia/epidemiologia , Psicologia do Esquizofrênico , Adolescente , Adulto , Idoso , Antipsicóticos/uso terapêutico , Benzodiazepinas/uso terapêutico , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/psicologia , Exame Neurológico/psicologia , Escalas de Graduação Psiquiátrica , Esquizofrenia/tratamento farmacológico , Fatores de Tempo , Adulto Jovem
11.
Nord J Psychiatry ; 73(7): 425-432, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31407936

RESUMO

Objective: The Brief Negative Symptom Scale (BNSS) is an instrument for evaluating negative symptoms (NS) in schizophrenia based on the 2005 consensus statement by the National Institute of Mental Health. This study examines the validity and reliability of the Danish version of BNSS. Materials and methods: Acutely and chronically affected patients with schizophrenia or schizoaffective disorder were assessed with BNSS along with other psychopathological scales and clinical measures. Convergent and discriminant validity of BNSS was evaluated by its relationships with these assessments. Inter-rater agreement was estimated by the intraclass correlation coefficient (ICC). Results: Forty-nine subjects were included; the mean age was 33.1 (±10.8) years and 32 (65%) were males. BNSS correlated strongly with traditional assessment tools for NS and poorly with measures of depressive and extrapyramidal symptoms, except for Parkinsonism. Moreover, BNSS correlated well with the assessment of positive symptoms. The ICC of BNSS was 0.95 (n = 19, 95% CI: 0.88-0.98). Conclusions: Overall, BNSS holds appropriate psychometric properties in terms of reliability and validity. However, discriminant validity was compromised by correlations with positive symptoms and Parkinsonism. The former originates presumably from NS secondary to positive symptoms since the sample included acutely psychotic patients, and the latter from overlapping rating criteria regarding facial expressivity impairment.


Assuntos
Escalas de Graduação Psiquiátrica/normas , Esquizofrenia/diagnóstico , Esquizofrenia/epidemiologia , Psicologia do Esquizofrênico , Avaliação de Sintomas/normas , Adulto , Estudos Transversais , Dinamarca/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Avaliação de Sintomas/métodos , Adulto Jovem
12.
J Autism Dev Disord ; 49(11): 4375-4389, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31378833

RESUMO

The objective of this study was to adapt and validate the abbreviated version of the "Autism-Spectrum Quotient" (AQ-Short) in a sample of Spanish native adults. A total of 46 individuals with ASD, 41 ASD-relatives, 17 patients with schizophrenia spectrum disorders and 190 non-clinical adults were administered the Spanish version of the AQ-Short. The results of the confirmatory factorial analysis found two high-order factors (Social Behaviour and Numbers/Patterns) and four subscales (Social Skills, Routines, Switching and Imagination). The reliability analysis showed very good internal structure and test-retest reliability. The AQ-Short also showed moderate convergent validity with ADOS-2. Differences by group were found in the ASD group when compared to other groups. Gender differences were only found in the non-clinical group.


Assuntos
Transtorno do Espectro Autista/diagnóstico , Hispano-Americanos/psicologia , Testes Psicológicos/normas , Inquéritos e Questionários/normas , Adulto , Análise Fatorial , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Esquizofrenia/diagnóstico , Psicologia do Esquizofrênico , Fatores Sexuais , Comportamento Social , Habilidades Sociais , Traduções , Adulto Jovem
13.
Psychiatr Prax ; 46(7): 376-380, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31412369

RESUMO

OBJECTIVE: The pilot study aimed to apply and evaluate the German version of DIALOG+ in patients with psychosis. METHODS: The German version of DIALOG+ was used with ten patients with psychosis in five sessions each over a 8-week period. DIALOG+ is a brief intervention that is supported by an App, structures clinical routine consultations and helps patients to define and achieve personal goals. For evaluating outcomes, symptom levels, disability and subjective quality of life before and after treatment were compared. RESULTS: Adherence was high with a total of 49 of 50 planned sessions completed. Patients showed significant improvements in schizophrenia symptoms (d = 0.88), depressive symptoms (d = 0.85), everyday impairment (d = 0.83) and subjective quality of life (d = 0.12). CONCLUSION: The German version of DIALOG+ provides a feasible and promising approach to make routine meetings therapeutically effective.


Assuntos
Transtornos Psicóticos , Esquizofrenia , Alemanha , Humanos , Projetos Piloto , Transtornos Psicóticos/diagnóstico , Qualidade de Vida , Esquizofrenia/diagnóstico
14.
Nord J Psychiatry ; 73(8): 515-521, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31464540

RESUMO

The purpose of the article: Brain-derived neurotrophic factor (BDNF) and matrix metalloproteinase-9 (MMP-9) are involved in the processes of neurogenesis, synaptic plasticity, learning and memory. Growing number of studies shows a relationship between BDNF or MMP-9 and schizophrenia. Also, BDNF and MMP-9 levels may be affected by metabolic parameters, such as obesity or dyslipidemia. Our hypothesis is that alterations of BDNF or MMP-9 levels in schizophrenia might be secondary to metabolic abnormalities, often found among schizophrenia patients. Materials and methods: We have compared BDNF and MMP-9 between patients with schizophrenia (n = 64, age 49 ± 8.2 y) and healthy controls (n = 32, age 51 ± 8.9 y) in the context of cardio-metabolic parameters. Serum levels of BDNF and MMP-9 were measured using ELISA test, body composition parameters were determined using bioelectric impedance analysis. Results and conclusions: Our results showed significantly lowered serum BDNF concentration in the schizophrenia group (schizophrenia: 23.8 ± 7.83 ng/mL, control: 27.69 ± 8.11 ng/mL, p = 0.03). Serum MMP-9 concentration in schizophrenia group did not differ compared with the control group (schizophrenia: 456.8 ± 278.4 ng/mL, control: 341.5 ± 162.4 ng/mL, p = 0.07). After adjusting for age, all anthropometric parameters, body composition and laboratory tests BDNF were still significantly lower in the schizophrenia group. However, MMP-9 became significantly elevated in the schizophrenia group after adjusting for several anthropometric and body composition covariates. Our results confirmed reduced serum BDNF concentration in patients with schizophrenia. Also, this reduction seems to be independent of metabolic abnormalities. On the other hand, our hypothesis that MMP-9 level in schizophrenia is altered due to metabolic abnormalities might be true.


Assuntos
Fator Neurotrófico Derivado do Encéfalo/sangue , Metaloproteinase 9 da Matriz/sangue , Esquizofrenia/sangue , Esquizofrenia/diagnóstico , Adulto , Biomarcadores/sangue , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
15.
Australas Phys Eng Sci Med ; 42(3): 887-897, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31364088

RESUMO

Cognitive dysfunction is a core defect for schizophrenia subjects. This is due to structural and functional abnormalities of the brain which can be determined using Electroencephalogram (EEG). The objective of this study is to analyze EEG in patients with schizophrenia using power spectral density during mental activity. The subjects included in this study are 52 schizophrenia subjects and 29 Normal subjects. EEG is recorded under resting condition and during mental activity. Two modified odd ball paradigms are designed to stimulate mental activity and named as stimulus 1 and stimulus 2. EEG signal is filtered using FIR band pass filter to extract delta, theta, alpha, and beta band EEG. This method measures powers of each band using Welch power spectral density method called absolute power. The absolute power of alpha band is low and beta band is high for schizophrenia subjects compared to normal subjects during rest and two stimuli. Student's t-test is used to find the significant features (p < 0.05) at each recording condition. The significant features from each recording condition are used to classify Schizophrenia using both BPN and SVM classifier. SVM classifier is produced maximum sensitivity of 91% when features from all recording conditions are combined together. Thus this work concludes that the mental activity EEG supports for classifying Schizophrenia from normal and hence absolute band powers can be used as features to identify Schizophrenia.


Assuntos
Eletroencefalografia , Processos Mentais/fisiologia , Esquizofrenia/diagnóstico , Esquizofrenia/fisiopatologia , Adulto , Fontes de Energia Elétrica , Feminino , Humanos , Masculino , Processamento de Sinais Assistido por Computador , Máquina de Vetores de Suporte
16.
Neurosciences (Riyadh) ; 24(3): 240-244, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31380826

RESUMO

New-onset refractory status epilepticus (NORSE) is a drug-resistant status epilepticus that often has a catastrophic outcome. Our patient was diagnosed with NORSE and had an EEG reading that showed status epilepticus persisting for 8 months in general anesthesia. After autoimmune workup showed positive antiphospholipid antibodies, his seizure was controlled, and he was discharged with good condition apart from moderate cognitive impairment. However, he later developed schizophrenia. Although psychiatric disorders have been associated with antiphospholipid syndrome, to the best of our knowledge, it has not been reported to be associated with status epilepticus. We recommend vigilance of psychological complications of refractory status epilepticus patients for early psychiatric referral, diagnosis, and treatment.


Assuntos
Síndrome Antifosfolipídica/diagnóstico , Esquizofrenia/diagnóstico , Estado Epiléptico/diagnóstico , Adulto , Síndrome Antifosfolipídica/complicações , Humanos , Masculino , Esquizofrenia/etiologia , Estado Epiléptico/etiologia
17.
Lancet Psychiatry ; 6(9): 778-785, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31296444

RESUMO

Developed in collaboration with WHO Department of Mental Health and Substance Abuse, this study (conducted in India, the UK, and the USA) integrated feedback from mental health service users into the development of the chapter on mental, behavioural, and neurodevelopmental disorders for ICD-11. The ICD-11 will be used for health reporting from January, 2022. As a reporting standard and diagnostic classification system, ICD-11 will be highly influential by informing policy, clinical practice, and research that affect mental health service users. We report here the first study to systematically seek and collate service user perspectives on a major classification and diagnostic guideline. Focus groups were used to collect feedback on five diagnoses: depressive episode, generalised anxiety disorder, schizophrenia, bipolar type 1 disorder, and personality disorder. Participants were given the official draft diagnostic guidelines and a parallel lay translation. Data were then thematically analysed, forming the basis of co-produced recommendations for WHO, which included features that could be added or revised to better reflect lived experience and changes to language that was confusing or objectionable to service users. The findings indicated that an accessible lay language version of the ICD-11 could be beneficial for service users and their supporters.


Assuntos
Grupos Focais/métodos , Classificação Internacional de Doenças/normas , Transtornos Mentais/diagnóstico , Serviços de Saúde Mental/organização & administração , Organização Mundial da Saúde/organização & administração , Transtornos de Ansiedade/classificação , Transtornos de Ansiedade/diagnóstico , Transtorno Bipolar/classificação , Transtorno Bipolar/diagnóstico , Transtorno Depressivo/classificação , Transtorno Depressivo/diagnóstico , Estudos de Avaliação como Assunto , Feminino , Guias como Assunto , Humanos , Índia/epidemiologia , Masculino , Transtornos Mentais/classificação , Transtornos Mentais/psicologia , Serviços de Saúde Mental/normas , Transtornos da Personalidade/classificação , Transtornos da Personalidade/diagnóstico , Esquizofrenia/classificação , Esquizofrenia/diagnóstico , Reino Unido/epidemiologia , Estados Unidos/epidemiologia
19.
Artigo em Russo | MEDLINE | ID: mdl-31317897

RESUMO

The author analyzes K. Conrad's concept of constitutional types based on the suggested differences in ontogenetic development of picnic and leptosomic physique, athletics and asthenics and also dysplastics. K. Conrad's typology is compared with the typology of Italian school of clinical anthropometry and E. Kretschmer's concept of constitutions. K. Conrad's criteria for the division of primary and secondary constitutions are delineated, one of the basic criteria are set by the differences in the physique proportions and tissue development. The different physiological characteristics of picnic and leptosomic constitutions as well as their cardinal mental differences are described. The special description of mental characteristics of the asthenic-hypoplastic type and some dysplastic constitutions is presented. Manic-depressive psychosis is considered by K. Conrad as a diathesis because due to the conservative constitutional development the mental disease in picnics is capable for compensation, schizophrenia is related to the system diseases, the normal leptosomic constitution is a 'milieu' which contributes to the manifestation of schizophrenia due to the peculiarities of ontogenetic constitutional development designated by K. Conrad as propulsive. As a result of this, the disease leads to the defect.


Assuntos
Transtorno da Personalidade Antissocial , Transtorno Bipolar , Esquizofrenia , Esportes , Transtorno da Personalidade Antissocial/diagnóstico , Astenia , Transtorno Bipolar/diagnóstico , Humanos , Esquizofrenia/diagnóstico
20.
Psychopharmacology (Berl) ; 236(11): 3081-3092, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31300829

RESUMO

RATIONALE: The licensed dose range for the long-acting injectable antipsychotic flupentixol decanoate (Depixol®) in the treatment of schizophrenia is very broad. This provides little useful direction to prescribers and may ultimately result in patients receiving unnecessarily high doses. OBJECTIVES: We aimed to estimate the effect of dose of flupentixol decanoate on relapse rates in schizophrenia and on tolerability by expanding on an earlier review and including non-RCT and German-language studies, as well as using pharmacokinetic and pharmacodynamic data to offer guidance on dosing. METHODS: A literature review using EMBASE, Medline, PsycINFO and PubMed was conducted. Treatment success rates at 6 months were extracted or extrapolated from the studies and plotted against dose to estimate a dose-response curve. RESULTS: Data from 16 studies (n = 514) allowed estimation of a dose-response curve which rises steeply between the chosen placebo anchor (25% success rate) and 10 mg every 2 weeks before reaching a maximum between 20 and 40 mg every 2 weeks (80-95% success rates). Extrapyramidal side effects (EPSEs) were frequently seen (12-71% of participants) in that dose range. Two -weekly injections seem to provide the highest trough plasma concentration per dose administered and the lowest peak-to-trough concentration ratio. Plasma concentration varied up to 5-fold among individuals receiving the same dose. CONCLUSIONS: The optimal dose of flupentixol decanoate is likely to be between 20 mg and 40 mg every 2 weeks although higher doses may be required in some individuals owing to variation in drug handling. Doses of flupentixol should be individually established in the range of 10 to 40 mg every 2 weeks according to response and tolerability.


Assuntos
Antagonistas de Dopamina/administração & dosagem , Flupentixol/análogos & derivados , Esquizofrenia/tratamento farmacológico , Psicologia do Esquizofrênico , Adulto , Antipsicóticos/administração & dosagem , Preparações de Ação Retardada/administração & dosagem , Relação Dose-Resposta a Droga , Feminino , Flupentixol/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Esquizofrenia/diagnóstico , Resultado do Tratamento
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