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1.
Epidemiol Psychiatr Sci ; 29: e86, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31915100

RESUMO

With cancer incidence increasing over time worldwide, attention to the burden of psychiatric and psychosocial consequences of the disease is now mandatory for both cancer and mental health care professionals. Psychiatric disorders have been shown to affect at least 30-35% of cancer patients during all phases of the disease trajectory, and differ in nature according to stage and type of cancer. Other clinically relevant distressing psychosocial and existential conditions (e.g. demoralisation, health anxiety, loss of meaning and existential distress) not included as 'disorders' in the usual diagnostic and nosological systems (i.e. meta-diagnostic conditions) have also been shown to be present in another 15-20% of cancer patients. In this editorial, we will present a summary of the extensive literature regarding the epidemiology of the several psychosocial disorders affecting cancer patients as a cause of distress and burden to be taken into consideration and addressed in cancer care through evidence-based intervention.


Assuntos
Transtornos Mentais/complicações , Saúde Mental , Neoplasias/psicologia , Estresse Psicológico/psicologia , Ansiedade/etiologia , Disfunção Cognitiva/etiologia , Efeitos Psicossociais da Doença , Depressão/etiologia , Humanos , Transtornos Mentais/psicologia , Neoplasias/complicações , Neoplasias/diagnóstico , Psico-Oncologia , Qualidade de Vida , Estresse Psicológico/diagnóstico , Estresse Psicológico/etiologia
2.
Rev Med Liege ; 75(1): 53-59, 2020 Jan.
Artigo em Francês | MEDLINE | ID: mdl-31920045

RESUMO

Psychiatric disorders in children may be the expression of underlying organic conditions. These are numerous and varied. The clinical presentation is often frustrating : psychiatric signs can remain isolated for years before other more specific organic signs appear. More recently, new treatments have been developed, making it possible to improve the prognosis of some of these organic diseases; screening them is therefore a daily concern for the child psychiatrist. This literature review discusses various paediatric treatable organic disorders that may have an isolated psychiatric presentation, to finally propose a decision tree algorithm based on somatic and psychiatric complaints reported.


Assuntos
Sintomas Inexplicáveis , Transtornos Mentais , Criança , Humanos , Transtornos Mentais/complicações
3.
Anaesthesia ; 75(1): 96-108, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31729019

RESUMO

Anaesthetists are thought to be at increased risk of suicide amongst the medical profession. The aims of the following guidelines are: increase awareness of suicide and associated vulnerabilities, risk factors and precipitants; to emphasise safe ways to respond to individuals in distress, both for them and for colleagues working alongside them; and to support individuals, departments and organisations in coping with a suicide.


Assuntos
Anestesistas/psicologia , Anestesistas/estatística & dados numéricos , Transtornos Mentais/diagnóstico , Estresse Psicológico/diagnóstico , Suicídio/prevenção & controle , Suicídio/psicologia , Guias como Assunto , Humanos , Transtornos Mentais/complicações , Transtornos Mentais/psicologia , Fatores de Risco , Estresse Psicológico/complicações , Estresse Psicológico/psicologia , Suicídio/estatística & dados numéricos , Reino Unido
4.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(11): 103-108, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31851180

RESUMO

Platelets are an easily accessible model for the study of biochemical mechanisms of mental diseases, including schizophrenia and depression. This literature review addresses a role of platelet activation in the pathogenesis of mental diseases. Platelet activation observed in patients with schizophrenia, depression and other mental illnesses is associated with the development of cardiovascular disease and an increased risk of thrombotic complications, which can be the main cause of morbidity and mortality in patients with mental disorders. A deeper understanding of the biochemical mechanisms of mental disorders will help in the study of clinical consequences of these disorders and in choosing the right therapeutic strategy for patients.


Assuntos
Transtornos Mentais , Ativação Plaquetária , Trombose , Plaquetas , Fibrinólise , Hemostasia , Humanos , Transtornos Mentais/complicações , Transtornos Psicóticos/complicações , Trombose/complicações
5.
Rev Med Suisse ; 15(672): 2159-2163, 2019 Nov 20.
Artigo em Francês | MEDLINE | ID: mdl-31746573

RESUMO

The main aims of the CoLaus/PsyCoLaus cohort study are to better understand: 1) the personal, biologic, genetic end environmental determinants of cardiovascular risk factors and diseases, and 2) the existing association of mental disorders with cardiovascular diseases. The study was initiated in 2003 and over 6700 participants from the city of Lausanne were include and very rich phenotypic data were collected making the study unique worldwide. Numerous scientific articles were published in various fields such as epidemiology, public health, genetic, social and environmental determinants of cardiovascular diseases and their association with mental health. We briefly present here some key results obtained over the last 16 years.


Assuntos
Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/genética , Transtornos Mentais/complicações , Doenças Cardiovasculares/epidemiologia , Seguimentos , Humanos , Transtornos Mentais/epidemiologia , Fatores de Risco , Suíça/epidemiologia
7.
BMC Health Serv Res ; 19(1): 749, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31651302

RESUMO

BACKGROUND: An estimated 8.2 million adults in the United States live with co-occurring mental health and substance use disorders. Although the benefits of integrated treatment services for persons with co-occurring disorders has been well-established, gaps in access to integrated care persist. Implementation research can address this gap. We evaluated if the Network for the Improvement of Addiction Treatment (NIATx) implementation strategy was effective in increasing integrated services capacity among organizations treating persons with co-occurring disorders. METHODS: This study employed a cluster randomized waitlist control group design. Forty-nine addiction treatment organizations from the State of Washington were randomized into one of two study arms: (1) NIATx strategy (active implementation strategy), or (2) waitlist (control). The primary outcome was a standardized organizational measure of integrated service capability: the Dual Diagnosis in Addiction Treatment (DDCAT) Index. Intent-to-treat analyses and per-protocol analyses were conducted to address the following questions: (1) Is NIATx effective in increasing integrated service capacity? and (2) Are there differences in organizations that actually use NIATx per-protocol versus those that do not? RESULTS: From baseline to one-year post active implementation, both the NIATx strategy and waitlist arms demonstrated improvements over time in DDCAT Index total and DDCAT dimension scores. In intent-to-treat analyses, a moderate but statistically significant difference in improvement between study arms was seen only in the Program Milieu dimension (p = 0.020, Cohen's d = 0.54). In per-protocol analyses, moderate-to-large effects in Program Milieu (p = 0.002, Cohen's d = 0.91) and Continuity of Care (p = 0.026, Cohen's d = 0.63) dimensions, and in total DDCAT Index (p = 0.046, Cohen's d = 0.51) were found. CONCLUSIONS: Overall, organizations in both study arms improved DDCAT Index scores over time. Organizations in the NIATx strategy arm with full adherence to the NIATx protocol had significantly greater improvements in the primary outcome measure of integrated service capacity for persons with co-occurring disorders. TRAIL REGISTRATION: ClinicalTrials.gov, NCT03007940 . Retrospectively registered January 2017.


Assuntos
Prestação Integrada de Cuidados de Saúde/organização & administração , Transtornos Mentais/terapia , Serviços de Saúde Mental/organização & administração , Transtornos Relacionados ao Uso de Substâncias/terapia , Adulto , Comportamento Aditivo , Análise por Conglomerados , Diagnóstico Duplo (Psiquiatria) , Feminino , Humanos , Masculino , Transtornos Mentais/complicações , Saúde Mental , Serviços de Saúde Mental/estatística & dados numéricos , Estudos Retrospectivos , Transtornos Relacionados ao Uso de Substâncias/complicações , Washington
8.
Fortschr Neurol Psychiatr ; 87(10): 564-570, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31627238

RESUMO

Multimorbidity in older psychiatric patients. OBJECTIVE: Multimorbidity represents a great challenge in the medical care of older people. METHODS: This exploratory study was part of the Gerontopsychiatry study Berlin (Gepsy-B), an analysis of data on all 941 older inpatients (> 65 years) admitted to a psychiatric hospital within a period of 3 years. RESULTS: Nearly all patients (94,2 %) suffered from a chronic somatic disorder. The mean number of chronic somatic disorders was 2.70 + 1.39 and showed age dependency (r = 0.257, p < .001). The most prevalent disorders were cerebrovascular disorders (56.5 %), hypertension (54.8 %), chronic ischemic heart diseases or arrhythmias (52.2 %) and diabetes mellitus type II (37.5 %). Furthermore, many of the patients suffered from disabilities such as movement disorders (26.2 %), severe hearing loss (16.5 %), incontinence (15.1 %) or severely reduced vision (7.4 %). Organic brain disorders were more often associated with chronic somatic disorders or disabilities. CONCLUSIONS: Older patients treated for psychiatric disorders very often show somatic multimorbidity that probably limit treatment outcome.


Assuntos
Transtornos Mentais/epidemiologia , Multimorbidade , Idoso , Idoso de 80 Anos ou mais , Doença Crônica/epidemiologia , Hospitais Psiquiátricos , Humanos , Transtornos Mentais/complicações
9.
Rev Med Suisse ; 15(665): 1770-1774, 2019 Oct 02.
Artigo em Francês | MEDLINE | ID: mdl-31580022

RESUMO

Nowadays, new psychotropic treatments might result on rapid onset of weight gain also related to other factors such as individual vulnerability, poor diet and lack of exercise. Many studies have reported that weight gain is only the premise of a series of metabolic disturbances and cardiovascular complications. In this context, we have established since June 2017 in an ambulatory centre in Geneva, a 4F program (Fit, Fun, Feel and Food), to optimize the measures and strategies needed to prevent and reduce weight gain in these patients. This transversal program is naturalistically and systematically centered on physical activity, healthy diet and improved body perception. We will show some preliminary results of 4F program.


Assuntos
Antipsicóticos/efeitos adversos , Terapia por Exercício , Transtornos Mentais/complicações , Transtornos Mentais/terapia , Serviços Preventivos de Saúde , Ganho de Peso , Assistência Ambulatorial , Imagem Corporal , Humanos , Transtornos Mentais/psicologia , Suíça , Ganho de Peso/efeitos dos fármacos
10.
Stomatologiia (Mosk) ; 98(4): 89-92, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31513157

RESUMO

The aim of the study was to determine the relationship between the background on-life drug therapy of psychoneurological disorders with dental pathology in children by analyzing the characteristics of pharmacotherapy and the physical characteristics of the oral fluid. The study involved 277 children with psychoneurological disorders and 270 children without comorbid pathology. The deterioration of the physical characteristics of the oral fluid in children with psychoneurological pathology associated with the experience of comorbid disease and drug therapy for the comorbid background has been established.


Assuntos
Transtornos Mentais/complicações , Doenças da Boca , Doenças do Sistema Nervoso , Criança , Humanos , Doenças da Boca/psicologia , Doenças do Sistema Nervoso/complicações
11.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(9): 896-899, 2019 Sep 06.
Artigo em Chinês | MEDLINE | ID: mdl-31474070

RESUMO

Objective: To explore the relationship between the level of mental stimulation and the suicide attempts of rural residents in Shandong Province. Methods: A 1:1 matched case-control study was designed to collect 1 200 cases from a survey of three suicide attempts in rural areas of Shandong Province. Controls were selected according to the following matched factors: age difference within 3 years, same gender, same village or neighboring village, no blood relationship, no suicide history. The basic characteristics of all subjects were collected through the questionnaire, and the level of mental stimulation of life events was measured. Multivariate conditional logistic regression model was used to analyze the relationship between the level of mental stimulation of life events and suicide attempts. Results: The mean age of the case group and the control group was both (36.6±0.3) years old, and 35.8% (430/1 200) were males in each group. The low-medium level of mental stimulation of negative life events in the case group was 16.7% (200/1 200) and 61.7% (740/1 200), respectively, which was higher than that in the control group, about 2.5% (30/1 200) and 29.3% (352/1 200) (all P values <0.05), respectively. A total of 11.1% (133/1 200) of the case group had positive life events, which was lower than that of the control group [16.8% (201/1 200)] (all P values<0.05). Multivariate logistic regression model analysis showed that after the adjustment of gender, age, place of residence, education level, marital status, occupation, family income, somatic disease, mental disorders, family history of suicide, and opposite life events, the low-medium and high level of mental stimulation of negative life events were risk factors for suicide attempts, with OR (95%CI) as 5.88 (4.53-7.64) and 13.94 (8.15-23.86), respectively. Mental stimulation of positive life events was protective factor of suicide attempts, with OR (95%CI) as 0.58 (0.41-0.82). Conclusion: Mental stimulation of negative and positive life events were risk and protective factors for suicide attempts.


Assuntos
Transtornos Mentais , População Rural , Tentativa de Suicídio , Adulto , Estudos de Casos e Controles , Humanos , Masculino , Transtornos Mentais/complicações , Transtornos Mentais/epidemiologia , Fatores de Risco , População Rural/estatística & dados numéricos , Tentativa de Suicídio/estatística & dados numéricos
12.
PLoS Med ; 16(8): e1002864, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31449518

RESUMO

BACKGROUND: One in 5 women experience mental illness in pregnancy or post partum. Universal preventive interventions have not lowered the incidence of perinatal mental illness, perhaps because those at highest risk were not targeted. Outside of pregnancy, chronic physical conditions are known to confer increased risk for mental illness. Our objective was to examine the association between chronic physical conditions and risk of perinatal mental illness. METHODS AND FINDINGS: We conducted a population-based retrospective cohort study using linked health administrative data sets in Ontario, Canada, in 2005 to 2015. We compared 77,385 women with chronic physical conditions to 780,619 women without such conditions, all of whom had a singleton live birth. Excluded were women with a mental illness diagnosis within 2 years before pregnancy. Chronic physical conditions were captured using the Agency for Healthcare Research and Quality Chronic Condition Indicator, applied to acute healthcare encounters in the 2 years before pregnancy. The outcome was perinatal mental illness, defined by a mental illness or addiction diagnosis arising between conception and 365 days post partum. The outcome was further defined by timing (prenatal or post partum) and specific diagnosis (psychotic disorder, mood or anxiety disorder, substance use disorder, self-harm, or other). Modified Poisson regression generated relative risks and 95% confidence intervals (CIs), adjusted for age, parity, rural residence, income quintile, and remote history of mental health care. Women in the cohort had an average age of 29.6 years (standard deviation 5.4), 44.2% were primiparous, 11.0% lived in a rural area, 40.1% were in the lowest 2 income quintiles, and 47.9% had a remote history of mental health care. More women with (20.4%) than without (15.6%) a chronic physical condition experienced perinatal mental illness-an adjusted relative risk (aRR) of 1.20 (95% CI 1.18-1.22, p < 0.0001). The aRRs were statistically significant for mental illness in pregnancy (1.12, 95% CI 1.10-1.15, p < 0.0001) and post partum (1.25, 95% CI 1.23-1.28, p < 0.0001). Psychotic disorders (aRR 1.50, 95% CI 1.36-1.65, p < 0.0001), mood or anxiety disorders (aRR 1.19, 95% CI 1.17-1.21, p < 0.0001), substance use disorders (aRR 1.47, 95% CI 1.34-1.62, p < 0.0001), and other mental illness (aRR 1.68, 95% CI 1.50-1.87, p < 0.0001) were more likely in women with than without chronic physical conditions, but not self-harm (aRR 1.14, 95% CI 0.87-1.48, p = 0.34). The study was limited by reliance on acute health care encounters to measure chronic physical conditions and the inability to capture undiagnosed mental health problems. CONCLUSIONS: Findings from this study suggest that women with a chronic physical condition predating pregnancy may be at heightened risk of developing mental illness in the perinatal period. These women may require targeted efforts to lower the severity of their condition and improve their coping strategies and supports in pregnancy and thereafter.


Assuntos
Doença Crônica/psicologia , Transtornos Mentais/etiologia , Complicações na Gravidez/psicologia , Adolescente , Adulto , Doença Crônica/epidemiologia , Feminino , Humanos , Transtornos Mentais/complicações , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Ontário/epidemiologia , Gravidez , Complicações na Gravidez/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
13.
Cochrane Database Syst Rev ; 8: CD006570, 2019 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-31425609

RESUMO

BACKGROUND: Catatonia is a debilitating disorder of movement and volition associated with schizophrenia and some other mental illnesses. People with catatonia are more likely to require hospitalisation and highly supervised care than those without the disorder. They also have an increased risk of secondary complications such as pneumonia, malnutrition and dehydration. The mainstay of treatment has been drug therapies and electroconvulsive therapy. OBJECTIVES: To compare the effects of benzodiazepines with other drugs, placebo or electroconvulsive therapy for catatonia in people with schizophrenia or other similar serious mental illnesses (SMIs). SEARCH METHODS: We updated our previous search (28 February 2007) by searching the Cochrane Schizophrenia Group's Study-Based Register of Trials (9 November 2016; 6 February 2019). This register is compiled by systematic searches of major resources (including CENTRAL, MEDLINE, Embase, AMED, BIOSIS, CINAHL, PsycINFO, PubMed, and registries of clinical trials) and their monthly updates, handsearches, grey literature, and conference proceedings, with no language, date, document type, or publication status limitations for inclusion of records into the register. We also manually searched reference lists from studies selected by the search. SELECTION CRITERIA: All controlled clinical trials that randomised people who have schizophrenia or other similar SMI and experiencing catatonia to receive benzodiazepines or another relevant treatment. We included studies that met our inclusion criteria and reported usable data. We excluded those not meeting our inclusion criteria or those not reporting usable data. We contacted authors when we required further information; and if we received no response, we put those studies aside as 'awaiting assessment'. DATA COLLECTION AND ANALYSIS: Review authors extracted data independently. For dichotomous data we calculated relative risks (RR) and their 95% confidence intervals (CI) on an intention-to-treat basis using a fixed-effect model. We completed a 'Risk of bias' assessment for the included study and generated a 'Summary of findings' table using GRADE. MAIN RESULTS: The searches found 130 citations, from which we could identify 22 possibly relevant studies. From these, we could only include one study. This study had a relatively small sample size of 17 participants who received lorazepam or oxazepam and were drug free for one week before the trial started. The only usable data reported by this study were clinically important change in symptoms of catatonia measured as 50% improvement on the Visual Analogue Scale (VAS). There was no difference in the numbers of participants showing a clinically important change in their catatonic symptoms (RR 0.95, 95% CI 0.42 to 2.16; participants = 17; studies = 1; very low quality evidence).No data were reported for other important outcomes of hospital stay, clinically important change in satisfaction with care, global state, adverse effects or general functioningWe did find a few studies meeting our inclusion criteria but they reported no usable data. We had to exclude these. Although poorly reported, these studies do illustrate that relevant studies have been undertaken - they are not impossible to design and conduct. AUTHORS' CONCLUSIONS: Analysis of the results from this review, which was a head-to-head comparison of two benzodiazepine monotherapies, does not show a clear difference in effect. No data were available for benzodiazepines compared to placebo or standard care. The lack of usable data and very low quality of data available makes it impossible to draw firm conclusions and further studies with a high-quality methodology and reporting are required in order to determine more definitively the outcomes associated with benzodiazepine use in the clinical management of catatonia in persons with schizophrenia and other SMI.


Assuntos
Benzodiazepinas/uso terapêutico , Catatonia/tratamento farmacológico , Esquizofrenia Catatônica/tratamento farmacológico , Antipsicóticos/uso terapêutico , Eletroconvulsoterapia , Humanos , Transtornos Mentais/complicações , Ensaios Clínicos Controlados Aleatórios como Assunto , Esquizofrenia/tratamento farmacológico
14.
Crit Care Resusc ; 21(3): 188-199, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31462206

RESUMO

OBJECTIVE: Acute liver failure (ALF) leads to severe illness and usually requires admission to the intensive care unit (ICU). Despite its importance, little is known about patients with ALF in Australia and New Zealand. DESIGN: Binational observational study to evaluate the aetiology, baseline characteristics, patterns of illness, management, and outcomes for patients with ALF admitted to Australian and New Zealand ICUs. SETTING: All six Australian and New Zealand ICUs in liver transplant centres submitted de-identified data for ten or more consecutive patients with ALF. Data were obtained from the clinical record and included baseline characteristics, aetiology, mode of presentation, illness severity, markers of liver failure, critical care interventions, utilisation of transplantation, and hospital outcome. RESULTS: We studied 62 patients with ALF. Paracetamol overdose (POD) was the underlying cause of ALF in 53% of patients (33/62), with staggered ingestion in 42% of patients (14/33). Among patients with POD, 70% (23/33) were young women, most had psychiatric diagnoses, and most presented relatively early with overt liver failure. This group were transplanted in only 6% of cases (2/33) and had an overall mortality of 24% (8/33). The remaining patients with ALF had less common conditions, such as hepatitis B and non-paracetamol drug-induced ALF. These patients presented later and exhibited less extreme evidence of acute hepatic necrosis. Transplantation was performed in 38% of patients (11/29) in this subgroup. The mortality of nontransplanted non-POD patients was 56% (10/18). Illness severity at ICU admission, initial requirement for organ support therapies and length of hospital stay were similar between patients with POD and non-POD ALF. CONCLUSION: POD is the major cause of ALF in Australian and New Zealand liver transplant centres and is a unique and separate form of ALF. It has a much lower associated mortality and treatment with liver transplantation than non-POD ALF. Non-POD patients have a poor prognosis in the absence of transplantation.


Assuntos
Acetaminofen/administração & dosagem , Acetaminofen/toxicidade , Analgésicos não Entorpecentes/administração & dosagem , Analgésicos não Entorpecentes/toxicidade , Overdose de Drogas/epidemiologia , Falência Hepática Aguda/induzido quimicamente , Falência Hepática Aguda/cirurgia , Transplante de Fígado/métodos , Adolescente , Adulto , Austrália/epidemiologia , Feminino , Humanos , Unidades de Terapia Intensiva , Falência Hepática Aguda/epidemiologia , Falência Hepática Aguda/etiologia , Transtornos Mentais/complicações , Transtornos Mentais/epidemiologia , Nova Zelândia/epidemiologia , Resultado do Tratamento , Adulto Jovem
16.
Ital J Pediatr ; 45(1): 92, 2019 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-31349869

RESUMO

BACKGROUND: Aim of the study is to intercept specific characteristics and psychiatric comorbidity in Down Syndrome (DS). The study describes the distribution and the age of specific aspects of behavioral phenotype in a sample of subjects with DS. METHODS: Psychopathological risk has been evaluated in a 97 DS patient cohort, aged 1 to 18 years, during regular follow-up neuropsychiatric visit and through administration of Child Behavior Checklist (CBCL); Childhood Autism Rating Scale (CARS-T) was assessed to verify the presence of autistic behaviors. RESULTS: The results show the presence of specific psychopathological risk factors in 90% of the sample. 7% of sample presents autistic features. The risk of psychopathology is independent of the degree of intellectual disability. CONCLUSION: The high frequency of psychopathological risk factors indicates the need for accurate monitoring to intercept specific characteristics, such as in the case of comorbidity for autism. The search for specific psychopathological factors is a little explored aspect to date, as evidenced by the literature. Despite the studies available to date highlight the presence of psychopathological vulnerability in DS, so far there are only few reports that explore this issue systematically.


Assuntos
Síndrome de Down/complicações , Transtornos Mentais/complicações , Adolescente , Idade de Início , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Masculino , Transtornos Mentais/epidemiologia , Fenótipo , Fatores de Risco
17.
Artigo em Russo | MEDLINE | ID: mdl-31317890

RESUMO

AIM: To study the psychopathological characteristics of infertile women with sexual disorders in assisted reproductive technologies (ART) programs to develop therapeutic and rehabilitative interventions and improve the quality of life of the couple. MATERIAL AND METHODS: An open continuous comparative descriptive study of sexual health, psychopathological features and personality characteristics of 589 women with infertility seeking treatment using ART was performed in 2013-2017. Clinical-psychopathological, sexological and psychometric methods were used. RESULTS: Non-psychotic mental disorders, predominantly anxiety disorders (28.0%), were identified in 58,9% of patients. Sexual dysfunctions of a disease level, among which prevailed disorder of libido (25.0%), were identified in 18.34% of patients. A high comorbidity of sexual dysfunctions and borderline mental disorders was detected (100% in patients with sexual dysfunctions versus 44.9% in patients without sexual disorders). an analysis of premorbid personality characteristics and severity of psychopathological symptoms based on the results of mpt, scl - 90 showed that patients with sexual disorders scored significantly lower on domains 'extroversion' and 'tolerance to frustration', while scores on 'esoteric tendencies', 'neuroticism', 'obsession', 'sensitivity', 'depression', 'anxiety', 'hostility' and 'psychoticism' were higher; significant positive and negative correlations between domains were noted. Increased or high levels of anhedonia assessed with scale SHAPS were found in 100% of patients, 43.8% had alexithymia according to TAS and 18.19% showed increased and high levels of asthenia (MFI-20). CONCLUSION: Characteristics of the psychopathological structure of sexual dysfunctions in women with infertility in ART programs should be taken into account in the development of treatment and rehabilitation options and improvement of quality of life of the couple.


Assuntos
Infertilidade Feminina , Transtornos Mentais , Disfunções Sexuais Fisiológicas , Ansiedade , Feminino , Humanos , Infertilidade Feminina/complicações , Infertilidade Feminina/psicologia , Transtornos Mentais/complicações , Qualidade de Vida , Técnicas Reprodutivas , Disfunções Sexuais Fisiológicas/complicações , Disfunções Sexuais Fisiológicas/psicologia
18.
J Integr Neurosci ; 18(2): 127-132, 2019 06 30.
Artigo em Inglês | MEDLINE | ID: mdl-31321953

RESUMO

Hippocampal neuron loss and reactive astrogliosis are pathological features of medial temporal lobe epilepsy. Here, the expression of hippocampal astrogliosis-associated genes are studied in subjects with medial temporal lobe epilepsy and mental disorders (such as depression, anxiety and psychiatric comorbidities). The relationship between functional changes in hippocampus astrocytes and concurrent mental disorders are discussed. Nissl staining identified medial temporal lobe epilepsy-induced neuronal loss in the CA1 region of hippocampus. Quantitative real-time polymerase chain reaction and immunofluorescence technology were used to detect hippocampus glial fibrillary acidic protein, metallothionein, and aquaporin-4. The hippocampus area of subjects with medial temporal lobe epilepsy (with or without mental disorders) were smaller than the control group. Hippocampal neuronal loss and astrogliosis were more obvious in groups of medial temporal lobe epileptic patients with mental disorders. Relative protein levels of glial fibrillary acidic protein, metallothionein-I/II, and aquaporin-4 were significantly higher in subjects with medial temporal lobe epilepsy than seen in controls. Medial temporal lobe epileptic patients with mental disorder or depression had elevated metallothionein-I/II protein level when compared to controls and medial temporal lobe epileptic patients without mental disorder. Protein levels of glial fibrillary acidic protein and aquaporin-4 in medial temporal lobe epileptic patients with mental disorders were significantly lower than that in medial temporal lobe epileptic patients with no mental disorder. It is concluded that functional changes in hippocampus astrocytes are associated with mental disorders in medial temporal lobe epileptic patients and the astrogliosis-related genes of glial fibrillary acidic protein, metallothionein-I/II and aquaporin-4, are involved in this process.


Assuntos
Astrócitos/metabolismo , Epilepsia do Lobo Temporal/metabolismo , Gliose/metabolismo , Hipocampo/metabolismo , Transtornos Mentais/metabolismo , Neurônios/metabolismo , Adulto , Epilepsia do Lobo Temporal/complicações , Epilepsia do Lobo Temporal/genética , Epilepsia do Lobo Temporal/patologia , Feminino , Expressão Gênica , Gliose/genética , Hipocampo/patologia , Humanos , Masculino , Transtornos Mentais/complicações , Transtornos Mentais/genética , Transtornos Mentais/patologia , Pessoa de Meia-Idade , Neurônios/patologia
19.
Nat Genet ; 51(8): 1207-1214, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31308545

RESUMO

Characterized primarily by a low body-mass index, anorexia nervosa is a complex and serious illness1, affecting 0.9-4% of women and 0.3% of men2-4, with twin-based heritability estimates of 50-60%5. Mortality rates are higher than those in other psychiatric disorders6, and outcomes are unacceptably poor7. Here we combine data from the Anorexia Nervosa Genetics Initiative (ANGI)8,9 and the Eating Disorders Working Group of the Psychiatric Genomics Consortium (PGC-ED) and conduct a genome-wide association study of 16,992 cases of anorexia nervosa and 55,525 controls, identifying eight significant loci. The genetic architecture of anorexia nervosa mirrors its clinical presentation, showing significant genetic correlations with psychiatric disorders, physical activity, and metabolic (including glycemic), lipid and anthropometric traits, independent of the effects of common variants associated with body-mass index. These results further encourage a reconceptualization of anorexia nervosa as a metabo-psychiatric disorder. Elucidating the metabolic component is a critical direction for future research, and paying attention to both psychiatric and metabolic components may be key to improving outcomes.


Assuntos
Anorexia Nervosa/etiologia , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Genômica/métodos , Transtornos Mentais/complicações , Doenças Metabólicas/complicações , Locos de Características Quantitativas , Adulto , Anorexia Nervosa/genética , Anorexia Nervosa/patologia , Índice de Massa Corporal , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Transtornos Mentais/genética , Doenças Metabólicas/genética , Fenótipo , Prognóstico
20.
J Surg Res ; 243: 440-446, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31279984

RESUMO

BACKGROUND: The association between psychiatric illness and outcomes in trauma patients in general has only recently been investigated. The aim of this study was to describe the unique characteristics, risk factors, and outcomes of patients with comorbid psychiatric illness and penetrating abdominal and pelvic injuries. MATERIALS AND METHODS: This was a retrospective review of trauma patients with open injuries to the abdomen and pelvis identified in the 2010-2015 the American College of Surgeons Trauma Quality Improvement Program database. Baseline variables extracted included demographics, comorbidities, including a discrete "psychiatric illness" variable that preexisted in the database, and injury information. Outcome variables collected included in-hospital mortality, length of stay and intensive care unit stay, and complications. Categorical variables were analyzed using chi-square and Fisher's exact test. Logistic regression was used to assess independent predictors for mortality with odds ratios (ORs) and 95% confidence intervals (CIs) constructed about group differences. RESULTS: There were 22,053 patients identified, 6.1% of whom were diagnosed with a psychiatric comorbidity. Patients with psychiatric illnesses were more likely to be aged ≥65 y (5.4% versus 3.2%, P < 0.0001), female (25.4% versus 12.4%, P < 0.0001), and have other comorbidities. Their injuries were more likely to be self-inflicted (34.9% versus 4.9%) and of a cut or piercing mechanism (33.7% versus 24.1%). Psychiatric comorbidity was an independent predictor of intensive care unit admission (OR 1.32, 95% CI 1.14-1.53) and was independently associated with decreased odds of mortality (OR 0.42, 95% CI 0.32-0.55) despite increased complication rates. CONCLUSIONS: The presence of a psychiatric comorbidity may be independently associated with trauma patients' complications and outcomes. Patients with psychiatric comorbidities have a unique set of risk factors and health needs that must be recognized and addressed by multidisciplinary care teams.


Assuntos
Traumatismos Abdominais/complicações , Transtornos Mentais/complicações , Pelve/lesões , Ferimentos Penetrantes/complicações , Traumatismos Abdominais/mortalidade , Idoso , Comorbidade , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Estados Unidos/epidemiologia , Ferimentos Penetrantes/epidemiologia
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